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U.S.POSTAGE>>PITNEY BOWES
Town of Barnstable f / C
Building Division
200 Main Street L• ZIP 02601 $ 000.485
Hyannis, MA 02601 f 02 4VY
0000336455 JAN. 05. 2016
ALAN R. & DA WAT Al. B URT li
338 PLEASANT PINES AVENUE
CENTERVILLF, , MA 02632 '
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L TURT4 TO SENDER t
NO SUCH NUMBER
B.C.: OZ691400290 *.9Z69-9.629,2—.9.5 --43
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CNASURETY t c �� E EIydS`iAf)L
1-800-331-6053
g Fax1-605-335-0357
PO Box 5077 Sioux Falls So 57117.5077 2006 APR —3 PM 2: 39 www.cnasurety.com
March 29, 2006 Agent—code: 20-18079
DiVISION
TOWN OF BARNSTABLE
BUILDING INSPECTOR
TOWN HALL
367 MAIN ST. , 4TH FLOOR
HYANNIS, MA 02601
Re: Bond No. 69857078 Penalty $1,020
DAWN M. AND ALAN R. BURT
338 PLEASANT PINES AVE.
CENTERVILLE, MA 02632.
ROAD/PERFORMANCE TOWN OF BARNSTABLE
Company Code: 0601 - WESTERN SURETY COMPANY
We have received a request to cancel or nonrenew this bond.
We wish to comply with the principal' s request by taking
advantage of the cancellation provision pertaining to this bond.
You are hereby notified that this bond is cancelled and voided
as of May 10, 2006, or the earliest time permitted by applicable
law, whichever is later.
Thank you for your attention to this matter.
cc: DAWN M. AND ALAN R. BURT
BAYBERRY INSURANCE AGENCY V
1645 FALMOUTH RD. , STE. 2G
CENTERVILLE, MA 02632 t/
l
Underwriting Services
TOWN OF BARNSTABLE
BUILDING INSPECTOR
TOWN HALL
367 MAIN ST. , 4TH FLOOR
HYANNIS, MA 02601
Town of Barnstable
Zoning Board of Appeals
• Decision and Notice
Appeal 2001-34 - Burt APR 7 Pil 3: 04
Special Permit - Section 3-1.1(3)(D) Family Apartment
Summary: Granted with Conditions
Petitioner: Alan R.Burt and Dawn M.Burt
Property Address: 338 Pleasant Pines Ave.,CaA%v=e,MA
Assessor's Map/Parcel: Map 214,Parcel 070
Zoning: Residential F-1,Resource Protection Overlay and Groundwater Protection Overlay
Background:
The applicants are requesting a Special Permit under Section 3-1.1(3)(D),to permit the reuse of an existing
family apartment for their daughter.
The property that is the subject of this appeal is a one acre lot improved with a 3,435 gross sq. ft. single
family dwelling which contains living space previously approved as a Fanuily Apartment under Special
Permit 1972-60 and again in Special Permit 1997-55.
The property is commonly addressed as 338 Pleasant Pines Ave., Centerville and is located in the
Residential F-1 Zoning District and GP Groundwater Protection District. The applicant is seeking
permission to again use this living space as a Family Apartment.
• Procedural.& Hearing Summary:
This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on
January 25, 2001. An extension of time for holding the hearing and for filing of the decision was executed
between the applicant and the Board. A public hearing before the Zoning Board of Appeals was duly
advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was
opened April 04, 2001, at which time the Board found to grant the family apartment special permit with
conditions.
Board Members deciding this appeal were Randy Childs,Dan Creedon, Gall Nightingale,Richard Boy,
and Chairman Ron S.Jansson. Mr. Burt represented himself. He explained the unit existed and that his
daughter wished to use the unit as her.residence. He noted that he has read the provisions governing
family apartments and will abide by those requirements.
Findings of Fact:
At the hearing of April 04, 2001,the Board unanimously found the following findings of fact:
1.. In Appeal 2001-34,the applicants,Alan R. Burt and Dawn M. Burt are seeking a Special Permit in
accordance with Section 3-1.1(3)(D) for a Family Apartment. The property is addressed as 338
Pleasant Pines Ave., Centerville, MA,Assessor's Map 214,Parcel 070. It is zoned Residential F-1 and
is in both a,Resource Protection Overlay and Groundwater Protection Overlay Districts.
