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HomeMy WebLinkAbout0004 HOLLYHOCK DRIVE 4 o �� a �0. 15Z 1/3 BRA - - 16,® ® o e � � � (3 04 � ( ��� . �q�� 032 o��s���3 �r k c��f i��3 i��7 (: { �. ;. r. �. s �. �; i' �. ��, t f` �. o 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 town (which you must do by M.G.L.-it does not give you permissiori t6 operate.) You must first obtain the necessary signatures on this format 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,.lst FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. . i , DATE: Fill in please: APPUCANT'S YOUR NAME/S: "s VSQ h BUSINESS YOUR HOME ADDRESS: `�' o/ �, n�Ic d✓. b 6-7-13^�/Z TELEPHONE # Home Telephone Number _9 ce yvi-P ' NAME pF CORPORATION � � ;. NAME OF NEW BUSINESS r TYPE OF BUSINESS 2 S IS THIS;A HOME OCCUPATIONS t�YES NO MAP/PARCEL.NUMBER .1 A. 5. ?�CX�^Z . (Assessing] 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. I 1. BUILDING CO MISSIO ER'S OFFI This indivi us h e in" a y per it eq irements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION j RULES AND REGULATIONS. FAILURE TO Au ho ' e Signature* COMPLY MAY RESULT IN FINES. OMME I W C A-& �s an s C9--Q,L. -r S:-Y,'; L��� 2. BOARD OF HEALTH ^ This individual ha been infpiyned f the ermit;r irements that pertain to this type of business. �G Authorize ignature* COMMENTS: 3. CONSUMER AFFAIRS[ ICE G AUTHORITY) This individual he i11 M b rm the licensing requirements that perta�irl to'tlhis typ of bus' ess Authorized i nature* COMMENTS: ` Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division t jAEjQSIA` $jam. s v Tom Perry,Building Commissioner 6 61 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma us [ Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: '%'w yl 0 Phone#: SD 6. 3 V-7- I S—C4 Z Address: / / 1 y�I`] l/) o ck nl-. Village: w Q aly)�Iabl)f- t I Name of Business:— Type of Business: Map/Lot: UgTF1NT: It is the intent of this section to allow die 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 die Zoning ordinance,prm ided that the actiiity shall not be discernible from outside die dwelling: there shall be no increase in noise or odor;no visual alteration to die S premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; o and no mcrease in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the �^ follovang conditions: • The actitaty is tamed on by the permanent resident of a single family residential dwelling Limit,located within that dwelling unit. p • 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 0- no outside eAadence of such use. • No tragic Rill be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,`abration,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. {- • Any need for parking generated by such use shall be met on the same lot containing die Customary Home G. Occupation,and not within tie required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to tie Customary Home Occupation,other than a one , n or one s pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to IJ�_ exceed 4 tires,parked on die same lot container tie Customary Home Occupation. `! • No sign shall be displayed indicating the Customary Home Occupation. • If die Customary Home Occupation is listed or advertised as a business, the street address shall not be included. • No person shall be employed in tie Customary Home Occupation Fvho is not a permanent resident of tie i dwelling unit. I 1,the undersign have read and agree�sitl die above restrictions for my home occupation I am registering. �. 8 A 6 !3 Applicant: Date: Homeoc.doc Rec.01/3/0,8 I 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 town (which you must do by 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. £�•.II .?4;ri'7: ir—Ir ; lid• DATE: "� ( � Fill in please: APPLICANT'S YOUR NAME/S: � ���� I� agf f .r.ryy,pppp;; , µ+ BUSINESS YOUR H10ME ADDRESS: 'A r+O ul�D c.�_(�r, •z s l3<.�rt I O� 6� �71 3 YsI 9 jJ((�,`IN P 1 l�M45 �S4^fir . � . sod i 3�7 _!s s-¢Z ',. ;tJYpur4t� TELEPHONE # Home Telephone Number 3 U •3 7 / S c%2 NAME OF.CDRPORATION .. .:' .Il.. h. �..•.. 1.J"1 I.t'... :�. .�I. ::.,.t ."/�1 .. �; :.1 ..�. :D: .: 1 .I.::I..:t...ICI 1 ..? NAME OF NEW BUSINESS .:.. :f N!•.: 0 r:`' w' >T1F EIOF"BUSINESS' o' e e 1 4 II' I&THIS A HOME OCCUPATION2: YES }1 yIJ:NO {• 3 ,I..II n' J' L..'. a ADDRESS OF BUSINESS ../ N�: u �o�-e;.:t1!�/1 .' MAP%PARCEL NUMBER.( 15 Z 1 ('Assessingj 00 'When starting anew 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. - (c er of Yarmouth Rd. & Main Street) to make su` you have the appropriate permits and licenses required to legally operate your busine ^' this town. 1. 'BUILDING COMMISSIONER'S O ICE This individual has been infor f any permit requirements that pertain to this type of business. o C brized Signature � 1�l" COMMENTS: 2. BOARD OF HEALTH This individual ham beepVonl�,ed,;of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS �ICEN NG AUTHORITY) This individual has ben i f r of the licensing requirements that pertain to this type of business. Au hot;iz�f�'Si�rat�tre* COMMENTS: D �� 7�J( Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division t RARNIR AMX. • MMM g Tom Perry,Building Commissioner b ►`0 200 Main Street, Hyannis,MA 02601 i www.town.barnstable.ma.us Office: 508-862-4038 Fax 50 -790-6230 Approve • ' Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: �C�s(� � � Phone#: 0Z.-2,07 , (5-LJ 2 \\I r .� ( i, p�►10C. �� Village: w ` Garnsi , (e i lV�� Address: . Name of Business: Lo1 Type of Business: �� w�0\S Maplot: IlVTEN'I': It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation Fizdiin single family dwellings,subject to the provisions of Section 4-1.4 of die 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 vzth die 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 dwellingg unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to die dwelling which are not customary in residential buildings,and there is no outside evidence of such use. e 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,hurnidity 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. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not N�athin the.required front yard. • There is no exterior storage or display of materials or equipment. • There are 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 sigu 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 j dwelling unit. 1,the undersignZhavgree with the above restrictions for my home occupation I am registering. 2' Applicant: Date: ! 6 Homeoc.doc Re%•.01/3/08 r z S4 _ 0k7& �pFTHE 1p Town of Barnstable *Permit Expires 6 months .o issr to Regulatory Services Fee • awartsrnat.E, v "SS. Thomas F. Geiler, Director HERMIT Building Division JUN 2009 Tom Perry,CBO, Building Commissioner"TOWN OF OF BARNSTABLE 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint 11apiparcel Number P Fh-'��y'' 0,2 8 —00 ol- Property Address--g—. au, , Residential Value of Wor dU ❑ 430 t_0 "'�� Minimum fee of$25.00 for wor/k� under$6000.00 Owner's Name & Address poyF�"* Contractor's Name_ Telephone Number I Ionic Improvement Contractor License 4 (if applicable) Construction Supervisor's License# (if applicable) ❑Workman's Compensation Insurance Check one: ❑ 1 am a sole proprietor ® 1 am_the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [� Re-roof(stripping old shingles) All construction debris will be taken to-11)Lj 1 QU A ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: t=)RMS\bZ rmit forms\EXPRESS.doe Revised 100608 i � . d� Ss' C,u ZHE Town of Barnstable t/ T Old King's Highway Historic District Committee • RARNSTAeU. MAC 200 Main Street, Hyannis, Massachusetts 02601 'EU MF (508) 862-4787 Fax (508) 862-4784 CERTIFICATE OF EXEMPTION Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Exemption under Sec6orr6 and 7 of Chapter 470,Acts and Resolves of Massachusetts; 1973,as amendgd,for proposed work as described below and on plans,drawings,or photographs accompanying this application: Date lop OR Address of Proposed work, Assessor's Map and lot# House# 7 Street Wjocll al U Village: ;t,,.1�5;, j B = This application is for an exemption of the proposed construction on the grounds that work: ❑ Will not be visible from any way or public place Is within a category declared exempt by the Old Kings Highway Regional Historic District Commission ❑ Other Description of Proposed Work: '-- '� 5 PIA F D Uj 1'V'f AI kv HO 0,5 1� 70 n? A-`t C ll A7 0 +1 0 i N1, 6p A 1,� y:1xN Agent or contractor(please print)` �'`a Pr aN1, �g4 � Tel.no. Address f"�4V .:3a d' ,�i , 2) � e Owner(please print): / M # i .; A �'A1 r "` r� el no. Owners mailing address: ` e¢C l . fPc;s'' ., �.X � Signed, Owner/Contractor/Agent 6 �' C For Committee Use Only This Certificate is hereby Approved/Derzied Date: Ylfz ,7 C, Committee Members Signatures: EC � � � � FEB 1 22009 JOWN OF BARNSTABLEay STORIC PRESERVATION Any conditions of approval: � Q IGMD-Groups101d Kings High waylOKH New App10KHF.xemption+Form 07.doc 1 / • 3:. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations- ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information x fPlease Print Legibly Name(Business/Organization/Individual): U Address: City/State/Zip: Phone.#: cU7 Are you an employer? Check the appropriate bog: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction ..2:0 I am a sole proprietor or partner-' listed on the attached sheet 7. -❑Remodeling ship and have no employees These sub-contractors have g,'❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'-comp..insurance comp. insurance.$ KI quired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. am a homeowner doing all work ofcers have exercised their 11.❑Plumbing repairs or additions yself. [No workers' comp. right of exemption per MGL 12.p%oof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 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. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M 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 tip 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 certify nder the pains d pe es o perjury that the information provided above is true and correct PP Si tore: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation foi 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 join--enferpnse�-.cl m`g.-tfie legal-represen�ali ea�f- dec aced foyer,�oirthe--_- ` - --:-- 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-Conti-actors)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 then 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple pennittlicense 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 maybe 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 leaves 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 De,pariment of Industrial Accidents O itce of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-$77-MASSAFE Fax#617-727-7749 Revised 1 i-22-06 ' www.mass.gov/dia Town of Barnstable ' Regulatory Services Thomas F.Geiler,Director t�nxsrwt;t.e. . Building Division Tom Perry,Building Commissioner _:_.. ._.. _......200 Maiti.Street;--Hyannis;MA 02601 _........_..._.... .._.__ ..._.._.. .. .. --_...... . ,Kww.town.b arnstable_ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: QUA/l� Il JOB LOCATION: pave; ywo 1 number I Istr=t village "HOMEOWNER": Z name home phone# work phone# CURRENT MAILING ADDRESS: wat K&ft�d A. city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied 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 suUeryisor. 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-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/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"bomeowner"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 Bar-astable,Buildiug Department minunum inspection pr ced es and requirements and that he/she will comply with said procedures and r ' ements. aturs of Homeowner • 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 of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such warier,that such Homeowner shall act as supervisor." Many homeowners who use this exemption an unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisor awareness,Section 2.15) This lack of often results in serious problems,particularly m a" when the homeowner hires unlicensed persons. In this ease,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 awa7 of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the raponnbilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt sucb a form/certification.for use in your community. Q:forms:homcexempt zTo,4� Town of Barn-stable Regulatory Services y 'BELIE$, Thomas F. Geiler,Director �j°�EpµjGt16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) 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:F0RMS:0 WNERPEPM1SS10N TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f�iap� Parcel : �ZF TOW Permit# � 6 Health Division � 6)V91a L! gb —�7? of BARMSTAB�E Date Issued Conservation Division r 5 6 1114 HA Y 14 PM 2: 02 Application Fee y DU Tax Collector Ll cl Permit Fee Jurc i 11#-Y& -- �• 6 Treasurer CIV C-*n 1 Planning Dept. SEPTIC SYSTEM MUST BE Date Definitive Plan Approved by Planning �NSTALUD IN COMPLIANCE � Board MW TITHE 8 Historic-OKH Oe-'W51 1rIeesccbrvation/Hyannis EWRONMENTAL CODE ANO Imay Project Street Address y C)I io k Village (A_)40��* R Owner _;o)a mks T)66f 4u Address L( yC`� Telephone S-O F5S __�G Z —_,S 0 7 Permit Request ZZY Z 4 EAM I L`[ ►?6d/VI (A,�S G R��X/pOI�G� Square feet: 1st floor: existing proposed 55Z- 2nd floor: existing proposed Total new&f Z Zoning District Flood Plain Groundwater Overlay Project Valuatio Construction Type WNWP 4`--f-AM9_ Lot Size u 3 S S QEI: Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 1 7 Historic House: ❑Yes kNo On Old King's Highway: W'Yes ❑ No Basement Type: KFull ❑Crawl XWalkout ❑Other Basement Finished Area(sq.ft.) -4E�7- Basement Unfinished Area(sq.ft) Number of Baths: Full: existing L4 new Half: existing new Number of Bedrooms: existing new —� Total Room Count(not including baths): existing -7 new First Floor Room Count Heat Type and Fuel: ❑Gas W(Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing Z New_� Existing wood/coal stove: XYes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:9 existing ❑new size Shed:Cl existing ❑new size Other: &ZLt- Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑pYes O(No If yes,site plan review# Current Use Proposed Use Sal A9- x BUILDER INFORMATION Name `-y bj, S Telephone Number SUR 3Q 4 1 Address "C'? t'avt wcrw L—QVtQ- License# (3 4(4 $ 111 SYCK Mw-f 11A N Home Improvement Contractor# ®S/71 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE D �t FOR OFFICIAL USE ONLY P z t. a PERMIT.NO. DATE ISSUED MAP/PARCEL NO. _ ADDRESS- VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION p- FRAME INSULATION � � FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL' FINAL BUILDING 'DATE CLOSED OUT ASSOCIATION PLAN NO: v , yoFt►o`ra,� Town of Barnstable Regulatory Services 1 t Thomas F.Geller,Director Mass. 9q, 1639• Building Division 'OTFD►.M'I a . Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Fax: 508-790-6230 office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property I , J -I� - I- to act on my behalf, hereby authorize W a s CFI Y U in all matters relative to work authorized by this building permit application for. (Address of J(ob) Date Si na e o r Print Name Q:FORMS:OWNERPERMJSSION Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 105179 W Type: DBA Expiration: 7/16/2004 WALLS CONSTRUCTION & REMODELING Troy Walls 1 ` d 87 CRANBERRY LANE SOUTH YARMOUTH, MA 02664 cum Update Address and return card.Mark reason for change. Address ❑ Renewal Employment Lost Card Board of Building Regulations and Standards License or registration valid for individui use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to. RegistratiiZzi on 105179 Board of Building Regulations and Standards Expiration: 7/16/2004 One Ashburton Place Rm 1301 Boston 02 WALLS CONSTRUCTION&RE/MODELING Troy Walls t� Y� j p1 87CRANBERRY LANE SOUTH YARMOUTH,MA 02664 Administrator Not valid without signature .