Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0040 MAGGIE LANE
llll ll�l9.5yatoc a UPC 12543 No.53LOR J.(pNSJ� HASTINGS, MN i { ;f 1 j� I. j - i 3 -� 1+llr;��� � ��'il�l �i����n A95 936 E!k 3 9 Ps 1. 4.5 "W JI '04-17—,2019 6) 03 !: 21--up BARNSTABLE TOWN CLERK 19 mAR 27 P 2 54 BARNSTABLE, MASS. 639. 1 Town of'Barnstable Zoning,Board of Appeals Decision and Notice. Compyehensive Permit.,N-0; 2006_105—Grossman Chapter-.40B C6tnPkc n 'ini.f. -ho sivId�Per Summa. ry: Comprehensive Permit No. 2006-1,05 is rescinded Applicant: Eric Grossman Property Address: 40.Maggio Lane, West,B,arqstable,MA Assesso,r's M-ap/Parcel: 217/032 Zonin9 Residential F Zoning.Distriot Deed Reference- Book 1-5.662;Page 72 Permit Reference: Book 21,635,.P* age 3 1 Locus-and Background; : The applicant applied for a Comprehensive Permit under Chaptor40B of-the G,eneral.Laws of,the Commonwealth of Massachusetts, and in accordance-with Article 1.1 of Chapter Nine of the Code of the town of Barnstable, more: commonly termed the ."Accessory -Affordable Housing Program." Comptehonsive Permit Numba,--2006`j,05 Was',1s§iied:'t6 the a*p-plicAnt,oh November 3012006 and a n recorded at the Bath. o9vIdtoky: Agreement: and. Declaration: -of C6ve 'aht§ Were. teoo ,. R.dgi.stry-%Of D.eeds�0 fi�Decdm�df.-'21.,2 $tAKIP County 006 in B66k,`2163 5,Page 3 1. On March. 4,.2015 the p1'1 Q--perty. :was-sold to;Robe P.c.4'aftd-Goratd.Hoffi. The new owners have 'that ':interested in it' ft the:program:m.ther6or communicated to Town,,. dg, 06 not 14P .therefore participating Atth . .gm lhe•perrnitmust be.rescinded.. Ttotedura'L&Hearing S. 'gin mi-a-ry: A p0lic hear'ing:4o rescind Comprehensive Pottni. t-1 .6. 2006 105. was duly advertised and,notice. sent-to-abutters and the property owner all in:accordance with MOL Chapter 40A. The hearing was opened, on March- D, 2019 at which tirne the Hearing Officer, Alex .Rodolakis, made the following,findings and-decision: 'Proposed Findings of Fact: Tewi of Barnstable,Zoning Board of Appnis Compr6hen.Mve Permit No.2006-1.05—Grossman is rescinded 1. The applicant, Eric Grossman, was granted Comprehensive Permit 2006-105 for an accessory affordable apartment at 40 Maggie.Lane,West Barnstable. 2. The applicant,Eric Grossman,sold the property on March 4,2015. .1 On. January 219, 2.019,.the. Accessory. Apartment.Program Coordinator-took action'to rescind Comprehensive Permit No.. 2006-105. Ordered:: Cornpreherisive,POrnit rituriber'2006-105`is rescinded. A.Written copy Of this decision-'shalt be..forwarded.to the.Zoning Board of Appeal as required by the'Town of Barnsta I Ke.Admini8trativo,Code Chapter-241,-section 11. if after fourteen (14) days from that1ransmittal the Members of the Zo ning.Board of Appeals takes no action to reverse the; decision, this decision shall.become final and a copy shall lie-the filed in-the office of the.Town., App eals of the final decision, if any, shall b6inade-to the BaffistAble, Superior Court pursuant to: MGL. Chapter 40A, .Section 17, Within twenty (20) days of the date of the filing 'of this decision in the-offic.6-of the.Tow ft.'Clerk. The applicant has thetighttoapp eal this.decision. s outlined in DJGL-C I hapter 40B., Section 22. Alex RbdolaTs,Hearing Officbr Date SiAed .1, Ann Quirk, Clerk of the Town,of.garbstablei Barnstable County, Massachusetts,.hereby certify that twenty 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 theTown.Clerk. Signed and sealed this. day o Ole under.-the.pain's`,and penaltiesof perjury, Ann Quirk,Town Clerk 1.00 co 0 P BARNSTABLE REGISTRY OF DEEDS John r. Meade, Register 2 � .� Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MAS& Posted Until Final Inspection Has Been Made. Permit tbs� Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-89 Applicant Name: Roland Langevin Approvals Date Issued: 02/07/2019 Current Use: Structure Permit Type: Building- Insulation-Residential Expiration Date: 08/07/2019 Foundation: Location: 40 MAGGIE LANE,WEST BARNSTABLE _ Map/Lot: 217-032 _ Zoning District: RF Sheathing: Owner on Record: HORN, REBECCA&GERARD T JR Contractor Name: -,ROLAND LANGEVIN Framing: 1 Address: 26 BUCKLEY ROAD Contractor License: CS-103861 2 WEST DENNIS, MA 02670 4 Est. Project Cost: $3,473.00 Chimney: Description: R-38 damming, r-37 in attic,gable vents,soffit vents, air sealing, Permit Fee: $85.00 dense pack r-28 in overhang, ? i t Insulation: Fee Paid:,f $85.00 Project Review Req: - � Date 2/7/2019 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months of ePgMR&Pfficial Final Plumbing: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. r Final Gas:, r, The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: c0 N taw.rw►R �r��T / Assessor's map,and lot number R...... . .. ..... X. THE T 0 Sewage Permit" number ... ...................��....... . ...I... . ...... B 9TAD ABB LE, • House number. ............... ........................................... ............... 900� a 9 O YPY a' TOWN ' OF- BARNSTABLE BUI•LDIHG INSPECTOR APPLICATION FOR PERMIT TO ......L11.1..e-(:......QDr0.n.P...................................................................... ,..,......���......... ...............:� ' TYPE OF CONSTRUCTION ....h� A)C�«(� ...,...�1�W.:............................................................ 9 ...1.. 19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....�n.....mp.(?. .1.s�.....,�1�......... 1:... '.r/. .Uq!az).le.................................................................. ProposedUse ......... .arn.....e.......................................................................................................................................... Zoning District R. Fire District .�.��r�S7` r(�1,.5,7'{ "(h/P Name of Owner k, 6h ... �O..r/.c....... �'../1l s...Address .. v.y....1.���21. ...,1'J..L1.........W... �.... ... Nameof Builder .......5.../MP..............................................Address ..................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation .�.�:?(.eC.l..........(..0............................................. �I ashaExierior ...��h/.n..Ci ICE,.,.5....................................................Roofing ..... h� ........ . Floors .......................................................................................Interior . .......:............................................................................ Heating -" ..........Plumbing Approximate Cost '.. "T� .... Fireplace ...........�. pp QQ......................... QQ D befinitive Plan Approved by Planning Board -------------------_-----------19_______ . Area .........U: .:....................... Diagram of Lot and Building with Dimensions -3�.7�....Fee ................. ....................... / 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 ....QrA.!r......r-y. ..Q_1 ......................... Construction Supervisor's License F76 .. FIELD, JOHN & CARIA A=217-032 No ...26974... Permit for ....Build Garage. ............ .... .... ........ Accessory .................................... Location AQ.�J9.?:e..Iane................................ West Barnstable ............................................................................... Owner ... Carla Field ................................................ Type of Construction ...TQXR.................I............ ................................................................................ Plot ............................ Lot ................................. - Permit Granted ....................September-17,• 19 84 Date of Inspection ....................................19 Date Completed ......................................19 Le �2,1 cl �C a r 4S-k �a � �/,Al .. . .......... ........... ...... . .. .. i Assessor's map and lot number I OF IME t0 Sewage Permit number .. S • Z BABB9T11DLE, • Housenumber ....................................................... ........ 3 \e TOWN OF BARNST�ABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......44u//4d.......9. Je. .................................................................... TYPE OF CONSTRUCTION .... ....... a/.... ..R�/22.e............................................................... ...........................�=.. .....,9. 7. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following Linformation: Location ........Vo.....r 4 ��1.e.....1..1?.........bj..... ar...n. lc./.:a�. ................................................................. ProposedUse ....... ...a4cay..,......................................................................................................................................... Zoning District ................6..ic............................................Fire District .W S7 ....)6a.rf2 &ble,,.............. Name of Owner ...,4 hf....7�!.r/Q......r/..t/ ...Address U. Q�l Q�t'.....,�111......:: v . Nameof Builder .......:kk me...............................................Address ...................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation pDre.(d......cnalr'.re��......................... Exterior ....��/..??��e�....................................................Roofing .....Q.SyO.h.Q:. `/.......:................................................. Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ............................ .................. Definitive Plan Approved by Planning Board -----------_______-----------19________. Area .........07.�......................... Diagram of Lot and Building with Dimensions Fee .�773 ............................................. 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 ....9.0-&n.......,.�k............................ Construction Supervisor's License P�o o9....,5............. . ..... FIELD, —C-ARIA ?' No 26974 Permit for ..Bui.l.d..Ga.r.age.............. . .. .... . ...... Accessory to Dwelling .............................................................................. Location ....49..nWi��..Lane.............................. .. ........ 'West Barnstable ............................................................................... Owner John & Carla Field .................................................................. Type of Construction ....Frame...................................... ................................................................................ Plot ............................ Lot ............................. September 17, Permit Granted .......Se...p....................... ......19 84 Date of'lnspectiov-::'g—R5.......................19 Dcite ,Completed ............... ..........AV J� P'z \ 90 Z -c� N )> o CEET/F/E'g pL OT t=,4,j4QA/ .4 04C.o-r10A.1 rW .� T�A�' S�i yQ��L- NIf�SS• � Pf���=-� �'. SCL7.L E 2 NE,eEBY CEBT/FY TNAT •T.NE 6(J/LD/.V�i ' SHOw.v O.t./ TI-//S 'AP4ACP.1 /S L.00097-&0 OA/ T/•/E �eoc%va •qs saro w.v Ncjeeov- - �jN OF o ARNE GJ, z H. I � OJA�A H V26346 wn c�jo� en9irreeriri9 0 c.�a.va suet/Yoe ,9��G SJ � E'OG/TE t • • . . . Complete items 1,2,and 3. A. Signature 13 r• oron Print your name and address on the reverse X Agent so'that we can return the card to you.. ❑Addressee Attach this card to the back of the mailpiece, S•Received by(Rrinted Name) C. Oate of Delivery the front if space permits. 1. Article Addressed to; D.'Is delivery address different from item i? 0 Yes If YES,enter delivery address beloW-. p No a TV, �2a - kV 3.II I IIIIII ItI ItI I lI ll l ll l III I I I I�I I II I I I III O AdulressO t Signature RpWcted'DeUM O RRegistered stereo Mce Type Q,Priority Mail�Restricted 9590 9402 1934 6123 0983 85 mneedd Mail Restricted Del" �Z mryRecelPtfor ❑Collect on Delivery Merchandise 0_Collect on Delivery Restricted Delivery O Signature Confirmations"° -' lured Mall 0 Slgnature Confirmation 7 015 1730 0001 4990 5091 ',.i"-lured MaTRestrlcted Delivery mated Delivery er$s0o PS Form 3811,July 201.5PSN 7530-02-000-9053 Domestic Retum Receipt First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 1934 6123 0983 85 United States •Sender:Please print your name,address,and ZIP+4®in this box• Postal Service TOWN OF BARNSTABLE BUILDING DIVISION r;k : x`Jr 200 MAIN ST , INNIS,MA oz6ot WA 'W � z � i� ~3�i��"I13F.,PJ CE t 200 Main Street U.S.POSTAGE»PiTNeYeowes Hyannis,Ma 02601 Rl i jA 4� y7015 1730 0001 4990 5091 �*� 'F, 02 os3sas$006.560 Lu �o Co m M Rebecca Horn Gerard Horn t_.. _ 26 Buckley Ra ,_ W Dennis, , . �., R,ETURN TO - SENDER NOT DE,LtVERABLE AS ADDREESSED LINAALE: TO IrORWARD _• 93260IS67-6907074 ;.UT.F SC' e260 1'40020t� 2661>� >4.