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HomeMy WebLinkAbout0189 LOTHROP'S LANE k NO. 152113 ORA MADE IN ESSELTE .4� ,k 74 - i M1, N� t. 3��Q� r .. � ... - - -_ _ ,. _. vofq n o ti6 e w co- _ F .. �• r FRIEDLINE&CARTER ADJUSTMENT';IN�¢ BARNSjABLE 436 Main Street, P. O. Box 338 14 Hyannis, Massachusetts 02601 2013 JUL '3 Tel. (508) 771-3232 FAX (508) 790-2344 DIVISION TO: (i uilding Commissioner or Inspector of Buildings ( ) Board of Health or Board of Selectmen ( ) Fire Department TOWN OF BARNSTABLE ' TOWN HALL' - HYANNIS, MA RE: Insured: PENNEY, Robert&Angela Property Address: 189 Lothrups Lane W. Barnstable, MA 02668 Policy Number: HOM00331245 Type of Loss: Mold Date of Loss: 6/7/2013 File#: 118329 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the captioned insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by First Class Mail. B. VALENTINI Adjuster 7/1/2013 i IMF I�' i I f 4 v 0 0 2 � r t ra r. s 1�1i!l�4tt!!litOtt t t*K �l��f t S 14 k t i�t ttiti i tlil�t h t lkjty�i l��ty !!t t tltllYi!li;l+ittfr 1i S4�As* !t i i i1i tti�f tll+�i*1, � 'f n4 a Q� � � o ZaAe (V6 / tl" T� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map , Parcel d Permit# c ova TUy�i� OF BAftt;�TASLFp Health Division q5 6 30 3 S �, ate Issued ' - 1-03 Conservation Division 2003 JUN 30 PH I: 2 Application Fee Tax Collector O �- — �/03 Permit Fee . 00 i rr __ Treasurer d � �� `—l9 0 7�5 EFVIf IONI`"I� SYSTEM MUST EE WALLED IN COMPLIANCE Planning Dept. V611TH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANL TOWN REGULVIONS Historic-OKH Preservation/Hyannis Project Street Address dG*AdA0_ Village Owner Address aq Telephone i J Permit Request I Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation i Ll i nooConstruction Type Lot Size _ 3,3 k,? L SQ fT, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family Cl Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No • Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes >(No If yes,site plan review# e Current Use Proposed Use UILDER INFORMATION �• /J Name elephone Number J G(f Y 7 7 Address a License# Home Improvement Contractor# � r2 Worker's Compensation# �/(tj�?—(5-?-)Xz --4-0 i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO A/d 4 RIP)-f SIGNATURE 2&Q DATE u FOR OFFICIAL USE ONLY 2i c7 0 PERMIT NO. DAT 34SSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER f ' J C n DATE OF INSPECTION: FOUNDATION i FRAME INSULATION S i FIREPLACE _S ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH, FINAL ,3 GAS: ROUGH' ? a FINAL ' FINAL BUILDING i o DATE CLOSED OUT ASSOCIATION PLAN NO. i oFViE, To" of Barnstable Regulatory Services � Thomas F.Geller,s�xxsrn�, i ,Director16 • Mess. 94'pjFn MAC�� BuRding DIVISIOU Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 • Fax:. 508-790-6230 Pennit-no. Date AFFIDAVIT . HOME JMTROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which.are adjacent to such residence or building be done by registered contractors,with certain exc ptions, along with other requirements. 3a Estimated Cost 3s Type.of Work: d' Address of Work: Owner's Name: Date of Application: a d I hereby certify that: Registration is not required for the following reason(s): FWork excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEN[ENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c, 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: O�Ato• tractorN a RegistrationNo. OR n-+e Owner's Name r The Commonwealth of Massachusetts Department of Industrial Accidents =_ - = Of!!ce oflosestl9at/oos _ 600 Washington Street Boston,Mass. 02111 Workers' Coin ensation Insurance Affidavit name: , location: hone A or ci I am a hom wner performing all work myself. 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(ippolgilygig LL :iF.•.�::•:............,.,.. �n•::•.•r.•:;•:i•.:•:?•:::::•:n.:........y{.:;t...r,,r;....,.F:n,.a+.;5:.rr]::}::.r..;...}.....:.......:................ .. a1 penalties of a tine up to s1S00.00 and/or p Failure to secure coverage as sdred wider Section ZSA of MGL 152 can lead to the iris osition of eriaiin , one yam,imprisonment as syeilIl as civil penalties in the form of a STOP WORK ORDER and a Sae of$100.00 a day against ma I understaad a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties f perjury that the information provided above is true and correct Date - signature - Print name official 1L4G only do not write in this area to be completed by city or town official permit/license# ❑Building Department city or town: ❑Licensing Board Oselectinews Office C]check if immediate response Is required ❑Health Department phone#; contact person; ❑Other -- O viaed 9/95 P!A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "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 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 section 25 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,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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate-of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and s. 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. City or Towns 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 permrt/hcense number which will be used as a reference number. The affidavits may be returiRio the Department by mail or FAX unless other arrangements have been made. 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 Office of lovestlgatloos 600'Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 °F"Er Town of Barnstable Regulatory Services 9MAM'sr I E Thomas F.Geiler,Director 039• .� Building Division �fD MAC s Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-'6230 Property Owner Must Complete and Sign This Section If Using A Builder I , as Owner of the subject property Nhereby authorize !" to act on my behalf, in all matters relative to work autho Oed by this' ding permit application for: W- (Address o Job) Sij&ture of Owner Date f,g,gz,lqr tiX Print Name Q:FORMS:OWNERPERMISSION \ r . 4 o, ✓die TDanvmsonu�ea� a�✓l�Cagaac/ued�,Qa _ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:_ 128202 ! Expirations:3/10/2005 Type Private Corporation HOLIDAY POOLS WALTER ZUROSKY 53 CAYUGA AVE MASHPEE,MA 02649 Administrator r102 7/17/09 AIH D%KIHM$O A 143 QI/DH1A1AlAG M 0191— I. al—,.I a I.I.c1.II.E.— Yl bt.11OIILI ••J&T ��TJ( to.l u3fo la ut wrnl. vi■V••3 ., ®� I y PLAH9 FOR Ll]CATIOIR• 2 Y �y B OTHER I'l w _ .= B_O� 11 8R•CEI � � 1 1 1�riGYYSfEEl N YIUrm • c s I RA.1EL y_SIe'A WOKE }. F oIAGDUAI en.0' 5-3I8•AM.KERSAml vO 1H5 7TPAHD 20 AdTNIO0ES5 L iKIH RhQG4GALY.&, YPKJJ. fWHE-fA&aUTE0 V—LMER ISFF SER.fY2 AH0 STYR ASgRB] •1 PU/IS FOR.Hr.TO15 STAIR UIC S-S/AA M.BOL7�� L8 OTHER fiE16 IN BRACE NUTS AND MASFjB 1 TYR J I — 20 MIL71M70ES5' PRE-q�iIUTED 20 Mid.—THICKNESS VMTL uEER / . STAIR ASSEMBLY ""� VMYL LPIER r ••TEFL STAR LWE GA.GALV STAIR LINE S-!