-�i/ie 77anaonarw,ea�c o�./ticrasac/x«eQ2 BOARD OF BUILDING REGULATIONS I License: CONSTRUCTION SUPERVISOR Number•,CS\ 044847 F Birthdate:•07/05/1962 { Expires:07/05/2005 Tr.no: 2452 Restricted: 00 l 'I TROY A WALLS i i 87 CRANBERRY LN S YARMOUTH, MA 02664 Y Administrator i 14110 lilt ur(A- -TN 141.6 2 "" Y ��httq�•FPa'db'! �'xble.t�.ik(cctttiaua�j ��g�zfl�ue1x • e 1'xrkx8a{ar Cp°sad 7rra<�'xex�#'I1.ald�tttixt Hultd����� PrztarlPm , . �IlritTM . F=usc? � q 1;•t�� gy�l�c R,��r . R Y� � 6 Namvsl • 1r�a 3701 to b5gq I;a�n 15�p� 10 Kncrccsc[ • 0.40 38 13 19 Ig IO b IS AFiI>i R t7.r� 03x 3a tg to b Namtxl 1xh t2`r q•5q 31 13 21 wA b Nast 4 t5'/. Q38 3t 19 r 19 to IS AFUE IA T r 0.44 3 a 25 NIA 6 I3 • 11 AM 13 lc U 15VA 0.44 38 19 19 I0 'NIA NaQ4 0,52 3s 13 23 NIA 141A Namml 18'h 0.3% 19 25 NIA b QO AFLM X IIIK 0.42 38 13 19 g0.hm Y 18'r� a.42 31 i9 tg to 0,30 3a 1 A�pRE58 OF PROPERTY: I��VI r // Tg�OR WALL � 2• SQYJARS FOOTA M OF ALL 1m 2 S g, S4UA�$OOTAd$OF ALL QLAZVGc; . �, ora �}LAZ�Q AREA(#31]NmED By 5 �•�RQY�Qj��vIENTS Mg,TRODS OF O$Ar'hc ARE AVAYLABLI;, A5�t US FOR'�5'� , pG Ir(SF�C LOR ApYROV�L: YES' f�80303� ' ___ __ The Commonwealth of Massachusetts Ent - .Department of Industrial'Accidents 600'Washington Street Boston, Mass. 02111 Workers'..Com ens ation.•Insurance Affidavit-General Businesses address / C ,k N work site location full address I am•a sole proprietor and have no ono Bli ess Type: (J Retail❑Restaurant/Bar/Eating Establishment working in any capacity. [] Office❑ Sales (including Real Estate,Antos etc.) ❑I am an em to cr with . en"I ees full& art time'. ❑Other %/�/////%%%%%//,r� % an 0 providing vL,orkers' compensation for my employees worldng on this job.. ..� ,,:1�--• 6� ` �� phone#.: Sri siiralice.ca:`::'..:':::.., '-, MMMINN Tam a sole proprietor and-have hired the independent contractors listed below who havo,the following workers' .compensation polices: coin an m a .:,' i:2,: . �ii'i lt, ,i f�,��.;:3 •1•.: . , •rN' '''' ::r,.'•. . r Y!' ,.j.a •:7.Ji... �^�::Q:Y. �.i .1rl' .. •i•' — •.1.,•Y �'�. h siirance'co.'. L.<•�:->�i`.?: K con eii. naBie: 1• il-.::.. address:. s. +' '• . � 'j Vic;. . . WAN, ' ti 1�• �•}%.i, r'r— �'1;.: .C.-. '.7,y...•,5a.4. ��'v �::•?i.• '.1'.:•,':..' ' •:i..` 1I15UI'8I1CP.°4;0'• `•t� •s...' Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to s1T500.0e and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK O"ER and a fine of$100.00 a day against ma I understand that R copy of this statement ma be rded to the Office of Investigations of the DIA for coverage verification. I do hereb certi u r th ins enalties of perjury that the information provided above is true an/ arre Date • Signs / /'/ • • '.• Ul l• Phone# Print official use only do not write in this area to be completed by city or Town official : permit/1lceuse# ❑Building Department city or town:- own: [3Licensing Board ❑Selectmen's Office 0 check if immediate response is required ❑Health Department contact person: phone#; ❑Other (revised Sept 20(3) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compevsatidh for•their. employees: As quoted from the 4`law", 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.employspersons to do,maiutenance, construction or repair work on such dwelling house or on the grounds or urtenant thereto shall not because of such,employment.be deemed to bean employer. budding.app ,. •. . . .. .. " MGL chapter 152 section 25 also•staies 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 regw,red Additionally,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 t: a insurance requirements of this chapter have been presented to the contracting . authority. Applicants please fill the workers'�compensation affidavit completely,by checking the box that applies to your situation..Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits 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.workeW compensation policy,please call the Depar n'=t at the number listed below. , City or Towns . Please be sure that the affidavit is complete andprinted 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. The.affidavits•may.be returned to the Department by mail or FAX unless other•arrangements have been made. I The Office of Investigations would like to thank you in advance for you 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 an"ofImstlgatlens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext:406 E r Town of Barnstable o� Regulatory Services g a sue`$ Thomas F:Gaiter,Director 00. Buiiding Division Tom Perry,Building Commissioner • 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date . AFFIDAVIT HOME IlYlPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PFPjy=APPLICATION MOL c.142A requires that the"reconstruction,alterations,renovation,repair,modernize io,conversion, 00u ier ion, emolition,or•improvement,removal, as one but not more than four dwelling units or oction of an addition to my rstmrt�which are adjacent to building containing at .. registered contractors,with certain exceptions,along with o er such residence or building be done by requirements. 1 GdV Estimated Cost Type of Work _ A ddress of Work: 4 ��� "` � ��' � • Owner's Name• ` / .e Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Jcb Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: TERED OWNERS PULLING THEIR OWNRNH IlYIPROYEMENT WR DEALING WITHUORKFDO�N CONTRACTORS FOR APPLICAB OR GUARANTY FUND UNDER MGL c.142 ACCESS TO THE NITRATION PROGRAM A. SIGNED UNDBRPENALTIES OF PERJURY Thereby a p1 for aperit as the agept of the owl/eor: m A< �P-0- w ontractor Name Registration No. Date OR r Owner's Name f _ v I CERTS.Fi ED 'PLOT PLAT LOCATION WES7 j?BG SCALE . .� ' °' DATE PLAN .REFERENCE-B7.vG LaT'''f1' iN J 1 CERTIFY. TH,E : SHOWN ON TH1S--PLAN tS LOCATED'ON,THE"GROUMp:: AS 5HOWN�FiEREON AND;THAT::ll CON0ORM.S:1O ,A SETBACK EQUI;REMEN?S OF :THE TOWfl:`OF :R _ 'CONSTRt1C.T.E �, DATE . ... y . D - .. � 6a E/ A 04/13/04 TOWN OF B TOTALS OR PERM t SELECTION CRITERIA: permit.permit_type matches 'Bt' and permit.dat SUMMARIES FOR TYPE: 756 CERTIFICATE OF OCCUPANCY VILLAGE TYPE TOTAL # VALUATION BARNSTAB 756 1 .00 COTUIT 756 2 .00 HYANNIS 756 11 .00, MARSTONS 756• 2 .00 OSTERVIL 756 1 .00 GRAND TOTALS: 17 00 REPORT TOTALS: 722 13,679,521.40 i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Buil$ing Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE / square feet x$96/sq.foot= �o Y' 0.�, x.0031= Q plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) 'GARAGES(attached&detached) square feet x$32/sq.ft.= S x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch �_x$30.00= J ' O (number) 7 Deck ( x$30.00 (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Application to ®1b Ringo jbtgbwap Regonar 3bfturic Alisstrut Co ' In the Town of Barnstable L CERTIFICATE OF APPROPRIATENESS row H/SrORrO ARNSTA Application is hereby made,with four complete sets,for the issuance of a Certificate of Appropria a a. 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and o , drawings, or photographs accompanying this application for. CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: New Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial 10 Other � '� 2. Exterior Painting: 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE -� - 0S ADDRESS OF PROPOSED WORK y 140iltiho C.k D_r J)• 80rn,Sf ASSESSOR'S MAP NO. OWNER JOLYi"1(?S t 1 • OAerhi - ASSESSOR'S LOT NO. 15-6� HOME ADDRESS �( 1Q2WCk C. - AlTELEPHONE NO. 54 '� �2 - SO7 '7 Ca FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners acrtss ar public street orway. (Attach additional sheet if necessary.) --j N l AGENT OR CONTRACTOR TELEPHONE NO. ADDRESS -- - - - - e DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used: Please include locations of proposed signs. -� G c") r- Signed -r, Owner-Con act g t i For Committee Use Only nO Me This Certificate is hereby ®_ (Gate ppro e D nied Committee Members' Signatures: tINN c .d ' Town of Barnstable — ' i= Highway Old Kin 's Hi hwa Historic District Committee . � SPEC SHEET ono pO�A.f'ze� N STQ N OF RAC p SgRNSTAB FOUNDATIONUVI. %L. � RESERVgTI /V SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL eo�l 0f COLOR i211 PITCH WINDOWS V`ldym dy' COLOR y'"' SIZE &iU" 0"3 TRIM COLOR DOORS SQUA% e. COLORS SHUTTERS � / � COLORS. GUTTERS /' COLORS DECKS � OY U�- MATERIALS kkWk GARAGE DOORS Q COLORS Ijt ' SKYLIGHTS i SIZE COLORS SIGNS _1 COLORS FENCE COLOR � NOTES! Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Pour copies of the Plot Plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 : y _z a� } ca , v' - 3 `.t r.. '3 9. .... ...:..::. .. so V /L 'P T:` :. P .,.. :,.. . . : .' CERTIFIED� ��. LbCATION WsT Bsrzr. .T�e SCALE . .... DAT.E l`..7.: ".. r.ta`_3 I PLAN .REFERENCE / BiVG LaT°'f1 - S.4b xi o fl . ..... .. ... 4� 5.7 `L AT TH. si? .G:i WZGf GERTIFYTH E. :'.,.:.