�Z s i ill(! t 711ljii ilea roc 19 t 1 ie c iii'(i !i 1 �� �� J i ' -• �� �_ ', I , �rr��y.�yt.-�. ^-_- _ ._. �� F ill )j 1 Y ,� �� i � r�_ i _ � �.�.. � �` �' � - i � �; - ��� .i _ ., ' cr Gam. .- ->e-� I Z. � � I I ► �— �-- _ . . - --- a ,.... Anderson, Robin To: Cadrin, Arden cc:, Coyle, Brenda Subject: 40 Maggie Lane, W Barnstable Hi Arden, Last Week I'was working with the property owner of 40 Maggie Lane in W. Barnstable concerning an accessory apartment created by a former owner. As a result, I had an opportunity to advise the current owner, Mr. Horn of the family apartment and Affordable Accessory provisions. He seemed interested in your program and subsequently he came in last week to see me. Unfortunately, I was out in the field when he arrived so I asked staff to-provide him with the updated Affordable Accessory brochure and your business card. I confirmed that Mr..Horn did indeed come in and that he left with the aforementioned information in hand. Could you•let•me Know if-Mr. or Mrs: Horn contacted you to discuss this option and whether or not they desire to pursue a comp permit, please? Thank.'you for your assistance with this matter. p�btn Robin C.Anderson Zoning Enforcement Officer iob*, Iain Street Hya�riis;MA 026oi 508-862-4027 17, ii , SENDER: COMPLETE THIS SECTION COMPLETE THIS S.ECTION ON DELIVERY ■ Complete-items 4i,,2jrand 3. A. Signatu 4 Agent ■ 1?rintyour narne.s4address on the reverse X ❑ so that we can refu�n the card to you. ❑Addressee ! ■ Attach this card to the back of the mailpiece, B. Received by(Panted Name) ��elivery ! or on the front if space permits. 1. ddressseed to: D. Is delivery address different low:m 1? s 'y ���(( � Y I If YES,enter delivery addre o Z U�eS-f kis-fa 0e, 3. Service e 0 Priority Mail r II I IIIIII IIII III I II II II I I I IIIII I I II I I II I II III ❑Adult Signature ❑Registered M�T"'. El Adult Signature Restricted Delivery ❑Re.9istered Mail Restricted, 9590 9402 1933 6123 1271 61 ❑Certified Mail® Delivery ❑Certified Mall Restricted Delivery ❑Return Receipt for 1 ❑Collect on Delivery Merchandise 2._Article Number ransfer from service label ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation*"' .Oj In_sured.Mall ❑Signature Confirmation i !1 0 `a' t r 10 i M'�lail Restricted Delivery Restricted Delivery 70`17 00i 0000 6759 6146 )0> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt 0 I � Ln Certified Mail Fee If Iti $ 0 7 J3 Extra Services&Fees(check box,add lee as eppmpd4te) ❑Retum Recelpt(hardcopy) $ r \ r-3 ❑ Receipt(electmnic) $ Postmark C3 ❑•-,ao ]ed Mall Restricted Delvery $ f +f J' Here❑AduhtSignature Required $ t `�)❑Ad6 SignatureRestrictedDelivery$ t"*-tp Postago $ f= Total Postage and Fees + r- $ r- Sent To �hlLDD O Street enorApt.Noi r d 1 ----------—-------------- a Q U C t Certified Mail serce p e following benefits: ■A receipt(this portion of theCertifiedMai or an electronic return receipt,see a retail ■A unique identifier for your mece. ssociate for assistance.To receive a duplicate ■Electronic verification of delivery or attemp ed tum receipt for no additional fee,present this delivery. USPSO-postmarked Certified Mail receipt to the ■A record of delivery Qncluding the recipient's retail associate. signature)that is retained by the Postal Service' Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the'addressee's authorized agent Important Reminders.,' Adult signature service,which requires the •You may purchase Certified Mail service with signee to be at least 21 years of age(not Rrst-Class Mail®,Arst-Class Package Service°, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is not available for requires the signee to be at least 21 years of age intemation!I mail. and provides delivery to the addres,.e specified ■Insurance cpooverage is notavaiiable for purchase by name,or to the addressee's iuVhozed agent with Cert)fied Mail service.However,the purchase (not available at retail). 11 It of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurancepoverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your -y endorsement on the mailpiece,you may request Certified Mail Item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion , of delivery(including the recipient's signature). of this label,affix it to the mailpidce,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a harocopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. Ps Forth 3800,'APrii tot a(Reverse)PSN 7e3o-02-000-9047 ) ov 3o cw��) w T . . t a r� 1 i 1 t t 0 I N' O O O n O � O N O r- (O O LL Postal CERTIFIED o RECEIPT a Donpstic Mail Only U. �r For delivery information,visit our website at www.usps.comO. OF FI C I A WASS Q' Certified Mail Fee iEr $' Evora SeNiCes&Fees(check box,add fee as appropriate) d Return Receipt(hardtop» $ ❑Return Receipt(electronic) $ i O t3Certified Mail Restricted Delivery $ ere i3 ❑Adult Signature Required $ '•� ❑Adult Signature Restricted Delivery$ to Postage N AUG242017LU tT ILI Total Postage and Fees Sent To /� / P 3heetandApElVo.,orP�BoxNo. o2(0X3ClC�(e.� N �ity,State,ZIP+4� ----------- PS Form :00 April 2015rr rrr• Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique Identifier for your mailpiece. associate for assistance.To receive a duplicate •Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Met1 receipt to the,I •A record of delivery(Including the recipients retail associate. C] signature)that is retained by the Postal Service— Restricted delivery service,which provides i 1J for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent C7 Important Reminders: Adult signature service,which requires the —a •You may purchase Certified Mall service with signee to be at least 21 years of age(not —e First-Class Mail®,First-Class Package Service®, available at retail). y, or Priority Mail°service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age, International mail. and provides delivery to the addressee specified i ■Insurance coverage is notavailable for purchase by name,or to the addressee's authodzedlagent with Certified Mail service.However,the purchase (not available at retail). L3 of Certified Mail service does not change the •To ensure that your Certified Mail receipt Is insurance coverage automatically included with accepted as legal proof of mailing,it should bear,a; certain Priority Mail items. USPS postmark.If you would like a postmark on fs� •For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail Item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipients signature). of this label,affix It to the mailpiece,apply t�, You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.13 electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7630-02-000-9047 i own of tiarnstaaie Building Department Services F1HE r Building Division Jeff Lauzon,Acting Building Commissioner EARNSTABLE, 200 Main Street,Hyannis,MA 02601 MAW. i639• ♦0 ,orFDA )38 Fax: 508-790-6230 Notice of Zoning Ordinances Violation(s) and Order to Cease, Desist and Abate: Rebecca & Gerard Horn, and all persons having notice of this order. As owner/occupant of the premises/structure located at 40 Maggie Lane,W Barnstable, MA 02668 Map 217 Parcel 032,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,August 24,2017 to: 1. CEASE AND DESIST IMMEDIATELY, all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Chapter 240 Section 14 A (1) RF'Residential Single-family District 2.'COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: Rental of former Amnesty apartment in detached garage. ` Remedy: i Immediately cease rental and/or marketing of apartment over garage. j Register primary dwelling as a rental unit with the Board of Health. Obtain.all.necessary building &plumbing permits to eliminate the apartment use and convert the subject space into an allowable use. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable, a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the.expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. B order, Robin C.Anderson Zoning Enforcement Officer QNORMS/viozonel i I Rebecca Horn Gerard Horn 26 Buckley Road W Dennis,MA 02670 Q/FORMS/viozonel f Official Website of The Town of Barnstable - Property Lookup Page 1 of 4 Select Language Assessing Division Property Lookup Results - 2017 367 Main Street,Hyannis,MA.02601 Q, <<BACK TO SEARCH<<� 9Prmt Friendly Owner Information-Map/Block/Lot:217/0321-Use Code: 1010 Owner Owner Name as of HORN,REBECCA&GERARD Map/Block/Lot GIS MAPS 1 a 111/16 T JR 217/032/ `I b 26 BUCKLEY ROAD Property Address l ;.Wjy� 40 MAGGIE LANE - J WEST DENNIS,MA.02670 V p Co-Owner Name Village:West Barnstable I V Town Sewer At,Address:No GIS Zoning Value:RF /1+D Assessed Values 2017-Map/Block/Lot:217 1 0321-Use Code:1010 f6k) 2017 Appraised Value 2017 Assessed ValuePast Comparisons InL J": JA�Ilding $89,900 $89,900 Year Assessed Value `fA) :-,:Value: F/+++CCCTTT Extra $38,000 $38,000 2016- 337,600 features: 2015-$323,000 W/ l 2014-$323,700 .� 2013-$330,800 DP Outbuildings:$39,900 $39,900 2012-$324,100 2011-$333,300 Land Value: $1.54,400 $154,400 2010-$364,700 2009-$615.900 2017 Totals $322,200 $322,200 2008-$575,700 2007-$596,800 Tax Information 2017-Map/Block/Lot:217 1 032/-'Use Code:1010 ((11 V� Taxes nn W.Barnstable FD Tax(Residential)$869.94 Community Preservation Act Tax $92.21 Fiscal Year 2017 TAX RATES HERE Town Tax(Residential) $3,073.79 $4,035.94 Sales History-Map/Block/Lot:217 1 032/-Use Code:1010 History: Owner: Sale Date Book/Page: Sale Price: HORN,REBECCA&GERARD T JR 2015-03-04 28718/40 $300000 http://www.townofbamstable.us/Assessing/propertydisp'layscreen 17.asp?ap... 8/24/2017 Official Website of The Town of Barnstable - Property Lookup Page 2 of 4 GROSSMAN,ERIC 2002-09-27 15662/72 $380000 WALLACE,STEPHEN E&JOANNE E2002-04-05 15022/286 $200000 FIELDS,JOHN E 1998-09-28 11726/247 $1 FIELDS,JOHN E&CARLA S 1971-08-09 1522/726 $0 Photos 217 1 032/-Use Code:1010 Sketches-Map/Block/Lot:217/032/-Use Code:1010 I 6.` $.•u� r�7.. r Alt BM V 't � � As Built CardS:Cliick card#to view:Card#1 Constructions Details-Map/Block/Lot:217 1 032/-Use Code:1010 Building Details Land Building value $89,900 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $118,313 Bathrooms 1 Full-1 Half Lot Size 0.87 / (Acres) Model Residential Total Rooms 6 Rooms Appraised $154,400 Value Style Raised Heat Fuel Oil Assessed $ Ranch Value 154,400 Grade Average Heat Type Hot Water Year Built 1972 AC Type None Effective 24 Interior Carpet depreciation Floors Stories 1 Story Interior Walls Drywall Living Area sglft 1,148 Exterior Walls Wood Shingle Gross Area sq/ft 2,804 Roof Gable/Hip Structure Roof Cover Asph/F GIs/Cmp http://www.townofbamstable.us/Assessing/propertydisplayscreen l 7.asp?ap... 8/24/2017 r Official Website of The Town of Barnstable - Property Lookup Page 3 of 4 `LN ` :Outbuildings&Extra Features-Map/Block/Lot:217 1 032/-Use Code:1010 Code Description Units/SQ ft Appraised Value Assessed Value FPL1 Fireplace 1 story 1 $3,400 $3,400 FPO Ext FP Opening 1 $1,400 $1,400 BMT Basement- 1104 $22,700 $22,700 Unfinished WDCK Wood Decking 552 $5,400 $5,400 w/railings BFA Bsmt Fin-Avg 800 $10,500 $10,500 GAR2 Det Gar-w/FHS 840 $32,400 $32,400 UTIL UTIL BLDG-Low 121 $700 $700 Cost WDCK Wood Decking 42 $1,400 $1,400 w/railings Sketch Legend !�'•" Property Sketch Legend B2N Bam-any 2nd story area FPC Open Porch Concrete Floor REF' Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) BRN Barn GAR Garage TQS" Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS. Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio 4Print FriencIN Contact Acting Director Pamela Taylor P 508-862-4022 F 508-862-4722 430a.m.to 4:30p.m. http://www.to'wnofbamstable.us/Assessin'g/propertydisplayscreen 1'7.asp?ap... 8/24/2017 f rr of Town of Barnstable Regulatory Services • BARN3I'ABLE. • „ASS. Richard V. Scali,Director i63� ♦0 AtF039. Building Division Paul Roma,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 November 16, 2016 Rebecca Horn Gerard T. Horn, Jr. 26 Buckley Road West Dennis, MA 02670 Re: Illegal Apartment located at 40 Maggie Lane, West Barnstable. Dear Mrs. and Mr. Horn, On November 15, 2016 we-received a complaint about the above referenced property. At this time, we need to inform you that you may currently be in violation of Barnstable Zoning Ordinance 240-11; any use other than a Single-Family home is prohibited. You must contact this office by December 5, 2016 to arrange to bring the above address into compliance or be subject to fines of$100.00 per violation, per day. Sincerely, Robin C. Anderson Zoning Enforcement Officer /blc Town of Barnstable - - "* ,' U.S.POSTAGE>>PiTNEY BOWES Building Division opp-740m 200 Main Street Hyannis, MA 02601ZIP 02601—$--000 4 cV5 10�i� p I�i :j �y• M 02 4VV . 1 00.00336455 NOV. 16. 2016. 28 P 16 .7 +j.00 11,11 Rebecca Horn Gerard T. Horn, Jr. 26 Buckley Fj o2d West Dennis v%',"NI xiE) 015 -N7E '1 16I'0011/.17Ii6 I; RETURN TO SENDER NOT DEr TVER.QR1_.E AS' AD-DRESSED I' UNABLE TO FORWARD 3S< 02 6014,002 09 *102Z-09398--1.6-42 � �-'=� ix.7: 0 a�8v►`.a trr���Ilii gill 9,g rr,: ii�ii.liitllilriillliuirillilr;illliili�lil:riiii'I� - � all , , , , g „] , ,,,, ( . '•1 .,,,, ,. �\ r y/� r" J 1 �� r ,f �� / 4 /, /• �Y ' r� I �. pf ..� /p/J��1 ...� . ! ,•^� � 7 i' �' ,` t ....— �" .r i+i .�� �)� ` 4 �� \. � "_ . e � /' l ..�.. t ..�.. .� 1 �� i J .'_' �'.....- e V � r 1 J oFt ,, Town of Barnstable Regulatory Services + Bn�wsrnsta.. ` ,,,, �, Richard V. Scali,Director 039. Building Division Paul Roma,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 November 16, 2016 Rebecca Horn Gerard T. Horn, Jr. 26 Buckley Road West Dennis, MA 02670 Re: Illegal Apartment located at 40 Maggie Lane, West Barnstable. Dear Mrs. and Mr. Horn, On November 15, 2016 we received a complaint about the above referenced property. At this time, we need to inform you that you may currently be in violation of Barnstable Zoning Ordinance 240-11; any use other than a Single-Family home is prohibited. You must contact this office by December 5, 2016 to arrange to bring the above address into compliance or be subject to fines of$100.00 per violation,per day. Sincerely, Robin C. Anderson Zoning Enforcement Officer /blc I Town of Barnstable F THE► do Regulatory Services Richard V. Scali,Director Regulatory Service xAs v� ,0$ Building Division s iOtFn 39. Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 February 24, 2015 Jesse W Morgan,Loan Originator Village Mortgage 30 Tower Lane Avon,Ct. 06001 Re: Proposed Transfer of Amnesty Unit Locus: 40 Maggie's Lane, W Barnstable,MA Dear Mr. Morgan: Please be advised that I had occasion yesterday to meet Rebecca&Gerard Horn and discuss the proposed sale and transfer of the aforementioned property. This particular home is a single family home with an existing Amnesty Unit created and permitted by the current record owner(Grossman). You should be aware that these units ai•e restricted in perpetuity as affordable accessory units so long as the owner/occupants remain in the program and all participants including the tenants qualify to continue. In the absence of eligible occupants,the property must be restored to a single family home again with the complete removal of the kitchen (counter tops/appliances/cabinets) as well recreating flow into the primary habitable space. However, the Horns have expressed a desire to enter the Affordable Accessory Unit Program(Amnesty)program and maintain the existing tenancy. As a result of our meeting on the afternoon of Feb. 23`d, I am confident that the Horns are not only aware of the property restrictions and status of the Amnesty unit but can also satisfy the program's required criteria. It is my belief that the Horns will be successful Amnesty candidates and property owners. I have provided them with the necessary paperwork to pursue the transfer of the Comprehensive Permit found on record with the Barnstable County Registry of Deeds. You may reach me directly at 508-862-4038 if you require additional information or clarification. Sincerely, 0i gbtn C oqndetson Robin C. Anderson Zoning Enforcement Officer J:\40 Maggie Lane WB Proposed Amnesty Transfer Letter.doc i Message Page 1 of 1 Coyle, Brenda From: Anderson, Robin Sent: Monday, February 23, 2015 3:19 PM To: Cadrin, Arden Cc: Perry, Tom; Coyle, Brenda Subject: Amnesty Unit in WB Arden, The perspective buyers came in to see me about transferring the Amnesty unit at 140 Maggie Lane in WB. At this time they are still awaiting a closing date but are expecting to hear this week. I have instructed them to contact you as soon as they close on the property in order to avoid enforcement actions. They have agreed and also expressed a desire to stay in the program. Please confirm their participation once they actually apply. Their contact information is as follows: Rebecca & Gerard Horn 508-332-6031 Thank you. Robin Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026oi 508-862-4027 2/23/2015 f T Town of Barnstable s r Regulatory Services BARMASS. Richard V.Scali, Director i63q. ,0� 16.39.�� Building Division Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PLEASE FORWARD THE ATTACHED PAGE(S) TO: j TO: r ATTN: I I FAX NO: -7eI —'��� — ��� RE: FROM: ��J0 DATE: PAGE(S): (INCLUDING COVER SHEET) Rev:121901 Amnesty Program Helping to make affordable housing possible. AM .,f Town Bamstable Certificate of Compliance This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building Code and Town of Barnstable zoning ordinances in accordance with the Amnesty prograrn. Owner Eric Grossman Location 40 Maggie Lane, West Barnstable, MA Unit Capacity On 'droom to exceed two people Inspector M/P No. 217-032 2/27/2007 .s �I"Eti Town of -Barnstable Building Department - 200 Main Street "M Hyannis, MA 02601 MASS. �' (508) 862-4038 1639- ArFO IVIA'I A Certificate of Occupancy Application Number: 200700103 CO Number: 20070036 Parcel ID: 217032 CO Issue Date: .02123107 Location: 40 MAGGIE LANE Zoning Classification: RESIDENCE F DISTRICT Proposed Use: MULTIPLE HOUSES ONE PARCEL Village: WEST BARNSTABLE Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: AMNESTY APARTMENT IN DETACHED GARAGE )�O d Building Departmen ignature Date Signed .:fie-,a'�...�'b.-+..•���+ia.:wk...:.s _-.wt..<...� aCv.'J�.�.�..�.._a..s .e�.+.Yf ...«.n�.s..i p �` < - .. w .'L�c...;..},aj„"' r ... ..M..i.:.Yo . I"E' ti Town of Barnstable Building Department - 200 Main Street BARNSTABLE, * Hyannis, MA 02601 MASS 9�A i639. . (508) 862-4038 Certificate of Occupancy Application Number: 200700103 CO Number: 20070036 Parcel ID: 217032 CO Issue Date: MOW Location: 40 MAGGIE LANE Zoning Classification: RESIDENCE F DISTRICT Proposed Use: MULTIPLE HOUSES ONE PARCEL Village: WEST BARNSTABLE Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: AMNESTY APARTMENT IN DETACHED GARAGE Building Departmen ignature Date Signed mot" ti TOWN OF BARNSTABLE Building Application Ref: 200700103 i BARNsrABLE, Issue Date: 01/19/07 Permt P" MASS. 1639• Applicant: GROSSMAN,ERIC Permit Number: B 20070113 a Proposed Use: RESIDENTIAL Expiration Date: 07/19/07 Location 40 MAGGIE LANE Zoning District RF Permit Type: AMNESTY W/CONSTR RESIDENTIAL Map Parcel 217032 Permit Fee$ 25.00 Contractor PROPERTY OWNER Village WEST BARNSTABLE App Fee$ 50.00 License Num Est Construction Cost$ 1,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND AMNESTY APT/EXISTING IN DETACHED GARAGE,ADD WINDOW IN THIS CARD MUST BE KEPT POSTED UNTIL FINAL BEDROOM, SEAL SUPPORT POSTS IN CEILING OF GARAGE INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: GROSSMAN, ERIC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 40 MAGGIE LN INSPECTION HAS BEEN MADE. W BARNSTABLE, MA 02668 Application Entered by: JL Building Permit Issued By: a THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR AN ART THE F,EITHER TEMPORARI t OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE UILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CO(NTT�R�ACCTTO�RSSyD�O NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). — ff.0 lS— � i�J+�J +SL�lie]l r+ rn L BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS A; s A�/zo � 2 2 2 J 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health 41 J� . -c � v a � � � i I 3 -1 a o r-••I � z 3 3 r Z 3 1 I m m m m 1•-I G7 a � H I 1 •• •• � 3 O /! /--1 Z C7 m _0 m I I m m 0 m '=o 1 1 3 Cn O {I"m m a Cn z C I O O m A -1 w 1 rs4M m o m r m x p r omo Cn _ CT ? 0 0 0 O I N O O O O i Town of Barnstable ermit:o2667 o4/as oFT►+ lw,, '`° Regulatory Services Date: Thomas F.Geiler,Director BARxsTABM Building Division ee � 00 y MASS. Ec.39.'�A.�� Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: ° L C t L j U 2 Phone: J G ' 3 Y7 r Install at: y-'i 4 •t - �;.� 4-pillage: " I l�y • �: Map/Parcel: c 7 /C Date: j ' L �� - v Stove A. New/eadiant B. Type: /Circulatin C. Manufacturer: r Lab. o. D. Model No.: Chimney��^^ A. New/► xistin (If existing,please note date of last cle nine B. Flue Size C. Are other appliances attached to Flue? V\ D. Pre-fab Type and Manufacturer E. Masonry: Lined/Unlined Hearth A. Materials: (� B. Sub Floor Construction: Installer Name: Addre c� Phone: J w Location of Installation: ¢ i N APPROVED BY: Please make checks payable to the To rnstable m rn *This constitutes an official stove permit a i spection,photographed, and approved by the Building nspector Q:forms:stove Rev 122801 West Barnstable -Private Location Page 1 of 2 Y , , cape cod crai slist > housing > apts/housing for rent email this posting to a friend Stating a discriminatory preference in a housing post is illegal-please flag discriminatory posts as prohibited please flag with care:f� Avoid scams and fraud by dealing locally!Beware any arrangement involving Western miscate orized Union,Moneygram,wire transfer,or a landlord/owner who is out of the country or cannot prohibited meet you in person.More info sham/ovemost $985 / 1br - 800ft2 - West Barnstable - Private best of craipslist Location (West Barnstable) (map) Date: 2012-05-08, 8:10AM EDT Reply to:iktcz-2993477595&hous.crai slist.org [E---he.reulvinatoads?, This private 1 bedroom apartment is above a detached garage and situated on a very quite, private, dead end road near the marshes.Over 800 square feet of living space in this 2 room apartment. 1 st room includes living room/kitchen room combination with ceiling fan, microwave, and refrigerator(wood stove has been removed). 