/B•lMBD17S C0RIN R F"EL �m • MATS AND2 :Jf MASHERS 7YP.E► ' - P.EL EIo T SERIES 550 6 650 STAIR CORNER 1 SERIES 750 STAIR CORNER r1 SERIES 850,950 6 1050 STAIR CORNER /1 RAP YID R RAEP Me SXMMI R y ' MOTOR IEOTM n$ �-1 ,/�E— _ ♦—�—— —.—— — 1 '•'FRAME ASSEMBLY ^/ 71f : }./, — LT2iL MEEiE s..oHw RETURN r (n= FILTER V FLTERY •I - = I FUE -►---►- ► -� - z 0) _'.'�:•".. S LIME ♦ ;a rnPE7iW�HTV � ET1IHr WIT � 2 . l.Y T MEIN '�3•''4' A7L� dED .1.-A - I rr rau. Y LME i T ' 1 9'D"" `_�'.�•. S.FETY LRE ISEL.oEO POR - L ♦ 1� 1 ` gxTs I ' I n 2 sHPOR f LFLAT AA�Aa .'"t. M�fORND A H1 1 TA FLQ � �(. ! s>•a•. ItT�fVYY NESENT AREAS co O CD 7oSTAIRS AREI 1= a L--►---� MAY BE a' w SKIMMER Q r z, SE S/Rf AIEAa ZIDOGAL.UB L.00=ID AT -I I SICTICH O �g G (gyp P06rt7dS QI LY O 51ZE -IRBAS6 fifLL SF A1�RE'AREA L 22, 0 GALCaF x YOR'Z• ♦ ' Rt m '2u.�o•292z Si suRE AREA 1: -SOO�-� I——— •———J z m 3 SERIES 2000 9 2050 INGROUND TYPIICAALL WHERE s>ff 910'RN•IBS�784 se SURE.AREA JQIOD CAL-CAP C p _ PEA O YAIENTLY ATTED O TER MO�IORYD S ARE OPTIC SAFETY LRIE fYRS •;i. ►----_~ -rye ~ - SERIES 2100 a 2150 INGROUND' S=S HvMH Ro,2G.x SwF AREA EL_•_2 S-E S AREA ER T E a 2E92B G.L.Hite . gP ARE T�wRALL 1 SERIES 2000 a 2050 INGROUND ♦ PERMANENTLY �'.. ATTACHED - •. `A•«:i+.J r9H.DED PORTIONS '3ivG_ REPRESENTS �C�y RF AREAS I p 1dl D ♦ / N/t N b - -4RER101 O�G• �LV•C� I. I 1 .A.FRA..E ASSEMBLY �a L-►-__►_1 2 TYRCLL MHETE Pn lilt SOM 9WR:16.3r W?SF S RF ARI 20720 GAL CAP v'T• ALSO AWA-AB F,0.41'713 SF SURE AREA.L24M GAL.CAP 2O.Q OSS Sr SRE AREAL 2922D GA-CAP . SERIES 2100 9 215OSERIES NGR"D o° b �a d y .;IersPropertyCasualty�� A�—tTravelersGroup WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6KUB-627X481 -A-03) RENEWAL OF (6KUB-627X481 -A-02) INSURER: THE TRAVELERS INDEMNITY COMPANY NCCI CO CODE: 11347 INSURED: PRODUCER: HOLIDAY POOLS INC MYCOCK INS AGCY PO BOX 61 20 SCHOOL ST MASHPEE MA 02649 PO BOX 437 COTUIT MA 02635 Insured is A CORPORATION Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 04-22-03 to 04-22-04 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here- MA 0 B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in "— item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit 0 Bodily Injury by Disease: $ 100000 Each Employee N C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: '^ SEE ENDORSEMENT WC 20 03 06 D. This policy includes these endorsements and schedules: i a� SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE o I4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 05-01 -03 WC ST ASSIGN: MA OFFICE: ORLANDO INDUS AFF 161 PRODUCER: MYCOCK INS AGCY 297SB 011280 C LOT 29 BENCHMARK TOP OF P.K. NAIL ' ELEV.=50..00' 0 (ASSUMED) 9 N85'21'0 »E, ��' rP�1H OF�; e OF P, 78.39 JJa R Y `4`1 R9-CAULEY Fn RESERVE y CIVIL AREAC� v No. 32036 m Na 3 / \ — — \ 9��� pEC1ST E�E� a �A 5101 LEACHING \ c� ,� ss. i. PATS ( _\ . 50 _ ��� ���a Rio s 51.5P 32 PROP. s� PTlcJ __-- _= _-Cc> LOT 30 1 __�6 -------- , 33830fsf 150 _�. PROJECT L OCA T/ON.• —_- - LOT '30 LOTHROP S LANE WEST BARNSTABLE MA OPEN w �� / �. / UTILITIES- APPL/CANT BO , B PENNY SPACE ,� ELE'C., TEL & 428-1694 0 CABLE ASSESSORS NO.: 110-25. 7 CF // /// / \ x YANKEE SURVEY CONSUL TANTS NOTES- / �' P. 0. BOX 265 q UNI T 5, 40B INDUSTRY ROAD SUBSTANTIAL REGRADING HAS BEEN DONE ' / � MARSTONS MILLS, MA. . 02648 ON THE SITE. THE GENERAL .CONTRACTOR IS 155_ __ &2' / ���'' �. LOT 31 PH.(508)428—0055 — FAX(508)420 . 555J ADVISED TO USE CAUTION TO PLACE ANY AND ALL STRUCTURES. ON NATURAL, UNDISTUBED, � - - 54 ` - 156 /i �� ~ ' � / 5 SCALE. 1 =30 DA TE.• 4/28/94 INERT SOILS: FAILURE TO DO SO MAY CAUSE __58 60 STRUCTURAL.DAMAGE. ]REVREFER TO -MASTER WELL-SEPTIC ` s % ,;;; 8 25 94F/?EV PLAN PREPARED .FOR THE SUDIVISION. - JOB NO. 50332A SHEET 1 OF z. ASSESSORS NO.: 110-25. 7 TOWN OF BARNSTABLE CERTIFICATE Oki OCCUPANCY PARCEL ID 110 025 007 GEOBASE ID 37065 ADDRESS 189 LOTHROP'S LANE PHONE W. Barnstable ZIP - i LOT 30 B�OCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 13566 DESCRIPTION SINGLE FAMILY DWELLING PERMIT TYPE BCOO, TITLE CERTIFICATE OF. 000UPANCY CONTRACTORS: Department of Health, Safety i ARCHITECTS: and Environmental Services TOTAL FEES: BOND CONSTRUCTION COSTS $.00 i 753 MISC. NOT CODED ELSEWHERE * . nARNSTABLE, MA93. OWNER PENNEY, ROBERT E & s639' ' ADDRESS LIACOPOULAS CHRISTOS . ESA 118 TURTLEBACK RD BUILD I�NG DIVISI MARSTONS MILLS MA BYi DATE ISSUED 03/01/1996 EXPIRATION DATE F BARNSTABLE, MASSACH'USETTS' BUILDING ' "PERMIt A=110.025.007s 37773 Ma DATE y 17 19 95 PERMIT 0. APPLICANT Robert Penney ADDRESS 189 Lothrops Lane, W. Barnstable 7 (wo.) (STREET) ICONTR'S LICENSE) PERMIT TO Build dwelling 2 Single family residence 'NUMBER .OF (TYPE OF IMPROVEMENT) --wo-7 STORY (PROPOSED USE) —DWELLING U I NITS AT (LOCATION) 189 Lothrops Lane, W. Barnstable ZONING Vr (STREET) DISTRICT_�� BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SMALL CONFORM IN CONSTRUCTION' TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION • (TYPE) REMARKS- Sewage #95-584 AREA OR 2,131 sq. ft. VOLUME TED COST $ 125,000.00 PERMIT s 152.00 ESTIMATED(CUBIC/SQUARE FEET) MA FEE OWNER Robert Penney ADDRESS 118 Turtleback Road, Marstons Mills :Y UILOI OF Y � ­* * APPLICABLE I RESTRICTIONS. - MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE IN-z0;r'T-0NS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION :HAS BEEN ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS IRE TO LATH). 3, FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. — . .I . POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS R6b 6-23­q-5_ 2--7b-r) 12--2­6 10 12(, rc I'See -66 2 C _C 9 2 Wk �INSO 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER 2 BOARD OF HEALTH 10 �Y ��- '95- WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VAAIOUUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. - ., 1-7,0,(_ `OF,ME A The Town of Barnstable O� BARARS- E. MASS • Department of Health Safety and Environmental Services t639. �Fo,�•p Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspections Location - T�l 'Qr� L �� — Permit Number Owner �� '� C`� Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: ` _ 1 It,yj P L k"-AT e I Al� C) 066 Y` 0�-eat.Owq GCS Please call: 508-790-6227 for reeinspection. Inspected by L? Date Z �''� TOWN OF BARNSTABLE, MASSACHUSETTS' BUILD 1 N G PERM 1 T , A=110.025.007F/ N - - DATE May 17 ,g' 95 PERMIT/NO. NO 37 773 - APPLICANT Robert Penney ADDRESS 189 Lothrops Lane, W. Barnstable (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO Build dwelling 2 STORY Single family residence NUMER OF DWELLING UNITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSEO USE) h 189 Lotrops Lane, ZONING AT (LOCATION) W. Barnstable RF DISTRICT— (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) ! REMARKS: Sewage #95-584 AREA OR VOLUME 2,131 sq. ft. ESTIMATED COST $ 125,000.00 PERMIT 152.00 (CUBIC/SOUARE FEET) FEE OWNER Robert Penney ADDRESS 118 Turtleback Road, Marstons Mills BUILoI F o BY . .._... ..._ __. ........