-., ... .�.::., :.. ...' .:'. M S�PgL HOWN ON THIS PLAN kS:LOCATED ON.7HE GROUNR";:. :. AS SHOWN 11ERMN AND TiiAT tT CONFOR'MS +D� .Tii � �`��\GQRE• SETBACK REQUIREMENTS OF THE TOWN OF d TRUCTED : �'T WHEN-N ''CONS - - DATE . . . . ,r. R JES �� N�'Rry REGIST RED LAbtL�;SC3RVE' " ll�ll 1 Atm Uw CO. INC. 4650 Route 28 Cotuit, MA 02635 (508) 428-6032 FAX(508) 420-0583 JUNE 14, 2004 JANES DOHERTY ` r 4 HOLLYHOCK DRIVE WEST BARNSTABLE, MA 02668 DEAR SIR/MADAM, IT HAS COME TO MY ATTENTION YOU HAVE RECENTLY TAKEN OUT A BUILDING PERMIT IN THE TOWN OF BARNSTABLE. AMES ELECTRIC CO., INC.HAS BEEN DOING ELECTRICAL WORK IN THE MID-CAPE AREA FOR OVER 50 YEARS. WE ENJOY A REPUTATION OF INTEGRITY AND DEPENDABILLITY. IF YOU REQUIRE ANY ELECTRICAL SERVICE, WE WOULD LIKE TO SERVE YOU IN THIS CAPACITY. WE GIVE FREE ESTIMATES AND WILL MEET WITH YOU AT YOUR CONVIENCE TO ANSWER ANY QUESTIONS YOU MAY HAVE. WE LOOK FORWARD TO HEARING FROM YOU SOON. SINCERELY, RODNEY W. AMES PRESIDENT AMES ELECTRIC CO., INC. 4660 RTE 28 COTUIT, MA 02636 (608)428-6032 Invoice Page 1 of 1 JAMES DOHERTY Invoice#: 10542 4 HOLLYHOCK DR Invoice Date: 2/16/2006 WEST BARNSTABLE,MA 02668 Due Date: 3/2/2006 Customer ID: DOH4066 Contact: JAMES DOHERTY Job: 4 HOLLYHOCK DR,W.BARNSTABLE Phone#: (508)362-3077 Job#: 185 Work Performed: INSTALL NEW 400 AMP SERVICE WITH 2-200AMP METER/PANELS(1 EXISTING AND 1 NEW) PAYMENT SCHEDULE:- $2,000.00 DEPOSIT, BALANCE UPON COMPLETION Item Description Qty Price Total T100 MATERIALS USED 1.00 2,535.00 E 2,535.00 Material Subtotal: 2,535.00 Sales Tax a@ 5.00%: 126.75 Material: 2,661.75 L132 Contract Labor 1.00 1,920.00 H 1,920.00 Labor: 1,920.00 M174 INSPECTION FEE WIRING 1.00 75.00 E 75.00 Misc Charges: 75.00 Total Due $4,656.75 Terms: DUE UPON RECEIPT Finance Charges after 30 days will be added. Any costs for outstanding balances sent to collection are the responsibility of the customer. ts C'i�- -q 3 oft Town of Barnstable Regulatory Services 9 MAM"BMg' Thomas F.Geiler,Director rFOppl► Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 t NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY li 717 Construction Supervisor License # , hereby certify that I have assumed responsibility for the project nder p o Q � construction, as authorized by building permit# U , issued to _? o C, (property Yaddress) TL- D � � on JVA 93 , 200 -O.K 1v n rn r The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration (if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) LICENSE HOLDER DATE q/forms/newcontrb rev:0R0102 Mi °PIKE roy� Town of Barnstable P Regulatory Services ra�si a Thomas F.Geiler,Director i639. ♦0 �. lFD MA'1 A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR owner of property located at l / � , hereby certify at d o 4E is no longer Construction� g cn N co Supervisor listed on the application for the project under construction as authorie_ by 8Z,6 building permit# �h issued on 2000`/ o co� r— I understand that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. PROPERTY OWNER/1 DATE q/forms/newcontr reference R-5 780 CMR rev:080102 Town of Barnstable Regulatory Services &&RN9rABLE. ; Thomas F.Geiler,Director MASS. 9. p,0� Building Division rEcr Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION --�+ Please Print J DATE: UyyE i�3 JOB LOCATION: Y �// number village street p "HOMEOWNER": j�lt"� a J'V J0,8-5 A P—.Z 77 . ,Jvm 8 3,6;—' 19J_l name ho a phone# work phone# CURRENT MAILING ADDRESS: / twtcz �f z l city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied 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. i DEFINITION OF HOMEOWNER ,�3 Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, I r is intei�ed to 3 be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm dtructureLA 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,tfa he/she all bye-' responsible for all such work performed under the building hermit. (Section 109.1.1) N p The undersigned"homeowner"assumes responsibility for compliance with the State Building Code nd other; applicable codes,bylaws,rules and regulations. ry 5' CD r The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building De artment;7' m minimum inspection procedures requirements and that he/she will comply with said procedures d req ' ents. Si lure of Homeowner 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 of construction 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 a 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:forms:homeexempt I • i BOOM78 PAGE 016 RECORD IN REGlS1RY OF DEEDS TOWN of BARNSTABLE IN COMPLIANCE WrrH SEC.11 CF CHAPTER��� ZONING BOARD OF APPEALS j SPECIAL PERMIT OCT -4 :�.:r 7 ! DECISION AND NOTICE APPLICATION: #1989-70 APPLICANT: JAMES H. DOHERTY, JR. i At a regularly scheduled hearing of the Barnstable Zoning Board lof.AppeaIs, held on September'21, 1989, notice of which was duly published in the Barnstable Patriot and notice of which. was forwarded to all interested parties pursuant to Chapter 40A of'the General Laws. of Massachusetts, the applicant, James H'. Doherty, Jr. , applied to the Board for a Special .Permit pursuant.to Section 3- 1. 1(3)(D), Family Apartments. The applicant's property is located at'4 Hollyhock Drive in West Barnstable, MA. It is shown on assessor's map 195 as lot 28-2 and is in the Residential F, one acre, zoning district. The applicant, James H Doherty,. is seeking a Special Permit to allow the construction of. a family apartment for his daughter and son-in-law. The family apartment will be ;r located- over the existing garage. The applicant is aware of the restrictions imposed on family apartments by Section 3- 1.1(3)(D) . F I ND i NGS OF FACT: IIIi I! Based upon the Informol!on presented, the Barnstable Zoning Board of Appeals made the following ffnd.Ings of fact: 1 the applicant meets the criteria of Section 5-3.3, I�' 7 Special Permit Provisions, of the zoning bylaw; and, 2 he complies with the. requirements of Section 3- (' . t. l(3)(D), Family Apartments; and, 3 the proposed apartment w111 not be detrimental to the public good or the neighborhood affected. The vote on the findings of fact was as follows: { AYES: BOY, BURLINGAME, BURMAN, JANSSON, LALLY ]' NAYS: NONE I I i i I I , I I I • Assessor's map and lot numbe` r ..!!.....9.. THE ' �°� TOE► Sewage Permit number ...........................1 7.9................: Z BA YSTSDLE, i House number ...................................................................... rasa 9 i639. ' � 'FO YpY a• TOWN OF BARNSTABLE. BUILDING INSPECTOR Construct a dwellimg and garage APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION ...................WOod..................................................... .............................................. ........1/18/86.....................19....86 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .-Lot G&�il--A3_—�1 j+i-set 1- ��s--��a�r- West Barnstable js ................................................:......................................................................... ,Proposed Use Home r RF Fire District ..West Barnstable ZoningDistrict ...................................................... ................................................................. Name_:of owner ., James Do)iurty Address .....9 Franbill road Hyannis Name. of Builder ,, Stanley E. St. . Peter. Address ...36g1 Main Street ,Barnstable .............................. .... Walter Schuley Cindy Lane . .Barns� le `4.• Name_ of Architect ..................................................................Address ................. Number of Rooms .8.,r .. ..........00ms 31/2 baths Foundation ,, 10" poured concrete ................................................................. ExteriorWh.ite. ...c.edar. . ...shingles. . .........................Roofing ...........Re.d,....cedar. . ...shingl. .es............................... .... .. .. .. .... .. ............. .... .. ..... .. .. .... ..... ....... ....... ..... Oak and plywood drywall Floors ......................................................................................Interior ............. ..::c _ ................ Oil fired hot water P.V.C . ' Heating ..................................................................................Plumbing ..........................:....................................................... 