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HomeMy WebLinkAbout2023 Inspections The Commonwealth of Massachusetts Fee Town of Yarmouth $110.00 Lodging License Number: BOHL-19-2342-04 Issue Date: 1/1/2023 Mailing Address: Location Address: TWO FAMILIES INC. 151 ROUTE 28 CAPE SANDS INN WEST YARMOUTH. MA 02673 149 ROUTE 28 WEST YARMOUTH, MA 02673 IS HEREBY GRANTED A 2023 LICENSE TO OPERATE: Motel This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2023 unless sooner suspended or revoked and is not transferable. Conditions *67 UNITS; 67 ROOMS, PLUS 1 MANAGER'S UNIT Standby generator required for septic system, per septic installation of April 2019. Board Hillard Boskey, M.D., Chairman Mary Craig, Vice Chairman of Charles T. Holway, Clerk Debra Bruinooge Health Eric Weston Bruce G. Murp , PH, R.S., CHO/James G. Gardiner Health Director/Assistant Health Director The Commonwealth of Massachusetts Fee Town of Yarmouth $110.00 Swimming Pool Operations License Number: BOHSP-19-2344-04 Issue Date: 1/1/2023 Mailing Address: Location Address: TWO FAMILIES INC. 151 ROUTE 28 CAPE SANDS INN WEST YARMOUTH. MA 02673 149 ROUTE 28 WEST YARMOUTH, MA 02673 IS HEREBY GRANTED A 2023 LICENSE This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2023 unless sooner suspended or revoked and is not transferable. Conditions INDOOR SWIMMING POOL Board Hillard Boskey, M.D., Chairman Mary Craig, Vice Chairman Of Charles T. Holway,Clerk Debra Bruinooge Health Eric Weston ruce G. Murphy, H, R.S., CHO/James G. Gardiner Health Director/Assistant Health Director The Commonwealth of Massachusetts Fee Town of Yarmouth siio.00 Swimming Pool Operations License Number: BOHSP-19-2349-04 Issue Date: 1/1/2023 Mailing Address: Location Address: TWO FAMILIES INC. 151 ROUTE 28 CAPE SANDS INN WEST YARMOUTH. MA 02673 149 ROUTE 28 WEST YARMOUTH, MA 02673 IS HEREBY GRANTED A 2023 LICENSE This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2023 unless sooner suspended or revoked and is not transferable. Conditions WHIRLPOOL.NAPOR BATH Board Hillard Boskey, M.D., Chairman Mary Craig, Vice Chairman Of Charles T. Holway,Clerk Debra Bruinooge Health Eric Weston Bruce Murphy, MPH, R.S., CHO/James G. Gardiner Health irector/Assistant Health Director The Commonwealth of Massachusetts Fee ie'' Town of Yarmouth $35.00 Food Establishment License Number: BOHF-19-2340-03 Issue Date: 1/1/2023 Mailing Address: Location Address: TWO FAMILIES INC. 151 ROUTE 28 CAPE SANDS INN WEST YARMOUTH. MA 02673 149 ROUTE 28 WEST YARMOUTH, MA 02673 IS HEREBY GRANTED A 2023 LICENSE TO OPERATE: Continental Breakfast; This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2023 unless sooner suspended or revoked and is not transferable. Board Hillard Boskey, M.D.,Chairman Mary Craig, Vice Chairman of Charles T. Holway, Clerk Debra Bruinooge Health Eric Weston Bruce G. M i rphy, PH, R.S., CHO/James G. Gardiner Health Director/Assistant Health Director The Commonwealth of Massachusetts Fee Town of Yarmouth siio.00 Swimming Pool Operations License Number: BOHSP-19-2346-04 Issue Date: 1/1/2023 Mailing Address: Location Address: TWO FAMILIES INC. 151 ROUTE 28 CAPE SANDS INN WEST YARMOUTH. MA 02673 149 ROUTE 28 WEST YARMOUTH, MA 02673 IS HEREBY GRANTED A 2023 LICENSE This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2023 unless sooner suspended or revoked and is not transferable. Conditions OUTDOOR SWIMMING POOL Board Hillard Boskey, M.D.,Chairman Mary Craig, Vice Chairman Of Charles T. Holway, Clerk Debra Bruinooge Health Eric Weston r G�phy,MP ,R.S.,CHO/James G.Gardiner Heal hector/Assistant Health Director TOWN OF YARMOUTH BOARD OF HEALTH :�'�/ APPLICATION FOR LICENSE/PERMIT-2023 * Please complete form and attach all necessary documents by December 18, 2022. Failure to do so will result in the return of your application packet. ESTABLISHMENT NAME: ,_. IAMISi i AX ID: - O 6 O 6 '7 LOCATION ADDRESS: TEL.#: S0 S - 77S-3g2f MAILING ADDRESS: S - AM' OZ 6 777 E-MAIL ADDRESS: ,as/,e n o , .�i/ ( 6 OWNER NAME: N/p,ts4ciCI / c.cAe"r7 CORPORATION NAME (IF APPLICABLE): 7 l es ,c. MANAGER'S NAME: / ,, vsI<1 / csJr i TEL.#: 2/2- - gSg - ,743 MAILING-ADDRESS: c,...Q POOL CERTIFICATIONS: * R - The pool supervisor must be certified as a Pool Operator,as required by Stats la iit-the designated Pool Operator(s)•L and attach a copy of the certification to this form. J�N 1. e&n czr c✓d 4--bj. n a o 2. HEALTH DEPT Pool operators must list a minimum of two employees currently certified in st mph' Cardiopulmonary Resuscitation (CPR), having one certified employee on premises at all times. Please list the employees below and attach copies of their certifications to this form. The Health Department will not use past years' records. You must - 6 provided/�� new copies and maintain a file at your place of business. 1. Le 0,7 er I f-; 10 2. fro/ g c",' /\ ecr 3. 5 X, Fi/,.S 4. ke ,'s � 7 ,.,re// FOOD PROTECTION MANAGERS - CERTIFICATIONS: All food service establishments are required to have at least one full-time employee who is certified as a Food Protection Manager, as defined in the State Sanitary Code for Food Service Establishments, 105 CMR 590.000. Please attach copies of certification to this application. The Health Department will not use past years'records. You must provide new copies and maintain a file at your establishment. 1. 2. PERSON IN CHARGE: Each food establishment must have at least one Person In Charge (PIC) on site during hours of operation. 1. 2. ALLERGEN CERTIFICATIONS: All food service establishments are required to have at least one full-time employee who has Allergen certification, as defined in the State Sanitary Code for Food Service Establishments, 105 CMR 590.009(G)(3)(a). Please attach copies of certification to this application. The Health Department will not use past years' records. You must provide new copies and maintain a file at your establishment. 1. 2. HEIMLICH CERTIFICATIONS: All food service establishments with 25 seats or more must have at least one employee trained in the Heimlich Maneuver on the premises at all times. Please list your employees trained in anti-choking procedures below and attach copies of employee certifications to this form. The Health Department will not use past years' records. You must provide new copies and maintain a file at your place of business. 1. 2. 3. _ 4_ RESTAURANT SEATING: TOTAL# OFFICE USE ONLY LODGING: LICENSE REQUIRED FEE PERMIT# LICENSE REQUIRED FEE PERMIT# �MOTERREQUIRED FEE PERMIT INN PERMIT# _ $55 _CA $55 SWIMMING POOL$110ea. —LODGE $55 INN $55 =CAMP TRAILER PARK $105 'WHIRLPOOL $110ea. FOOD SERVICE: • LICENSE REQUIRED FEE PERMIT# Lr SE REQUIRED FEE'—PERMIT# LICENSE REQUIRED FEE PERMIT# 0-100 SEATS $125 , ONTINENTAL $35 _NON-PROFIT $30 >100 SEATS $200 COMMON VIC. $60 WHOLESALE $80 RESID.KITCHEN $80 RETAIL SERVICE: LICENSE REQUIRED FEE PERMIT# LICENSE REQUIRED FEE PERMIT# LICENSE REQUIRED FEE PERMIT <50 sq.ft. $50 >25,000 sq.ft. $285 VENDING_ -FOOD $25 —<25,000 sq.ft. $150 _FROZEN DESSERT $40 _TOBACCO ► 1 $110 NAME