_... _. . ---._ .._...._. ---....__ _. ...._ . _....... ---- .._. ..___..__ ..._ ... . _._..... ....__ __ __.. OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. • • MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS Z3-q5' 24Znj — S l� 2,6 - Q.ilNso 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT t • OTHER Z BOARD OF HEALTH �x �1,4 A� WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTIOn I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. The Town of Barnstable MRSSTAOLL Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection 1d Location �--yT� , .�tJ L 1 . �`�,-- Permit Number 6� p Owner �_.`� \1.- ����`' N Builder . One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: r ' l 7 SST IL Please call: 508-790-6227 for reeinspection. Inspected by Date l Assessor's office(1st Floor): ,�j 4 Assessor's map and lot numb Ule&d � poi THE Conservation(4th Floor): e�Q w ♦w Board of Health(3rd floor. 9 � �/ / / IC SYSTEM MU �T.�Lt i Sewage Permit number 1. � f''� WALLED IN CO MPL ' b o• �a° Engineering Department(3rd floor): r— kn r- WITH TITLE 5 '"'r Mouse number �h Definitive Plan Approved by Planning Board •.19 ENVIRONMENTAL CO AND APPLICATIO PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN REGULATIONS TOWN OF BA.RNSTABLE BUILDING INSPECTOR ON FOR PERMIT TO 18� LOVLO-a Z/y TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 192 YOZI A SO em&_,T-a94,:f Proposed Use Zoning District Fire District 4�Z&RE Name of Owner Address- as Name of Builder PPI`INM Address J 1W TiA ri(-e-.foa k ( 1 Name of Architect Address Number of Rooms d Foundation Exterior (few S s5&4)KCC-T Roofing Floors CAe&7_— � i�2WP L&X Interior Heating G/ Gc� Plumbing 2 CC/ �✓L Fireplace Approximate Cost a� Area Diagram of Lot and Building with Dimensions Fee 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 u� Construction Si ipervisor's License 9�t 110.025.007 No Permit For Location 189 Lothrops Lane W. Barnstable - Owner, Robert Penney l Type of Construction I Al Plot r'- Lot Permit Granted 19 Date of Inspection: Frame 4 19 � GC2 43,,//^^ Insulation �� �� 19- Fireplace Date Completed 19 h ti Application to ' Old King's Highway Regional Historic District Committee :. in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application.is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: &New Building ❑ Addition ❑ Alteration Indicate type of building: X House Garage ❑ Commercial ❑ Other 2. Exterior Painting: 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE " VA - 9 5 ADDRESS OF PROPOSED WORK LQA 30% 119 LQAhra�5 LQ' ASSESSORS MAP-NO. 1 09 5 rns be- OWNER Rb PeK)f e-�j ASSESSORS LOT NO. 3O HOME ADDRESS It 1 ►ArA if hac k L[Abr'- rnl I �S TEL. NO. q(;LL 1(QQ q FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). G(Ict Rhonda R1.5ley. 163 Lp+hrops lane_ V) (3Gif nst3�b12 L64-falryos Lr ne h). ('ga(ns-hb) e �.0 Q d-- C I k-Lc e-�-h R I t f-0 , 1R q Lugrr��s Lone W. �acnSiA I el AGENT OR CONTRACTOR nr)!P TEL. NO. �a2'- (bq `t ADDRESS 11 W :JA6 fha IL �cl, �a�5hxls 1 ,11 � IS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). �-e�l�oom colon l� I `'`'/ 2- c�l� at..-F�c hed �� Q� Signed a C Owner-Co ctor-Agent Space below line for Committee use. Received�byTH:D:C. Date d he i ' e is here Date TiPR 141995 OLa 6%1� t HiGHVVAY Approved ❑ IMPORTANT: If Certificate Is approved,approval Is subject to the 10 da appeal period provided in the Act. Disapproved ❑ r . r r TOWN OF BARNSTABLE fit, BUILDING DEPARTMENT 4 HOMEOWNER LICENSE EXEMPTION Please print. DATE -'- JOB LOCATION Number Street Address Section 'Of Town "HOMEOWNER" 4_; �Z Name Home Phone Work Phone PRESENT MAILING ADDRESS Jig 7UI�ZC�ACK ��� hllc-S 1v8 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 such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six 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 "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements HOREOWNER'S SIGNATURE FA bt:97- APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. NISC5 HOME OWNER'S EXE14PTION • The code states that: "Any Home Owner performing work for which permit is required shall be exempt from the (Section 109. 1.1 provisions of thissectionlding - Licensing of Construction Supervis n ors) ' provided that if Rome Owner engages a Person for hire to do such Owner shall act as supervisor. „ work than such Horne Many Home Owners who use this exemption are unaware that the the -responsibilities of a supervisor (see Appendix for Licensing Construction Supervisors, Section 2.15 a are gus tin awareness often results in serious problem pp x Q, Rules and Regulations -Owner hires unlicensedinsepersons. s, particularlyhwhenatheoHome against the unlicensed erson as it would cwith ase olicensed ur Board cannot Home Owner acting as supervisor is ultimately responsible. proceed supervisor. The many To ensure that the Home Owner is fully aware of his/her res Ownerccertify1thatequire, as he/she undeart of the permit ponsibilities, rstands thepre ponsibilitiesPlicationoftaasutee Home On the last page of this issue is a form currently used b You may care to amend and adopt such a form/certification p rvlsor. community. Y several towns. for use in your I e. n n n T L.or unoizcuea1tla of Olaajczclzudetb c�apa.tnent a���fria[�ce 600 W-1-y1 m St-d James J.Campbell &&n, //`amadmd d & 021 f 1 Commissioner Workers' Compensadon 'i nsurance davit 1, with a principal place of business at: do hereby certify under the pains and penalties of perjury, that: () I am an employer provid'mg workers' compensation coverage for my employees war this job. Insurance Company Policy Number () I am.a sole proprietor and have no one working for me in any capacity. I am a sole proprietor, general contractor or homeowner (cirde one) and have hirec contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Pit Contractor Insurance Company/Policy NL Contractor Insurance Company/Policy NL () I am a homeoN%,ner performing ail the work myself. . c;r!unc:.._,Z ccz; of c s_:emem w-il!to fone.-Uced tc d:c of ice cf 1r,.esdrrons of d.e 0TA for ems-erage verifica:icr. and that fain cc-:r.aje=rEe_:ed uncer Sec_cn 25A of MGL 152 can ieao to vic Imposition of criminal pen;lt]es eonsisdne of a fine of t:p to S 1,500.0 •ea::' imrrLcrment well as dvii ;enalties in the fern-cf 2 STOP WORK ORDER and a fine of S100.00 a dry agzinst me. Signed this � day of , 1,9�� Licensee/Permittee Building Department Licensing Board Selettmens Office 37 7,,F Health Department 7 C ''�� 'F'" COVEF-AGE INFO i0?: Cr',LL: 61 7-727--900 X403, 404, } Town of Barnstable Old King's Highway Historic District Commission SPEC SHEET I FOUNDATION Zq C e, ent SIDING TYPE() lar9hv(jV-dS¢ C.0, 1nJD,3COLOR !aJ221— CHIMNEY TYPE (IC C f Coo COLOR Ij ROOF MATERIAL_ Q Sw � n P W COLOR PITCH WINDOW b o je (o 6nY :[�rI � SIZE TRIM COLOR W Vl 1 DOORS & 10 S COLOR Vj h I Iz- SHUTTERS {� GUTTERS DECK i' .T GARAGE DOORS_ pp� COLOR Lk) �A ► tt— NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan and elevation plans, when o� applicable. Plot plan need not be "Certified",� but should show all structures on the lot to scale. SPECSHT o WEL WELL LOT 29 BENCHMARK TOP OF P.K. NAIL ' ELEV.=50.00' O (ASSUMED) „E, , ,: N85 21'�� _ `JO ' P�\N OF p's � ;��t« OF 1 - - - - - - - - ,�' S�� ��UL Sys .+; . y JOHN ��yc / O MER,ITHEVV �NnER3-CAULEY CIVIL y / RAERSEAVE �' > � 3 No. 32098 0� r 'No. 5101 / LEACHING — — — — ve� �Frsj�EG�STER�S�@a ��,+STER�O :\ SAL lkMa / ��i LNG\� PATS ( _ 50_ 3,2.R' p PROP. T.D p, y ,LL ox SEPTIC J =__--�= -__ LOT 30 TANK 'o ___=== 33830fSf \ '� PRO✓EC T L OCA TION: LOT -30 LOTHROP S LANE 52 ;! �� !-__ WEST BARNSTABLE MA OPEN �o \� �. / �� UTILITIES- APPLICANT• BOB- PENNY SPACE �" ti i - ELEC., TEL & 428-1694 // 0,' CABLE ASSESSORS NO.: 110725. 7 YAWEE SURVEY CONSUL TANTS NOTES: / ,' /' / P. O. Box 265 UNI T 5, 40B INDUSTRY ROAD SUBSTANTIAL REGRADING HAS BEEN DONE ' �� MARSTONS MILLS, MA. 02648 ON THE SITE. THE GENERAL CONTRACTOR IS 55 LOT 31 PH.(508)428-0055 - FAX(508)420-5553 AD VISED TO USE CAUTION TO PLACE ANY AND - - 56 ALL STRUCTURES. 01V NATURAL, UNDISTUBED, - - 54 , - j C�� ~ SCALE. 1"=30' LDA TE. 4,�28194 INERT SOILS. FAILURE TO DO SO MAY CAUSE -58.6 p STRUCTURAL DAMAGE. 62 - REV 8 25 94 REV.6 %. �68 { REFER TO MASTER WELL-SEPTIC �`Scp�9s 4 PLAN PREPARED FOR THE SUDIVISION. NO. 50332A SHEET 1 OF 2 ASSESSORS NO.: 110-25. 7 - ` - = - - - - - � l ?U. v v (ASSUMED) i 85 ! N X .� Ne C�> PROPOSED \ -HOUSE - t � GRASS � \' O 52 UTmME'S." T3 �Q' ELE'C., TEL & OPEN `�o_ "'� � 01 CABLE SPACE ` LO T 31 PROJECT L OCA TION. - X5 LOT 30 LO THROP'S LANE WEST BARNsTABLE, MA APPLICANT. BOB PENNY 428- 1694 ASSESSORS NO.: 110-25. 7 �C6 in 1 yob a i 1 t: r: —-- ----- ---- -- -- 2 _ S'•7' 2 U' S l o' ............ 2'a" PQOVic E Pl' 'PKKE'f 77. I '89Q_il'G2, LIY4V OukZ2 EA'q ,Do0rzs I <i �---------T [•IOTe: .: / 4woo -,. a6O.W i- isv 6.Z�ia tR - c- -I OFS�g'F1IIE.000e' I A T94 lL.q,.� v oC. F,. —yr .S N E E7' (Lo'c IG' j I /��i I ; ` \ l �} e ! I i OI 4"O LALLY COL I I Q":Cd QC.:1 IQ.O..(Z. S LA -7 .!0/10.;N.'.v M T'G-, i ,y 1 7:7- 7 7 7: 7 Y^ CO�l C. 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L J I 1 CT.8•-O"x '6 10 oVeQ 4 E A 0 0goi'2S a. 3 ac k rpDD Il � � 0 rt UNITED CASUALTY AND SURETY INSURANCE COMPANY LICENSE AND PERMIT BOND For County,City,Town or Village Only. Not Valid for Contract,Performance,Maintenance, Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. KNOW ALL MEN BY THESE PRESENTS: BOND NO: 001195 Thatwe Robert Penney of the Town of Marston Mills ,State of Massachusetts as Principal,and UNITED CASUALTY AND SURETY INSURANCE COMPANY,a corporation duly licensed to do business in the State of Massachusetts, as Surety, are held and firmly bound unto the Town of Barnstable , State of Massachusetts, as Obligee, in the amount of Five Thousand and 00/100 dollars----------- ($5,000.00------)DOLLARS, lawful money of the United States, to be paid to the said Obligee,for which payment well and truly to be made, we bind ourselves and our legal representatives,jointly and severally. THE CONDITION OF THIS OBLIGATION IS SUCH,That whereas,the Principal has been licensed or issued a permit for work to be completed at 189 Lothrop's Lane West Barnstable MA by the Obligee. NOW THEREFORE,if the Principal shall faithfully perform the duties and comply with the laws and ordinances (including all amendments), pertaining to the license or permit, then this obligation to be void, otherwise to remain in full force and effect for a period commencing on the 21 st day of March , 19 95 , and ending on the 20th day of March , 19 96 , unless renewed by continuation certificate. This bond may be terminated at any time by the Surety upon sending notice in writing to the Obligee and to the Principal, in care of the Obligee or at such other addresses the Surety deems reasonable, and at the expiration of thirty-five days(35) days from the mailing of notice or as soon thereafter as permitted by applicable law, whichever is later, this bond shall terminate and the Surety shall be relieved from any liability for any subsequent acts or omissions of the Principal. Dated-this 21st day o March , 19 95 Witnessed s\ ___-_---------•------- Principal t�. T IWiSU E COMPANY By Todd S.Cartigan Paaidem&Attorney-in-fad ss: ACKNOWLEDGEMENT OF SURETV STATE OF MASSACHUSEM County of Suffolk On this 21 st day of March , 19 95, before me, the undersigned officer,personally appeared Todd S.Carrigan,who acknowledged himself to be the aforesaid officer of UNITED CASUALTY AND SURETY INSURANCE COMPANY, a corporation, and.that he'as such officer, being authorized so to do, executed the forgoing instrument for the purpose therein:con_ t�ii 4'by sigrs itg the name of the corporation by himself as such officer. IN WITNESS WHEREOF, I have hereunto set my hand and off sca? l " i' t` =d . .otax Public ACKNOWLEDGEMENT OF PRINCIPAL �' Q ss: (Individual or Partners) STATE OF County of On this day of 0_,before me personally appeared known to me to be the individual(s) described in and who executed the forgoing instrument and acknowledged to me that_he executed the same. My commission expires , 19_ Notary Public ^ tY LR• ACKNOWLEDGEMENT OF PRINCIPAL ss: (Corporate Officer) 1 STATE OF County of On-this day of , 19 , before me, personally appeared ,who acknowledged himself to be the of , a corporation,and that he as such officer, being authorized so,to do, executed the forgoing instrument for the purposes therein contained by signing the name of the corporation by himself as such officer. My commission expires Notan Public J A OA l '0 F } ',..��''�///wJ��� rA 64 H Q 0 a 0 I U141TED CASUALTY AND SURETY INSURANCE COMPANY BOSTON, MASSACHUSETTS POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That UNITED CASUALTY AND SURETY INSURANCE COMPANY,a corporation of the State of Massachusetts,does hereby make,constitute and appoint Todd S.Carrigan of Quincy, Massachusetts its true and lawful Attorney-in-Fact,with full power and authority,for and on behalf of the Company as surety,to execute and deliver and affix the seal of the Company thereto,if a seal is required,bonds,undertakings,recognizances,consents of surety or other written obligations in the nature thereof, as follows: Any and all bonds, undertakings,recognizances,consents of surety or other written obligations in the nature thereof and to bind UNITED CASUALTY AND SURETY INSURANCE COMPANY,thereby,and all of the acts of said Attorney-in-Fact pursuant to these presents, are hereby ratified and confirmed. This appointment is made under and by authority of the following Resolutions adopted by the Board of Directors of UNITED CASUALTY AND SURETY INSURANCE COMPANY at a meeting duly called and held on the 1st day of July, 1993 which Resolutions are now in full force and effect: Resolved that the President in conjunction with any Secretary or Assistant Secretary be and they are hereby authorized and empowered to appoint Attorneys-im-Fact of the Company, in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances,contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys-in-Fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected Officers of the Company in their own proper persons. This power of attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of UNITED CASUALTY AND SURETY INSURANCE COMPANY at a meeting duly Called and held on the 1st day of July, 1993: That the signature of any officer authorized by Resolutions of this Board and the Company seal may be affixed by facsimile to any power of attorney or special power of attorney or certification of either given for the execution of any bond,undertaking,recognizance or other written obligation in the nature thereof;such signature and seal,when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS WHEREOF,UNITED CASUALTY AND SURETY INSURANCE COMPANY has caused these presents to be signed by its proper officer and its corporate seal to be hereunto affixed this 1st day of July 1993. UNITED CASUALTY AND SURETY INSURANCE COMPANY By Linda Howley, Secretary State of Massachusetts,County of Suffolk ss: On this 1st day of July in the year 1993 before me personally came Linda Howley to me known,who,being by me duly sworn,did depose and say: that she resides in the State of Massachusetts;that she is Secretary(Surety)of UNITED CASUALTY AND SURETY INSURANCE COMPANY the corporation described in and which executed the above instrument; that she signed her name thereto by the above quoted authority;that she knows the seal of said corporation;that said seal affixed to said instrument is such corporate sal,and that it was so affixed by authority of her office under the by-laws of said corporation. 70 Notary Public My commission expires: I,Timothy Carrigan,Treasurer(Surety)of UNITED CASUALTY AND SURETY INSURANCE COMPANY certify that the foregoing power of attorney,and the above quoted Resolutions of the Board of Directors of July 1, 1993 have not been abridged or revoked and are now in full force and effect. Signed and sealed at Boston, Massachusetts, this 21st day of March 19 95 AAP Treasurer APPLICATION FOR PERMIT TO INSTALL AND REQUEST FOR ELECTRICAL SERVICE 61 Inspect$?of Wires � E Wiring Permit #---�"—�COM/EleFjct ric #. 310933 Town of f f,6 r, 1 Massacht Building Permit # Date�J'Customer: 0 3 J AA"i on (Street #) 11 n.`�"Z fon S L A. Lot # 1b in the village of u utility pole amber or underground number � � Customer's billing address t 1C , Temporary ew installation v hange of service Starting date ` ci Job description /►tt+ \'f w� e.A V �A r L- 1 Service entrance voltage o �fo Amperage QC Phase Wire size(cu. or al.)2 1 Conductor per phase Number of meters Water heater Off peak: YesNo— Estimated load: Electric heat/—� &kw, lights kw, Range dryer Motors,H.P.&Phase Ready for first inspection r_ k Ready for final inspect' p Electrical Contractor Lic. # �s Telephone#4'1' `'1®70 Address -126 a mou Additional Remarks: Falmotith, 457-9020 Do Not Write Below This Line w ELECTRICAL WIRING INSPECTION CERTIFICATE 4; INSPECTOR OF WIRES 1,AX INSPECTIONS DATE FEE CHARGE Temporary Service Roughing in _ Service and Meter 11 701 Off Peak Meter Final Approval Disapproved' I f "For the following reasons CERTIFICATE OF INSPECTION Date -',0"-z7-965 To the COMMONWEALTH ELECTRIC COMPANY.The installation described above has been completed and has this day been inspected and approval granted for connection to your service. _ nspector of Wires WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION Permit Good For One Year From Date Of Issue CA 46 INSPECTOR'S NOTICE TOWN OF BARNSTABLE TEMPORARY SERVICE PARCEL ID 110 025 007 GEOBASE ID 37065 ADDRESS 189 LOTHROP'S LANE PHONE W. Barnstable ZIP - LOT 30 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 6709 DESCRIPTION TEMPORARY SERVICE PERMIT TYPE BELEC TITLE WIRING PERMIT CONTRACTORS: GHERTLER, GARY ARCHITECTS: TOTAL FEES: $10.00 BOND $.00 CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE 1. PRIVATE PROPERTY OWNER PENNEY, ROBERT E & ADDRESS LIACOPOULAS CHRISTOS 118 TURTLEBACK RD MARSTONS MILLS MA DATE ISSUED 06/22/1995 EXPIRATION DATE i t Department of Health, Safety . and Environmental Services ? OF THE r, BARNSTABLE, 9 MASS. 1639. BUILDING DIVISION BY GENERAL.DOC REVISED 4/26/95 I IMF TO The Town of Barnstable BARN LE. Department of Health Safety and Environmental Services 26)9• .00 i '�FD,rw+a Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location 189 Permit Number 0 Owner �. PewBuilder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: j--Ll- �S o to - 9s �- Please call: 508-790-6227 for reeinspeccttion. Inspected by � C- ^ Date i The Town of Barnstable MARSL Department of Health Safety and Environmental Services Et6391. Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection ,I�G Location LD-'j4 RD P' 11"` Permit Number � d ! Owner , � 14q Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: / �/�-A S.1 0) 01 o\j6U.— SQA-N c�0 MAY- SPMA 7-X-L V, Please call: 508-790-6227 for reeinspection. Inspected by Date � e (blo a G� Town of Barnstable Op SHE►� o Building Department Services sniuvsrnaiE. Brian Florence, CBO 94> M639 �0g Building Commissioner 200 Main Street,Hyannis, MA.02601 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 bob I am the owner/resident of the property located at: rd as (�� - darns blv aA 62L2 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: C O Name &relationship to owner: _ Z � o Name &relationship to owner: N a The Family Apartment will be the primary year-round residence for the abr&e-identiA z family members. In the event that the listed relatives vacate said apartment, I will i mediat not fy the Building Commissioner in writing. I understand that no subletting or sub asing.of zicl 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 OA�j 2019. /�✓� � 30� 3ba 3�.��c' Signature {{�� (� Phone Number (- Print Name otO T" q:forms/famafd.doc rev 11/08/13 i CIO . Town of Barnstable tNE G Building Department Brian Florence, CBO 10 w • snxrrarnsi> rA $ Building Commissioner u, c39. r 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us 0 rn Office: 508-862-4038 Fax: 508-790-6230 Town of Bamstable Family Apattmentfi avit I,being on oath, depose and state as follows: My name is -- - - I am the owner/resident:of the property located at: l_4tn►os The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: - Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes 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 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 2018. �SV�Y 3 -3b Signature Phone Number Print Name IJ q:forms/famaffid.doc rev 11/22/2017 Town of Barnstable Regulatory Services ofTM� Richard V. Scali, Direct nWN OF BARNSTABLE Building Division STAB Paul Roma BuildingCommissi er AM IY , N 30 PM2 29 Ar 163�. &� 200 Main Street, Hyannis, MA 02601 ED MIS www.town.barnstable.ma.us Office: 508-862-4038 nIVISION Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: bMy name is I am the owner/resident of the property located at: � � (_(�` -r-O The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this (:9 C. day of Jonoar 2017. / 0 ,a 5 3 aa3�lw Signature bob Phone Number Print Name Po 0 s-�-e q:forms/famaffid.do c rev 11/08/12 Town of Barnstable Regulatory Services ,oFTME*Orti Richard V. Scali,Director s Building Division 7 C> $"x'',',& Thomas Perry, CBO,Building Commissioner 0 , i639. `0�' , ArEo ,�, 200 Main Street, Hyannis, MA 02601 �.. www.town.barnstable.ma.us v � Office: 508-862-4038 F 508-790-600 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is PI am the owner/resident of the property located at: I 1 LA+r00_s Lai - , The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Mjt� E-e�A � -dq�kA� Name &relationship to owner: I The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner.immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: , The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 16. s0�s- 3(:201-_-;& 9- Signature ,^ Phone Number Print Name rJ Fe r�r\ q:forms/famaffid.doc rev 11/08/12 I Town of Barnstable oFr+e rq� Regulatory Services Richard V. Scali,Director (0141N OF BARNS TABLE BARNSPABM » Building Division _ y MASS. 16 39. Thomas Perry, CBO, Building Commissioner` S PM 2: 5 4 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 DiVISIpr4► 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: fName &relationship to owner: BSI C pit,LC_l� 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 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 of perjury this a day of qbfuo r�L 2015. Signature ,Q Phone Number Print Name b Ve t,a�4_/ q:forms/famaffid.do c rev 11/08/11 Town of Barnstable Regulatory Services oFTME royti Richard V. Scali,Interim Director TOWN OF BARN,STAB:LL Building Division '�"B Thomas Per CBO Building Commissioner E rM MASS Perry, g F, i 9 E 7_ O d �A>i63y p�0 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 O1h�SY(',1�F 0-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is nor) I am the owner/resident of the property located at: L &Llns-fAb� M 01(dg The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 6" — 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 notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this I q day of Te bj( +,2014. Signature 1^ Phone Number Print Name '6O rJ -PCLL(\� q:forms/famaffid.doc rev 11/08/11 r e ns'aa;s:uiws...t&J,eve'+i6e,:is i�S.,a.,bi..u�'d.y.id uiai"o.;.::�`•�-b3�t.0 t..ts.:.,a: 6. ..,"e.:L.r.,... .Lt+t.� w�.a.....:..�t�....:�.�..,......:<�._.... a.La..,.,..,.:...s;a...�_.,...a.•-a....nv.�s....._�. �_ - i t At e it i i - r r � i .. r 1 Town of Barnstable Regulatory Services rq Thomas F. Geiler,Director Building Division TOWN OF BARNSTAB'F MW Thomas Perry, CBO,Building Commissioner A1639. �•� 200 Main Street, Hyannis, MA 026U. 1 JAN 15 AM !1: 30 tED MA'S� www.town.barnstable.ma.us Office: 508-862-4038 —Fax 508-790-6230 DIVISION Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is &)12 I am the owner/resident of the property located at: b J Lash bU MA oz6 6� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: ke�- aca��� 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 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 andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2013. Signature Phone Number Print Name q:forms/famaffid.do c rev 11/08/11 Town of Barnstable Regulatory Services of Thomas F. Geiler,Director Building Division T'o'""N 0r .`:' 'S f, E L E BAMSTABMAML ` Thomas Perry, CBO,Building Commiss_oner /� S//fit � ��0 200 Main Street, Hyannis, MA 02601° ' �� 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 b I am the owner/resident of the property located at: � So 6Z&68 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: I Q�2 Name &relationship to owner: � rii'G I U d — NiS Q4— d 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 note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of eb( 2012. Signature Phone Number Print Name q:forms/famaffi d.do c rev 11/08/11 Town of Barnstable Regulatory Services of Tod Thomas F. Geiler, Director" Building Division ., ►. 72 BARNSTABLE,$' Thomas Perry, CBO Building Commissioner MASS. �At 1639. p�0 200 Main Street, Hyannis, MA 02601 EO MA'S 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 y CJ 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: G- PP_nn��n- Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately 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. 1 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 J 011. Signature e-eanfw- UPhone Number Print Name 6b Town of Barnstable Regulatory Services FtHe�°"ti Thomas F.Geiler,Director TOWN OF VIRP11STABLE Building Division 9sn STABLE, Tom Perry, Building Commissioneron MASS. , M 13 1639• $ 200 Main Street,Hyannis,MA 02601 g' 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 LI am the owner/resident of the cl property located at: �� C_CL-U8 f U a j Gy�.a� �r��ns�l-xlolQ OZ( ;a C The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: 0(�e nd6a 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 2010. Signature Phone Number Print Name ee n=P-4 Q/bldg/forms/famafd Rev:12/08 Town of Barnstable Regulatory Services F1ME lqy Thomas F. Geiler,Director Building Division ► �1F lil�Klt�ABLE BAMSrABLE, Tom Perry, Building Commissioner MASS, 1639. �� 200 Main Street,Hyannis, MA 02601 2W JAW 28 Ail 11. 05 e AIEp �a www.town.barnstable.ma.us '•���D1VkSiON 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 h I am the owner/resident of the property located at: L( ( S L��S�il�l�iLkA 0 Z� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: 1Md Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 1 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 not&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 e pains and penalties of perjury this oq IV day of Jan aa../` 2009. Signature Phone Number Print Name /1 fpn n-e. Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services pFIME Top, Thomas F.Geiler,Director ti Building Division aAxxsTAsLE. Tom Perry, Building Commissioner MASS �p 1639• 10� 200 Main Street,Hyannis,MA 02601 TFv � 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 I am the owner/resident of the property located at: 'E"OshkAo (M The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: 0 (1, dA Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. 