'I Side by side 150.000 Fireplace ..................................................................................Approximate Cost : ::......:::....................................................... Definitive Plan Approved by Planning Board -----------____---------------19________. Area ..................................:...:... Diagram of Lot and Building. with Dimensions see attached plotplan Fee and building plans SUBJECT TO APPROVAL.OF BOARD OF HEALTH r� ,l 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. - ti Name 4<4 Construction Supervisor's..License d r)Q 3`� 1 �: � DOB����, J�2��S A=195-028 0U � �'� l� S ' 29l,, Story No -----.. Permit 6r .................................... - ' ^ Siogle Fumily Dwellio8 -----------------------.--- ' Location —'Luc�#l�—''4''B«Ily..Bock..Drive. � West. Barnstable ` ` . ---------.----------------.. . ' � James Doherty ' ` Owner . ^ � ----------------- ----. | � Frame ` Type of Construction -------------- . . --------------------------. � ' Plot ............................ Lot ----------' ` , i Permit Granted .......#.pgKil..�4^----.lg 86 � Date of Inspection ....................................lV Dote Completed ......................................lV - | l ` ' . / ) - ' . / ' . ` . ' , ' ' \ ` G'c2QGQi s _���re�aG oZ,auy Jv�'�-w• � -�ad� ��runcd, ��ZJ� O26/l1 � ,e� JJ05--11006 March 3, 1987 I Joseph DaLuz Building Inspector Town of Barnstable Hyannis, MA 02601 RE: James H. Doherty and Mary Ellen Doherty 4 Hollyhock Lane West Barnstable, MA 02668 Dear Mr. DaLuz : Kindly forward to this office a copy of the plot plan filed with the Application for a Building Permit for the above-referenced property. The contractor was Stanley E. St. Peter. Very truly yours , Jai es J.' Hig i� s JJH: cf / cc: Mr. and Mrs . Doherty FROM • :r TOWN OF BARNSTABLE Mr. Stanley St.Peter BUILDING DEPARTMENT 3691 Main Street 367 MAIN STREET HYANNIS, MA 02601 Barnstable, MA Phone:775-1120 J SUBJECT: BUILDING PERMIT .#29197 4 Holly Hock Drive, West Barnstable F-0 HERE DATE November 18, 1987 MESSAGE J Please be advised that I have received the following complaints re the home constructed by you for James Doherty: Massachusetts Building Code #10004.4 rr rr Ir #2101.11 Copy to: James Doherty SIGNED . Alfred E. Martin, Building Inspector DATE REPLY SIGNED N87•RMI - RECIPIENT:RETAIN WHITE COPY.RETURN PINK COPY SENDER:SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. I PINK- DEPT. FILf COPY/WHITE- FIELD COPY/YELLOW-APPLICANT COPY ~ t _ Zo BUILDING TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT VALIDATION �'. I. DATE �\j.)ril 1<i ;c APPLICANT 5t.='rll•�y E. St. pf�%a_1 ---- 19:�U_— PERMIT NO. i'�•` I, - 9 _ C. ADDRESS Jh 1 t`f?'T Street., a L:.iCk:hl(' b(;0O3 LJ 7 7 (N0.) f PERMIT TO bUild UFIE:•L.L'1Ll; 1 7 (STREET)EE'f) (CONTR'S LICENSE) (TYPE OF IMPROVEMENT) ( Nod) STORY i�.LLI)��¢; �,';;_i�l]-� L))4Jt?"�"J.J tlh NUMBER OF (PROPOSED USE) DWELLING UNITS AT (LOCATION) Lot V 1 4 iiD1J_' Clc .;%r._yr, ',,;,.;• (N0.) (STREET) ScLi�'�(: ZONING DISTRICT ^ BETWEEN (CROSS STREET) AND STREET)SUBDIVISION (CROSS - LOT BLOCK LOT SIZE BUILDING IS TO BE FT WIDE BY ' FT. LONG BY FT. HEIGHT AND SHALL-CONFORM IN CONSTR UCTIOi TO TYPE USE GROUP • BASEMENT WALLS OR FOUNDATION REMARKS: .,tromp•.. If; �'—�-`, (TYPE) — AREA OR I: VOLUME 1954 sq. ft. . . (CUBIC/SQUARE FEET) ESTIMATED COST �(11`�I1/(),(:l.l PERMIT FEE $- 111 OWNER. T'I PS T " , I 'u . ADDRESS 'T' '"T'•' l = BUILDING DEPT. _ BY %a% <" ,. _ ' ":L=_•.I'F(G7vl '1'n C'UC'r'n A`.'n,�r.'.�:. " V 'r1 C•-"n J ./ OF ANY APPLICABLE SU6DIV!S!ON RE S TRICTIONS.I���ANLt OF TFi15 PERMIT DOESIJOT RELEASE THE APPLICANT FROM THE CONDITIO MINIMUM OF THREE CALL INSP ECTIONS REQUIRED F APPROVED PLAN THIS ALL CONSTRUCTION WORK R CARD KEPT POSTED UNT L FINAL INSPECTION HASDBEEN WHERE APPLICABLE SEPARATE 1. FOUNDATIONS OR FOOTINGS. MADE• WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHAMITNPERMITSICALE NSTALLATI REQUIRED ON SFOR 2. PRIOR TO COVERING STRUCTURAL ELECTRICAL, PLUMBING AND MEMBERS(REApY TO STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. \ ' ��ST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROV S 1 _ 1��� ?h cr • 3 " z 2 - �IIo4/(� ✓, yscro�.�-G z { 3 � HEATING INSPECTING A PROVALS REFRIGERATION INSPECTION APPROVALS 1 1 NEE ING OTHER 2 BOARD OF HEALTH ,i • WORK SnP.LL NOT•?P.00EED U.V71L THE PERMIT W!STAGES OF :1q5 APPROVED THE VARIOUS LL BECOME NULL AND VOID IF CONSTRUCTION iN$PECTIONS INDICATED ON THIS C� SrgGES OF CONSTRUCTION, WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN PERMIT IS ISSUED AS NOTED ABOVE. OR w81ETTEN NOTIFICATION. ARRANGED FOQ.BY TELEPHC 1 it cam. LOCATION 4 , SCALE . �: ` �. . . DATE PLAN REFERENCE , .4 .7,!�< ', ,l-o, T -5446 WI, OA .� Ply ra . SQ 0 /. ,Da�/� .?Y. 'J??. . . . . . .7p. . ED;Af, ELLEY y o. 28100 o 9FC/STI ' c�s 14 A� Z N of / tA q 5 / Tz-'sT AO Z \� Z8� IL V. �/ y/�oC/•C �2/VE Jgiy�3 H. DoNER�-7)/�.?K - �E7i77v�vc� Dom` - .5;qtz1-- Z of Z Sf/EZ•T"S L. . 147.4.o ... . TOP OF FOUNDATION r � CONCRETE COVER CONCRETE COVERS 2;g3' 4 CAST IRON ' MAX. s OR SCHEDULE 40 4"SCHEDULE 40 PV.C.(ONLY) 12 MAX. ""r"'r•"�� • P.V.C. PIPE ' PITCH 1/4"PER. PIPE- MIN. LEACH PITCH 1/4�PER.FT. PIT PRECAST e e. NVERT a LEACHING •� EL..! v.7. INVERT , INVERT e . ; PIT OR SEPTIC TANK DIST.. , EL.i¢3;Sz, BOX EL i3.i8 >x ;:; EQUIV. ,•� INVERT /Sod EL../43,77 • . .••.•. GAL. INVERT �; G' F- �' EL!43:3► INVERT we p: 3/4��T0 I V2' EL......... U. . WASHED i,. W .;; STONE tz./jL, • ••• /o" DIA �,,co..,,ep PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY.: DATE Dom. !o,/!l TIME. A,o0 9 �`! .G/`� !p S•. BOARD OF HEALTH TEST HOLE I TEST HOLE 2 y . ENGINEER 07/ DESIGN DATA : ZZ./9$•So �L. /¢Z.S`o NUMBER OF BEDROOMS TOTAL ESTIMATED FLOW . . ,r. c? . . GALLONS/DAY BOTTOM LEACHING AREA �B�So . SO.FT. /PITIG.P.D. /BB..�o SA�vD SIDE LEACHING AREA . . . . . . . . . . . SQ.FT./ PIT�47/C,^D, �oNt1/ 8o^/ty GARBAGE DISPOSAL n/oN� (50% AREA INCREASE) TOTAL LEACHING AREA SQ.FT �� PERCOLATION RATE . . . .n'!� . . . . . . MIN/INCH K4 EZ./38 /44 &Z./3Z.S'o N.� .WATER ENCOUNTERED LEACHING AREA PER PERCOLATION RATE .0Y? SQ.FT�G,p,D Z />/� NUMBER OF LEACHING PITS . . . . . . . . . . .�/77V. APPROVED . .. . . . . . . . . . . BOARD OF HEALTH 77,Vo C4�of OAI A'LG. S/D6-Z DATE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AGENT OR INSPECTOR V, OF `r. �P�tH a Ass o E�j�yAN LOT lE' c oN otELLEY y z ��/vim No. 26100 o{ - o �"ss 9fCOST0,��yEv QfSTE.A�` SANRI1mw* PETITIONER..; boilE7?Ty.�,Q. e ,A;sessor'S map and lot hu' m er l.f.:7..:.�P�. ! D�ai�-K. -SEPTIC SYSTEM BUST 0*THE ro,� • - - f Swage Permit number � �......:.:-1. g...... INSTALLED IN Cp �� �P o MPLIANCE WIT H TITLE S i BaS9T aBaL E0m, House number ........................ .............. .......... OENVIRNMENTAL C®DE AND 1b9• ..( REGULATIONS �i o Awl TOWN OF - BARNSTABLE BUILDING: ,,. I-HSPECTOR APPLICATION FOR PERMIT TO „ Construct.;a dwellimg and garage s TYPE OF CONSTRUCTION Wood .....................:.............................................................................................................. ........1/18/86.....................19....86 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according o the following information: ' tlo LL LioG,� �� Location Lot..l........0��—S:-z�o na�r... �........ ...�n - eW ......West...Barnstable.................... Proposed Use Home Zoning District RF ...........................................Fire District ...;N,est Barnstable Name of owner .,,James Doherty Address'......9., Franbill road Hyannis .................................................................... Stanley E. St. Peter 3691 Main Street Barnstable Nameof Builder ....................................................................Address .................................................................................... Name of Architect Walter Schuley Cindy Lane Barnstable ................................................Address .........................................................:.......................... Number of Rooms 8 rooms 31/2 baths Foundation .,., 10" poured concrete ........................................... Exterior White cedar shingles ....Roofing Red cedar shingles . .............................................. ............................. Floors ........Oak...a...n..d......plywood......................................Interior ... rwal .............................................................. Oil fired hot water P.V.C . Heating ......... ...................................................................Plumbing .................................................................................. Fireplace Side by side PP 150- 000 ............................... .......................................:...A Approximate Cost ................................. Definitive Plan Approved by Planning Board ------11L_3-----------19 Area 9 ....... Diagram of Lot and Building with Dimensions see attached plotplan Fee ... l.../...'