2nd room is a private bedroom with ceiling fan and closet. Off the bedroom is a full bathroom with bathtub. Available June 1 st- 1 st, last, and security required. Utilities not included- electric hot water and electric heat. rC 6y o ss 4to J yo &Wle- e�4e 4s$ tv LA Maggie Lane at Route 6A 00 le ma (yahoo map 1 , t ' Y V 1 http://capecod.craigslist.org/apa/2993477595.html 5/9/2012 West Barnstable - Private Location Page 2 of 2 • cats are OK-purrr • dogs are OK-w000f • Location: West Barnstable • it's NOT ok to contact this poster with services or other commercial interests PostingID: 2993477595 Copyright©2012 craigslist,inc. terms of use privacy policy feedback forum I http://capecod.craigslist.org/apa/2993477595.htm1 5/9/2412 Page 1 of 1 � F _ z= I y: http://images.craigslist.org/5 W55H35M63E43Mf3H6c53fU32adaa57bal662.jpg 5/9/2012 Page 1 of 1 ti ,7' - Ji j ff s ' ray http://images.craigslist.org/5I75E95Ka3Gf3Fe3L6c539fe23138e22dlfe2.jpg 5/9/2012 oFTHE ro,,, Town of Barnstable Regulatory Services + BMWSTABLE. y MASS. Thomas F. Geiler,Director 1639. �plFDnnat° Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601. Office: 508-862-4038 Fax: 508-790-6230 October 10, 2007 f Eric Grossman 832 Main Street Osterville, MA 02655 Dear Eric Grossman, RE: 40 Maggie Lane, West Barnstable, MA 02668 We have issued a building permit for an Amnesty apartment at the above referenced address. The apartment passed all inspections relative to the construction involved and subsequently we issued a Certificate of Occupancy for the apartment on 2/23/07. Sincerely, Sally Shea Division Assistant i q/fonns/bondre12 i 40 Maggie Lane, West Barnstable Eric Grossman 1 bedroom, not to exceed 2 people Existing apartment above detached garage. Owner came in 12/26/06, working on per app. TP decision: 2nd egress not required (unobstructed distance from most remote end of unit less than 75' from main entrance of 2nd floor apt.) must have emergency window in bedroom (clear opening 20 x 24). 1/22/07 bldg per issued, called to pick up 2/23/07 CO issued 2/27/07 Certificate of Compliance issued s i 12/26/06 Madeline Taylor will send their inspection reports with recorded documents. Also said she's send me copies of emails re property inspections (example attached). See below re 2"d egress 40 Maggie Lane, West Barnstable Eric Grossman 1 bedroom, not to exceed 2 people Existing apartment above detached garage. Owner came in 12/26/06, working on per app. TP decision: 2"d egress not required (unobstructed distance from most remote end of unit less than 75' from main entrance of 2"d floor apt.) must have emergency window in bedroom (clear opening 20 x 24) /-7 4g; o �_,A Message Page 1 of 1 Barry, Lois From: Taylor, Madeline Sent: Tuesday, December 26, 2006 11:25 AM To: Barry, Lois Subject: FW: 2nd means of egress -----Original Message----- From: Perry, Tom Sent: Wednesday, September 27, 2006 1:51 PM To: Taylor, Madeline Subject: RE: 2nd means of egress you are right on the egress issue.The one that was there is new and didn't know my reasoning on the issue;now he does.However my understanding is that there are other issues there. The bedroom doesn't have a window large enough and will need one installed and the wood stove-doesn't have the proper clearances., Unfortunately Jack is not available.The other one is Art Bela nger--508-428-5937 -----Original Message----- From: Taylor, Madeline Sent: Wednesday, September 27, 2006 1:37 PM To: Perry, Tom Subject: 2nd means of egress Hi Tom For future reference, and so we are all on the same page, can you clarify the second egress issue?Am I correct in stating that if the unobstructed distance from the most remote end of the unit to the main entrance on a second floor apartment is less than 75 feet then they don't need a second means of egress?,Should they have a roll-down fire ladder? I just want to make sure that I understand it as I am somewhat confused and I don't want to misinform people. I guess I just want to ensure that we tell people they don't need one and then at final inspection they are told that they do need one. Also, do you have a contact number for Jack Fitzgerald? I need to get the bids for our program inspector asap and didn't know if you thought he would be interested. Thanks Madeline Madeline Taylor Accessory Affordable Apartment Program Coordinator Growth Management Department Town of Barnstable 367 Main Street Hyannis,MA 02601 Phone:508-862-4743 Fax: 508-862-4782 12/26/2006 ,. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a / Parcel © � Permit# 62Od 616?. f.gt,, riF F,;,;�.�?i�STABLE f61 Health Division 24Date Issued /// 7t 4 � _ Conservation Division ZnI JAB Ate 11. 23 Fee Tax Collector _ 4-0 "r-1,N Treasurer Planning Dept. 0�- Checked in By Date Definitive Plan Approved by Planning Board �.�� Approved By Historic-OKH Preservation/Hyannis ��Ch/r�? � ; Project Street Ad ress l7 6 s Village /— , Owner l; Address y0 /k 419 Telephone d� a Permit Request 0 ti. rr"_1 C Q c�S <r�e CCCU Cs� 0 Square feet: 1st floor: existing proposed 2nd floor: ex tin proposed Total new '�e Valuation l \V44 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes O No If yes, attach supporting documentation. Dwelling Type: Single Fa"ily Two Family O Multi-Family(#units) Age of Existing Structure 1 g 0 --g g Historic House: ❑Yes O No On Old King's Highway: ❑Yes Cl❑ No Basement Type: O Full Cl Crawl O Walkout &tither !I a� a�` Basement Finished Area(sq.ft•) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new (0 Half: existing new Number of Bedrooms: existing new o Total Room Count(not including baths): existing Z- new O First Floor Room Count Heat Type and Fuel: ❑Gas O Oil 2-fllectric ❑Other Central Air: O Yes UK Fireplaces: Existing New Existing wood/coal stove: M'les O No Detached garage:existing O new size Pool:O existing O new size Barn:O existing ❑new size Attached garage:O existing Cl new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization C Appeal# �� J Recorded Commercial ❑Yes 2lo If yes, site plan review# i Current Use Proposed Use BUILDER INFORMATION G. Name [�! . L C� o S s Telephone Numbers o �- Z 1 Y Address L-i D M a ,x- License# 1,4j • 0 a.-n') 4 S It Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �- �-/����� DATE / - 7 - di FOR OFFICIAL USE ONLY PERMIT NO. 1 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME 3 INSULATION l FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL "' FINAL BUILDING /6'' i A DATE CLOSED OUT ASSOCIATION PLAN NO. V The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ^M �•'y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Nance (Business/organization/Individual): C f t c^ Address: '-A 0 M a y ;-� L—'J^A � City/State/Zip: .. �� °t"J ; 5U l�- Phone#: S U Are you an employer? Check the appropriate box:. Type of project(required): I.❑ I am a employer with . 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or p=er- listed on the attached sheet. $ �• ❑ Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its ME] Electrical repairs or additions officers have exercised their 3.erequired-1 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 13Co - ( jt comp.insurance required.] � � ^'' 1 t "- a *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 tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'.comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct V Si ature �� � �,��.�y.�- Date.' 1 Z 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 for their employees. h Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as`.`an individual,partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such.employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es) and phone number(s)along with their certificates) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain.a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should-enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum 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 Department of Industrial.Accidents Office of Investigations 600 Washington Street ` Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia °FTHE T° Town of Barnstable Regulatory Services Thomas F.Geiler,Director 039.'OWED MA'S�' 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 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. � WSJ Type of Work: �cC'�u�'"� a d`o"" � a" 1A eCX3 Cr �stimated Cost Address of Work: y O M 4, 0.^ �� � L Owner's Name: r a S .r �— Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑�B ding not owner-occupied I�Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING.WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR �./ Date Owner's Name I/ Q:folms:hameaffidav I 4 r f On SA c1r) -�tL I-ZZ71;A--F L 7�, It ol FT _V VTP Al UJ! ul oil- Lu Ut Lu- -9 4=1 C�o cr C.3 Lu cn Lu gs Lu e, cc c, LU m ui U) u-p 0000 j 7;Zj ct v J Fr� I-P c/5 i..,ta, U, Al T , r s i t ! ; t f 1 f • r MO + + t Tiz + I , , � ! I t _.. �_ --`� __ l� .l. .1.-Afv 1 + � _ �- ➢ _ - T :; � ��--^-1 �__ _i..r.-t�->' 2' _ 1 - i - -t- _{__--f .. — _-- - -- ID - `! — � - 1 --• ��.,._.,_ .. - --.�-r-�. --zz _ r-___ter..,.._ _.. - .— -- — . �--. _, . 41 i- i } I i i i 1 � � �• � i t � ! i 1 i- i 1 i i t . • f - 1 - t L'k 21635 Po31 JILr79662 12-21-2006 a 1 1 =�1 CL BARNSTABLE TOWN M-ER K �IM '06 NOV 30 P 3 :31 M4 `s8 Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Appeal 2006-105-Grossman Decision - Chapter 40B Comprehensive Permit Applicant: Eric Grossman Property Address: 40 Maggie Lane, West Barnstable,MA Assessor's Map/Parcel: Map 217, Parcel 032 Zoning: Residential F Zoning District Applicants: The applicant is Eric Grossman, who resides at 40 Maggie Lane,-West Barnstable,MA. Mr. Grossman was granted title to the property by deed recorded in the Barnstable County Registry of Deeds on September 27, 2002 as recorded in Book 15662, Page 72. Relief Requested: The applicant has applied for a Comprehensive Permit under Chapter 40B of the General Laws of the Commonwealth of Massachusetts, and in accordance with Article II of Chapter Nine.of the Code of the town of Barnstable, more commonly termed the "Accessory Affordable Apartment Program." The zoning relief necessary for this Comprehensive Permit to be issued is that of a variance to Section 9- 14 of the Code—Amnesty Program to permit an accessory apartment unit attached to a single-family owner-occupied residential dwelling. The issuance of this Comprehensive Permit would allow for an accessory.affordable apartment unit located above the detached garage. Locus and Background: The property at issue is a 0.87-acre lot located at 40 Maggie Lane,West Barnstable,MA. The lot was developed in 1972 with a single-family raised ranch style home. The effective living area of the main residence is 1391 square feet. The accessory apartment is a one bedroom unit located above the detached garage. The square footage of the rental area is approximately 700 square feet. The lot is served by public water and private on-site septic, and is located within an Aquifer Protection Overlay District. The town of Barnstable's Public Health Division reviewed the application, and on September 28, 2006 approved a total of four(4) bedrooms at the property with the on-site septic system. Procedural Summary: . A site approval letter was issued for the property by Elizabeth Dillen of the Growth Management Department on October 13, 2006, in accordance with MGL Chapter 40B and 760 CMR. Notice of the site approval letter was sent to the Department of Housing and Community Development in accordance with the requirements of CMR 760. An application for a Comprehensive Permit was then filed at the Town Clerk's Office and the Office of the Zoning Board of Appeals. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on October 20, 2006 and October 27, 2006, and notices were sent to all abutters in accordance with MGL Chapter 40B. On November 15, 2006 Hearing Officer Gail Nightingale presided over the public hearing. The applicant, Eric Grossman, was present at the hearing. Madeline Taylor of the Growth Management Department was also present. Ms. Nightingale reviewed the file with the applicant to assure compliance with all of the program requirements. Findings of Fact on the Comprehensive Permit: At the hearing on November 15, 2006 the Hearing Officer made the following findings of fact: 1. The applicant is Eric Grossman who resides at 40 Maggie Lane, West Barnstable, MA. He is requesting a Comprehensive Permit to convert'an existing unpermitted one-bedroom apartment located above the attached garage into an accessory affordable unit. The conversion of the unit attached to a single-family dwelling qualifies for the "Accessory Affordable Apartment Program." 2. Eric Grossman was granted title to the property by deed recorded in the Barnstable Registry of Deeds on September 27, 2002 as recorded in Book 15662,Page 72. 