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HomeMy WebLinkAbout0029 CHURCH STREET ------------------------ Ja911cvcL4Fa6 UPC 12534 • No.2-153_L_OR HASTINGS, MN i i 7 1 Town of Barnstable Regulatory Services '3U/kOINC ofTMm Richard V. Scali,Director FPT Building Division JUN 10 201 BARN MM ' Paul Roma CBO Building CommissionerOw 6 �. MAM �39. 200 Main Street, Hyannis,MA 02601 N OF 13ARNSIA13L� www.town.barnstable.maxs Office: 508-862-4038 Fax:*508-790-6230 a Town of Barnstable Family Apartment Affidavit I, being on oath , depose and state as follows: My name is I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner:OLU Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2016. Signature Phone Number Print Name q:forms/famaffid.doc rev 11/08/12 Town of Barnstable of r Regulatory Services Richard V. Scali,Director MINN OF VANSTABLE IAMMBLE. * Building Division 1639. A Thomas Perry, CBO, Building Commissioner! ,, Ep MA'S 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 1 'Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath epose and sta as follows: My name is I am the owner/resident of the property located at: i The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: ' � G Name &relationship to owner: e n-� Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of KL 2015. - 3-34 - a t5o / ck) Signature Phone Number Print Name r)- ) q:forms/famaffid.doc rev 11/08/11 I\ Town of Barnstable Regulatory Services oFTME roy, Richard V. Scali,Interim Director, do �1W Building Division N OF BARNSTABLE A SS. Thomas Perry, CBO, Building Com issioner 1639. ,0 �M4 JL"'�J -2 PM 12: 23 ArEo �A 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 ®I / m;tFax5.08-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oat depose and state as follows: My name is 4 I am the owne resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: VGK.r-Oq `— Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. . I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and lties of perjury this day of�& 2014. 30 Si6at&e Phone Number Print Name G d q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services Tod Thomas F. Geiler, Director Building Division STA AS& Thomas Per CBO Building Commissioner Mass. �+, Perry, > g �039. , 200 Main Street, Hyannis, MA 02601 EO Mp'l www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit, I, being on oath, epose and state as follows: My name is I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: `5 Name &relationship to owner: The Family Apartment will be the primary year-round residence for the abo e-ident led family members. In the event that the listed relatives vacate said apartment, I will i mediate'ly note the Building Commissioner in writing. I understand that no subletting or subl asing of fa-id Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Buildin Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2013. V3z?a3 SignatureV cr Phone Number 3" 4al 9 J Print Name, i q:forms/famaffid.do c rev 11/08/12 Town of Barnstable Regulatory Services oFTME Thomas F. Geiler, Director Building Division TOWN OF BARNSTABLE BAPUN Thomas Perry, CBO,Building Commi n AD A`�$ 31 200 Main Street, Hyannis, MA 026(T 2 b �'! ' www.town.barnstable.ma.us Office: 508=862-4038 ® "FRR-75-08---790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: C - My name is MAOU WM I am the owner/resident of the property located at: � I The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: e `J Co Y,-w Name &relationship to owner: C SD 9—of 3 7 ' 8 q( The Family Apartment will be the primary year-round residence for the above-identified family members. Iri the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. i The apartment has been transferred to the Amnesty Program (Appeal No. - ) Other Sworn to under the pains and penalties of perjury this p`� day of 2012. Si tore (, hone Numb Print Name _l� v'o q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services FTHEl°� Thomas F. Geiler, Directo5,..,.1 C, P."-I •S, IE Building Division BARNSfABLE, ' Thomas Per CBO Building Commissioner2 r,i 11= � MASS. $ Perry, > g Ar 1639. �� 200 Main Street, Hyannis, MA 02601 EO MPS www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of..-Barnstable Family Apartment Affidavit I, being on oat -, depose and state as follow &Awq, My name is Pun the o er/resident of the (� .property located at: J The-following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning.Ordinances Section 240-47.1 Family Apartments. I agree to not f�the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled._ The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury thisQ� day of V 2011. r L v - a/ Signature Phone Number Print Name N A V� C V-0 Town of Barnstable Regulatory Services pFTHe rq�� Thomas F.Geiler,Director Buildifi' F!b' isIo�n�STA��E BAsexsrnai.e, Tom Perry, Building Commission r �. a„at tiM : 35 039. 10 200 Main Stree iPlyannis)MA 0260'1 ArEo��s www.town.barnstable.ma.us Office: 508-862-4038 DIVISION Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: Wnme is Jo Y)A UAW 0 the owner/resident of the a �.property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of pe 'ury this day of CkAQU 2010. co Signature Phone Number' a Print Name CkVV,,_ I NINITN Q/bldg/forms/famaffid Rey:12/08 Town of Barnstable Regulatory Services pU1HE Thomas F.Geiler,Director Building Division BARNSTABI . ` Tom Perry,Building Commissioner MASS. 1a3q �0 200 Main Street,Hyannis,MA 02601 QED"A°�A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 " Town of Barnstable Family Apartment Affidavit C3. I, being on oath, depose and state as follows: My name is I am the owner/resident of e N _ w rn property located at: Q' The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: s— Name & relationship to owner: 6k io Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing.the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the'sole of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Progr (Appeal No. ) _/Other_P(OG�LC �C ►� � p Sworn to under the pains and penalties of perjury this j G day of pA L 2009. 4 ignature �.X) ::&9 Phone Number Print Name {� 1 Q/bldg/fbrms/famaffid Rev:12/08 April 6, 2009 To: Town of Barnstable Regulatory Services—Building Division From: James and Nancy Conroy 29 Church St. W. Barnstable,MA 02668 Re: Family Apartment Affidavit Please be aware of the death of our Family Apartment resident, Marie Conroy on Dec. 28, 2008. Marie was James' mother who lived in the apartment for the last 16 years. During the last year or so James& I took care of Marie on a daily basis due to failing health and a very difficult stressful illness of Alzehiemers Disease. We had some family assistance but we were her primary caretakers and spent days & over night stays @ her apartment on a rotating basis. Unfortunately this took a terrible toll on our marriage and we have decided to separate and due to the economic times James has decided to stay over @ the family apartment. This has been a most difficult time in our lives due to the loss of Marie and the marital problems that have developed, and we would appreciate the understanding of the Regulatory Services for this arrangement. We will certainly let the Building Division know of any changes that may occur in the coming months,regarding our living arrangements if they change. Thank You, Nancy E. Conroy James P. Conroy Town of Barnstable Regulatory Services °etH�'oy, Thomas F.Geiler,Director Building Division i Wit `i' �'��'�� t- v �BAMSTABIZ Tom Perry, Building Commissioner 1(l MR 2 7 AM S� 1639•� 0�0 200 Main Street,Hyannis,MA 02601 ATfO MA'S www.town.barnstable.ma.us OWISION Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: PMy name is EQ I am the owner/resident of the property located at: 62 (to � The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Md Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments.. I agree to notify the Building Commissioner immediately in the event of the-sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains a I penalties of perjury this day of 2008. XNa Phone Number e (/Lry) es P &trocw Q/bldg/forms/famaffid Rev:l/03 Town of Barnstable Q �� Regulatory Services pFIKE roy, Thomas F. Geiler,Director Building Division % j , 4 sw�xns Tom Perry, Building Commissioner��I MASS. 200 Main Street,Hyannis,MA 02601���E$ 2� �k" www.town.barnstable.ma.us " Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: a,/h�5 aownelrf-o Mynameis C 0 Do the esi ent of the property located at: 199 A bUO a4 NJ 5A le, The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Name &,relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this Io� day of U, i 664 Signature , - _ _Phone Number Print Name Cv V-0 L/ Q/bldg/forms/famaffid Rev:1/03 Mar 28 06 10:01a James Conroy/Nancy Conro 1-508-362-4219 p,1 'own of Barnstable >6 Regulatory Services pf�KE A Thomas F. Geiier,Director U'11"+"Ic, S I t LE 1 Building Division ,5 Tom Perry, Building Commiss011ir, MAR28 AM.1 1 200 Main.Street,Hyannis,MA 02601 rFo l��► www.town.barnstable.ma.us Office: 508-862-40 38 Pax: 508-790-6230 Towns of Barnstable Family Apartment Affidavit I,being on Bath,depose and state as follows: My name is � { ��' %i r ! I am the ov ner/resident of the property located at: �� Ii�L%°�f 1 _ C, :�� -Y1;/V Map and Parcel Number The following members of my family will be the sole occupants of the Family apartment at the aforementioned address: M - r Name&relationship to owner: / ' J C. cyLu -' �'1 k' c V C� L' Name&relationship to of%mer: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately notify the Building Commissioner in writing.I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that i am required to comply with,all conditions imposed by the ZBA Special Perm'. and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family.4partrnents. I agree to notiry the Building Commissioner immediately:in the event of the sale of this property. If there is no longer a Family Apartment at this location;please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this -d( day of / _2006. Lf") Signature n� Phone Number / y Print Name Q.'Lldg.