.. ............ and building plans 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. Name ' .. .. . .....``.. .. .. . .... Construction Supervisor's License d.Q 3Y 1 f �w DOHERTY, JAMES 29197 Ij Story 4o ................. Permit for ..................................... Single Family Dwelling....................... .................................. ................... Location West Barnstable. ................................................................................ • Owner .....James. . ...D.oh�.r.q................................ Type of Construction ...Frame...am.le...............................I, , ................................................................................ Plot ............................ Lot ................................ Permit Granted ......A.....pril 14.............. ..............19 86 Date of Inspection© ..(e..a.ja..............19. Date Com let /,Z 77g Vp, d ......19 TOWN OF BARNSTABLE Permit No. ..2.9197 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ' t f639 '�touv HYANNIS,MASS.02601 Bond .....FF �'.. CERTIFICATE OF USE AND OCCUPANCY Issued to Janies Dohorty Address Lot ij 1, 4 Holly Hock Drive 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. J,unuary..5.' .... 19.... 87 ........ . ,r:.5 !' :�`.......... Building Inspector � �, 1 . . � � � _ � . � ,, . z . . , . ' r j o .. .. _ � � j. . Town of Barnstable CF[NE 1p� o• Building Department Services Brian Florence, CBO • anaxsTna[.e. v� MASS.9: �0r Building Commissioner 'OWN OF RARNSTAGLE AIFDnM+A 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us �, G ,��V4 14 tort 3 Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment7Affidavit I, being on oath, depose and state as follows: My name is ltT �� �7� I am the owner/resident of the property located at: ,1 r1 ��D Cx- u ya u�T 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:_ D A-l>G 1•j" 1+�s �l � 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 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 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 f perjury this day of—QW 2019. Signattra `�" Phone Number v Print Name INES �4 d q:forms/famaffid.do c rev 11/08/13 Town of Barnstable Building Department Brian Florence, CBO MAS& ' Building Commissioner SC SIN i639. lJ[ �fD MAC 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit--- I, being on oath, depose and state as follows:/ My name I am the owner/resident. f theC= o property located at: z 0 The following members of my family will be the sole occupants of the Family Ap ent aLthe aforementioned address: c ' w Name & relationship to owner: i-,r�`ta�' 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 p nalties o p rjury this__ day of._�1,111V 2018. C). A"', ��B ��� 9 q Signatur Phone Number Print Name e& e q:forms/famaffid.doc rev 11/22/2017 Town of Barnstable P Regulatory Services 0% - Richard V. Scali, Director o Building Division , BARNgrABM Paul Roma,Building Commissioner o 39. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us a Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and stateas follows:/ My name is S� �S r4 DO��fozl I am the owner/resident of the property located at: �A26ziill- &941 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: DA � ) c Name do relationship to owner: 5 V J a nd ,J FpqsT 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 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-4Z I 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 pains and penalties f pe ' this �� day of S� 2017. Gc� � ,9 --36 0 /�-3�1' Signature Phone Number Print Name /T_ q:forms/famaffid.doc rev 11/08/12 Town of Barnstable Regulatory Services of tW�. Richard V. Scali,Director Building Division BAMSTABM ' Thomas Perry, CBO,Building Commissioner ArEo039. a 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us. Office: 508-862-4038 - Fax: 508-700-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �S 4 00HEIMI I am the owner/resident of the property located-at: k,,o//j/�� 1�21 11)16: T �'���% /1{4. DaCv® The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: S S k) Dd6bWV 64:�2'r Name &relationship to owner: r16AtW 1==z5_T 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. 01 Z=� I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said FamiUy,A artmenf1 als- understand that I am required to comply with all conditions imposed by the�ZBA Special­permit� and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family�$partmentsNi agree to note the Building Commissioner immediately in the event of the sale of thislproperty} If there is no longer a Family Apartment at this location,please explain: rn The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and pe ties f perjury this 8 day of 2016. Si a Phone Number Print Name J l lYV 1 f4 DOM> X 1 / q:forms/famaffid.do c rev 11/08/12 Town of Barnstable oF ,al, Regulatory Services Richard V. Scali,Director®"� BARNSi'AB1E a aAsr"LE. = Building Division 7n,4 PM •0� Thomas Perry, > g CBO Building Commissioner lED M1p`l A 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us .. DIVISION Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is Jt4y 5 is I am the owner/resident of the property located at: zy 1740 111hDo<"' vvv u,t ; g;q-(WS�Q1z7 me. - The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner:,Jt(4k4 aeo_ Name & relationship to owner: /,zW_,�L- 7e 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 f perjury this 'N day of 3 2015. 0".". /-,/7 ,S og -3 G - t 93"9 Signa a Phone Number Print Name q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services �TME rqy, Richard V. Scali,Interim Director Building Division TOV'!f ORSTP,��.E M ' Thomas Perry, CBO, Building Commissi r e� ies� .•� 1 jAt -S Ali 9 59 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 DIVISICFax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �� �S /4 D WV I am the owner/resident of the property located at: D�YAOCI< I-E;7 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: .Susp)� Name &relationship to owner: v/lD,s� 0" /vv 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 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 penalti s of erjury this)�'W 6 day of O ly 2014. Signa JJ n� Phone Number Print Name J Y 2�� / u D�8 J �9` q:forms/famaffid.doc rev 11/08/11 Ile°� i } C ' f f y i ----------------- .___._..__.___.._____ ___ _______.•: .___•...r..._.:. �. _ _________ ___......._______ ______.--------------------------------------------------------------------_----__u� Town of Barnstable Regulatory Services rq Thomas F. Geiler, Director Building Division TOWN ar- BARNSTABLE $"R''�"B Thomas Per CBO Building Commissioner MASS. Perry, g . A i639. aim 200 Main Street, Hyannis, MA 02601013 JAN 17 RM 1: TFD MA'S www.town.barnstable.ma.us Office: 508-862`4038 _Faac�5.08=7=90-6230 DIVISION Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is 0 t�' "� � I am the owner/resident of the . �.J 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 vS�) r U S Name &relationship to owner: ✓L 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 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 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 t pains and penalties of pfrjjury this-J� day of l� 2013. Signature / Phone Number Print Name q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division �` Thomas Perry, CBO,Building Commissioner }b? tj ��f !2. 0,s9- � 200 Main Street, Hyannis, MA 02601 24 www.town.barnstable.ma.us Office: 508-862-4038 508-790 6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: l/ My name is J M� �-'po �� ( I am the owner/resident of the property located at: 4 11V� C The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: /� Name &relationship to owner: S 05h)j R . 