3. On October 13, 2006 a site approval letter was issued for the property by Elizabeth Dillen of the Growth Management Department, in accordance with MGL Chapter 40B and 760 CMR. Notice of the site approval letter was sent to the Department of Housing and Community Development, in accordance with the requirements of CMR 760, and no issues were communicated from the Department on this particular application. 4. The proposed accessory affordable unit is approximately 700 square feet, and is located above the detached garage 5. The applicant is aware that the unit must meet all applicable building codes to be occupied and that the Building Division and Fire Department will also be inspecting the unit for compliance with all applicable building and fire codes. 6. The house is served by public water and private on-site septic and is in an identified Aquifer Protection Overlay District. The proposal has been reviewed by Thomas McKean, Health Director, and he has approved a total of four(4)bedrooms at the property with the existing on-site septic. 7. On September 14, 2006 the applicant signed an Accessory Affordable Apartment Program Agreement Affidavit that commits,upon the receipt of a Comprehensive Permit, to the recording of a Regulatory Agreement and Declaration of Restrictive Covenants at the Barnstable Registry of Deeds. That document will restrict the unit in perpetuity as an affordable rental unit and requires that the dwelling be owner-occupied as his principal residence. 8. The applicant understands that the affordable unit will be rented to a person or family whose income is 80% or less of the Area Median Income (AMI) of the Barnstable Metropolitan Statistical Area (MSA) and further agrees that rent(including utilities) shall not exceed 30% of the monthly household income of a household earning 80% of the median income, adjusted by household size. In the event that utilities are separately metered, the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated. 9. According to the Massachusetts Department of Housing and Community Development, as of November 15, 2006, 6.3% of the town's year round housing stock qualifies as affordable housing units. The town has not reached the statutory minimum of affordable housing under MGL Chapter 40B Section 20-23 or its implementing regulations. The Town of Barnstable's Local Comprehensive Plan encourages the use of existing housing to create affordable units and the dispersal of these units throughout the town. 2 Finding Summary: Based upon the findings, the Hearing Officer ruled that the applicant has standing to apply for a Comprehensive Permit under MGL Chapter 40B and the Town of Barnstable's Accessory Apartment Program. The proposal is also deemed consistent with local needs because it adequately promotes the objective of providing affordable housing for the town of Barnstable without jeopardizing the health and safety of the occupants provided all conditions of the Comprehensive Permit are strictly followed. Ruling and Conditions: Based upon the findings, a ruling was made to grant the Comprehensive Permit in accordance with MGL Chapter 40B to the applicant, Eric Grossman. It is issued to allow for a one-bedroom accessory affordable apartment unit in accordance with the following conditions: 1. Occupancy of the affordable unit shall not exceed two persons. 2. The total number of bedrooms on the property with the existing on-site septic system shall not exceed four(4). 3. The property owner shall occupy the principal dwelling as his principal residence. .4. This unit shall not be occupied by a family member of the owner(s). 5. All parking for the accessory apartment and the main dwelling shall be on-site. 6. To meet the requirements of affordability, the cost of housing(including utilities) shall not exceed 30% of 80% of the median income for a single individual for the Barnstable MSA. In the event that utilities are separately metered, the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated. 7. All.leases shall have a minimum term of one year. 8. The Growth Management Department shall serve as the monitoring agent for the accessory apartment. 9. The applicant must apply for a building permit for the accessory unit, whether the unit is new or pre-existing. Before securing an occupancy permit and certificate of compliance, the Building Commissioner must determine that the unit conforms with the approved plans as submitted with the building permit application and meets state building and fire codes. The Health Division must determine that the dwelling is in compliance with applicable on-site wastewater discharge requirements. 10. The applicant may select his own tenant provided the tenant meets the requirements of the program as cited above and provided that person's income is reviewed and approved by the Growth Management Department of the town of Barnstable as a qualified individual. The applicant will be required to work with the town to provide information necessary to document that the tenant qualifies. -The unit shall be rented on an open and fair basis to an income eligible in or family. Whenever a vacancy occurs, notice must be given to the Growth Management Department and the unit must be listed with the-Town. 3 11. Every twelve months the applicant shall review the income eligibility of the individual occupying the unit. No later than a year from the date of issuance of this Comprehensive Permit, the applicant shall file with the Growth Management Department of the town of Barnstable an annual affidavit listing the rent charged and income level of the occupant of the unit. The applicant shall provide the town any additional information it deems necessary to verify the information provided in the affidavit. Upon any report from the town that the terms and conditions of this permit are not being upheld, the Zoning Board_of Appeals or it's Hearing Officer shall have the ability to hold a hearing to show cause as to why this permit should not be revoked. 12. This Comprehensive Permit shall not be transferable to any other person or entity without the prior approval of the Hearing Officer or Zoning Board of Appeals. This decision,the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed at the Barnstable County Registry of Deeds. If the ownership of the property is transferred, the Growth Management Department of the town of Barnstable shall be notified within 60 days of the name and address of the new owner. 13. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its issuance or it shall expire. Ordered: Comprehensive Permit 2006-105 has been granted with conditions. A written copy of this decision shall be forwarded to the Zoning Board of Appeal as required by the Town of Barnstable Administrative Code Chapter 241, section 11. If after fourteen (14) days from that transmittal the Members of the Zoning Board of Appeals takes no action to reverse the decision,this decision shall become final and a copy shall be the filed in the office of the Town Clerk. Appeals of the final 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. The applicant has the right to appeal this decision as outlined in MGL Chapter 40B, Section 22. In accordance with Chapter 214, section 11 of the Town of Barnstable Administrative Code, the hearing officer transmitted a written copy of the Comprehensive Permit decision to the Zoning Board of Appeals on November 15, 2006. Fourteen (14) days have elapsed since the transmittal to the Board, and no Board Member has taken action to reverse the decision. bllkr , e u G Nightingale, learing facer Date Signed I, Linda Hutchenrider, 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 bee led in t office of the Town Clerk. Signed and sealed this / day o �p under the airs and penalties of e irr-'. sue— ,— P � p :p,rJ..,..>' :::r2 Linda Hutchenrider, Town Clerk 4 f r IKE�, Town of Barnstable Regulatory Services BARNSTABLts, : Thomas F.Geiler,Director Y MASS. g 2639• ,0 Building Division lfD MA't 0 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 1,, Please Print DATE: I J �[[ ,� G `4 JOB LOCATION: `� Q p tit 4 number street village "HOMEOWNER,,: G -L C�T s s •�• ... 5 0 £S 3 Z-s z Z�� Ed d' 3,u Y-7 y 0 Z name home phone# work phone# CURRENT MAILING ADDRESS: O ((��Y�'1 G 0� `•n ;iJ , 1�ar�S�'•.J� Mf's 6 ZV � �i 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. 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"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. I undersigned"homeowner"certifits-that-hetshe- drrstan&-thy'own-of-Barnstabie-Buil-dmg-Depm-tn --- - - minimum inspection procedures and requirements and that he/she will comply with said procedures and r uirem�nts. ` 1 Signature of Homeov r 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 U-k 21635 Ps35 g79663 12-21-2006 a 1 1 - 41 u ' REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS THIS REGULAT RY AG EMENT and DECLARATION OF RESTRICTIVE COVENANTS,is made - this��day of r- ,2006,by and between E ric Grossman of 40 Maggie Lane, West Barnstable,MA and its successors and assigns (hereinafter the "Owner"), and the TOWN OF BARNSTABLE (the "Municipality'),a political subdivision of the Commonwealth; WHEREAS the Owner has been granted a Comprehensive Permit under Massachusetts General Law Chapter 40B and local regulations by the Zoning Board of Appeals to permit the creation of an accessory apartment in an owner occupied dwelling which will be rented to a Low or Moderate Income Person/ Family(hereinafter "Designated Affordable Unit"); and NOW THEREFORE,in mutual consideration of the agreements and covenants contained herein,and other good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties agree as follows: I_ PROJECT SCOPE AND DESIGN: A- The terms of this Agreement and Covenant regulate the property located at 40 Maggie Lane, West Barnstable, MA as further described in deed recorded herewith as Barnstable County Registry of Deeds Book 15662 &Page 72. B. The Project located at 40 Maggie Lane,West Barnstable,MA will consist of one accessory apartment unit which will be rented to an eligible low or moderate income individual or family(the "Designated Affordable Unit" or the "Unit"). C The Owner agrees to construct the Project in accordance with the terms of comprehensive permit Appeal No. 2006-105 and any plans submitted therewith and all applicable state, federal and municipal laws and regulations.Said permit is recorded herewith as Barnstable County Registry of Deeds Book p &Page 3 D. The Owner agrees to occupy the principal dwelling unit located on the property as their principal residence in accordance with the terms of the comprehensive permit. II. THE OWNER'S COVENANTS AND RESPONSIBILITIES• A. THE OWNER HEREBY REPRESENTS,COVENANTS AND WARRANTS AS FOLLOWS: 1 In receiving the comprehensive permit to create the Designated Affordable unit,the Owner agreed that the Designated Affordable Unit shall be set aside in perpetuity for the public purpose of providing safe and decent housing to persons earning at or below 80% of the area median income of Barnstable Metropolitan Statistical Area(MSA) and that the Designated Affordable Unit sliall be deemed to be impressed with a public trust. 2. The Designated Affordable Unit shall be rented in perpetuity to a household with a maximum income of 80% of the Area Median Income (AMI) of Barnstable MSA and that rent (including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent level. 3. The Designated Affordable Unit will be retained as a permanent,year round rental dwelling unit with at least a one-year lease. 4. The Owner has the full legal right,power and authority to execute and deliver this Agreement. 