�fornsJfam8li id RevaiO3 e iC Town of Barnstable �6 Regulatory Services �pF11HE loq� Thomas F. Geiler,Director tQ��l�y p� 6ARNSTAB�E Building Division TOVV?4 OF aaxrvsTaste Mass Tom Perry, Building Commissioner � ��� 039. A�O� 200 Main Street,Hyannis,MA"HAPR ATED"AP� www.town.barnstable.ma.us 8 P� 3' �� - UIdISION Office: 508-862-4038 UlY1SWN Fax: 508-790-6230 ' 'own of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is OroqI am the owner/resident of the property located at: 0 Map and Parcel Number o �O The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Pe),�o _ ma Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury thi day of 2005. 41,VLA tore Phone Number Print Name —NUQ A Ca�a, Q/b1dg/forms/famaffid2 Rev:1/03 X Town of Barnstable I� Regulatory Services oFn+etq�, Thomas F.Geiler,Directoc, BL E ~� Building Division 20 RAms-rnai.e, = Tom Perry, Building Commissioner Mass. 1639. 200 Main Street,Hyannis,MA 02601 ArFD MAr A Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: an G�ncry My name is l C I am the owner/resident of the located at: — — (n.0 r(',Pn . S E "" U4 property f Map and Parcel Number / The ZBA granted me a Special PermitNariance on Date Appeal No. The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: ! r l N p Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. . I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other .. Sworn to under the pains and penalties of perjury this" t day of c;L 3 2004. Signature Phone Number Print Name C U 6 Q/bldg/forms/famaffid Rev:1/03 ul/ZZ/ZUUJ 14:btf VAN buff 4Zu luau uaicer UUStOm AlU tool Town of Barnstable Regulatory Services 0 A ap Thomas F.Geller,Director Building Division. 4 i su, i Tom Perry, Building Commissioner 16-1 200 Main Street,Hyannis,MA 02601 oil►�s Office: 508-862-4038 Fax: 509-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state As follows: /Vatey C— My i�C IS ec. �o Yo I am the owner/resident of the ff,, 11 property located at: 0C �( 5 lit/ �C/1/S Map and Parcel lumber The Z 3A granted me a Special Permit/Variance on _ Od 7'/ Date Appeal No. The decision of the Zoning Board of Appeals has been recorde4pth the Registry of Deeds in . Barnstable County: Book Page t The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 0 �1 Name &relationship to owner. The Family Apartment will be the primary year-round residence far the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Fancily Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the wilding Commissioner listing the names and relationship of occupants in.said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family.Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and ties of perjury this day of 003. Sigma T Phone ber t acne - Prin 4 - g3jq QibWfora>s Un&ffid Rev:l/03 Town of Barnstable Regulatory Services °Ft►+�t Thomas F.Geiler,Director ?� Building Division TOWN OF BABNSTABLE sARNszABM Peter F.DiMatteo, Building Commissioner (D 9 1639. ,0� 200 Main Street,Hyannis,MA 02deW MH Y 6 PPS 12: S ��ED MA'1 A Office: 508-862-4038 Fax:.508-790-6230 .......... f)IWISION Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at:. a a WL Q �� �"p=� /JS/ZL-f' Map and Parcel Number The ZBA granted me a Special Permit/Variance on ,��_ 0 7 Date Appeal No. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 6A i ,0)(RO 1)9QC"h eotC­' Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner.in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other ' Sworn to under the pains and penalties of perjury this day of �F�/ 2002. Ile 7 W-7 Signature Phone Number Print Name Q/bldg/forms/famaffid Rev:010702 COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT I, *4,4)(V— 6�co k0 ,being on oath, depose and state as (follows. Q 1.) I reside at �/ aurck, UTL � l 2.) I am the ownV of the property to ated � '�- at zde. s \� shown on Barnstable Assessors maps as MAP 153 PARCEL 3.) I Do V Do not have a Family Apartment at this locatiez. 4.) On 3 r ` O , 199 the Zoning Board of Appeals, on Appeal No. a+writed me a Special Permit/Variance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME M4"P, �/ c, 00 A wo y Relationship to owner: /V1 D b) NAME Relationship to owner: 7.)The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. ' 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. T Sworn to under the pains and penalties of perjury this day off/ Signature Print Name i COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT I P _ — 2 -- _ ----—_, being on oath, depose and state as follows: 1.) I reside at h'-U1Q.CA+ - 2.) I am the owner of the property located at shown on Barnstable Assessors' maps as MAP_ /,S=3 PARCEL 3.) I Do 1'1�Do not have a Family Apartment at this location. 4.) On 3 , 199_ the Zoning Board of Appeals, on Appeal No. /99Z —G7 granted me a Special Permit/Variance to maintain a Family Apartment at the above address. i 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6. The following members of my family will be the sole occupants of the Family Apartment at the above address: ^ A a) NAME— r"� Q _— --------- ----- �` Relationship'to-owner �Z ,r b)_NAME ' Relationship to owner:__ 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 112.) I agree{to mlrnediately notify the building Commissioner ' the event of the sale of the above- . ._:_. _ ,listed property. ,Sworn to under,tie pzdns and penalties of perjury this _Z_ _day of_ , 199 r i Signature ' Print --- QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 12/30/97 PARCEL ID 130 016 GEO ID 7017 LOT/BLOCK DBA PROPERTY ADDRESS OWNER CONROY 29 CHURCH STREET JAMES P & NANCY E W BARNSTABLE 29 CHURCH ST WEST BARNSTABLE MA 02668 PHONE DISTRICT WB DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY (NOTES) ZONING DIST/ZOC RF SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? Y # BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 65340 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST WP (N) EXT / (P) REVIOUS / NO (T) ES / PERMITS / (V) IOLATIONS / (G) EOBASE / (E) XIT :. - B,._, =_, Town of Barnstable Zoning Board of Appeal FEE -4 P 24 Special Permit Decision and Notice Application: #1992-07 Applicant: James Conroy At a regularly scheduled hearing of the Zoning Board of Appeals, held on January 23, 1.992 notice of which was duly published in the Barnstable Patriot and forwarded to all interested parties pursuant to MGL, Chapter 40A, the applicant, James Conroy appealed to the Zoning Board of Appeals for a Special Permit to allow a family apartment , within an existing garage pursuant to Barnstable Zoning Ordinance Section 3-1 . 1 3 (D) . The applicant's site is shown on Assessor's Map/Parcel Number 130/ 16 and more commonly addressed as 29 Church Street, W. Barnstable, MA, and is zoned RF Residential District. The following Board members heard the petition: Luke Lally, Ron Jansson, Gail Nightingale, Betty Nilsson and Chairman Dexter Bliss . Summary of Evidence: The applicant, James Conroy, presented his request to the Board for a Special Permit'. Mr. Conroy explained that his motKer". who is retired, will occupy the family apartment.,} Mr. Conroy stated that the proposed family apartment will occupy approximately 875 sq.ft. area of the overall existing 1 ,288 sq.ft. of garage. The Board asked the applicant if he read and understood the conditions of the Zoning regulations regarding family apartments. The Board informed the applicant that if at any time a family member is not living in the apartment then the use as an apartment will be abandoned. Also, the Building Inspector would have to be notified once a year as to who is living in the unit. Mr. Conroy replied yes . The Board discussed the denial of the applicant's request by the Old King's Highway Historic Committee (OKHC) for the alteration of the garage on January 8, 1992. The Board asked the applicant if he will reapply to the OKHC. Mr Conroy stated that the OKHC Committee has concerns with the pitch of the back roof and the size of the proposed windows for the apartment. He will reapply to the OKHC with some modification to the structure,Oafter receiving an approval from the Zoning Board of Appeals. ' I The Board also asked if the modification will change the area of the family apartment. Mr.. Conroy replied no, and explained that the modification will be to the exterior 'of building. The Board informed the applicant if any modification to the design -that produces any change to the square footage of the proposed family apartment, it will require another hearing before the Board. Mr Conroy stated that he understood the Board's concerns. Mr. Dan Luechauer, Architect for the applicant, explained the proposed changes to the structure. He further explained that the concerns of the OKHC could be accommodated without anticipating any difficulties. Mrs Conroy and MR Conroy's mother spoke in favor of the pet i t.i on. No one spoke in opposition of the petition. Finding of Facts: At the meeting of January 23 , 1992, �tHe Zoning Board of Appeal made the following finding of facts as related to Appeal # 1992-07: 1 . The petitioner complied with all the provisions of Section 3- 1 . 1 (3) (D) of the Zoning Ordinance as far as they relate to family apartments. 2. Granting of relief sought by the petitioner is not detrimental to the neighborhood effected, or derogation of spirit and intent of the Zoning Ordinance. The vote was as follows : AYES: LALLY, JANSSON,• NIGHTINGALE, NILSSON BLISS. Decision: Based on the finding of facts, at.a meeting held •on January 23, 1992, .by a motion duly made and seconded, the Board voted to grant the Special with the following restrictions: 1 ) Total floor area of the family not to exceed 875 square feet as proposed per plan submitted by the applicant. 2) The applicant receive an approval from the OKHC of the proposed alteration to the garage to occupy the family apartment. AYES: LALLY, JANSSON, NIGHTINGALE, NILSSON BLISS. THE PETITION IS GRANTED WITH RESTRICTIONS. i i i Ary person aggrieved by this decision may appeal to the Ba—scab?e r=bed in Sect-on 17 of C:.aocar 40�, of th e Su=er'_or Court, as desc Ge_e=al La.s of t_`.e Co=or.:e:lth of t�yssac^usects by bra L G^_ ac__o. c. Chia t-�;encJ days after the decision has been f-'?ea in the off-ice of the Tou-a Cler".c. Czai—_an I, Clerk of the Toum of Barnstable, Barnstable County, Massachusaccs, "hereby certify .that c:;enc-y (20) days have elapsed s .ca the Board of Appeals rendered its decision in the above entitled pecic;on and that no appeal of said decision has been filed in the office of the Toy.-a Clerk_ Signed and Sealed this day of 19 under t`e pains and"penalt=es of perjury. Distribution: Propert1 Owner Tou-n Clerk ToG-i Clerk Aoul_cant Perscas Interested Build_=g Inspec!cr Publ'_c In=or___at_on Boar- of Aooaals I Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division anxxsrABLE. v MAM Thomas Perry, CBO,Building Commissioner 1639• ♦0 ArEn r�r►+" 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 SECOND NOTICE March 5, 2012 Nancy Conroy 29 Church Street W. Barnstable, MA 02668 Re: 29 Church Street Dear Ms. Conroy: Our records indicate that you have not responded to our letter of January 3, 2012 asking you to complete and return the Family Apartment Affidavit. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. Please return the enclosed affidavit as soon as possible. If you no longer have a family member residing in the family apartment, please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home, or Apply to the Amnesty Program If you have any questions, please call Brenda Coyle, Principal Division Assistant, at 508- 862-4039. Sincerely, Tom Perry Building Commissioner Enclosure fasnd 'ME The Town of Barnstable Department of Health Safety and Environmental Services ,,�,, , 'r Building Division � `►,39. 367 Main Street, Hyannis MA 02601 ATED MA'S� Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissione December 30, 1997 The Conroy Residence 29 Church Street West Barnstable, MA 02668 Re: Family Apartment located at above address Dear Mr. Conroy, Our records indicate you have not filed an affidavit regarding the above referenced family apartment in quite some time. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable Zoning Ordinance that an affidavit be submitted annually for the duration of such occupancy. Please indicate the status of the family apartment on the enclosed affidavit return to this office by January 30, 1998. Enclosed is an affidavit for your convenience. Thank you in advance, Ralph Crossen Building Commissioner o� The Town of Barnstable Department of Health Safety and Environmental Services Building Division 039. � 367 Main Street, Hyannis MA 02601 Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commission February 18, 1998 The Conroy Residence 29 Church Street West Barnstable, MA 02668 Re: Family Apartment located at the above address Dear Mr.Conroy, A letter was sent to you on December 31, 1997 requesting information regarding your Family Apartment. The affidavit.has not been received as of this date. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable Zoning Ordinance that it be submitted annually for the duration of such occupancy. Please indicate the status of the family apartment on the enclosed affidavit and return to this office by March 1, 1998 in order to comply with the conditions of approval. Thank you in advance, ` c Ralph Crossen Building Commissioner Town of Barnstable Building Department 1 Complaint/Inquiry Report Date: Rec'd by: Assessor's No.: tT_O1(rl' Complaint Name: Location Address: INV Originator Nwne: Street: 4�0 Village: State: Zip: Telephone: D/E Complaint a . Description: ` Inquiry Description: For Office Use Only Inspector's Action/Comments Date: Inspector. Follow up Action Additional Info. Attached Copy Distribution: 61,7ute-Depamnent File 3 ellow-ImPector pink-Inspector(Return to office Manager) R130 016 . A P P R A I S A L D A T A KEY 70176 CONROY, JAMES P & NANCY E LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF 46 , 000 9 , 300 148, 100 2 A-COST 203 , 400 B-MKT 147, 300 BY 00/ BY ML 3/93 - C-INCOME PCA=1011 PC8=00 SIZE= 19.80 JUST-VAL 203 , 400 LEV=500 CONST-C- 0 ----COMPARISON TO CONTROL AREA 84AC. -- --MAY NOT BE COMPARABLE-- - NEIGHBORHOOD 84AC WEST BARNSTABLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 460001 LAND-MEAN +0% 2034001 . 100293 IMPROVED-MEAN +480 250 ] FRONT-FT 1] 100 DEPTH/ACRES TABLE 02 100%1 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] I R130 a16 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 70176 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT [B35034] [05] [92] [AD] 570001 [LK] [01] [93] [100] [NEW ] [WB DORMER ] i i i I i [ ] fh130 016 . ] LOC] 0029 CHURCH STREET CTY] 05 TDS] 500 WB KEY] 70176 ----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 CONROY, JAMES P & NANCY E MAP] AREA184AC JV] MTG12010 29 CHURCH ST SP1] SP21 SP31 UT11 UT21 1 . 50 SQ FT] 1980 WEST BARNSTABLE MA 02668 AYB] 1900 EYB] 1975 'OBS] CONST] 0000 LAND 46000 IMP 148100 OTHER 9300 ----LEGAL DESCRIPTION---- TRUE MKT 203400 REP; CLASSIFIED #LAND 1 46, 000 ASD LND 46000 ASD IMP 148100 ASD OTH 9300 #BLDG (S) -CARD-1 1 93 , 900 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 9, 300 TAX EXEMPT $#BLDG (S) -CARD-2 1 .54 , 200 RESIDENT' L 203400 203400 203400 #PL 29 CHURCH ST W BARNS OPEN SPACE #RR 0308 0282 1013 0445 COMMERCIAL #SR MEETINGHOUSE WAY INDUSTRIAL EXEMPTIONS SALE] 11/90 PRICE] 220000 ORB] 7365/145 AFD] I TE LAST ACTIVITY] 01/25/91 PCR] Y s Y. - Asse'ssor's map and lot number Y y� r G Sewage Permit number �...b... ...cutit .. ... ..... ............ V .. Z 333AR39TIB E. Housenumber .................................................................:....... 1639 00 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....................................................( L 1 1 . ...l�Qf�................... TYPE OF CONSTRUCTION ...��� ��.� : : 5:� F...ncre e... 070vu;l ....)t};��I.1 Vw?....... .:.19. . . U TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit` according to the following information: Location* ......�Z` ..........CAc�.`.:.c.t'...... - W.CSI .......3nle/I�S.TW.Ti3��: ................ ProposedUsed.!.�!,.!`.......... .....................................................................i.............................................,......................... Zoning District .................................. ..:......... ............�.. ...� ...............Fire Distract �t}eS:�- �nY �s-4-C �?1.:....,.....:.............. I1111 e' Name of Owner ..UVQ� C ✓�... .(,J.S o..! .......................Address .....J.?..ci ....�`: .V r C ....................... Name of Builder l..rli.e. ..... GVYIC'...... -? ?'1� .... ��dP(......Address ........ ... yGi c J ..............h. ......... y........�l opt ti t5 Nameof Architect .....:............................................................Address .................................... ' / � .... Number of Rooms ................i 1.A....................................Foundation .t1/, ,. ....................... .................................. Exterior ........................A/./ .................................................Roofing ............. / ........................................................... Floors ............�(/�: ...........................................................Interior ..............,/.. ..........•.:...:..:....................................... Heating .............. I .....Plumbing �Z �� qo v✓C Fireplace ...........................................................,:.....................Approximate. Cost ........../........:............................................... Definitive Plan Approved by Planning Board -------------_____----_______19_______. Area Diagram of Lot and Building with Dimensions Fee ,�..�. ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH �k(S T I K C— C-INC 12 1017400�- 4 oo� P- OCCUPANCY PERMITS REQUIRED FOR NEV1rDWELLINGS �_,.,.--iI hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ ...�./.+; 1.. !{?<f.................. ....... �. Construction Supervisor's Licenseo. 3......... DYSON, WARREN k--130-16 No ..... Permit for _P_ 1_. ........Singl Family..P��Ii .... /........ ... Location C 11d CGh.St.r ....... ....... ...................weat-Ba1w.ta ........................... Owner .........W=ej.l..DYP.QXI............................... Type of- Construction ....Fr.aM............................ ............................................................ ................... Plot ............................ Lot ................................ Permit Grant ....June........ ..6.,......................19 .84 Date of Inspectio . .... .................;.-n...........119 Date Completed ..... ................................19 I •. ..r, "° ✓`;-64''j� l_W'A.$3, 'i' g y., ' _,. + ,a ''!� / } - -'+ ts• -air y��"_ /t " v � Assessors map and lot number .... ..:.....:.........,..................... _ f?H E Sewaget Permit number .........,............................................... Z BABBSTABLE, i Housenumber M1Da.........................:..........................................:.. 9 • � �O 1639. �•0 YPY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... ../�. G e.................... TYPE OF CONSTRUCTION ............ ................................................................................ ................../. 1....�............19. . 3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location / ProposedUse ........... .YA.a?.;i..��...w ................................................................................................................................. Zoning District ...R .....................Fire District ........./�.�' S ; �Vk S �'4� ................................... ^/ !...,..................... ....................................... V(J�311`V rG�/..... .....�!�.....�r.Q .....Address �,g�.•(�/�<,/ ... OJ, � Nl�.S. h...�p.... Name of Owner ............ y �••••• ••••• a / Name of Builder � �.....................................Address . ...................... .. .................................................................................... Nameof Architect ..................................................................Address ................................................................................ [�// Y. Numberof Rooms ..................................................................Foundation ...(....�..�.-..1.-....................................................... Exterior ....1 11.0. ......................................................Roofing /•.C.••••.............,..,.(� Floors ....(,..r/I.1.1.1//.e..1...�...............................................Interior .................................................................................... Heating ..................................................................................Plumbing ...................................................................... 16 Fireplace ..................................................................................Approximate. Cost ................. r.�1(?r��........... Definitive Plan Approved by Planning Board -----------_______-----------19_______ . Area .... .. .................... Diagram of Lot and Building with Dimensions Fee ....... .0....1*4 ....0.................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. t Name .... .................... Construction Supervisor's License�4,Z...P................ DYSON, WARREN L. 25836 Build Garage No -----.. Permkfor ------------ Family Dwelling ............................................................. --- . . 29 Church Street Location ................................................................ ' ~ 8a�oo �-----' . -- . ! ' � ' ' .---'.-----------' ^ ' � Owner Wa��ez� I,. D�oou ' . � | ��n�, -----.---_—___________.. , . ^ � ��ame� Type of Con/�ruchon --.-----------.. . -------------------------- . . ` plot \_ �� ' ` ------ -- ----------.. . ' ! Permit Granted ..Der-L -r I . . . ' ` . ""'= of Inspection" . ^ ~~'~ ~~ 'r�'^~ . � . . _ ~ , . ` ' ^ / ' . . ' . . , . � ' | ' � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION A Map Parcel b- Permit# Health Division Date Issued ,�R - 29 G Conservation Division Fee Tax Collector SEPTIC SYSTEM MUST BE Treasurer INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. ENVIRO MENTAL CODE ANid Date Definitive Plan Approved by Planning Board TOWN REGULATION'S Historic-OKH Preservation/Hyannis Project Street Address 2 TCA8v Village vV K) - Owner Address Telephone Permit Request - K / d -l 0/2 I Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family V Two Family ❑ Multi-FamilY(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout • ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing r new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric . ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Carent Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR �I DATE K Z21-03 ' FOR OFFICIAL USE ONLY _ PERMIT NO. ~ DATE ISSUED MAP/PARCEL NO. ADDRESS, VILLAGE OWNER` DATE OF INSPECTION: r FOUNDATION FRAME t INSULATION• a FIREPLACE r • ' ELECTRICAL: ROUGH z J FINAL ' PLUMBING: ROUGR ; !~ FINAL GAS: ROUGH" , ~: FINAL FINAL BUILDING V DATE CLOSED OUT _ ASSOCIATION PLAN NO. The Town of Barnstable MAMDepartment of Health Safety and Environmental Services-' Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen. Office: 508-8624038 Building Commissioner Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Estimated Cost Type of Work: Address of Work: S� Owner's Name: w ` N Date of Application: —�V�T1�v►�� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ' Job Under$1,000 Building not owner-occupied �Wwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. O Date O er's Name glorms:Affidav I 07/08/99 08:17 FAX 7814472528 BC TENT&AWNING 1a002 t COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 WASHINGTON STREET BOSTON, MASSACHUSETTS 02111 James J.Campbell WORKERS' COMPENSATION INSURANCE AFFIDAVIT Commissioner (licensee/permittee) with a principal place of business/residence at: (City/State/Zip) do Hereby certify,under the pains and penalties of perjury,that: lain an employer providing the following workers'compensation coverage for my employees working on this job. 1�U.7tcdT) S::GL �2�►�N�U i(Ca/k.C+O C,< 97 7 -3 50(� / Insurance Company Policy Number [ J lam a sole proprietor and have no one working for me. [ ] I am a sole proprietor,general contractor or homeowner (circle one) and have hired the contractors listed below who:have the following workers'compensation insurance policies: Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number [ ] I am a homeowner performing all the work myself. NOTE:Please be aware that while homeowners who employ persons to do maintenance,construction.or repair work on a dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not gener-. ally considered to be employers under the Workers' Compensation Act (GL.C. 152, sec. 1(5)),application by a homeowner for a license or permit may evidence the legal status of an employer under the Workers'Compensation Act. I understand that a copy of this statement will be forwarded to the Department of Industrial Accidents'Office of Insurance for cov- erage verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crim- inal penalties consisting of a fine of up to $1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of$100.00 a day against me. Signed this day of 19 Lice'nsef'/Permittee Licensor/Permittor f t4�Xrfi tCate u---*f .Aetna 1K eat eattaw t a n C r G`ST�Q REGISTERED Q of CALF Fo ISSUED BY APPLICATION Q �y ANCHOR INDUSTRIES INC. Date of Manufacture NUMBER EVANSVILLE, INDIANA 47711 F031.02 9y Fj �PQy�Q MANUFACTURERS OF THE FINISHED T1679 F RETP� TENT PRODUCTS DESCRIBED HEREIN 3-13-89 This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: B.C. TENT CITY . AVON STATE MA — Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 GOVERNMENT CERTIFIED LAB #6360 Method-of application: LAMINATED Type, color and weight of canvas/vinyl: 15 oz VINYL LAMINATE SUPERWHITE C Description of item certified: 30x60 4pc SQ. END PARTY TENT TOP Flame Retardant process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric - �uBAcozE - Signed C•LZ Name of Applicator of Flame Resistant Finish �� 1 RAVENNA, OH TENT D AR MENT—.ANCHOR INDUSTRIES INC. LOUIS R. BROWN _ > > � �� �����'Iri,�'(�1 i > > (� ((l n � (��1�C�1.(l�.(fl i(1�C�i'°ii�,�}'�rLu�,� •,.((l(11��.C�1`,.��(1.��(l . Department of Health Safety and Environmental Services Building Division • 367 Main Street,Hyannis MA 02601 MMM Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissione: HOMEOWNER LU3XSE EKEM riON Please Print DATE JOB LOCATION: CCiauYI-. W I Borg lz�h ,V t� umber street tillage ER""HOMEOWN : // C,- �— name /^� r bo,�,me phone# Writ phone# CURRM,ff MAUMG ADDRMS: I/W IfZ - 0 E 0 26G «WAU" sm *code The current exemption for`$per"was extended to include kd dwellina of six twits or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the Miner a�ervisor. DEFU41MON OFHOMEOWNFR Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such . ....._ "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/sbe shall be - nsnons'ble for all such work performed under the building, era n (SeWon 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Build in Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and - )4a S1 of Appmvai of Budding Official Note. Throe-family dwellings gaining 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction ConVmL HOMEOWNER'S EXEMTION The Code starts that "Any homeawnew performing work for which a building permit is eegvim I shall be exempt fmm the Provisions of this section(Section 109.1.1-13omsing of consmcdon Supatismsr provided that if the homeowner cup a persons)for hire w do such work.that atrdt Homeowner sbad set as supavisor." Many homeowrtas who no this are unaware that they sae assuming the mmonsibiiltla of a supervisor(see Appendix Q, Rules&Regulations for IJtxasing Coastructtoa Supervisors,Section Zls) This lack of awareness often results in serious pmbieaw parneolariy when the homeowner hires u ndoensed peomm In this case,our Board carrot proceed against the udieeased pesos as it would with a liaffied Supervisor. The homeowner acting as Supervisor is uWma dy responsible. To castare that the homcoamer is foHY aware of bbihar raponsi dlitiM many amities requiems as part of the permit application, that the homeowner axtify that helshe tmdestands the responsibilitlea of a Supervisor. On the last page of tbls issue is a form curently used by several towns. You may cars to amend and adopt such a formlcertificatioa for use in Your r=nvmity, I p"essor s map and lot number .............................. ........ . f_. � . �%�� �' Q�oF rot` THE Sewage Permit number ...°........... ......:.. ......... . .... . Z SAWSTAI E, i Housenumber ................................:.................. .................... 90 a a O,o� 39• �0 T TOWN OF BARNSTABLE BUILDING' INSPECTOR APPLICATION FOR PERMIT TO .. v w I.IIAyA t ................. TYPE OF CONSTRUCTION ... TC..�=.�r .� 5.�..C1S.� ...........9. �R.......�i T9.0 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 12.9 CA c),-c-14 ....... �.0 u� ...........................................:..::...:.. ....... ... . S/.................................... ProposedUse ...... ��.v. !... ........................................................................................................................................... �L� .✓....................................................Fire District ... .... Zoning District ...........q ' v tis G .�.4-1�1,,................... Name of Owner ...V.�!QV(/ ✓t Y S O v� Zq u ,C-� St 0.�' S�-�! (�.. .............Address ..... �. . ..............................................�..... Name of Builder 4(�i?. .... �!Kel......-WY4�0.... �� . Address 2� r�t.o Jc� `..............................�.�KK IS ................. ... J r Name of Architect 1.(........................................Address ..................,..J..... ......................./............................................................ Numberof Rooms ................Nlt ...................................Foundation .......... ,1 ..................................................... Exterior ........................ ...............................................Roofing ............. 1.. ........................................................... Floors ,ijl A Interior .:.:....... '�. ' Heating ............W/t1i.........................................................Plumbing ......... ...........In/C................ Fireplace ..................................................................................Approximate. Cost ..........1......:................................................. Definitive Plan Approved by Planning Board _____________________________19_______. Area ...................... . ..... ........ .. . Diagram of Lot and Building with Dimensions Fee ✓.l. .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH S Ek LSTI K.C— 'f"t � I eooL S P�ne OCCUPANCY PERMITS REQUIR OR EADWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �1 ,� Name .............e' ,-47. .. .�1 /....:......................... • 4 Construction Supervisor's License OO.iS.S-3 DYSON, WARREN ;r 26549 Swinunin P No ................. Permit for ..................g....Q9l..... .......Sin�le,.FamiY 1ie1�, g...................... Location 129....Ck117 .Qh..Street...................... ..................West.B---,u stable........................... Owner .....Warr.exi..Dyaoa..........................:. Type of Construction ...Frame........................... :. ................................................................................ Plot ............................ Lot ................................ e Permit Granted ....June 6......................19 84 Date of Inspection x" O/ �, .. Date Completed .......................... ,4,1.......19 o Application to �.t .r. 1 Old Kings Highway Regional Historic District Committee fl in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as'described below"and-on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior BuildingConstruction: New Building YI❑ g ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or BillBoar s: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: eFence ❑ Wall ❑ Flagpole ❑ Other '!1���s=Jll(( O /�n o (Please read other side for explanation and requirements) r TYPE OR PRINT LEGIBLY DATE �! ADDRESS OF PROPOSED WORK o� / C,i� r> Gh s?4. G{/' rlrks,ZU�ASSESSORS MAP NO. l36 r � i// i..e.,.. r A 1 :a�.F �r iv - _ ._OWNER W4rreu-, t!. 4t r I/ul ,��7/:��� •-=` ASSESSORS LOT NO. - - � HOME ADDRESS a2� f/�!�'i1N�/.� � �,�/Jt�NN t- a '- ��f•�`�` TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary).t y , VN� 1ii /a K/d0 4 kr{ ��s�` t`/ :/��^C�[. �7�,. . n�•, �/. �y�Nlld/j / a 4 it of arl� Y,Nr _ --� Gll,. :.�/Gwl/�CI:Ci �� «,'..�"'4..� .L`�7 .: !.'.'S•_: ?.}^,.r ..� :,,r tl..=a � e AGENT OR CONTRACTOR '�'' '" � _t= TEL. NO." ' 7-2 c;2��� ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of'vvork io be done-(see No. 8, other side),-including materials to be used, if specifications do not accompany plans. In the case of signs;give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). 't 1. ... .. ^:;,+a,;,.� "S�• t-^�.]'�.^.'. }E, ."7TT:: r''.. Jrlit - .?'_ .'i :1'.1�L:i C .- y� %1:� L T L.ia:u%-. .. 'i/�i F." ,� :4 i,'f~�1j .J?`si?i23 tt'' "r':�"�� • .rl_ _ , i:,- ,.r a "!: :1. . .,.I -.r; .:4� C...'i._� r''r ' �'.'Y Y "1• .kK�♦: ��/��yC�� '�� •- a: Signed ' _ Owner-Contra -Agent Space below line for Committee use. Recei� b OKH HISS,DISC'. , Date_�A NSTABLE The Certificate is hereby .Datef Time Azle, By 4 Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ _ CZ� t o 7 y �S� _ ' D t e c- Y t s1 •o a 1 - • XJ 1�� R `• - _ ��'i i./.'_S Win_ L 7 CE'�':try TiJ-�T ?ZJE p .•c� ..;C_. — /v��✓'N ON %•IZi= .�i�j-► Fri 4e- OKH HIST. DIST. BARNSTABLE MAY 1 5 IP04 l ty j- $I5�'" 1�'�lt r'�• ()CiT!4WK -91 � - 2yr,,� n ': �:.,,> Wt�17i AREA• �,�1 mac..-�. ., 34 t > ♦ E 'a' + 20 • . ..' ( . -�P COL .LC yCA7'c)N `moo G� :::. ; t'. 'r->. .:�:-•. :•;: Adjustable A-Frame I Safet Line Useo o �• Braces At}Nall Jo;n;s• o Iridiceted i3y A g J;D. . t,. i�ima TN i.s• t s r' °au 1.f m ` A _ ... r 011 In9 ,. a all.COnerDetail'S N PI; ` (Typicot Au Corners) .. m .. TYPE;1.1:DIMENSIONAL;,.. SPEC.IFICATIONS �45 APPL '• ^ s f IED _ <Wx. EATHERKIN .TO .�,.F .: G POOLS q _...._ 1..Overhan of r ♦ >: 3 {p 4, 0, A g, vmg r)oard from edge r.r,gar - �ol Is 2'-8tl7/8 ( 3 inches :Water depth.under tip of Giving board 2 'r~ Plan ' r{ , , is a'minmum of.72",af Point"A ° ?` 2'-8 7/8" (*3") Overhang Distance. Stainless SteeLWall - 4,�'�'..+� 3 Maximum board en th s 8' 0 • �. -4. Maximum boara the ynt over'water is` r' T j _ hers,42"High'. A ... i ) 20 Max.mum Height Above Water 1._0.. -,Ot , 20 inches Oivingboara must be centered.in width 5 �... �SafetyLine: "'.. of;Pool:, _ r Mmimum.Watei Level 6. Refer to manufacture.s'specificatir-ns o 4' `Below Top Of Liner `'fo..{ `...,...:.. , •'i f UICrUfn locations: !.e..q....s s L_ 7:'Safety hnesfmusY be mechanical) at- �s Point';A":,. + Undisturbed Earth y i;►e Nofe'2' _ fa,6 ed•on one Side' supported'''by'' Vinyl Liner Cver' :•buoys ? r 2" Cor6pacte'd Sand r i ' :•- I 8 A;Step,or Jadder or•other approved 4'-0' 0' 14'_p� _ means shall tie provided at both the : shallow and•deep ends.' Profile FOLLOW ALL APPLICABLE SAFETY-AND': BUILDING CODES, AS WELL AS INSTALLA ' TION INSTRUCTION':FOR THE POOL`:• AND ALL EQUIPMENT AND AdCESSORIES. /6' l6'• l6vi CAUTION: DIVE FROM DIVING BOARD ONLY.' �. 16x34' RECT ; �I /6x34 RECT.. /4 2 /4'SECTIONS 1/4' 2-15 --SECnoncs VI/EAT H E �C I A 4 /s,s£CneNs ;> 15 4-Asv!'SECT/DNS /�' C P R C D U CT S I N C 4 ,/it 90'ROL4.EO Cyt1 -4-3 PC.90'CORNERS ` a..' /o.-Ccw/n�CL/Ps. . EAST GREIWICH;:'R:I: ` M 3 /6.. ../6' /6d? :� . DRAWNAFIH APP.' ,.J.P.P. •l Iioltda 6 x 34` 8 RGT I I .DATE '.�z=sz y Coping Layoui' Snap Strip Coping Layout ` ` ' ` � RECTANGLE o 34 4 Ai Ass�tssor% map and lot number ....A$.�.:..-. .�Gr...`. �� *THE Sewage Permit number ....... _ �Q o Z BAWSTADLE, i Housenumber ....................... ................................................. ro rasa p 039• \e0 �0 MOR a' TOWN OF BARNSTABLE BUILDING J INSPECTOR APPLICATION FOR PERMIT TO ......414.l. : ..... �'�1'2 ............................................................... TYPEOF CONSTRUCTION ............( C./...P :..... ................................................................................................. al....�... .........19.a... • TO THE INSPECTOR OF BUILDINGS: ' r' The undersigned hereby lies for a permit according to the following information: yy — / Location ...r ./.� Y .... y' .,r/ a.�! .................................. ProposedUse ........... ....._................................................................................................................................ Zoning District ...R. ...........................................................Fire District ........ /,.. LNG( -�`'�_.................... Name of Owner ...!' ..s��^!!��G.t1......^.�......1�.f.0K.....Address e,j..4 4l. .. Name of Builder ...Address ........................................... Nameof Architect ..................................................................Address .......�............................................................................ Numberof Rooms ..................................................................Foundation tl.f/.U..YPr .................................................... Exterior ....(NO U.. .....................................................Roofing ...w9w- _A� .... :............................................. Floors ....C...�.Ci.1/.:e-. ..............:..............................................Interior ....................................................... Heating ................ .......................................:. ,.........................Plumbing .................... ............................................................ . Fireplace ..................................................................................Approximate. Cost .................` .�.......... ................. Definitive Plan Approved by Planning Board -----------_------_-----------19_______. Area .`.... .................... .. . . 11 Diagram of Lot and Building with Dimensions Fee ................ .. . ................... SUBJECT TO APPROVAL OF BOARD OF HEALTHCl ►fib / OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .. . ' ...... ........... .......................... ense Construction Supervisor's . ............... --,-PYSON WARREN L. 2-5836 Build Garage • No ................. Permit for .................................... Single Family Dwelling ................................................................................ 29 Church Street ' Location ................................................................ • W. Barnstable ............ .................................................................. Owner ..Warren...L..*...Dyson........................ ..... .. .... .. Type of Construction FRa.me............................. ....... ..... . ................................................................................. Plot .............................. Lot ................................ PermitGranted .......December- 1,.................................19 83 Date df Inspection-9'Z— ............ .......................19 Date Completed .................. ... . ..........19 k S> Y R (b r r rr JAI e i • r �x� } APPROVED OKHRHDC T ; r . 1; wE07- lz- F t 5e A4-- 4/0 S • G'7.C/N6Z7G/NG �y� s�2•✓y�^/� a Y on/ T,V r s 2_32- %y((:, Town of Barnstable Regulatory-Services TOWN OF BARNSTABLE �DFTHE rp� o Thomas F. Geiler Director • Building Division 7011 AUG -5 PH 2. 2 9 + BARNSTABLE, yp KkSS. Tom Perry, Building Commissioner I7 t639' °tEon�'ta 200 Main Street, Hyannis, MA 02601 www.town,barnstable.ma.us ®IVIS)ION Office: 508-862-4038 Fax: 508-790-6230 Approved:" Fee: — Permit#: . C1 HOME OCCUPATION REGISTRATION e::�� Phone Naive: 640 / j : Address: 2aj C64y4C//� SJ Name of Business:_ H,4 'Cype of Business: L U ►2 Map/Lot: c3C, INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home Occupation ciritlaiu single Family dwellings,subject to the provisions of Section 4 L4 of the Zoning ordinance,provided that the acticrity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no�risual alteration to tlae premises which would suggest Anythiaag other thaaa a residential use;no increase in traffic.above tiormal residential volunies; and no increase in air or grounchcater pollution. After registration Mth [lie Building Inspector, a customaryy home occupation sliall be perri itted as of right subject to tlae following conditions: • The aakrity is carried on by(lie permanent resident of a single family residential divelling unit, located Witlaiia that dwelling unit.. • Such use occupies no more than 4.00 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic drill be generated in excess of normal residential vohumes. • The use does not-involve tlae production of offensive noise, Vibration,smoke, dust or other pau'tic•ular matter, Odors,electrical disturbance,heat,glare, humidity or other objectionable effects, • There is no storage or use Of toxic or ha-rlrclqus materials, or flammable or explosive materials, in excess of nomlal 11oUSelaolCl quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not ccrithin the required front yard. • "I'laere is no exterior storage oi••display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one call or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sigar shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised;is a business,the street address shall nail be included. • No person shall be employed in the Customauy Home Occupation caho is-not a penraaucnl resident of(he we ' unit. I, the undersigned lam read and agre 'th the - ove restrictions fir my home occupation I ana registering. Applii'anl: Date: YOU WISH TO OPEN A BUSINESS? { For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. Fill in please: DATE APPLICANT'S YOUR NAME/CORPORATE NAME •� S fi�� �� BUSINESS TYPE:_ BUSINESS YOUR HOME ADDRESS: "' �� c TELEPHONE # Home Telephone Number C>>S�--- 2- — ' 'Z j NAME OF NEW BUSINESS'. 2 /-'_$' OR EIN: Have you been given approval from.th bui ding divisio S NO ADDRESS OF BUSINESS yCC 1 G h� A1,14APIPARCEL NUMBER__Zao ®/ When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. $ Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFF E This individual has been i of any it requirements-that pertain to this type of business. onze 1 ture 1t ST COMPLY WITH HOME OCCUPATION COMMENTS: ;?ULES AND REGULATIONS. UC)P0PL7MAY RESULT 2. BOARD OF HEALTH This individual has been informe f th perm't r uir^ that pertain to this type of business. �2 AutftofIxW8ig a , , -..:.,, COMMENTS: "'',` '' &VSt`%>OMPLY WITH Al I MATERIALS R 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has t i orm of the licensing requirements that pertain to this type of business. Aut ornzed Signature's" COMMENTS:_ NeCdS m of Ul'Q,l/lV 44,m,�-Uoh W I-M d- W 01,E Town of Barn �2�! 0*W r, stable Permit# Expires 6 r the m issu to Regulatory Services Fee - BAxrvsrwat.e, MASS. Thomas F. Geiler,Director 1639• ♦� lFD IdA't� Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstabld.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number i Property Address oq— $ T esidential Value of Work 3t � Minimum fee of$35.00 for work under S6000.00 Owner's Name & Address J.-4ptr-S 19- cow �� �'6�y�2cG�- � �itl�5T' �.fi�w s�•�l �i'� Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) r". -m1=00 PERMIT ❑Workman's Compensation Insurance Check one: APR 2 0 1Q�$ ❑ m a sole proprietor I am the Homeowner `f.OVVN OF BARNSTABLE ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit eFeqquest(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to Re-roof(not stripping. Going-over existing layers of roof) Er— tce-si e ^^ww �a lJf S��Q #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. i ***Note: Property Owner must sign Property Owner Letter of Permission. A opy of the Home Improvement Contractors License & Construction Supervisors License is Vre,,uired. SIGNATURE: QAWPFILESIFORMS% ' ing permit formsTXPRESS.doe I?. ;,-A n71)l In The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 EiP�; :i;;U / t500 Washington Street `ell:j Boston, MA 02111 c www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: �, yr2c " City/State/Zip: ZV967— /�7 'bg is1,,3 is _ Phone #: 6-,�i 3G Z -cf 2_15 Are you an employer?Check the appropriate box: Type of project(required): l.❑ I am a employer with 4. ❑ I am a general contractor and I 6 ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its ME] Electrical repairs or additions r tred.] officers have exercised their 3. I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself [No workers' comp. c. 152, §](4),and we have no 12.❑ Roof repairs . insurance required.] t employees. [No workers' 13 ❑ Other comp. insurance required.] Any applicant that checks box#t must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c rtify nder the pains and penalties o erjury that the information provided above is true and correct Si ature: Date: ^ Phone#: Official use only. Do not write in this area;to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: -.�.Ap Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction-or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or.to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is-required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the-affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn)'eaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-N ASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia i Town of Barnstable y� o Regulatory Services Thomas F. Geiler,Director WIA 4C 16S9. Building Division PrfD µA'�a Tom Perry, Building Commissioner 200 Main-Street,_Ayannis, MA,02601 www.town-barnstable-ma.us Office: 508-862-403 8 Fax. 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE.- t�� JOB LOCATION: / number street village "HOMEOWNER": �// "'£S �1J .5��-�GZ name home phone# work phone# CURRENT MAI-NGADDRESS: 'e7 eityhown state rip code TI?e current exemption for"homeowners"was extended to include owner-occupied dwellings of six to its or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to.reside, an which.there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structtn es. A person who constn}cts more than one home in a two-year period shall not be considered a bomeowner. Such "homeowner"shall submit to the Building Official on.a form acceptable to the Building Official, that helshe shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned `homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that•he/she.understands the Town of Barnstable Building Department inspection procedures and requirements and that he/she will comply with said procedures and r c cnts. Sign re of Homeowner Approval of Butlding•Official Note: Thrce-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be cxmTpt from the provisions of this scc6gn.(Scctio ecru n 109.1.1 -Liing of c=truction Supervisors);provided that if the homeowner engages a person(s)for hire to do such wont,that such Homeowner sW act as supervisor.,. 14any homeowners who use this exarrption are unaware:that they arc assurrring the responstb'litirs of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Scetion 2.15) This lack of awareness bfien results in serious problans,particularly on when the homeowner hires unlicensed persons. In this ease,our Board cannot proceed against the unlicensed person as it would with i licensed supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/hcr responsibilities,many communities require,as part of the permit application, that the homeowner certify that hcJshe undo stands the responsibilitics of a Supervisor. On the last page of this issue is a.form eurrcntly used by several towns. You may care t amend and adopt such a forr✓eertification for use in your community. THE ro Towll of Barnstable o Regulatory Services Thomas F. Geiler,Director E16jq- Building Division Tom Perry, Building Conunissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subect ro e j .r r mT hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Srof Owner ate Print Name If Property Owner is applying for perrmt pleas e complete. the j Homeowners License Exemption Form on the reverse side. r►�rr Tows of Barnstable Z.o�o�t ���oF �ti - Permit# O Grpires 6 Inonl/ujroirr issue ale Regulatory Services Fee ^' EtARYSTABLE, + ;(Ass. 16J9_ $ Thomas F. Geiler, Director Building Division Tom Perry, CBO, Building-Cominis.sioner 200 Main Street, Hyannis, MA 02601 www.town.-barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Vnii(hpithout Red X-Press Irrtprinl Map/parcel Number / 36) 1)1 Property Addres �) A.4?, Vs tesidential Value of Work L �� Minimum fee of$35,00 for work under S6000.00 Owner's Name & Address �iu.