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 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 -DROU 2012. 00"W' 2�� �f'6 7 l'n-'( C\ d - Signatur Phone6 �,Number Print Name �T ft*FS 14 P 6!/6 y q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services oFTME roy, Thomas F. Geiler, Director Building Division � �� Thomas Perry, CBO, Building Commissioner Ar i639. 0 200 Main Street, Hyannis, MA 02601 ED MA'S www.towh.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: 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: 09� f Name & relationship to owner: v Name & relationship to owner: Q ,v4 PA.oc(f 'Ow !'k-) 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. 1 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 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 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_JAW day of 9A, 2011. C) 3Zf—�L I —/fj q Signature j� / Phone Number Print Name ��1 1'V 1 PS f 4 D 0�/ Town of Barnstable Regulatory Services F1ME T Thomas° F.Geiler,Director TOWN OF BAR�!ST��BLE °s Building Division r RMMSTABLE. II Tom Perry, Buildin Commissioner +� 1 a++I. y MASS. g Building'Commissioner JAN. !0 Hi 8• J 0 1639• 200 Main Street,Hyannis,MA 02601 ArEo �s www.town.barnstable.ma.us DIVISION Office: 508-862-4038 Fax: 508-790-6230 .Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: tt My name is 3A MES 1 D ®T1761` Y 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: C / 7' Faegf D W6087R Name & relationship to owner: (T 1A E U47 S8L ,iAJ G 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 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 3A'VV day of i 2010. Signatu Phone Number Print Name- T-A � Q/bldg/forms/famafti d Rev:12/08 Town of Barnstable Regulatory Services �FIHE Tp� Thomas F.Geiler,Director Ott Uf BARNSTABLE Building Division t saxxsrnaie. Tom Perry, Building Commissioner mass �009 , N 13 Q . 35 i639 ,0�4 200 Main Street,Hyannis, MA.02601�,,rEOxA www.town.barnstable.ma.us . � 1J1VlS'1QN Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name'is � Z '- � �O 1 am the owner/resident of the property located at: L7C� (y Uy l t�rS B'avu_ Ik Rk �266� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: z—i2 ! RU,S )- 14A Name & relationship to owner: F/I crs 0 .Vi 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. 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. 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 immediaiely 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 2009. Signature Phone Number Print Name Q/bldg/forms/famaffi d Rev:12/08 Town of Barnstable Regulatory Services oFt►+e loy, Thomas F. Geiler,Director ti Building Division C04fi1 " 13l�ft3a1ASL BARNSPABM Tom Perry, Building Commissioner � ; Q� 619. ,0� 200 Main Street,Hyannis,MA 02601 2cQ9 JAN I 1 ATEp �A www.town.barnstable.ma.us ---- UIVISiO� Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is � I2rt I am the owner/resident of the property located at: ll 6 �Z The following members of my family will be the sole occupants of the Family Apartment at.the aforementioned address: Name & relationship .to owner: cS A-a J COAC�J () �- Name & relationship to owner: RAS .goo 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. 1 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 p alt' s of erjury this�day of �"� 2008. 8 �;� /9S9 Signatur Phone Number Print Name �V/ j 1� Do1�E;71?—Ty Q/b l dg/forms/famafTd Rev:1/03 Town of Barnstable OV11-1 Regulatory Services FINE Tn Thomas F.Geiler,Director Building Division r 1a,51�1a �1Eil_E i C , • saRxszAs Tom Perry, Building Commissioner MASS. 1°rEc 3r a`0� 200 Main Street,Hyannis,MA 02601 L��� J�`N 2 2 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: My name is Z2� d 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: (, , f S412�W-2) Name & relationship to owner: The Family Apartment iOill 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 f perjury this day of 2007. C-1. al6zl-27 Signature Phone Number Print Name )+ Q/bldg/forms/famaffid Rev:1/03 Town of Barnstable 0d Regulatory Services °Q'114E tOk, Thomas F.Geiler,Director ti Building Division 0 81\R ;'Z') BAMSTnai.E. Tom Perry, Building Commissioner 1639. ,0$ 200 Main Street,Hyannis, 60 $$ �For�+p L JHAN 23 P�1 www.town.barnstable.ma.us -�- �DIVlSi01d Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: -- - � 1 .. !fir _ . -- my-name is lm —�—r — yproperty located at: G�< Dlu L7 iF Map and Parcel Number A �S�SSQn s IVA 12 19S" A01- a 9 d 7- The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name,-&relationship to owner: c.0 S pAk, Q O m�d`l r5-77<,-.7— ?� ) 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. 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 and penalties of perjury this day of 2006. 369 ?o SignaV Phone Number Print Name MAM tS H- DO 1OK- Y Q/bldg/forms/famaffid Rev:1/03 0 /ef Town of Barnstable 16 Regulatory Services °FVE T°� Thomas F.Geiler,Director Building Division BARNSTABie = Tom Perry, Building Commissioner r "; v� . 10$ 200 Main Street,Hyannis,MA 02601 _ f ATFv��n 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 lstate as follows: My name is 741M � �► t'j I am the owner/resident of the property located at: Map and Parcel Number - 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: �jA'C_ 6 LIE;:/2 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 1 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 f perjury this day of 2005 2005. 0a_r_nJ21_ 3,�?- Sd q ' Signatures Phone Number Print Name .Q/b)dg/forms/famaffid Rev:1/03 Town of Barnstable Regulatory Services °Ft►+�tqy� Thomas F.Geiler,Director Building Division �. OG BMWSTABM Tom Perry, Building Commissionerre' 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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: 1k4h dC �� Map and Parcel Number � l��-;a The ZBA granted me a Special Permit/Variance on / lQ JQ Date Appeal No. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: 1 Name&relationship to owner: �S S J u�UGI 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 penalti of p *ury t day of 2004. Signatur Phone Number Print Name V Dolls Q/bldg/forms/famaffid Rev:l/03 Town of Barnstable /G Regulatory Services �oFI roi�.� Thomas F.Geiler,Director do TOWN OF BARPdSTABIE Building Division t EAANsMI ' Tom Perry, Building Commissioner 203 FEB t 1 P 12: 30 MASS.9�03 `0� 200 Main Street,Hyannis,MA 02601 �fD Mp'l a Office: 508-862-4038 DIYl5lOM Fax: 508-790-6230 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: ` c ��t t V W Map and Parcel Number ,��— �� O z. The ZBA granted me a Special Permit/Variance on d 7 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: ,�'U.�/a-�✓ �� 1t; 7 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 day of7 2003. Signature Phone Number Print Name _19wa 14 Q/bldg/forms/famaffid Town of Barnstable v/c Regulatory Services Thomas F.Geiler,Director TOWS; OF BAR STABLE Building Division BmwgrABLE, Tom Perry, Building Commissioner 2Q-93 FEB I I PM 12: 30 MAWv� . `0� 200 Main Street,Hyannis,MA 02601 iDrFn nw+ DIVISiON - Office: 508-862-4038 Fax: 508-790-6230 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: Map and Parcel Number ��%� O C2 The ZBA granted me a Special Permit/Variance on C2 O 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: / cra_-� ►��h� i Name &relationship to owner: ` OA 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. 1 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 72003. Of 75 6,2- 5k Signature Phone Number Print Name SAw63- 14 Q/b1dgf forms/famaffid Rev:1/03 Town of Barnstable Regulatory Services °F�►+e rqL Thomas F.Geiler,Director Building Division TOWN OF BARNSTABLE sARNST" a Peter F.D1Matteo, Building Commissioner &a� $ 200 Main Street,Hyannis,MA 02602002 MAR 7 AM 8. 4 2 6 �A�Ep MA'S a i Office: 508-862-4038 Fax:.508-790-6230 VISION Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is ���}d I am the owner/resident of the c E property located at: - 4—� Map and Parcel Number f 9 O`� P The ZBA granted me a Special Permit/Variance on l C 710 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: ()S P-LAJ Dc Name &relationship to owner: igl )L2 f'Z 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. 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(�7 �-- 2002. Signature Phone Number Print N Q/bldg/forms/famaffid Rev:010702 COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT I : — d)���5 , being on oath, depose and state as follows: 1. 'I reside`at L. 2.11 an the owner o the op "ty I d at shown o Barnstable Ass ssors' maps as MAP j5a PARCEL 3.) I Do Do not _. have a Family Apartment at this location. 4.) On G ,N � Z:YY , 199 ,.the Zoning Board of Appeals, on Appeal No. granted 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 rel'ate' d1o"mi e by blood or by'marriage. 6. The-following members bf my family will be the sole occupants of the Family Apartment at the above address: a) NAME j _ Relationship to owner: b) NAME Relationship to owner: 4Q 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'sulilYeasin 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 coin ly with Al conditions imposed by the Board of Appeals in Appeal No. e of 12.).I agree.to immediately notify the building Commissioner in the event of the sale of the above- listed'properry. d° Sworn to'under the pains and-penalties of perjury this,_( ay of_ �C) 199 ignature Print N�une COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT 1, �h� d - - I OiDID depose and state as follows J V MAR 1 8 1.) I reside at----- < --- /!` --------- -------1999 TOWN OF 2.) I am the owner of the property located B I N R DIV.ABLE at------------------------------- � ! -------_------- shown on Barnstable Assessors' snaps as MAP___ PARCEL _______________—_ 3.) 1 Do— __----Do not _____________have a Family Apartment at this location. 4.) On___ __________, 199---_, the Zoning Board of Appeals, on Appeal No. grantcd 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 Ap tment at the above address: a) NAME UJ .- ---—� _ __ f� Relationship to owner:---------------------- � —�l %7 , b) NAME_ ----------------------------------------- ____ - Relationship to owner:__________ -------------------------------------------- 7.) The Family Apartment will be the primary year round residence for die 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.) 1 understand that I ain 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 dic above- listed property. , Sworn to'under the pains grid penalties of perjury this _c a o ___________, 199______ Signature f _ ------------------- Print Name - -016� alft �/ " COMMONWEALTH OF MASSACHUSETTS BARNSTABLE Tp���x," +FFIDAVIT n on oath - ---- -,�`R g , depose and state as follows: 2 1928 1.) I reside at all 2.) I am the owner of the property loc ted at / fly 4G� f, ,>` 1 - o, shown on Barnstable Assessors' maps,as MAP : _ 15' PARCEL__ �'yoZ to o� S 3.) I Do Do not have a Family Apartment at this location. 4.) On , 199 ,.the Zoning Board of Appeals, on Appeal No. granted 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 S Relationship to owner: LOW,,), b) NAME e ations-'p t6 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 die building Commissioner in the event of die sale of the above- listed property. Sworn to under die pains and penalties of perjury this .2j-day ol��--, 1. 9_7 Signature Print Nai C-�r 1Q,4 _— — ,*WE r� The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street, Hyannis MA 02601 ArEp MA'S A Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissione January 6, 1998 The Doherty Residence 4 Hollyhock Drive West Barnstable, MA 02668 Re: Family Apartment located at the above address Dear Mr./Ms. Doherty, 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 QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 12/24/97 PARCEL ID 195 028 002 GEO ID 12161 LOT/BLOCK 1 DBA PROPERTY ADDRESS OWNER DOHERTY 4 HOLLYHOCK DRIVE JAMES H & DOHERTY MARYELLEN W BARNSTABLE 4 HOLLYHOCK DRIVE W 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 43560 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST (N) EXT / (P) REVIOUS / NO (T) ES / PERMITS / (V) IOLATIONS / (G) EOBASE / (E) XIT I 6. TOWN OF BARNSTABLE ZONING BOARD OF APPEALS SPECIAL PERMIT ( ""T - DECISION AND NOTICE APPLICATION: #1989-70 APPLICANT: JAMES H. DOHERTY, JR. At a regularly scheduled hearing of the Barnstable Zoning Board of Appeals, held on September 21 , 1989, notice of which was duly published in the Barnstable Patriot and notice of which was forwarded to all interested parties pursuant to Chapter 40A of the General Laws of Massachusetts , the applicant, -James H. Doh—er=ty;, Jr. , applied . the Board for a Special Per pursuant to Section 3 1 1 1 (3 ) (D) , Fam i 1=y-Apartments-:�°� The applicant's property is located at 4 Hollyhock Drive in West Barnstable, MA. It is shown on assessor' s map 195 as lot 28-2 and is in the Residential F, one acre, zoning district. The applicant, James H Doherty, is seeking a Special Permit to allow the construction of a family apartment 'for his '< daughter and son-in-law,. The family apartment will be located over the existing garage The applicant s aware o the restrictions imposed on family apartments by� Section 3f 1 . 1 (3) (D) . 1 FINDINGS OF FACT: Based upon the information presented, the Barnstable Zoning Board of Appeals made the following findings of fact : 1 the applicant meets the criteria of Section 5-3 .3 , 1 Special Permit Provisions , of the zoning bylaw; and, 2 he complies with the requirements of Section 3- 1 . 1 (3) (D) , Family Apartments ; and, 3 the proposed apartment will not be detrimental to the public good or the neighborhood affected. The vote on the findings of fact was as follows : AYES : BOY, BURLINGAME, BURMAN, JANSSON, LALLY NAYS : NONE DECISION: Based upon the information presented and the findings of fact, at a meeting held on September 21 , 1989 by a motion duly ymade and seconded, the Zoning Board of Appeal s �oted•.-to_—, <grant—a_Spec i-a Perm it, for a fam i 1 y apartment. The vote was-----.� as follows: AYES: BOY, BURL:INGAME , BURMAN, JANSSON, LALLY NAYS: NONE J Any person aggrieved by this decision may appeal to the Barnstable Superior Court, as described in Section 17 of Chapter 40A of the General Laws of the Commonwealth of Massachusetts by bringing:.an action within twenty days after the decision has been filed in the office of the Town Clerk. Chairman I, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decision in the . above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this day of 19 under the pains and penalties of perjury. Distribution: Property Owner Town Clerk Town Clerk Applicant Persons Interested Building Inspector Public Information Board of Appeals I"ARDFC-00:1 K'EY' 12 16 1 C' F 1.9`5 2'.---.' C) P E R M I -F I Flei AC'. 0 0 C1 I M -.—BY MID YR %I-MP NEW/'F-IEMI-- FJARM I I IN CCI Y R W __ClE_ ,:., C Cl I::*-_-,i C NEI-I 1 .1 is A IV,1 1013 C 1. C.N I.---w I I"WB 11 /2 S*T-I 7 is C r 1 1-' 1 C I C :,I 1 3 E I- 'I I D I" C I is "I C F. J 'J c I C I c I I c L I D E -,I C j C 3 1 L C 3 1" D I' J ..I J L .1 1 c I c 1 C j c I c I c C D 1.. 3 i I 1. L. D I., I E D :J I J r ..I .3 1: C D I' E L I IL R195 028. 002 11 0 T S INOT3 ACTIONER3 CARDE0003 KEY 121610 ACTION-CODES R=READ W=WRITES X=EXIT-NO-WR D=DELETE 00000000:1 NOTES C*MEAS 5/87. . . . . . 3 C*ANGLES SQUARED I EFOR VECTORING. . . 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J ? ,'� 4 v b ---+-- �D�D t1 E vu .s a. ,�+' �j ' ��2; - D I ra� iq st o -- - �, -- _ f \J , vv ? 1 �idw PL� /g �e.,.�s -�I'JT 4 � tCAP�lc i 4-j 1- _ ' } / I j - I V ------ ____ _--_rI h U p 2 P rtr 5 i d 4►o + Gb 23 --f .y t �G✓`'^''/ Y�IC - - �/',� DATE too O2G-1�- _ r� REVISE - - - �- _ DONALD I. MEYER r ��4 t � 1 Professional Building Designer � P.O. Box 532 DqA ING NUMBER w d So. Yarmouth,MA 02664 - pr (508) 394-5296 a i l LMIN - ; T p ' _ CJ x w i R.J 0 t IL ! Pt,sjdp Cr2.. - v C1 TO Ln d) -- - LN_IG - I : { r^L t M v 6 qJ&U, CS a . . DATE'- - - .` DONALD I. MEYER REVISED ✓ � --� Professional Building Designer P.O. Box 532 A f So. Yarmouth,lVlA 02664 DRAWING NUMBER14 (508) 394-5296 z iL T'�' o c. b10Lln x- �Oa oa ► ��� Gv1.y�t '� _ _ i 14\ f -4 . a �,►�.t�..Y��j 4LX2o�C-- ��wc� 'r ;!cr,14- 7.. r�`� �g �Ft2u•, bpi 3 1 - 0 ' of iv t LZI-T , 1 i I J o ` '1•; D `E` n Ot1� c r+�,.)C-- \gip-L L— y ' _ 23 ' F ° 4 IbG y . M QbN--P-u"3T,&Pot- J h ',l Cyi `�J a DATE DONALD I. MEYER REVISED Professional Building Designer P.O. Box 532 W N ER So. Yarmouth,MA 02664 a a (508) 394-5296