CHANGE: $15 Amount Due= $ ` 1S *****PLEASE TURN OVER AND COMPLETE OTHER SIDE OF FORM***** ADMINISTRATION Under Chapter 152,Section 25C,Subsection 6,the Town of Yarmouth is now required to hold issuance or renewal of any license or permit to operate a business if a person or company does not have a Certificate of Worker's Compensation Insurance. THE ATTACHED STATE WORKER'S COMPENSATION INSURANCE AFFIDAVIT MUST BE COMPLETED AND SIGNED, OR CERT. OF INSURANCE ATTACHED )( OR WORKER'S COMP. AFFIDAVIT SIGNED AND ATTACHED Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits. PLEASE CHECK APPROPRIATELY IF PAID: YES NO MOTELS AND OTHER LODGING ESTABLISHMENTS TRANSIENT OCCUPANCY: For purposes of the limitations of Motel or Hotel use,Transient occupancy shall be limited to the temporary and short term occupancy,ordinarily and customarily associated with motel and hotel use. Transient occupants must have and be able to demonstrate that they maintain a principal place of residence elsewhere. Transient occupancy shall generally refer to continuous occupancy of not more than thirty(30)days,and an aggregate of not more than ninety(90)days within any six (6) month period. Use of a guest unit as a residence or dwelling unit shall not be considered transient. Occupancy that is subject to the collection of Room Occupancy Excise, as defined in M.G.L. c. 64G or 830 CMR 64G, as amended,shall generally be considered Transient. POOLS POOL OPENING: All swimming,wading and whirlpools which have been closed for the season must be inspected by the Health Department prior to opening. Contact the Health Department to schedule the inspection three (3) days prior to opening.PLEASE NOTE: People are NOT allowed to sit in the pool area until the pool has been inspected and opened. POOL WATER TESTING: The water must be tested for pseudomonas,total coliform and standard plate count by a State certified lab, and submitted to the Health Department three(3)days prior to opening, and quarterly thereafter. POOL CLOSING: Every outdoor in ground swimming pool must be drained or covered within seven(7)days of closing. FOOD SERVICE SEASONAL FOOD SERVICE OPENING: All food service establishments must be inspected by the Health Department prior to opening. Please contact the Health Department to schedule the inspection three(3)days prior to opening. CATERING POLICY: Anyone who caters within the Town of Yarmouth must notify the Yarmouth Health Department by filing the required Temporary Food Service Application form 72 hours prior to the catered event. These forms can be obtained at the Health Department, or from the Town's website at www.yarmouth.ma.us under Health Department,Downloadable Forms. FROZEN DESSERTS: Frozen desserts must be tested by a State certified lab prior to opening and monthly thereafter,with sample results submitted to the Health Department. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms have been met. OUTSIDE CAFÉS: Outside cafes(i.e., outdoor seating with waiter/waitress service), must have prior approval from the Board of Health. OUTDOOR COOKING: Outdoor cooking, preparation,or display of any food product by a retail or food service establishment is prohibited. TOBACCO PRODUCT PERMIT CAP & VIOLATION ASSESSMENT A tobacco permit holder who has failed to renew his or her permit within thirty (30) days of the previous year's permit expiration date is considered an expired license,and the tobacco license cap is reduced. Violations of 105 CMR 665.000, State minimum standards for retail sale tobacco,shall be assessed as follows: 1st Violation a fine of$1,000.00 shall be imposed,2"d Violation within 36 months of 1st violation,a fine of$2,000.00 shall be imposed and a prohibition on sale of tobacco products may be imposed for at least 1 day and up to 7 days, 3rd Violation within 36 months of 1st violation or additional violations during that time period,a fine of$5,000.00 shall be imposed, and a prohibition on the sale of tobacco products may be imposed for at least 7 consecutive business days and up to 30 consecutive business days. NOTICE:Permits run annually from January 1 to December 31. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED RENEWAL APPLICATION(S)AND REQUIRED FEE(S) BY DECEMBER 18, 2022. All renovations to any food establishment,motel or pool(i.e.,painting,new equipment,ect.),Must be reported to and approved by the Board of Health to commencement. e vations y require a MA engineer site plan. DATE: /11� ,; SIGNATURE: PRINT NAME&TITLE: W.:;'v.ice/ � ��� Y Rev. 10/11/2022 / • gyp;?"c,:' "•+i • .i.,sin ..:W �;?�, „ d W., t x • ° t .k . C s € C: • • R ,r %` _ > tow it) ..1 I 4.01 ,,-:,.,'! ',., ::•. y... 4 y COv• I"at 7 ti VI " a xR W g `" - - -.t i t._ .,. �. xis a a g ,tom .. %sue :,:t r4 "� S's �*;',3 ,� t "eta 1?..+� q t f� "s Ni S: , Se € .. ,.�.. r" i .. s4 .."` Y �, 44 xr _ ,.«s, I44: € V;Y.' "4py°' `.;_, t,.._.4 "'. • a r t.:. 4 " ":, ` `>» 4 3 x .ie g.. b' . 0fix,- ,4 d s > . r"' .�'t ^ tea' r'S ' aa'- 5 aka,. . s N:+ �/ 11 s � ss✓ � :•7'a. r, r �,a,Nc - fir. 3. , ,b°0 : � `' .$bra a ar. :'?�,e s�' a y^" e a ,: 14 & .., . 0 , . , ,,;imi:e.,Vst. 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C1/4)y, i Instructor Signature Holder's SignettA re of a medical emergency Call 1-800-222-1222 in ci poison emergency Fi;' , ',A CD or first Aid trairnng information Call 1-888-277-7885 or visit cproedcoursecerl American American Health Care Academy Renewal Recommended every 2 years Ve American A2015419 ,(.17,.".$"..., Health care Academy -,'''''• we hew*Owvatr......„ a, � . �,,• 0 This Card Certifies That -al. : ` •• -; Monzur Khan 'g.. • "(•w Has successfully completed the requirements in accordance alkl rill; with American Health Care Academy's curriculum for the course 0 2 ..• CPR/AED: Adult, Child, Infant Validate Now + Standard First Aid (BLS) American Health Care Academy 03/01/2022 03/01/2024 Date Completed Valid Until Instructor Signature Holders Signature Can Sri in case of a medical emergency Call 1-800-222-1222 in a poison emergency '-r CPR/AED or First Aid training infarmatianCalll-888-277-7865 or visit cpraedcourse com r'r' .l American American Health Care Academy H ith(.3renwdciny ! Renewal Recommended every 2 years �wn..w0+.,ya.wK+.. s" 4 �, �... `*"- `e�'k.at r,*;: tea! ,•s„t , l.R y �� " 3, s • R-A+:+fi`s 4aifw}+,»+�:.:. .,.,.<, • - ..`'` e —'',c? 4-_cad•. • _- '= a - THE CXI+ ( W1FALTH OF MiSS4QI SETTS TOWN OF YARMOU H HEALTH DEPARTMENT POOL INSPECTION REPORT NAME C Cira. DATE / e 7 / j ADDRESS /`7 ! F CD '' pr ' , , + " TELEPHONE NUMBER OPERATOR -.10 rL 17CTz5 PERMIT POSTED N Regulations of the Massachusetts Sanitary Code: Article VI, Minimum Standards for Pools; and Town Amendments to Article VI. 1. All items approved on the construction plan are of permanent nature and need not be checked at each inspection. e�2. HEALTH: Shower and health signs posted which state that bathers take showers; no sick or infected bathers; no glass or dangerous objects; and children under the age of 16 must be accompanied by an adult swimmer within. 0I3. CERTIFIED POOL OPERATORS: Must staff at least two (2) certified operators in First Ai Water Safety, C.P.R., and have one available on the premises during pool operating hours. S'j1R -�� is - `4. SAFETY: One shepards crook and one ring toy with adequate rope for each 2,000 sq. ft. water surface. One pool divider forj,vcclow end with floatation buoys. �� 00. FIRST AID: First aid kit (see back), emergency telephone numbers posted, local police, state police, fire department, and several available physicians. Telephone available or other means of communication (no+ pay station). 1<'Cn7 1)1 G 1 9 1/ r-..o f'° S e6 L.v.-9--1 S . CCT' Qvl6. RECORDS: Written records available of daily operation of the pool, including attendance, water tests, chemicals used, hours of operation, backwashing and other information required. 00( 7. RECIRCULATION - FILTRATION: Purification system capable of maintaining quality of water, turnover every 8 hours, maximum filtration rate 2-3 gal. per min. r sq. ft. filter. Dis'n c on uipt�t finely adjustable. Flow meters and pressure gauges are required. V j oti ^ tv C L, s Gt� /f���L 3 S c� +f'- c�,��r Tic QL<8. DEPTH MARK NGS: Must be clearly marked on deck and wall of pool. Markings must be displayed for every foot down to a depth of 5 feet, and then at appropriate places of not more than 25 foot intervals around the deep portion of the pool. ti+1 9. DIVING BOARDS: Rigidly constructed, properly anchored, braced for heaviest load, sound no splinters or cracks, non slip surface. Not over 10 feet above water level and at least 13 feet unobstructed head room. _ I�T"'-10. WATER SOURCE: Water used in any swimming pool shall be from a source approved by the Health Department. cy,C 11. BACTERIOLOGICAL QUALITY: Health Department shall cause water samples to be analyzed as considered necessary. Quality shall meet the USPHS drinking water standards. Untreated water not over 2,400 MPN Coliform. QL.2. CHEMICAL STANDARDS: Treated with chlorine or other effective method. Tests taken at least 4 times a day as required by Health Department. Free Chlorine 1.0 - 3.0, pH 7.2 - 7.8, Bromine 2.0 - 6.0, Total Alkalinity 50 - 150 p.p.m. and Combined Chlorine less than 2 p.p.m. are required once a day. SWIMMING POOL: Cl = a7.V pH = J S T.A. _ 90 Combined Cl = '` 2- SWIMMING POOL: Cl = pH = T.A. = Combined Cl F CI VALRLROQL.: Cl = Z , 0 pH = 7' T.A. _ 5'^./ Combined Cl = • �- G /�,J �W DENGG POOL: Cl = pH = T.A. = Combined Cl = Esc 13. TFSTING EQUIPMENT: Testing equipment provided, in e good repair and c Zaa� , _p complete with fresh reagents. '1l �1C14. WATER CLARITY: A 6 inch black disc at bottom of deepest part of pool visable at 10 yards away. Jt 15. WADING POOLS: Quality of the water shall be the same as swimming pools. Turnover 4 hours or less. �0446. WHIRLPOOLS: Quality of the water shall be the same as swimming pools and shall be equipped with a thermometer and a time instrument for the use of bathers. s i 5•, csi.e 75.m*l` cc o r CIA( - Z<17. EIVCLOSUPE'' A 6 foot high fence in accordance with M.G.L. c.140 with self-closing and self-latching gates or doors. Indoor pool must also be restricted in a similar manner. Pool entrances and exits to be locked during non-operating hours. o-,74C 13. CLOSURE: Operator to close pool when water does not meet the requirements of this code. Operator understands their responsibilities in regards to operating a public/semi-public swimming pool. NOTES: L CrjeS Cx5 C\ ) PERSON 1'NTEItVIE3NFD TOOL INSPEICT 10/96 SAFETY SIGNS AM) EQUIPMENT' 1. Signs to be posted at the pow include: * All persons are required to take a cleansing shower before entering the pool . * No person with a communicable disease is allowed to use the poc_. * No bather shall wear a bathing suit that is unclean. • No person suffering Fran a cough, cold, infla:mnation of the e ,es, nasal or ear discharges, 0: any camnuticable disease shall be allowed to use the pool. * No person with sores or other evidence of skin disease, or who is wearing a bandage or medical cover u:a of .a_ly kind, shall be allowed use of the pool. * No person shall spit or in any other way contaminate the pool, or its floors, walkways, aisles, :;_ Setesinf; rooms. * No glass containers shall be permitted in the pool or on walkways within B feet of the pool. • No person shall bring or throw into the pool any object that may in any way carry contamination or endanger the safety of the bathers. 2. Lifeguards and operators must enforce the rules noted on the above-signs. 3. A shephards crook or reaching pole with a minimum handle length that extends greater than 15 feet .aaast be provide;: each 2,000 sq. ft. of water surface area (lvL, c140, s206). 4. One Ring Buoy or Rescue Tube with a in polyethelene rope attached, no less in length than 1} the width of the pool . If the pool has lifeguards, a rescue tube must be located at each station. 5. Emergency communication equipment mast be available for reaching emergency response persons. Appropriate teiephc,nc numbers and directions for the use of the equipment must be posted. 6. There must be an appropriately equipped first aid kit. Public pools must have a room designed and equipped for emergency care of sick and injured bathers. 7. Whirlpool - Must be drained every 30 days and scrubbed and disinfected. FIRST' AID KIT 35 1' Band-Aids 10 3" x 3" sterile gauze pads 2 5" x 5" surgipads 1 8" x 10" surgipad 2" soft roller bandage 2 3' Solt roller bandages 1 roll 1/2' hypoallergenic tape 1 triangular bandage scissors 1 rescue blanket 12 antiseptic wipes 2 disposable instant ice packs sterile isotonic buffered eye wash 2 pair one size-fits-ail latex gloves 1 microshield or pocket mask with a one way valve POOL I1]C'S ,ogs crust he kept each clay the pool is in operation. Toot for: Free Chlorine 4Xlday Combined Chlorine IX/day ph 4Xlday Total Alkalinity 1X/day Also note on the log: Clarity Good/Average/Poor Chlorinator On(Off Chlorinator Setting Low/Median/Nigh or 1/2/3, etc. Weather Sunny/Cloudy, etc. Air Temperature Bather Load Chemicals Added Any Other Actions Taken Initials of Tester Aa4INISIRATICN POOL CLOSURE IT IS THE RESPONSIBILITY OF 171E TOOL OPERATOR TO C1L1SE THE POOL WHEN ANY OF THE CHEMICAL, PHYSICAL OR SAFETY STAMMRI i ARE NOT JITT, OR FOR ANY ODOR REASON MAT WOULD MAKE POOL. USE UNSAFE. USE GOOD) JUIX NT!!: ERR ON THE SIDE OF SAFE lY in compliance with MGL I40.206, when closing your outdoor inground swieniirig pool for the season, pools must be drained a.d remain dry throughout closure time, or covered within seven (7) days of closing. i(X)L OP/.NINC In the event that your pools have been closed for the season, all swimming, wading and whirlpools are to be inspected by the Health Department prior to opening. Prior to calling for an inspection appointment, a water sample from each pool and whirlpool ;mist he sutxnittec r r tostin,, for coliform and pseudcrnonas by an independent lab. Lab results must be surmitted prior to inspector: and opening.