�tS • ���� Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: NOV ❑ I m a sole proprietor I am the Homeowner TOWN OF BARN S_TABL� ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) U-Ke-roof(hurricane nailed) (stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed) (not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .35)#of windows *Where required: ISSLIanCe ofthis permit does not exempt compliance wish other town department regulations,i.e. Historic,Conservation,etc. ***Note: Property Owner must sign Property Otvner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is quired. . SIGNATURE: ):\wPrn cc%PnRM3lhuiddina,dermii rnrmclpypprcc.4..1 The Caminottwea.11h qi'.Afassachuselts f Department of iditsfrialAccidents Office of Investia afions 600 Washingto775'Ireel Bostan, M4 02111 ivivw inass.gotildia "Workers' Campensation Insm-.qnce-Affida'Vit: Builders/Conti-,ictors/E leajidaus/Phunbers Applicant hfo.rmatian — Please hint Legibbi Name. (B.Lisinew,/OrgauL7a6ongnchvidtial): Addnfss: C I'L -city/state/zip: W2,61— Are you an employer?Check the appropriate box.: Type of project(required) L El I am a employer with 4. ❑ 1 am a general contractor and 1 6. EJ.New constraction eirTloyeez(fuJ!and/orpart--fitne).* have hired the sub-contractors 2-0 1 am a sole proprietor orpartner- listed outbe attached sheer. 7. EJ Remodeling ship.and have no employees These sub-contractors have 8- EJ.Deviolition -working 1or me in any capacity. employees and have ivaikers' 9. EJ.Building ad-ditiou ,[No ivc;Tkers' comp.insurance comp-insurance..?ed_.] 5. El We are a coiporitionand.its 10.EJ Electrical repairs or additions r, 3. 1 am a.horneolim-er doing ail work aexercisedcexs have exercised LEJ.PluaibinZ repairs additions myself. [No workers'comp. right of exemption'per iMGL 12.j��oof repairs insurance.required.] T c. 152, §1(4),and we have no emptoyeas.;'[No Avorkers, 11 ElOtber comp..insurance requi-e'd.] Any applicant that clwcks box#I mw also 571oul the section below showing theirwDY)iers'compensation policy infonnstiom Homeowners who submit this-af.Unrit indicating they are-doing aftwork and then hire outside contractors must submits ueiv flffjdavit indicating such- "CGroraciors that check this box must attached an sdditiDn2lsbeet showing the mame of the sub-cmstracz.Ts 3nd stale whether at not those entities have employees. If the sub-contractors1ave einp1vyus_fbqy.must provide their workers'comp.policy number. I ant an euipZoyer that is providing i jorkers'vo niponrafion hisu rancefo r tiv elaployeas. Below is the palicy and job site in/orivratioit. Insurance Company Name: Policy#or Self-Ins-L.C.-ff.. Expiration Date.- Job Site Address: Attach a copy ofthe workers'compeirsn-tionpolicy declaration page(sh-oiiing the policy number and expiration date). Failure to secure coverage as required under Section 25A of 1YfGL c. 152 can lead to the imposition of criminal pemifties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP 1VORK,ORDER and a fine of up to$2250.00 a day against the violator. Be advised that-a cop),of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce i under the pgi ysand rialtiesofpe:jjjiryt.hattlieii.tfortttaho-i.iproiididaboii?istrii.eajidcorrect. Si gna tire: Date: 1113 /1D Phone M ,FOt0 Official use only,. Do not ifvite in this area,to be contpLeted by cih'or toitii qfficiaL ffe'" IISO ate-or Town: Permit/License Issuing Authority(circleone): 1,Board of Health 2.Building Department 3, f_1t-Y/Tovvn Clerk 4. Electrical Inspector 5. Plumbing Inspector 6 0 J lier CnntAct Person: Phone fl: Town of Barnstable Regulatory Services " g^I S.^BLE' Thomas F. Ceiler, Director y ws �, `bolo;9 `� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www,town.ba rnsta ble.ma,us Office: 518-862-4038 Fax: 508-790-6230 ------------------------ HOMEOWNER LICENSE EXEMPTION lPlease Print DATE: 113110 JOB LOCATION: 7 n C f�y2C — GtJ F 6% 13�i2.��S/ /mac_ number street village "HOMEOWNER" name home phone N work phone N CURRENT MAILNG ADDRESS: �f7"U t�G'/f 6-T city/town state zip code The current exemption for"homeowners" was extended to include owner-occLIpied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) Who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm.structures. A person who constructs more than one home in a two-yearperiod shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The u dersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pr ed res.and requirements and at he/she will comply with said procedures and requirements. Signa re of HomeowQ,cr Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section.127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states That: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing orconstruction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of s Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and _ adopt such a form/certification for use in your community. Q:IWPFILESIFORMSIbuilding permit formslEXPRESS.doc R.—:,.,,a n-»t 10 of IKE Tp� • BARNSTADLE, MASS. Town of Barnstable pIFD Mp.l A Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 wivw.town.ba rnsta ble,m a.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign.Thi.s ction -.If Using A Build r as O ner of the subject property hereby authorize to act.on my behalf, in all matters relative to work authorized by thi/b ' gpermit application for: (Address off ) Signature. of Owner Date Print Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the 'reverse side Q.IWPFII_EMFORMSIbLIiIdinR oermii formslEXPRESS.doc NNW d ,,I PERMIT C'A�1�NT RECE -P1 TOWN OF-B5,r�'T,%BL.,, i BUILDING iD �,'AR. X r 200 MAIN,; ` EEf HYANNI S 02601 DATE: 05/03/06 TIME: 15:17 --- PERMIT $ PAID 25.00 A'111' FENDERED: 25.00 APPLIED: 25.00 C: '00 . ' _1CATION NUMBER: 2 6k"!200 PAYMENT METH: PAYMENT REF: �U�il t� Town of Barnstable Regulatory Services E 1 �0 Thomas F.Geller,Director �1 00 'J Building Division CQ V BAMSfABLE, v MASS Tom Perry,Building Commissioner �i0rE0 Mprl�,� 200 Main Street, Hyannis,MA 02601 vvv www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date:—McLq 5 1 q 00 S 1 Name: Phone#: SO 9 Address: r��l_l V� V Village: Name of Business: � Type of Business: �� (�` r Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the',Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity;is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance;heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. j. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation)and not within the required front yard. • There is no"exterior storage or display of materials or equipment. r • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit 1,the undersigned,have read and agree with above restrictions for my home occupation I am registering. �j Applicant• Date: Homeoc.doc Rev.5/30/03 TO ALL NEW BUSINESS OWNERS DATE: Fill in please: 4 rh APPLICANT'S YOUR NAME: rC� BUSINESS r a YOUR HOME ADDRESS: � TELEPHONE ot Telephone Number Home , �I v' .: �i: •.I rU.S .S..,.I ! ...v. .. _.....A r. :,.,_Y... .. v.._r. r_:,f', .v r,.,. .!._.r. !, .. 1 .1.. E -T iO.NAME.._...!.N.. ...,..,__,.,......_(..._.��.,.. 1 , _•.;: XP A.. .-o. _I.v,ru.._..r.,.._..r,.t_.......l.I,r._ ,:;..::4.ra7 u.l ,I>t :. - _� 5_ x .. ,: .. .._ J "4u'I .r. ..._r.,'...4,,..._ .. r:::� ..i. .. ,'S r.r....r. t• ADD:RESS.::OF_.I�rUS1N SS,., ,!.,,r r..,r , ,..U_, �.t... ,;::-,,r�! :.. ,r.;(� ,,,',.:,1: ! ,.:,'-::.;,,.,.VIA r.,t/� .��:y( "'B{1,... M■�/''( _ ,r.. _...�//( ///.��� ! ....:__+4-S.:.L,.r � �-'d• x' I !.. � L..}..:: Y�II�iU:,.11,.11K.�.t: - i;�, :�... ....C.n��.... I•r.. When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you.may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St.— (corner.of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER' OFFICE This individual has been informed o any permit requirements that pertain to this type of business. Aut ed Signature** COMMENTS: 2. BOARD OF 4ALTH This individual has b en info med f the permit req cements that pertain to this type of business. thorized ignature" COMMENTS: ��v�eD2_S �Ez � vzo 61a-z Ajaky'c� 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual een i. medf I' ensy�g requirements that pertain to this type of business. MUt4At1-1Authoriz d Signature"* �, ,w / COMMENTS: t ✓�lC — / ,CO-A. /"//(&4A-q -eA I t nc T707'L Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. *"SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. 0 /6 'r The Town of Barnstable orc Permit# Massachusetts • Date / - aS- 9� BAWMABLL KAM SOLID FUEL STOVE PERMIT Fee This constitutes an official stove permit after inspection and approval by the building inspector. Owner �S Q10 R o -----Telephone no. . �i _ �—/ C p . 3 � Z 113 — / r � Address of Property 2 c7 C U k C 1+ St • Village �,t) • (D�'� Location and Stove Type 0-0or L— -- L)&ob 1r,0AL Date: Building Inspector The solid-fuel burning stove at the above location passed: failed: inspection. r� ` -�`�`� �' � 3a - 0 /6 The Town of Barnstable t Permit# D 47-, Massachusetts • Date • SAPIMABIZease M • SOLID FUEL STOVE PERMIT 1e39- .� Feed, a D Mfg� This constitutes an official stove permit after inspection and approval by the building inspector. Owner 'S O0 R o Telephone no. 7i _ / C Z p 3 � � Address of Property 2c7 C t'UaC 1+ ;t • Village LJ • 8holel'J Location and Stove Type Uftb 1roAL i Date: Building Inspector. The solid fuel burning stove at the above location passed: failed: inspection. I TOWN OF BARNSTABLE Permit No. , 35034 • ` BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ■M• ib'v. HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to James P. Conroy (Family Apartment) Appeals #1992-07 Address 29 Church Street West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. November 27.'..., 19....92......... ..... .. . . ................ Buis'ing inspector r.'- .--�..rt "�.w ,•W. 41.i ..��"i0". r+c,•:.r� ,.+. •,�.• ,t�.�.-.n:w.�w.,.i+.:.Fi,.__._.. :�'•• ,•E � . u.,.=�� :��.iJ�.,;�_w -�,.'}��itiA�?OF%3� � TOWN OF BARNSTABLE 35034 BUILDING DEPARTMENT Permit No. ......:......... I IL"'T I TOWN OFFICE BUILDING Cash HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to James P. Conroy (Family Apartment) Appeals #1992-07 Address 29 Church Street West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD 1 THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN ` REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. November 27, 92 .. .. . .. . ..... ..... . 19................. . ....... ......� .�. ................ Buil ng Inspector tw,;IsdE .: Assessor's office(1st Floor): �/ Assessor's map and lot rwmber / I OI TALLED IN (;OFAPLIf�,i -' '.,of THE roo. Conservation — WITH TITLE 5 •`' :, Board of Health(3rd floor): =NVIIHONMENTAL r' Sewage Permit number - 3 'TOWN ODE AND t+�as�T�nt. �EOVLATI®���' rut Engineering Department(3rd floor): a G �o .eso. House number �0 rsr Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE r BUILDING INS--PECTOR APPLICATION FOR PERMIT TO XJJ 0tzm;q tom-CAS IO1) TYPE OF CONSTRUCTION O /J/1 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Z -�UE2-C�/� S/ Gv ° ,�i�'/2 syil'�j /� *,V o;.d. Proposed Used Zoning District ,1�)F Fire District Name of Owner !✓ e�S' C� ® Address Z9 ��U H-r�`w L� ,�,4,0,4v; ,A I 7hA. �,t�l�� . Igo ��/G� �/y- � 7 - � .�. y6— Name of Builder Address /Le�QAS,42-&,0 lei!�14i2 �A Name of Architect z u e-c w e le /v $0 C , Address Number of Rooms Foundation �;Un•ej L'em eti/- / /tld' Exterior �f4nAI ba,,� Y /UetJ ��C S`j ��/P,1' Roofing �Sb h A�Sal i n.� Of Floors V a Interior A# IHeating 2�/r��G Plumbing Fireplace Approximate Cost S ? Od Area ��o _ Diagram of Lot and Building with Dimensions gY'� tn/�U,� Fee Z d�s74 '\ V 7 G 0\ sL a 9, g 5� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License 0/A© S / CONROY, JAMES P. t �0 35034 Permit For ADD DORMER/ALTERATIONS Single Family Dwelling Location 29 Church Street ` W. Barnstable Owner James P. Conroy Type of Construction Frame Plot Lot Permit Granted May 5, 19 9 2 Date of I�pection 19 Date Completed i 19 s •�� 7._p Lip -rZ ;--- ------ i 0 v , V� i CONROY 1. LUECHAUER ASSOC. ARCHITECT 508 548-Q D Z L t BEDROOM LIVING o P _. _ _ ♦ - RIDGE Ic ---------------------L�_--- C 1O O LINEN A CONROY UPPER LEVEL PLAN 1/41N/Fr 11/12/91 2 LUECHAUER ASSOC. ARCHITECT 508 548-1244 i FRONT ELEVATION CONROY ELEVATION V4IN/FT fl/s& 35`0.(4 LUECHAUER k90C. ARCHITECT 508 548=1244 Frm --------------- • aDa DDD DDD Effl DOE] DD❑ DDD . aD❑ aaD Daa . DDD ❑DD DDD DDD DDD DDD . RIGHT ELEVATION CONROY ELEVATION 1/4D/FT IV12191 3!a l41 d arww •"1 LUECHAUER ASSOC. ARCHITECT 508 548-1244 - I REAR ELEVATION CONROY ELEVATION V41N/FT 11/12/91 S[l(lyl 5 1prK LUECHAUER ASSOC. ARCHITECT 508 548-1244 - -------------------------------------------------------------------------- LEFT ELEVATION F OY 1V12/9 1 w<�' LUECHAUER ASSOC. - ARCHITECT 508 ._548-1244. Application to Old Kings Highway Regional Historic:District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this.application for: CHECK CATEGORIES THAT APPLY: 1r. Exterior Building Construction: ❑ New Building ❑ Addition [Q"Al.teration !'Indicate type of building: ❑ House jgGarage ❑ Commercial ❑ Other 2. Exterior Painting: [EY 3` Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other r (Please read other side for explanation and requirements), m TYPE OR PRINT LEGIBLY � DATE �'/ �'C/� i/god R ADDRESS OF PROPOSED WORK 2 2 .C//'%eC.�/SX l f 61�/!2Taf ASSESSORS MAP NO. /' 7 3 OWNER JA NANC-y CO4-),� ASSESSORS LOT NO.-� HOME ADDRESS __c(C1 CflL.R(:i4 :ST. w (P(J51-7-a :1 144 TEL. NO. -34 'y4 9 FULL.NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). _(,DES i ��?I �N Co�.x�;�� C�4rloAlAr ('�I:P�rI ,P7 /yq GCA& P>1Uit '!oze HIL C• �f r cc)IeP, �1 (a!C' t t� %r I Z �J A,? 0 ,;u t CL S r,�1�('_t di_ w 4 T e ; h �'�f�ucti i �C�'���1i O 7�� I{� Cu , �i(.r���+� S�, c517.N ✓Y!-o -AGENT OR CONTRACTOR TEL. NO. ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of'signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). C n rr J Sf EC (4ZC_ 1 0 C 0 ��r l�G S ( roR_T'A C0/,1/1J6-) 9 Signed _ Owner-Contracto - g rent Srkjce below line for Committee use. Received.by H.D.C. 1 Date ' The Certificate is hereby Priv cue Y Date ��Z_ Tir 1F. �> Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period - provided in the Act. Disapproved d '-iul Town of Barnstable Zoning Board of Appeals 32 Special Permit Decision and Notice Application: #1992-07 Applicant: James Conroy At a regularly- scheduled hearing of the Zoning Board of Appeals, held on January 23, 1992 notice of which was duly published in the Barnstable Patriot and forwarded to all interested parties pursuant to MGL, Chapter 40A, the applicant, James Conroy appealed to the Zoning Board of Appeals for a Special Permit to allow a family apartment within an existing garage pursuant to Barnstable Zoning Ordinance Section 3-1 . 1 3 (D) . The applicant's site is shown on Assessor's Map/Parcel +Number . 130/ 16 and more commonly addressed as 29 Church Street, W. Barnstable,. MA, and is zoned RF Residential District: The 'following Board members heard the petition: Luke Lally, Ron Jansson,' Gail Nightingale, Betty Nilsson and Chairman Dexter Bliss. Summary of Evidence: The applicant, James Conroy, presented his request to the Board for a Special Permit. Mr. Conroy explained that his mother, who :is retired, will occupy the family apartment. Mr. Conroy stated that the proposed family apartment will occupy approximately 875 sq.r•t. area of the overall existing 1 ,288 sq.ft. of garage. The Board asked the applicant if he read and understood the conditions of the Zoning regulations regarding family apartments . The Board informed the applicant that if at any time a family member is not living in .the apartment then the use as an apartment will be abandoned. Also, the Building Inspector would have to be notified once a year as to who is living in the unit. Mr. Conroy replied yes. The Board discussed the denial of the applicant's request by the Old K.ing's Highway Historic Committee (OKHC) for the alteration of the garage on January 8, 1992. The Board asked the applicant if he will reapply to the OKHC. Mr Conroy stated that the OKHC Committee has concerns with the pitch of the back roof and the size of the proposed windows for the apartment. He will reapply to the OKHC with some modi,f-ication .to the structure, after receiving an approval from the Zoning Board of Appeals . i t, The Board also asked if the modification will change the area of the family apartment. Mr. Conroy replied no, and explained that the modification will be to the exterior of building. The Board informed the applicant if any modification to the design that produces any change to the square footage of the proposed family apartment, it will require another hearing before the Board. Mr Conroy stated that he understood the Board's concerns. Mr. Dan Luechauer, Architect for the applicant, explained the proposed changes to the structure. He- further explained that the concerns of the OKHC could be accommodated without anticipating any difficulties. Mrs Conroy and MR Conroy's mother spoke in favor of the petition. No 'one spoke in oppositi.on of the petition. Finding of Facts : At the meeting. of January 23 , 1992, the Zoning Board of Appeal made the following finding of facts as related to APPeal # 1992-07: • I . The petitioner complied with all the -provisions of Section 3= 1 . 1 (3) (D) of the Zoning Ordinance as far as they relate to family apartments. 2. Granting of re lief sought by the petitioner is not detrimental to the neighborhood effected, or derogation of spirit and intent of the Zoning Ordinance. The vote was as follow. : AYES: LALLY, JANSSON, NIGHTINGALE, NILSSON BLISS. Decision: Based on the finding of facts, at a meeting held on January 23 , 1992 , by a motion duly made and seconded, the Board voted to grant the Special with the following restrictions : 1 ) Total floor area of the family not to exceed 875 square feet as proposed per plan submitted by the applicant. 2) The applicant receive an approval from the OKHC of I the proposed alteration to the garage to occu family apartment. OCCUPY the AYES: LALLY, JANSSON, NIGHTINGALE, NILSSON BLISS. THE PETITION IS GRANTED WITH RESTRICTIONS. Ary person aso:_e,.red by this decis_oa may appeal to t.`:e Ba--staple Super--:or Court, as desc__bed in Sect-:on 17 C .acer 40n . he ca=erM-1 La.:s of the Co=arn:azi th of by br__.:—g..an act--;Or. wichin t ;ancy days afcar the decision has- been f=?ed in the office of the To,--a Cle-zk. • './�• •• Chai.—. nn Clerk of the Town of Bar-astable, Barmscable Councy, Massachusacts, hereby. ce'rc_;y .that t'ae_^_ry (20) days have elapsed sir-ce the Board of Appeals rendered its decision in the above entitled pecition. and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this a day of fa r• � 19 (-t under t`_e pains and,penalties of per�ur- . Disc==buc'_on: P:oper=y Owner Town Cle_:ti • { Towa Clerk Aool_cnnc y Persons Incareszad Bu'_ld=g Ins-o ec 2a r ` Public Infor-_.:,c_on Boar- of Appeals LE COVERAGE ROOFING DOUR •%,,' jaC10 RAFT�SS ASPHALT/F r (3) 2X8 HEADER SHINGLES (3) t75)61 MICROLAM BEAM... 2X6 STUDS 16IN. OC GLUF,-.-F7-NAIL , V 1 • ' 12 _ ' 8 NEW *W JOISTS16 OC EXTSTon JOISTS EXISTING BEAM TAIL OF EXISTING 10/12 ROOF BLOCK AS NECESSARY TO PROVIDE SOLID SUPPORT UNDER NEW DORMER WALL 'EXISTING CONC WALLS AND SLAB SECTION CONROY SECTION 1/4IN/FT 11/23/91 LUECHAUER ASSOC. ARCHITECT 508 548-1244 7._O- 7._0- FIELDSTONE ATE FTC 10IN THICK CONC FOUND WALLS... I , X1 CONTINUOUS � 20IN WIDE X 10 IN DEEP COW FTC- �' 2X4 KEY TO 2X1 JO TS 6IN N 2X70 JOI TS 1 IN N WALL...TOP o t EL (3IN).- + BOTTOM• MIDI i 4FT BELOW FIN GRADE 1/2IN ANCHOR NE•W CON P 2FT X 1F BOLTS 6FT OC -- ---= --- ---- •••- ---........... .... •• --- --- - TO P T 3 1/2I DI 4IN SLAB—TOP • --------- •----•---•- •--•------�J------••----•••-- ---= -- LA Y C LS V EL 0 (MATCH E)IST) "s �.1I X1L •Q: eta: e :� - o ~ FOUNDATION e PLAN Y 0 H W • FLOOR FRAMING PLAN . CONROY FOUNDATION. FLOOR FRAM 1/4IN/FT 11/23/911 LUECHAUER . ASSOC. ARCHITECT. 508 548-'�244 7--0' 1 2X10 RAF1 ERS 16IN 2)(10 RAF TERS 16IN OC MAT PI TCH EXISI DORMER ROOF i (2 2X12 BEA M LINE OF F ZGE ! l 14 IDG B M E .........................•................. ........ .......•........ ..... r• LINE OF RIDGE EXISTING ROOF EXISTING ROOF A=B� RAFT6IN' OC DOUBLE AT VALLEYS AND EDGES ROOF FRAMING PLAN CONROY ROOF FRAMING PLAN 1/4IN/FT 11/23/9- LUECHAUER• ASSOC::- ARCHITECTS " 508 548-1244-