5. The execution and performance of this Agreement by the Owner will not violate or,as applicable,has not violated any provision of law,rule or regulation,or any order of any court or other agency or governmental body,and will not violate or,as applicable,has not violated any provision of any indenture,agreement,mortgage, i mortgage note,or other instrument to which the Owner is a parry or by which it or the Owner is bound,will not result in the creation or imposition of any prohibited encumbrance of any nature. 6. The Owner,at the time of execution and delivery of this Agreement,has good,clear marketable title to the premises. 7. There is no action,suit or proceeding at law or in equity or by or before any governmental instrumentality or other agency now pending,or,to the knowledge of the Owner,threatened against or affecting it,or any of its properties or rights,which,if adversely determined,would materially impair its right to carry on business substantially as now conducted (and as now contemplated by this Agreement) or would materially adversely affect its financial condition. B. COMPLIANCE The Owner hereby agrees that any and all requirements of the laws of the Commonwealth of Massachusetts to be satisfied in order for the provisions of this Agreement to constitute restrictions and covenants n,nning with the land shall be deemed to be satisfied in full and that any requirements of privileges of estate are also deemed to be satisfied in full. G LIMITATION ON PROFITS 1. The Owner agrees to limit his/her profit by renting the Designated Affordable Unit in perpetuity to a household with a maximum income of 80% or less of the Area Median Income (AMI) of Barnstable Metropolitan Statistical Area (MSA) and that rent(including utilities) shall not exceed an amount that is . affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. -2. The Owner shall annually deliver to the Municipality and to the Monitoring Agent,as designated by the Town Manager,proof that the Designated Affordable Unit is rented,the tenant's income verification, a copy of the lease agreement and the rent charged for the unit or units. Such information shall also be forwarded to the Monitoring Agent within 30 days of the occupation of the dwelling unit or units by a new tenant. The Owner shall notify the Monitoring Agent, as designated by the Town Manager,within thirty(30) days of the date that a tenant has vacated the Designated.Affordable Unit. III. . MUNICIPALITY COVENANTS AND RESPONSIBILITIES 1. The MUNICIPALITY,through.the monitoring agent designated by the Town Manager agrees to perform the duties of verifying that the Designated Affordable Unit is being rented in perpetuity to a household with a maximum income of 80% or less of the Area Median Income (AMI) of Barnstable MSA and that rent (including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA.In the event that utilities are separately metered, a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. IV-. RECORDING OF AGREEMENT- Upon execution,the OWNER shall immediately cause this Agreement and any amendments hereto to be recorded with the Registry of Deeds for Barnstable County or,if the Project consists in whole or in part of registered land,file this Agreement and any amendments hereto with the Registry District of the Barnstable Land Court (collectively hereinafter the "Registry of Deeds"),and the Owner shall pay all fees and charges incurred in connection therewith. Upon recording or filling, as applicable,the Owner shall immediately transmit to the Municipality evidence of such recording or filing including the date and instrument,book and page or registration number of the Agreement. 2 i ' V. • GOVERNING OF AGREEMENT: This Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any amendments to this Agreement must be in writing and executed by all of the parties hereto. The invalidity of any clause,part or provision of this Agreement shall not affect the validity of the remaining portions hereof. VI. NOTICE: All notices to be given pursuant to this Agreement shall be in writing and shall be deemed given when delivered by hand or when mailed by certified or registered mail,postage prepaid,return receipt requested,to the parties hereto at the addresses set forth below,or to such other place as a party may from time to time designate by written notice. VII. HOLD HARMLESS: The Owner hereby agrees to indemnify and hold harmless the Municipality and/or its delegate from any and all actions or inactions by the Owner,its agents,servants or employees which result in claims made against Municipality and/or its delegate,including but not limited to awards,judgments,out-of-pocket expenses and attorneys fees necessitated by such actions. VIII. ENTIRE UNDERSTANDING: A- This Agreement shall constitute the entire understanding between the parties and any amendments or changes hereto must be in writing,executed by the parties, and appended to this document. B. This Agreement and all of the covenants, agreements and restrictions contained herein shall be deemed to be for the public purpose of providing safe affordable housing and shall be deemed to be, and by these presents are, granted by the Owner to run in perpetuity in favor of and be held by the Municipality as any other permanent restriction held by a governmental body as that term is used in MGL Ch. 184,Section.26 which shall run with the land described in deed recorded herewith as Barnstable County Registry of Deeds Book 15662 & Page 72 and shall be binding upon the Owner and all successors in title. This Agreement is made for the benefit of the Municipality and the Municipality shall be deemed to be the holder of the restriction'created by this Agreement. The Municipality has determined that the acquiring of such a restriction is in the public interest. The Municipality shall not be subject to the defense of_lack of privity of estate.. The covenants and restrictions contained in this Agreement shall be deemed to affect the title to the property described in deed recorded herewith as Barnstable County Registry of Deeds Book 15662 &Page 72. IX- ' TERM OF AGREEMENT: The term of this Agreement shall be perpetual,provided,however,that the Owner of a Designated Affordable Unit or Units may voluntarily cancel the granted Comprehensive Permit and the terms and restrictions imposed herein. Such cancellation shall only take effect after: 1) expiration of the lease terms entered into between the Owner and Tenant occupying said unit and 2) notification by the Owner of said dwelling to the Zoning Board of Appeals of his/her desire to cancel the Comprehensive permit upon a date certain and the recording of said notice at the Barnstable County Registry of Deeds or Barnstable County Registry of the Land Court as the case may be,thus rendering said Comprehensive Permit void. Upon the cancellation of the comprehensive permit,the property which is the subject matter of this restrictive covenant shall revert to the use permitted under zoning and the restrictive covenant shall be rendered void. X. SUCCESSORS AND ASSIGNS: A. The Parties to this Agreement intend,declare,and covenant on behalf of themselves and any successors and assigns their rights and duties as defined in this Regulatory Agreement and the attached comprehensive 3 'permit. B. The Owner intends,declares,and covenants on behalf of itself and its successors and assigns (i) that this Agreement and the covenants,agreements and restrictions contained herein shall be and are covenants running with the land,encumbering the Project for the term of this Agreement, and are binding upon the Owner's successors in title, (ii) are not merely personal covenants of the Owner,and (1) shall bind the Owner,its successors and assigns and inure to the benefit of the Municipality and its successors and assigns for the term of the Agreement. XI. DEFAULT:. If any default,violation or breach by the Owner of this Agreement is not cured to the satisfaction of the Monitoring Agent within thirty(30) days after notice to the Owner thereof,then the Monitoring Agent may send notification to the Municipality that the Owner is in violation of the terms and conditions hereof. The Municipality may exercise any remedy available to it. The Owner will pay all costs and expenses,including legal fees,incurred by the Monitoring Agent in enforcing this Agreement and the Owner hereby agrees that the Municipality and the Monitoring Agent will have a lien on the Project to secure payment of such costs and expenses. The Monitoring Agent mayperfect such alien on the Project byrecording a certificate setting forth the amount of the costs and expense due and owing in the Registry of Deeds or the Registry of the District Land Court for Barnstable County. A purchaser of the Project or any portion thereof will be liable for the payment of. any unpaid costs and expenses that were the subject of a perfected lien prior to the purchaser's acquisition of the Project or portion thereof. XII. MORTGAGEE CONSENT: The Owner represents and warrants that it has obtained the consent of all existing mortgagees of the Project to the execution and recording of this Agreement and to the terms and conditions hereof and that all such mortgagees have executed consent to this Agreement. IN WITNESS WHEREOF,we hereunto set our hands and seals this, 11 day of 62006. OWNER BY: Signat= Printed:Eric Grossman COMMONWEALTH OF MASSACHUSETTS County of Barnstable,ss: On.this`L 1 day of��2006 before me,the undersigned notary public,personally appeared Owner(s),proved to me through satisfactory evidence of identification,which were ,to be the person(s) whose name(s) is signed on the preceding or attached d6rument and acknowledged to be that hdshe signed it voluntardy for the stated purposes. IJ w Notary Public Printed: My Commission Expires: ==MADEIINEA LOR lic ssachusetts Expires 9MQ 4 i TOWN, F B STABLE BY: i AGER COMMONWEALTH OF MASSACHUSETTS County of Barnstable,ss: this Z�S` ay o &5'4.d�-"2�06 fore me,the undersigned notary public,personally appeared Z6- e- oager for the To of Barnstable,proved to me through satisfactory evidence of identification,which were ,to be the person whose name is signed on the preceding or attached documentand acknowledged to be thaf he/she signed it voluntarily for the stated purposes. yJ OR ItNotary blic ub lc Printissachusetts My Commission Expires: 5 CAPECODONLINE•' 1.10/CAPE COD TIMES 1 , �" ' < JQ �padmeniS �fA72QOgSBS=�, 665 t "ti ApadmeAl . ararlen . SANDWICH:Studio,Avail 101 BOUR nonlsmokirtits -` � BR, NNISPORT:1BR.($875)& 1st&last,$1000/ ARNSTABLE, W• 1 2Bc($1095) includes all. isth&t ecurity. $745Ud Avail 10/1,(50B)i / MORTGAGE RATES° North of 6A, ets OK.Own last & security no p First, 5 pets,non smoking _--=— ^Economy°in Sunday Cape er/Broker(508)362 5224 'pets.508 760 27 6 (508)-428-1347 BREWSTER:3 OR. Cod Times or Interne t Fireplace,6A are. �,�pecodonlme.com BOURNE: (31 1 BR•studios pEN, includes T: Studio.•$200/ outside sower I $750 inClu es all utilities,no wk includes all utildres & SANDWICH: Unique o en immediate. wPoea1,508 888 5806 pets,781-771-3334 cable TV.508-532-8470 plan 1 br.,near beach,$ 75 BOURHtlSAGAMORE BEACH: DENNISPORT: Year round, SANDWICH VILLAGE: BUZZARDS BAY: / merge 1 2 bedroom a art Studio Apartment.$200 per bsmt. W1D hoo pp week INCLUDES ALL Studio Apartment$825 ences$950mo, meets near canal. $$50- UTILITIES AND CABLE TV 1 Bedroom Apt.$2b s, wired, t 1st,last,secur- Call 508 432-B470 2 Bedroom Ap• curdy U $12001mo+• All include Heat ing/peL�508-751 + 1 year lease red. EASTHAm:2 Br.Apt.Avail. Non-Smoid gMo pets �� , FI0 pets.508 564 5900. 508-833-1040 CENTERVILLE:2 RENTALS thru 8/31/07 -240-6 01 F P quiet setl BREWSTER. 