2. In 1997, the Board did grant a family apartment permit to the previous owners of the property in
Appeal 1997-55. The new owners of the property,Alan R. Burt and Dawn M. Burt wish to keep the
unit for their daughter and have the permit renewed.
3. They have stated that they will abide by all of the provisions of Section 3-1.1(3)(D) for the grant of
• the permit.
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4. Special Permits pursuant to Section 3-1.1(3)(D) -Family Apartment- are permitted in all residential
Zoning Districts.
5: Upon evaluation of all the evidence presented,the proposal fulfills the spirit and intent of the Zoning
Ordinance and would not represent a substantial detriment to the public good or the neighborhood
affected.
Decision:
Based on the findings of fact, a motion was duly made and seconded to grant the appeal with the
following conditions:
1. The locus shall comply with, and be maintained in accordance with, all restrictions of Section 3-'
1.1(3)(D) of the Zoning Ordinance and shall be the primary year-round residence of the family
member residing therein.
2. The family apartment shall be maintained in substantial conformance to plans presented to the Board.
Which plans are identical to those presented to the Board in Appeal 1997-55. A copy of which is
entered into the file.
3. The locus shall comply with all State Building Code, Town of Barnstable Board of Health and State
Fire Prevention Regulations.
The vote was as follows
AYE: Dan Creedon, Richard Boy,Randy Childs, Gail Nightingale, Chairman Ron S.Jansson
NAY:
• Ordered:
Special Permit 2001-34 is granted with conditions. This decision must be recorded at the Registry of
Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals
of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20) days
after the date of the filing of this decision. A copy of which must be filed in the office of the Town
Clerk.
Ron S.Jans , hairman Date Signed
I, Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County,Massa&dsefts,,11ereby.
certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this �izc lion and That
no appeal of the decision has been filed in the office of the Town Clerk.
Signed and sealed this day of eZjLuA oloo under the pains and penalties-oi f erjuiy.
Linda Hutchenrider, Town Clerk' .
2
i
giMeenng ept. r o Map � Parcel ® �d 3 Permit#
House# ?I?�(.r pry Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:3$m G `� . (G ee'
Conservation Office(4th floor)(8:30- 9:30/1:00-2:00)
Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC SYST 1HE E/
Definitive Plan Approved by Planning Board 19 [ [STALLED IN E
WITH T � �9.s,�
TOWN OF BARNSTA ®0� � �� AND
Q Building Permit App� ation
Project Street Address ,���V �/4 Sby4"f �Y���I Lt (f, q-i)t✓
Village �V IaA,4 S
Owner f2 12 e,4 Address 3 3� /���.�S eK f
.Telephone 36 2 3 7
Permit Request SC0 -C-C.J '_1�o,4C L( 6G( S .? 'C IL
First Floor square feet Second Floor square feet
Construction Type L"O O
Estimated Project Cost $ �', 2d0 r —
Zoning District Flood Plain Water Protection
Lot Size 3. -(?o Grandfathered ❑Yes ❑No
.-
Dwelling Type: Single Family l9' Two Family ❑ Multi-Family((##units)
Age of Existing Structure Historic House ❑Yes 2- 1I�o On Old King's Highway ❑Yes e<o—
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No. of Bedrooms: Existing New 50?l12o,L'
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use ,�nk e ni I �r/C�
Builder Information
Name e"Vf f Al't-es ��1,i-Sfo S' Telephone Number ?-2 0
Address lk3 Oe l License# DD 66 C3
C'ekf j nA ✓ez'le 026 3 S` Home Improvement Contractor# 11 (1`Py11
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATU
BUILDING PERMIT DENIED FOR LLOWING REASON(S)
FOR OFFICIAL USE ONLY
i PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE -
r r t l + -3
OWNER
DATE OF;INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH; ` FINAL
PLUMBING: 19019GH - FINAL '
E7 �'9
GAS:` 4 FINAL
FINAL BUILDING
� :7-M0
DATE CLOSED OUT,
M 0
ASSOCIATION PLAN
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The Town of Barnstable
Department of Health Safety and Environmental Services
i639• a Building Division
Eo N,or g
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
TOWN OF BARNSTABLE Permit
A4(f(o 37
SOLID FUEL STOVE PERMIT Date:
1 Fee: �-oo
Owner: i' L /30 U--r- "Pfio e: (� -
Address: 2j 3� /C -�.Cr-Sys,. &v- Village:
Map/Parcel: o?/ Date:
Stove
A. New/Used _T
B. Type: Radiant Circulating
C. Manufacturer: a Lab. No.
D. Model No.:
Chimney
A. New/Existin If existing,please note date of last cleaning
.B. Flue Si
C. Are other appliances attached to Flue?
D. PraAh Type and M acturer
E. aso in nlined
Hearth
A. Materials: 1")jC4
B. Sub Floor Construction: rl W-—
Installer
Name: Address:
Phone:
Location of Installation: 0 /4-
APPROVED BY: ((/tjW0-0
Please make checks payable to the Town of Barnstable
*This constitutes an official stove permit after inspection,photographed, and approved by the
Building Inspector `
Stove.doc
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-001M."ASSAM Ifflumist ff- imlo
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Assessors map and lot number .. ' .................... ?NE
Sewage Permit number
I BAWSTADLE, i
House number * ""�a
�O i639• �0
0YFYa
TOWN OF BARNSTABLE
BUILDING 1_N-SPECTOR
�..APPLICATION FOR PERMIT TO/�................ .:.,.......,....���''?....^......:... ..............:+ .�..............................
:...........................................................................TYPE OF CONSTRUCTION
` :..... ...................19.e��
TO THE INSPECTOR OF BUILDINGS: o +,
The undersigned hereby applies for a permit according to the following information:
Location ?....! � h?SA.0 T.....P IN .....5-�V45 Lo' 1 f, O
Proposed Use ..... �',JT..�......................................................................................................................................
..........................
• 4�
ZoningDistrict ........................................................................Fire District .... .:..e .....................................................
Name of Owner ... ..........Address .e... OA) V/c GIJ...,.�1:,•, "'16 7Z:_'V/LlF
Name of Builder '' �� s ..............Address '`��`.
...... ............... .............. .
Name of Architect ....�..:. 5...........................Address (..., ./......... `
ti
ON C
Numberof Rooms ............ ................................................Foundation ........................,.....................................................
...... ��ti� r .......
Exterior .......................................................Roofing
Floors �UL . rS�F'l7C�. .....................................
f� f n ��®fa.Q ........ ...........................Interior
....
7 f0 i �^�« ......fir...///� �'
Heating ..................................................................................Plumbing �...........v..............................................
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L
Fireplace ................i..............e.. ...........................................Approximate. Cost ..........J�....... 071"V
Definitive Plan Approved by Planning Board -----------____---------------19________ . Area ..........................................
Diagram of Lot and Building with Dimensions
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 ,. r....... pC -,•^..............
�1 f ...
Construction Supervisor's License .....qps-
_:...'......................
7
ALSAIN, GEORGE J. A=214- i
27491 A Sto
No ................. Permit for ................. ....... .........
Single Family Dwelling
................................................................ ...........
Location .. .. .� �?Xl ..� X1�..1�V.Prild�..........
..................We5t..I�.table...........................
Owner .... .................
Type of Construction ...Fxame...........................
................................................................................
Plot ............................ Lot ................................
February 6, 85
Permit Granted ........................................19
Date of Inspection ....................................19
Date Completed ......................................19
3 �5 �
__
The Town' of Barnstable ,
9q,ArF'. �e� Department of Health Safety and Environmental Sefvices
►
c Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date r
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�
Type of Work: SCL-et0 '7G✓'C Est. Cost a ao.
Address of Work: 23 S 12 (e7 9-e,�-if '721 12e U.'. 1, il1Ay.r 1�tL1•C
Owner's Name G�9-�1—P �u o7�2,P.1 ,
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000.
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 Owner's Name
r •
The Commonwealth of 4fassachuseas
Department of Industrial Accidents
Office 51fteslfgalfoos
,•-\�:;..:___r :, 600 11a.dithigrour Slrcct
Bumvrr.Afars. 112111
` Workers' Compensation Insurance Affidavit _
Atiniic'sint information':- —" Plcose PRINT le!+�j]y'�""-'-•'"-"'-""•- � -
name:
location-
city nhonc 0
❑ Jrri a homeowner performing all work mvself.
I am a sole proprietor and have no one working in any capacity
[] I am an emplover providing workers' compensation for my employees working on this job.
comnnnr name:
"' address• •
city' nhonc q•
insurance en. