HomeMy Public PortalAboutCatering Application TOWN OF BREWSTER
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REGISTRATION FOR CATERING
In accordance with the provision of 105 CMR 590.000, Minimum Sanitation Standards for Food Establishments, State
Sanitary Code Chapter X, you must submit written notice within 72 hours of serving a meal.
Name, address and phone#of catering business
Owners Name Emergency phone#
Name, address and phone# of Base of Operation
Location where meal will be served:
Date of event: Time:
Estimated number of meals to be served:
Proposed menu:
Signature: Date:
"Please provide a copy of Caterer's Permit
"Please provide a copy of CFM Certificate and the Allergen Certificate
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DRR�s4c BREWSTER,MASSACHUSETTS 02631-1898
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j 4 .g2 Amy L.von Hone,R.S.,C.H.O.
�' `"a = Director
a �r PHONE:508.896.3701 EXT. 1120
Q <' FAX: 508.896.4538 Sherrie McCullough,R.S.
�” _ •�= brhealth ,brewster-ma.gov Assistant Director
/Va RP9 �A$ \ � WWW.BREWSTER-MA.GOV Tammi Mason
Senior Department Assistant
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Food Establishment Plan Review Packet
To be used for:
❑ New Establishments
❑ New Owners
❑ Renovated or Altered Establishments
❑ Change in Use
Incomplete packets will not be accepted
Name of Establishment
Location of Establishment
Contact Person/Title Phone#
Projected Start of Project: Desired Opening Date:
Category: ❑ Restaurant ❑ Institution ❑ Retail Food ❑ Other:
Type of Service (check all that apply):
❑ Sit down meals—number of meals
❑ Meals to be served (check all that apply): ❑ Breakfast ❑ Lunch ❑ Dinner
❑Take Out
❑ Catering
❑ Mobile Vendor
❑ Retail food—total square footage
❑ Residential Food
Please include the following documents:
n 3
f Proposed menu (including seasonal, off-site and banquet menus)
„ a Manufacturer Specification Sheets for each piece of equipment shown on plan
Site plan showing location of business in building: location of building onsite including alleys, streets:
and location of any outside equipment (dum sters, septic sstem—if applicable)
Plan drawn to scale of food establishment showing location of equipment, plumbing, electrical
services and mechanical ventilation (see next page)
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Completed review packet
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Content and Format of Plan and Specifications
1 . Provide plans, including the layout of the floor plan accurately drawn to a minimum scale of 1/4 inch = 1 foot.
2 . Show the location of each piece of equipment on the plan . Submit drawings of self- service hot and cold holding
units with sneeze guards
3 . Designate clearly on the plan equipment for adequate rapid cooling, including ice baths and refrigeration and for
hot holding of potentially hazardous foods .
4 . Label and locate separate food preparation sinks, hand -washing sinks, three bay sinks .
5 . Clearly designate restroom areas and fixtures
6 . On the plan, represent auxiliary areas such as storage rooms, garbage rooms, toilets, basements and/or cellars
used for storage of food preparation .
7 . Include and provide :
a . Entrances, exits, loading and unloading areas and docks
b . Complete finish schedule for each room, including walls, ceilings, floors and coved juncture bases (use
enclosed form )
c . Lighting schedule with protectors
d . Equipment schedule to include make and model numbers
e . Flow chart demonstrating flow patterns for:
i . Food (receiving , storage, preparation, service)
ii . Food and dishes (portioning , transport, service)
iii . Dishes (clean, soiled, cleaning , storage)
iv. Utensil (storage, use, cleaning)
V* Trash and garbage (service area, holding , storage)
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Food Preparation Review
Food Supplies:
1. Are all food supplies from inspected and approved sources? ❑ Yes ❑ No
2. What are the projected frequencies of deliveries for:
Frozen foods: Refrigerated foods: Dry good:
3. Provide information on the amount of space (in cubic feet) allocated for:
Dry storage:
Refrigerated storage:
Frozen storage:
4. How will dry good be stored off the floor?
Cold Storage:
1. Is an adequate freezer and refrigeration available to store frozen food at or below 0° and refrigerated foods at 41°
or below? ❑Yes ❑ No
2. Will raw meats, poultry and seafood be stored in the same refrigerators and freezers with cooked/ready to eat
foods? ❑Yes ❑ No
3. If yes, how will cross-contamination be prevented?
4. Does each refrigerator/freezer have a thermometer? ❑Yes ❑ No
5. Is there a bulk ice machine available? ❑Yes ❑ No
Cooking:
1. Will food product thermometers be used to measure final cooking/reheating temperatures of TCS's? ❑Yes ❑ No
i
2. List types of cooking equipment
Hot/Cold Holding:
1. How will hot TCS's be maintained at 135° F or above during holding for service? Indicate type and number
of hot holding units
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3. How will cold TCS's be maintained at 41' F or below during holding for service? Indicate type and number
of cold holding units
Cooling:
Please indicate by checking the appropriate boxes how TCS's will be cooled to 41° F within 6 hours (135° F to 70° F in 2
hours and 70° F to 41° F in 4 hours)Also, indicate where the cooling will take place.
Cooling Method Thick Meats Thin Meats Thin Thick Rice/Noodles
Soups/Gravy Soups/Gravy
Shallow Pans
Ice Baths
Reduce
Volume/size
Rapid Chill
Other
(describe)
Reheating:
1. How will TCS's that are cooked, cooled, and reheated for hot holding be reheated so that all parts of the food reach
a temperature of at least 135° F for 15 seconds? Indicate type and number of units used for reheating.
2. How will reheating food to 135° F for hot holding be done rapidly and within 2 hours?
Preparation:
1. Will food employees be trained as Certified Food Managers? ❑Yes ❑No
Number of employees trained:
Dates of completion (please enclose copies of certificates):
2. Will disposable gloves and/or utensils and/or food grade paper be used to prevent handling of ready-to-eat
foods? ❑Yes o No
I
if no, do you have a written plan for alternative to no bare hand contact with ready-to-eat foods? ❑Yes ❑ No
(ifyes,please provide a copy ofyour plan)
3. Is there a written policy to exclude or restrict food workers who are sick or have infected cuts and lesions
(please enclose if applicable)o Yes o No
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4. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which cannot be
Submerged in sinks be sanitized?
Chemical type:
Test kit provided:
5. Is there a designated sink for produce washing/food preparation? ❑Yes ❑ No
6. Is there a dishwasher? ❑Yes ❑ No
Type of sanitization used (hot water or chemical type)
Are the temperature/pressure gauges accurately working? ❑Yes ❑ No
Are there test kits/papers for checking sanitizer concentration? ❑Yes ❑ No
7. Is there a three-bay sink? ❑Yes ❑ No
Does the largest pot fit into each compartment of the sink? ❑Yes ❑ No
Handwashing/Toilet facilities
1. Is there a handwashing sink in each food preparation and warewashing area? ❑Yes ❑ No
2. Do all handwashing sinks, including those in the restrooms, have a mixing valve or combination faucet?
❑Yes ❑ No
3. Do self-closing metering faucets proved a flow of water for at least 15 seconds without the need to reactivate the
faucet? ❑Yes ❑ No
4. Is hand cleanser and drying facilities available at all handwashing sinks? ❑Yes ❑ No
5. Are covered waste receptacles available in each restroom? ❑Yes ❑ No
6. Is hot and cold running water under pressure available at each handwashing sink? ❑Yes ❑ No
7. Are all toilet room doors self-closing? ❑Yes ❑ No
8. Are all toilet rooms equipped with adequate ventilation? ❑Yes ❑ No
9. Is handwashing signage posted in the employee restroom? ❑Yes ❑ No
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Small equipment requirements
Please specify the number, location and types of each of the following:
Equipment T e Number Location
Finish Schedule
Applicant must indicate which materials are in place or will be used in the following areas (quarry tile, stainless steel,
etc.)
Floor Coving Walls Ceiling
Kitchen
Bar
Food Storage
Dry Storage
Toilet rooms
Dressing rooms
Garbage/refuse area
Equipment Storage—
other
Mop service area
Warewashing area
Walk-in
refrigerator/freezers
Insect and Rodent Control
1. Will all outside doors be self-closing and rodent proof? ❑Yes ❑ No
2. Are screen doors provided on all entrances left open to the outside? ❑Yes ❑No
3. Do all openable windows have a minimum #16 mesh screening? ❑Yes ❑ No
4. Is placement of electrocution devises identified on the plan? ❑Yes ❑ No
5. Will all pipes and electrical conduit chases be sealed: ventilation systems exhaust, and intakes protected? ❑Yes
❑ No
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6. Is area around building clear of unnecessary brush, litter and other harborage? ❑Yes ❑ No
7. Will air curtains be used? ❑Yes ❑ No If yes, where:
Garbage and Refuse
1. Do all containers have lids? ❑Yes ❑ No
2. Will refuse be store inside? ❑Yes ❑ No
3. Is there an area designated for can or floor mat cleaning? ❑Yes ❑ No
4. Will a dumpster be used? ❑Yes ❑ No
Number of dumpsters: Size of dumpsters:
Frequency of pick up: Contractor:
5. Will there be outside garbage cans? ❑Yes ❑No
6. Describe surface and location where dumpster and garbage cans will be stored
7. Describe location of grease storage receptacle
8. Is there an area to store recycled containers? ❑Yes ❑ No
If yes, location:
General:
1. Where will cleaning agents be stored?
2. Are insecticides/rodenticides stored separately from cleaning and sanitizing agents?
❑Yes ❑ No Location: j
3. Area all containers of toxics clearly labeled. ❑Yes ❑ No
4. Location of clean linen storage:
5. Location of dirty linen storage:
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Statement:I hereby certify that the above information is correct, and I fully understand that any deviation from
the above without prior permission from this Health Department may nullify final approval.
Signature Date
Signature Date
Approval of these plans and specifications by the Health Department does not indicate compliance with any other
code, law or regulation that may be required. A pre-opening inspection of the establishment with equipment in
place and operations will be necessary to determine if it complies with the local and state laws governing food
service establishments.
**All new or revised Food Service Permit application shall be reviewed and approved In-House by the Brewster Health
Director and/or the Assistant Health Director. Applications that require a Hazards Analysis Critical Control Point (HACCP)
Plan or a variance will require a full Board of Health review and approval.
Any applicant aggrieved by a decision of the Director or the Assistant can appeal the decision to the full Board of Health.
A request for appeal shall be in writing and received by the full Board of Health within 10 days of receipt of the
Director/Assistant's decision. If no request for appeal is received within said 10-day period, the decision of the
Director/Assistant shall be final.
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