1 BR apt,pass" utils.Pets ok 508 240 6001 mo+.1st,last& t 954-1 Lodging,B&B 703 ble 2nd for right tenant.Full pets.508 - kitchen Rent Boardwalk,wal to 705 kitchen & bath. $12001mo EASTsM 50, 240.2836ed S�iWbyH VILLAGE: Beep r Wanted including util 568-641-0245 room.. 0,includes uti8 hit location, no pets,retereDncese& CENTERVILLE: 707 secu � House Sitting $1000 mo+utils.Avai 10i1. HYANNIS POR BREWSTER:fBBovadedl fSO895 F+�IottUsunny 2 floor Off � deposit required, F.P., deck, 1�J Roommates 710 furnished, street arki Near every 508-888 7142.I f pfulgl heal! 712 month includes all, non yp1300/ma 1 br $800 in- VILLAGE 3br Home Sharing smokinpp/lppets, secuntY thing. ! Rooms ro Rent 715 (508)385 3015 508 680 6107. YARMOUTH.dudes*2 br$975 Includes Harvard FALNIOUTH EAST: 1 bed- *3 br S1200•DENNIS:1 lot room, famished. Cable & BR,$685,Small 3 br$1:D0 CENTERVILLE:i d Apartments 7205 B2 people ele1 BREWSTER-. pets!Non utilities included. $9501 •HYANNIS:2 br OTHERS! Houses Yearly Smoking. $95 +ufld. Call month.Call 509 292-3312. br$750 a -394 qaq 3 min.w 730 last, secu FALMOUTHINYANNIS/ BR Props.,508 394-4446 aae alvrlp a( i Condos Yearly 508 96-7053 Ist 732 CENTERVILLE: YARMOUTH: 1BR, Avail. ly/ e ,ished bsmtr- I Summer Rentals 733 BREWS' Small 1 br,Non, RENT FOR 12 MONTHS... 15.$800/mo.Includes utlr non smok ' no pets• Avail PAY FOR 111 ties.Call Kim 508-360-3141 please.Call Winter Rentals smokingg, Spacious 1 & 2 BR apts, Ape Rentals 734 now.$750+electric.Lease YARMOUTH,S0:2 bedroom, � required 508-896-4360 $900-$1200/m�a pl&securerty d er, 735 No pets• t, renovated. Washer, CE khc en sN aRUWIalLki Florida Renrols dishwasher, BUZZARDS BAY:1 Br,$1000 required.Basic cable included cabinets private drjveway. fsove&12; Vacation Properties 737 includes heat & hot water, in Hyannis.Year round. $1200 617 417 5236 eded bead 740 no pets,508-833-8259 Cal(Mon Fn.,508 775 9316 ideal Nursing Homes YARMOUTH, W.: lake, $161 home,non smokin ets, for 1,all included,$800. B044 or 5( ' Commercial 745 BUZZARDS BAY:2 BR,$1125 FORESTDALE:1 br.in Ca11508-775-4633 --- inch des heat & hot water. $950 incl all 508 477-026g CENTERVILI Space For Rent 750 No ppets.508 394 7221 Pleasant Bay YARMOUTH,.WEST: 2 bed- br, 2-bath 755 capecodcanalapartments.com HARWICH E: Michelli Rentals Waned area,IBA walk out,includes room.Housingg welcome.No Ream heat, laundry & trash, non pets.$975+.508 385{060 Rental Services 760 CENTERVILLE;New, smokingg,no pets,$850Imo. WEST: r �A nstine studio,ideal lace- Ca11508 237-0808 YARMOUTH, HOUSE rive. entrance & OPEN � ; ion, P aRral fumrshed 1100/ 7ownho puseS�tmg# + drive, P ly HYANNIS NNQ�iet Bocat'on,$oven- 1*Lovely $825mo rncludes (508) * 12.2 Mature female, non smoker, 771 3038 after 6PM Mo.+utils.(508)280 3752 SUNDAY L L 1 Cen ( with impeccable Cappe refer- HYANNIS: *Supere ence5.(508)775 1290 2BR Du lex, $900lino. Call CENTERVILLE' BR den,dryer, pp , r 2 bath, n a dishwasher washer, dryer, 774 836 0877 1 Rent to r Roommates {�O walk to 6raigville Beach, 1 Yarmc elk to month utilities in HYANNIS: Downtown, large - 1000lino. including *Fabuli CENTERVILLE: Share 38r cluded.Call Monday.�00 y heat 8$hot water, ideal for f 1 townhoi home, large Br. prorate Ba. 508 420-0226 ext roommate situation. Avail• year round(508)619-2154 1 new,2 Mari CV 2 Br., last,se immediatery 1st mo. ant . �� 2 mash HARWICH:Big house,3 fur- m�i$ 80/982 91 36mok HYANNIS:3Down°ow n Bright 3 ,� 1 wwu side decks, hot tub,rite Se nished rivage room,p designer stu 1,S7 r.ma.in, p MI year tin a lice p. r KINGSBURY 1.. . new bath for singlet., y• C tions� newly g pp cludl util es.$Reterences artments CHATHI round.$800/mo,utildres in- constructed 2BR eluded. Please call (508) 2 &3 br apartments.Inter �5p8)-36q 2129 Townhouse Ap 9uded. 5 ested applicants must meet Spacious 1 BR & den,2 full dogs, income qualifications. ANNIni w certetn$1200/ BA fultY applianced kitch, mo. SANDWICH, E:Roommate to, 2.br 2-4 Per 020 mo+utils.508 775 7949. deck o targge I'rvinaldining $28,700 utet 2 area,hrdwd firs,amprre closet CHATH share 3 br home, $700 in 3 br 3-6 ersons HYANNIS: Modern, bsmt wlwasher-dryer bead dudes all.Call $38 700-$49,920 Bedroom, new app renew, space, as he at water, depo Scott 50B-776-0597 or please call for applications deck, washerldryer,• sky hookups, 9 No p Caroline 774A87 2811 1_gg8 324 196 lights non smokinglpet trash remove!, outdoor pool, utils $1150.(n n 3-8075 rec bid &tennis couA•Close SANDWICH:Professional per- Hyannis. CHAT; son e, share 3BRurnished, A 2 bath HYANNIS:Studio&1 home,very nice, � bedroom apartments. 24 HOUR MAINTENANCE idez dose to bridge 7225mo Call 508-776A137 'SENIOR DISCOUNT &t plus(508)3 ,00.0 *° �.�. —I 1st AND SECURITY r Non-smoking grand new yr rHYANNIS:.Studios to 3 brs, unf YARMOUTH,S.: s/ CHATHAM: many include utilities.1 9 Directions:Rt.I to Exit 7, illy F. $445/mo+. Reference round 1 BR,2 full BA large 1 Call for daily le. emnt 1 south on Willow St')use left i n lease.508 957-5845 den/gas FP.gas heat,A ,ail newMCP property 77 Cam St.to Open House sign COT r yw .' .+1C� ggrani►e, hdwd tirs1500+mo 1 Charlie 50 -778 9 77 1 moo lit,or Rt.28 to W. St to �71+i APPI'ianesMd $ charlie� � turn onto Camp pU Reams io Rent - cal Darci®1 508 274 6700 L cppm-e=es.m j sign on lets. ty Owner/Broker BOURNE: LoveN room, 9.!est Prestige Properties HYANNIS:Very close to hos• location, cab e, pdal, spacious STUDIO in- (508)-394 8800 x152 OR 1 CO"C $125/wk.(508)759 0305. CNATHAM, S: 1 bedroom, eludes heaUcable,771�3730 1 800 822 3422 ` heated, avail. tot Oct- 1st• D&B REALTY Equal Housing Opporiun'dY *j CENTERVILLE:1 of 2 Br apt $975mo(508)737-3384 HYANNIS,YARMOUTH, f includes all utils & cab e, 28; clean 18r. $125/wk, located on Phin DENNIS&HARWICH AREAS: 1 neys Ln.Call 508-771-4756 COdTR � ideal for 1,$850 CAREFREE LIVING or 774 810-0668 includes all.(508)420-5727 AT REASONABLE RATES I We offer locally 4 owned, yrww•davenPortrcelly•com G A.Min- - .• .0 1 hnth. ri.nn well maintained 1 ^MOT• hr Cot Town of Barnstable t KME Regulatory Services Thomas F.Geiler,Director • BARMSTABLE. NIL% 9 t639. `0� Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINTANOUIRY REPORT Date: 9-,�r —O , Rec'd by:_ � Complaint Name: �. � Gi�� Map/Parcel 7— O v� Z Location Address: Originator Name: Street: Village,,7�0* State: Zip: Telephone: . 7 Complaint Description: f e Fa` FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: Additional Info.Attached Q:forms:complaint L ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map— /�Parcel Permit# �O I Health Division v`C �/L � 1�41� o,�c¢ �^ "� Date Issued '7111 k2 Conservation Division Application Fee v Tax Collector �0 o o� — (� iC /V�— 1 f�Ip� d o� Permit Fee f 00 Treasurer 0 ►C. UV L_ (p/27/0 Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address d Aoc)we �•��� Village f i�� , ►JsB8�JA,, '� Owner St y✓ W AUAc P, Address P Telephone - O& :�,6 -Z, 5)27 i o Permit Request A�I -v Cotii_ fion G9jfj�.M OcI nnl-f-r6o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Totalew w r Zoning District Flood Plain Groundwater Overlay 00 Project Valuation ."onstruction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure S 8 Historic House: ❑Yes JQ No On Old King's Highway: ❑Yes %XNo Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other�`�) 0 �� —A b=e, GwAAe)ej P D t 14 Basement Finished Area(sq.ft.) N o u,�, Basement Unfinished Area(sq.ft) _ t� O 0� Number of Baths: Full: existing new N 1A Half:existing N new N R Number of Bedrooms: existing_ new N o "A-/ Total Room Count(not including baths): existing '2, new 09 First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other Central Air: ❑Yes )6 Fireplaces: Existing New Existing wood/coal stove: ❑Yes )No Detached garage:❑existing ❑new size Pool:O existing ❑new size /a Barn:❑existing ❑new size Attached garage<existing ❑new size NA Shed:❑existing ❑new size /, Other-r Q, a�, In Q Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes >tNo If yes, site plan review# Qurrent Use�t��Fa i+,�w,,r, Proposed Use o ff BUILDER INFORMATION Name � � �' , /�)AJ/.A &e, Telephone Number Address rn P 6t t3 fir— License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING F OM THIS PROJECT WILL BE TAKEN TO SIGNATURE".* DATE FOR OFFICIAL USE ONLY =_ " PERMIT NO. DATE ISSUED a ; MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL- FINAL BUILDING 1'� . CIIJ;, � Az DATE CLOSED OUT ASSOCIATION PLAN NO. a Iry The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION- O AJ`t number street villa/gee "HOMEOWNER': AI, YY�4 4*1 O O— " ,�j - . rN name / home phone# work phone# CURRENT MAILING ADDRESS: • 1 t) ci /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. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she yesides 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"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Depart ent minimum inspectio rocedures and requirements and that he/she will comply with said procei4s and re q ' e ignature 9f 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:EXEMPTN pQIME rp� Town of Barnstable Regulatory Services 9sARx MASS. Thomas F.Geiler,Director �A .s63q �0 �E1639 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.,142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building:'-be done by registered contractors,with certain exceptions, along with other requirements. C'� ^ ����� ,gyp., � � •�-^G�.® Type of Work:9Q Mat/A Q �/� �-) Estimated Cost M&9 9,50 v Address of Work: �i L/ Owner's Name: ,� (/t/i�L/�.P,u.J (A2A_11,4 6-4.) Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY �I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date DD Owner's Nam Q:forms:homeaffidav The Commonwealth of Massachusetts Department of Industrial Accidents Office offnyesaff'o foffs . 600 Washington Street Boston,Mass. 02111 Worker Censation Insurance Affidavit name: �'�� /� /�r lV 118 i`7 CC . I locatio {V �A tic ci t�.f fix' hone A I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one workingin2 ca achy I am an employer_ roviding workers' compensation for my employees working on this job. .:..:..:::... ..... .. ............................t..�:::::i:..:.:.n:.i:.}i:.:S.ii:ii.}.:.:................. ........,:.:::::::::..�S:..i::.}.:.}.:.+.::::::... ..t ... .......t ...... ..........................................:.::::..:::::.�::::..�::::.::.�::.�:::::::.:t•::::::::::ir:-?:iri:.iii::.}:.3:.>:4:.i}..i:.}:.)>:.:.:::::::.:.:.:a:{.::;.:�:.:.... ......................:wnv:::::w.v:::::::•r.•:.v v:- .....,...Ji:v:•.v::: ...........................:..:v:4;?{S:h:•?:3:Si.}}}:}:iw:•.:...............•:•:::•.v:nv:v.v.v::.v.v::•:.v.v:::::::v::.v:::wnv::::v:v:::.{•}}3:•}:•ii.:..rx.3:•.':?:':v'4:k::4'•}: i'kk •r::Yi%� k•i'v:::n;:nv::::::::3?......:::::::.v•tv::r:::::•..v.....,....• ..v?::-}:-?:•}:3:::::::'•}?}„•.. ..:..:::.:::::w::::..::nvn.......•:}i:.:v::::::::n;:.k••}:';v+;•}i}'}?v;v}'+••', ...........t ....:4•:v3}}Y.41;4}:,3::;44:3:4i)?:3: n..tw:::::::.v::•,:v:::.w.v:- w:::::::::.^.};+:•:v:.:.......:.. +:::n•:•:{;;4y.v;v: ...:........ tik4iii:?:: ...............::.:w::.v::::::{:4?:4:;v........,....r.i•):v?:}?:•}}}:•}:b:?•i:-iiil•:....;n, .:v::4'`'r::>}??):?:??3}?? ... •..................,. .........:...........n....r...... ..........................:..3.wn3}?`?:{?•}}?.,....v.,.:::::::::.v:::::::::..:.v.v........:..............v:::::•: ::v::::?::::::::.v:•.v•......r .n.... ....... .................. .,....... w:::w:::i•t?}:3}:•:;:...............:::.w:::{w.v::r.•}:4.}::::::n.........,......., n..........:::...,?v.v......;...•...,.....+ k.,...,. ... :........ ....n....v.....+...-..v........,n•:.:v:::::::n................. ....::::::v:::::.v:::•.4}:•::;•+:?•}:?•}?}:.:{•}i:4:{•}::::•:::::r.....:........: •t¢!•rw:;...,.;. w h •:+jj:�iiiiiT+:}}'?4y;{•}^:::}:•}}}}:!'?::::::.}'.}?.v•w:,x;.•v::{::•.;{n.... • '..GS`J::ti:{is�n:j;: .......i iii:v ii?}Yi:k�{:.'•i:{k::;::i`ii::iii::}:vk<:$y:{:;:•}},'4'3:-:43:4ii?i:{v:h):?•:{.:.:?:?::ij5Lj:2:::i'ri:iCii.`ii'l.:iiiiii::j;:{:v:ii:>.>.kS:i:?<::}:3:!i:!S:i{v?}:i4:•{{<!v:>i{4?}}i):?•i?:?•is4):•}:ii::?•i:•?i?}:;..............:>.:i.v k?::::ii?:4i ............... .. .... .......:...::::. ................. ..:..........n.:..... ....+..v ...•.:w::::::•}:.v::v::.::::v:+:+. •v4 ..... .............:.v::.::::..:.........................v::::::::::::::........:::::.v::::::;.....'::::::::::'•:viii<::;::::::::::........:X......•' rv:v.:v;........v.... ................. ... ..n.....................• .......n...................:::::::::....... .... v.v::::::::•.v:::::::.v::, ,}+r: ,:.,...v...::::::::::::::.v:w:::;.iv::.}i:w::.v:.:v;:}:...:.t:.+ ::•:•$:v:4:vv::•::•};?.y :i:<k:Tiiivvi'r?ji?'rii:iii:L::'Ji:iii:'>:k:iiiii::Y:f::iiiji:i:i�t:SR�n.:. .v;.., ..;..... .. ...:?i}}i}:'kk>::•i}i::}ii}}}}}••�:;3}3:{::i:::i:ihi}??:•i'r$}};i.;.:.::?-??:•)?i:{{•}:}:i.}•..::?:i +i.3i::'r:iy}::::i:::.v{v}Y:Lh.:•:4......'::•.Sy:;4:•:::: n..... '::..:n ::::nv::::.........•;:.. i ::;:;:::::::nv:w:::+•}}•{.:)isv:?}}•.}k4;^::}'::•i:':':••::4ii:k::•?;;ii::•i?::•::.-::::G}i:::}}}?fi:}i::..:nv:::v:. w::::.+w.v::::w.:vxr::<4:;^??::r. ............ +.:.............................. .................. ..................n n..n.... •y.v:::.v. t..3}:•Y.i:}:•:v::.v::::::::n•tii:4:.+.. }.t e•7lii:i?i•?:•}?:•)i}i}�i•}:?.}:•Y:i:4}:{{{3: ;Cl ' i.+•:k:::jiii:;�iii:�ii:k?:.{{::<:'ii::il: ?;:;ii:'iiY!:kiii::;{!f;i:;}:>':'?t�:-i::::`•::i}iskkk:j?;:kyy;:}:?':kk:i::i:i:ii:k:i:?:iiii:kU:ii::`k}?ii::<}y:^?k?}}}?:•i}}:k•}}}?}}:;?•:4:{v':•}ki:•}S:•ii?}:•}):•}:•}:?•}:•)':?}.}::}-.:.}• ;:'4:.•• •�llSlttah ❑ I.am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who _ have _ .• . the'followin workers com ensation olices: :�,:. ; . I?........................:::..:........:...........:........::.:.....,...............,...........,.........................:.......,.,..........,.., ' ::}}yi•ysjj;?iJ:k:::ii:k�''ri:k'l,.jiiiiii`:k:i.+•ii:::i:?:;:iiiii;i.i::iiii:viv:•:•::k:?:;:{is�::•:::::t•::•ii'r,:;:;;;;`..::::y:#;:: :tii:4?}: >m . i.} ••�ti 'rA • ............. .r'.v::v�v:::nv:.v:::.:v::::L:::.vi:::.v.v.v:::::;:v:::::8):•3:•}??:;4:L?'isi•)}}:::i)}}:Sv.v::::;...;...:...,..,..:•.:.::::.....::::............,..i{:}}:;;}}iw{:?::n::{.::::.`;?4:j•k•}}:;:?jr{.ki::k:f}::�:nv::.v: ..................... ........... ...........t:v+i?};::'F..}}::ti•.it•i:}4•}:;:iii???1k:};{i••ii:;:;i?:;:;iiti4i}:•.'.!K•.v:?•:ti4:r}:v?:;::! kkk::::•y}} ...... 'v:iR:; t:•/.fir?vY{i:i tf:iiii F.,i•r.v:.v .. ......:......... .......t,,.,r............... .r..................,. .............,..}.. ...........,..:............t•::::::::::::::}:r.;:;3::..::::: r::i::;•:;.;:::.....:........t•.�:::r:::::}::::.�+w+:•. •:::).t:}:. •.•iJ°:..... ......:•.:................::vv.........t......... .......:v:.:.............v...•:.:.:.:v............:....t,.:v:::::nv...........................:..w..•w::nt:?•..:........{.}:4::.:.....::::::::.v:::::::........ .....vr.r.4.a...k.\... v}.....t{, }••.} .........,v{v:i:4::•:+........w:4?•.-�v:.`.A•t4:?•i:•r:::.v:nh:.v:;:}:::+.yi4:3::;::v:...+.:....;.-•-vn•• ................. v............... ess:.:4:.;::44.;;;i}}:?•:i.:•;;:<??�3:.:.................................. ..........t.:::•::.:::•.::..:::::........:...... ....,...t..�:r.......:........,..............t.:..::. ....... ........:::•::.�:.:::,... .. .............. ,..+r....+. .......,..•......t.....r.oii?}a.......:.:�;::yi4}}r.....r...+.::.k•::.t•::?•}i?Y<!-3{?{:<+.•}i••}:::::.n;.;,..4...:.:.t .3. .................:?..............?.:.::,.:fix?:+:.:,..,..:.....,.....:::::::...+....{:.:.:.+....:,r,..:::•..., --::..... ......k...:::.�.�::t:.):.�.�::•::: .. ,t.�-{.,+xt,{4:4•:•i}::r:%+..:. t•:.�•.,,+5,...5.> ..:}::•:.v::: -:}i}:4Yf•:.v:•:::r- :!4:}}}}}:•::?itiY:?:4:{ }n:i:•:w:w:::::•x i:•::•:^:+::r::v::.v::,r:n ... :..... v.v:,::::::nv.,:•::::::•:: n...: r....v;.. .v:•:......r44:3:ii v: i)�::k:i:';.ii3':+r S:v:'..:??•l.:i:•?}}:v:wi+:ii}:i:4::{43'!-}:i.:•:::•?i}}?:4}}i:t r?SKi`}, w:,}}: x. v::' 'Q `is�,.{?4:•:•:{+.i4}:-?:4:4:{?•iiir:iisy:•.::•::.}}`;jrr}::ik:i}}:•.+y}::{?`;;:{:.}} .. ..........n......r... ......n.r.;;{..,.......v... ......:•:::r:......n• ..?:x.v:,:::v:;.. .... x::::. � .Y:!•}}:!{-?:}?.}:ii:???v:3•.}}}:..v',:::;k:i>:{<: h:-'f.=i•}i?Y:::{!v:h,{{'4•Ln:{4:i?:?•:4:;4:•}}}:i:•:::::::{:.}:x::::::•.:3...;i. 4 3 .......:•.v:::::.n.:::{•}}?:^:•:vw••isw?:•:'}}:8:-.v?}:•}:•}}}..tv.v:??•?}n.... ,, ....::::w:�::.:..... .... .. v.v:+.3i;:!;:;:j;4:;}.... ...}..n. :,..,+...r.. ....r..... ..:............ .............. ......... .....v...n.. ................::.v:::::..r:..v::::::::v..:.....•.......•.......:?n...- v......C•v}:?•n+... :.,..... .....,.......................,...n......n..t..+../..v....... ......................n• ....v....::.v:::::::....:. ........5{•?i:•.v:::::•-::w:.t.......... .....:-:•:n.,{.:+fv:-w:::vt•:•v,:..;...::�v.4:.:v.................... {.�................v.........v:::;...+.. .::}......... +ii•.::...... ::.{•}:nv.r•... ::.4:::4}::#:.v:Si-nv::„x::::�.;;<.;f..,. ..+,•?'+ :4 •}}...n.......... .::n:.v•.n.......w.v:r:.w.Yi:•ii:^.,•}}?:•i}:•}:::::::::.v;::iL4:•}:h}........ ...:'-"n:{•i}Y•?:.. ... r.v;.}}}}}yv}}i.'rrr... r...n.... ........... +w ....................... ....... :...n...v.v.:,w..n.v;..:.. :.:......::..... ...w.--.?'+::}..r:�v+:•}})•:::.:.....n.•n•v:?::r..........:...:r. �Ii�� Y.'titi v:. x:.... ....n:•:rr:....... :. +.r...:.....:w::n,•.....................n:Lv.......{•`,.k..,r.. ::^:.,.:.:::}::?}:Yii:•.............. ;+•>:<••;?.,..:�.(�`r.�Lj y,•.•:.:yti .r. 5......n.,r....•:..........{r..4:.r nn........• .....v......n............• ..n...,. :;•• lx.n, ........... '43:4:}}?i}{nv.{w:}.{h:4i??))n,tn•:,;;%!•}:•}ii}:•.�}:?vi:k}:. W� .).4::.v}: :..!i..n ..t:..n.4. ...+...:f.•:........,a :i.+.:.,.,•::::r:: ..k......,,;tn�}+:�?Y.y}X.•?.v:: :: .+.v •: v....•v..-:v:?•34:::nw:•wr::n:.....•;........v.....•,....•.....r.....v.;..,...::.:..........•.:..:......::::::::::::::.v 0� i• :i:•......:..::::•}?:?.....::....:.:.:.::: :ilnshrattce..c�;>):<.}:.:}:..?:+::::s:n•:n.:::+:::.:::::..�:...:::::::..:::::::.:.:::........... ....... ............ ....... •:;.:.}:3}}:::..:.::::...:::. ..........}..}...::.. ............................:.:::::....::::....:::....::::::::::.?;.}:.;:.:;•::•i;.:{.}:.}:.}?:.}?:;.?;:;.}-:.�:::{.;;.:::.;i:•):.::;•:;•};:;•»:�::>�:»:<::<:::;<;:::»>::><•:::>:;>;k::k:>:k:;;;k:<•}:•:•;i:;.}}:>;;<;i;•;:•};;)::•;:;.}?}:•:»::>;k:;�;>:•ii3::.}:.;•:.;.;:.;•.;.}:i::•i:{>'>}�:;:::>: .............:::..:..............::.:..:...............................:.:.:......................:. ............ ,.......... ...................... .......r...............:::::.vi::r?:nv:::::::w::••.:.n .........,..r....::.w:::::w:::;.y::::+vi;•};x.::...........n......n.....,...nn.•••.:vr.+....;....i .v\w •i:{L•. ..... ......,... :...r:.......................... ......................::.::.�: .... t•::::::?:::-?:....r......r..x:;•::.•::.t•r:.:::::+:::::::.::..:.:,•::::::r.::�•:;::•:.......{,.}:•}}}}:•}xi:•:{•:•. .3..:. ta.a ah:�'amp:?:::::•i:._.t.:.......t.............+.. :......... ...........................:w:::::r..+.....r.t.........::.:....t..t....rr...........,......t�+::::,::::::....:.....::.v:::::•::i: v.;v-?: �„ .. ....................................:...v....................w:::..v...........-........:v:r:::.. .......................n. .....n...... v.......L........n.... .v:\:....n..... ...5.•::v...::v....:t.; ....................................:n.............r. ..................v........:..............n.......t.vvw::•. �v:::::.v:.v.v:.v.vv•:v.v::nv:::::}::::rr:.v::.....•v::.v::3}.v1::•x,3.•:::?•.y;:.?}::: .... .........:...........r.............:-......r....,...•......................:.....:w::::::w::::::.:v}:.-,A:v-:+:::::}:::w:::•v::nv::n:t:..,:::•:::::•.v:::::}::::::::::::::::.v:::•:..............-............n.. t. v,0.....kv,(•.vn. :•::.•v::nv:::;.:.......:........... v,v:4::.v::}:...........:............,v..•... .... .:n......... ........ ........ ,•::::::::-:•:nv::.v:.v:::x ....................:v:vnv::n,:..r...lv:.v::.:.......... ...;•............-:...t :A:::..v. ...... .............. ..+......,... ...........................:w.v:::v:::::::.v:..n:::::.n:::.:::::::•: ............................. vn..:h3:'+L{r.}t::;..v?:.::{):•}:;}i•. .................. ....r......n.n.,............:.......................... ......................v.. ...n........., v:.v::.......:..........:....:....:............... ' p);:rk::::S:::::::k::::':::k::k;:k:':::'<:4akk):::<`}�S i;'•}•:ii:':::Qkkkk::'•::k::;:k:::::::fi:`•:>:::;�:a:.};}}?:.i;..n.,i?i}i::a:•:):4•}?}}:•::•}:::::::::::::•::::::::::.v.v::::.3:n•:::::•:..... ............. .......... .....n..............•:......... ....... -v v:?rv:?•} +.n.+.....r........ .. ...K!?.QS?i:!C.tik iv^:•.�-�•..!4�M. .. ........ ...v... ....r..........}. ............... .Av. >.v:..n..........v.......v-- 'i}:......,�•:.:::..- .�v..::::::::nw:::•. .,.::::r.w::;r...... r:... ........... ......r.......-. .r....+.. ..........+....... :..........:...nt:.......:-:•::::.:,.,...:............ ........w.}.....,•.:..,:::.,.;:?i3)::.;•i•}}:•i}:;+:{.}}>:•:;•?:.;.,y..,::::.�i•i.i•k%•:<4!-}::. .....:..:•:}.:.t.....:. ..:.:•::..............r.t..r........::-•:::......................:?.�:...+................:,.:.,:..:.�............... ..... ::.4,..•:;}::•.,........ •• ...:.................. �.ii;3):•x•... t..,; t•..n)..>,-•n+•:::'�. : .......r..:..hnv..:n..............••w: .............. .... ,r...... .. ......t..:.,.}:..:- ..:,v:•h•:{:::w.:n••}:v:i•.+n.r, .-}:. Wa:::::v:v:v:::::.v:::t:•.v.:v::�:w.v•:r::+....... ........ r:v.,.......••v::•:•:;;..... ...r... .........n.... ..:.. ..n.....rv...... .m::::rw.....t........... ..v.n..i.,.........n{...:v?+•�,+::::.�:.v:n3•... .....:::..::... .... '.L•... -..!4{.44-. ....x............:• ...r... :r. ..r.......v...t.. ...^.:nv v:::::::::.. 4::}:....--....:n................ vnv v:v;:: :...,. .. y...,v'i+;]r:v,{.'vr'' iii':Y•;?!,;w:xfi ..:.........n....•..a .......w,....r.. :4..:r.. .....+............... ....n........,..........::::::.vv. .... :.....r............... :w:::"tit•::v'•... .•nr�:�!ty n+.n.v..:::::,. ,::�jji;'/.•:ti•}i.:•{:.;::yiFri•:a}:i}::. ..............:•:1....4................1•}vn...... .....n........•:w:::........r...... .5..:v..........:OJ.,...n:n......+.•:van....,{...... .. .. .;.,}, ...,..... . ..........:..}...t..,r,.t+...Y,.....,. ......... ....:::.....n•::::::::::::. Olie..ii�:i•::::•::....:.;:.. •:•. ...:: .....ky:,•:}:•::::.t:?•:ii;:;: :. •:;-::.i:•:;'::•::$•y+;h'+:i?.;•}:•i:<•i}:-}:-S:•r,•.i-)?:•>':•:k::k:::::::4'k::::::k::::i:-.r•:;•::-:-:;•}•>:•:- ?:-}:.;:i•:::•i... 1:::::•:::•:;i::::..,i..;.::.:.?.;':,::•.,... Fafiure to secure coverage a+required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of$100.00 a day against me. I undersfand that a'. COPY of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification —" I do kereby-certify thep /n`s e perjury that-the-information_pr-ovided-above-is-t ra=iLcorsect_ _ G d Date Signature ) Print name �/ A ;Phone# 3d� ofncial we only do not write in this area to be completed by city or town official city or town: permit/license# OBuilding Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office _❑HealthDeparhnent contact person: phone#; ❑Other (revised 9/95 PIA) r. 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. j 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,neitherthe' 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 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 i 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 ca1L 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 le 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.pernutllicense number which willbe used as a reference number..The affidavits may.�ie'reto the Department bymaiT of FAX unless other arrangements have been made: The Office of Investigations would like to thank you in advance rfor you cooperation and should you have any jquestions. . 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 InvestleaUens 600 Washington Street -. Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.1� >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= (number) Deck x$30.00= (der) 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 projcost