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 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 2008. /�� P . . . PlC.1�lr+3(7 LR9--3 Signature Phone Number Print Name :ZI Wd 11 93A NOZ Q/bldg/forms/famaffid Rev:1/03 Town of Barnstable a `� Regulatory Services Thomas F.Geiler,Director Building Division BMM si8 .� Tom Perry, Building Commissioner erra �:,y 1BLG �AT 1639. A�0 200 Main Street,Hyannis,MA 02601 L l F Eo"AP www.town.barnstable.ma.us FEB 23 2; 26 Office: 508-862-4038 Fax. ,50,8;7;90-625t Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is toPenn-ev I am the owner/resident of the property located at: 1 e)arn s-x"I L The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: — Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of t>,� 2007. Signature Phone Number Print Name ' Q/bldg/forms/famaffid Rev:1/03 Town of Barnstable 016 Regulatory Services �FIME TOk� Thomas F.Geiler,Director Building Division i r anxivsTnaM S Tom Perry, Building Commissioner MASS, 200 Main Street,Hyannis,MA 02601 FEB 21 42 ArE pr 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 s tateas follows: My name is 20 e n Y u I am the owner/resident of the property located at: Map and Parcel Number I I QTa:S - The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: h r I fty 5 t a-C o o v ul hS -G�-4ve r I Y1 A U/ 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 andlor 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. T 6�� Signature Phone Number... Print Name o -e-n Y\-e- �! Q/bldg/forms/famaffid Rev:1/03 Town of Barnstable ' G �� Regulatory Services °F'THE r°� Thomas F. Geiler,Director Building Division _ saxnszasi.E, Tom Perry, Building Commissiofiei•^ Mass. � 1639. ,0� 200 Main Street,Hyannis,MA 02601 prEv �a 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 bobEknA"__ I am the owner/resident of the • located at: 0 property S n s�-xbC� h Map and Parcel Number 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: w Name &relationship to owner: J� i' S�S �--I a C 00 D L)i DS - "- Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually.with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA 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 2005. Signature Phone Number. Print Name -e Q/bldg/forms/famaffid2 Rev:1/03 Town of Barnstable Regulatory Services Thomas F.Geiler,Director TOWN OF BARF�STABLE Building Division snxrisTnsis = Tom Perry, Building Commissioner 2to� APR 20 AM 9' 39 � 039. 200 Main Street,Hyannis,MA 02601 �FD MA't A DIyISIOPd 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 C�? �`P.l`�.(.��Y I am the owner/resident of the roe located at: iLA6 S W p r rh' r -` Map and Parcel Number The ZBA granted me a Special Permit/Variance on 112q Ig ITJ Ms— I 3 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: C I�U'I a C.nn_n 01 bS= t'l+�1 Al (i W Name &relationship to owner: `�ZI kj,dam CA 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 I understand that I am required to file an Affidavit annually with the Building j 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 der the pains and penalties of perjury this "'day of af 2004. SAI _moo Signature Phone Number Print Name Q/bldg/forms/famaffid Rev:l/03 r Town of Barnstable �' �c Regulatory Services l Thomas F.Geiler,Director TOWN'Of:BARNSTABLE Building Division BAMSTABM Tom Perry, Building Commissioner 2003 JAM 22 AM 11: 15 1 MASS.. 200 Main Street,Hyannis,MA 02601 0 ArED iVIP'1 a 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 ecb �1 J I am the owner/resident 1-of�the property located at: � i -r) l'm s � � 1 N11S Map and Parcel Number 1 0/,2 S The ZBA granted me a Special Permit/Variance on I I z_q 139 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:CL rl S LI as n 9 f fl - o f I r\ )OAAr 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 of 2003. _ - SDS 3 0-3(0 Signature Phone Number Print Name Q/b ldg/forms/famaffid Rev:1/03 Town of Barnstable Regulatory Services °Ft►+e tqy� Thomas F.Geiler,Director Building D vij8WH " BARNSTABLE RUMSTA13M Peter F.DiMatteo, Building%W'orz Mass.1a39. �0200 Main Street,Hyannis, 4 ArED MA'1� / �J Office: 508-862-4038 IYISION 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 The ZBA granted me a Special Permit/Variance on l aq jq3-- 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:CALL )s Name &relationship to owner: T-LLLZ L0 r11X?(lY I"- 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. 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 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 �-k Sworn to under the pains and penalties of perjury this day of e,hru 002. Signature Phone Number Print Name Q/bldglformsdamaffid Rev:010702 COMMONWEALTH OF MASSACHUSETTS , ell( ., BARNSTABLE AFFIDAVIT 0 I ,being on oath, depose and state as follows: 1.) I reside at LAAro ` , �� )k<zt Eaf ns-}xb(.0 2.) I am the owner of the property located � i t��-Pn►� `s L�an.Q ��- �-ns�loln pZ� : o shown on BarnstableAssessors' maps as MAP 1 1 D PARCEL 3.) I Do L/ Do not have a Family Apartment at this location. 4.) On �1hP �� , 199�, the Zoning Board of Appeals, on Appeal No.]995- 13� 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'�bS Li ae.a ov IUS Relationship to owner: - - b) NAME `�R-tiQ �aC.oPoul�s Relationship to owner: -(_h- LAA ro— 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 1 comply with all conditions imposed by the Board of Appeals in Appeal No. ` g 5 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. Sworn to under the pas and-penalties of perjury this , day of 1 e t9g O in Signature Print Name {� ery NEY COMMONWEALTH OF MASSACHUSE,TTS R C BARNSTABLE a Q _ FE9t4 depose and state as^follows: T�WN.OF . i Bul 61N R�sTABLE � Nc`D 1/ 1.) I reside at 2.) I am the owner of the property located at S8 shown on Barnstable Assessors' maps as MAP__1152-------PARCEL_oQS = 3.) I Do---- ___—Do not_______________have a Family Apartment at this location. 4.) On---ILI 1—----------- 199 i� the Zoning Board of Appeals, on Appeal No. _J9=1S granted me a Special Permit/Variance to maintain a Fainily 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_— �r I S�©S Relationship to owner:__ --------------------------------- b) NAME---,J-fQn --�=t � ��--5----------=---------------------------- Relationshi to owner:____ 2 Y - P mom---��1a_LAD ------------------------- 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 rclative(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. —l CLa 5'�3�---------------------------------- 12.) I agree to immediately notify the Building Commissioner in the event of the sale of the above- listed property. Sworn to under the pains and penalties of perjury this _ s day oflQf 199 ____ Si tore 7 — -- ----------------- ---- -------------------------- Print N Oobef_�_ _ e ---------------------------------------- I i COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT I, — b n—e-��------------------------- being on oath, depose and state as follows: TOWN OF BARNSTABLE ` 1 J I reside at �q kV W1 rods_1�01�/ � lie ��,�Z to(( BUILDING DEPT. _ 2.) I am the owner of the property located _L D (JAN 2 6 '1998 ko shown on Barnstable Assessors maps as MAP_IQ 5 PARCEL__— 3.) I Do 1/ Do not __— __have a Family Apartment at this location. 4.) On�o V e e i �q__, 199�, the 7�oning Board of Appeals, on Appeal No.agb7_139 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 Maddress' a) NAE---� �LS�OS I._ ¢ o _U(AI V�------------------------ Relationship to owner:_ �e c i n—L a it) b) NAME .1_ f e n e- �_i ac o l u g vS Relationship to owner:---_—_-1M o e C_► vLJAU)--------------- ------ 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. --t q 2 S 139 _-- --__---__--- 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. d Sworn to under the pains and penalties of perjury'this _s-L_day Ua of_12L) f 199 q 0 __ Signature ,&- -—-------U­ Print Name Town of Barnstable Zoning Board of Appeals Decision and Notice Appeal No. 1995-139 Penney Special Permit-Family Apartment Summary Granted with Conditions Applicant: Robert Penney Property Address: 189 Lothrop's Lane,West Barnstable, MA Assessor's Map/Parcel 110/25-7 Area 0.78 Acres Zoning: RF Residential F Zoning District. Groundwater Overlay: AP-Aquifer Protection District Appeal No 1995-139 Special Permit-Section 3-1.1(3)(D) Family Apartment. Background Information: The locus of this appeal is on 189 Lothrop's Lane, West Barnstable, MA. The surrounding neighborhood is residential in nature with the majority of the lots being between 3/4 to 1 acre in size. The Applicants dwelling is located in a Residential F Zoning District which allows family apartments as a Conditional Use providing it complies with Section 3-1.1 (3) (D). The Applicant is requesting to construct a family apartment for,his Mother-in-law, who is disabled, and Father-in-law. The proposed family apartment is located over the 720 sq.ft garage and is attached to the principal dwelling of 2678 sq. ft. Applicant has received Old Kings Highway Regional Historic District Commission approval. This proposal meets all setback requirements of the district. Procedural Summary: This appeal was filed at the.Town Clerk's Office and at the Office of the Zoning Board of Appeals on September 15, 995. A public hearing was before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on October 25, 1995, at which time the Board found to grant the appeal with conditions. Board Members hearing this appeal were Ron Jansson, Emmett Glynn, Gene Burman, Robert Thorne, and Chairman Gail Nightingale. The petitioner represented himself before the Board. The house is currently under construction and the family apartment will be over the basement garage and on the same level as the first floor of the main house. The home is located in an open space subdivision that provides for varying lots sizes based upon overall density and protected open space. This will be the petitioner's permanent residence upon completion. No one spoke in favor. In opposition, was Francis Maioli who was concerned because the petitioner at present does not live in the house. He questioned if a precedence was being set. Finding of Facts: Based upon the testimony given during the public hearing on this appeal, the Board unanimously found the following findings of fact: 1. Appeal Number 1995-139 is for a Special Permit for a Family Apartment at 189 Lothrop's Lane, West Barnstable, MA on Assessor's Map 110/Parcel 25-7, in an RF Residential F Zoning District and AP Aquifer Protection District. Zoning Board of Appeals-Decision and Notice Appeal No. 1995-139 Penney 2. The petitioner is seeking a Special Permit which is allowed.under Section 3-1.1(3)(D). For the purpose of providing housing for a parent.. 3. The house is currently under construction and upon completion the principal dwelling will be occupied by the petitioner and the apartment by the petitioner's parent. 4. In granting the relief, it would not be in derogation of the spirit and intent of the Zoning Ordinance nor would it be detrimental to the neighborhood. Decision: Based upon the positive findings a motion was duly made and seconded to grant a Special Permit in accordance with Section 3-1.1 (3) (D).-Family Apartment, with the following conditions: 1. Sixty (60)days from the date the family member vacates the apartment, kitchen facilities must be removed and the Building Commissioner shall inspect the premises. Also, the premises must be restored as nearly as possible to a single family dwelling. 2. The Building Commissioner shall have the right to further inspect the premises upon which the apartment has been vacated at least three times per year for three years. 3. This Special Permit is not transferable and is only issued to the Applicant. 4. Scaled plans of the proposal must be submitted to the Building Commissioner 5. The petitioner at all times must comply with the provisions of Section 3-1.1(3)(D). Failure to do so shall result in a show-cause hearing before the Board on revoking of the Special Permit. The Vote was as follows: AYE: Ron Jansson, Emmett Glynn, Gene Burman, Robert Thorne, and Chairman Gail Nightingale. NAY: None. Order: Special Permit Number 1995-139 for a Family Apartment has been granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A, Section 17, within twenty (20)days after the date of the filing of this decision in the office of the Town Clerk. 1995 Gail Nightingale, Chairman Date Signed I Linda Leppanen, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20)days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this day of 1995 under the pains and penalties of perjury. Linda Leppanen, Town Clerk 2 of WE The Town of Barnstable Department of Health Safety and Environmental Services 's ,AMST„ , 'r Building Division MAM 16 9. � 367 Main Street, Hyannis MA 02601 Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commission January 7, 1998 The Penney Residence 189 Lothrop's Lane West Barnstable, MA 02668 Re: Family Apartment located at the above address Dear Mr./Ms. Penney, 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, t� Ralph Crossen Building Commissioner QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 01/07/98 PARCEL ID 110 025 007 GEO ID 37065 LOT/BLOCK 30 DBA PROPERTY ADDRESS OWNER PENNEY 189 LOTHROP' S LANE ROBERT E & PENNEY ANGELA L W BARNSTABLE 189 LOTHROPS LANE 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 33976 . 8 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST (N) EXT / (P) REVIOUS / NO (T) ES / PER (M) ITS / (V) IOLATIONS / (G) EOBASE / (E) XIT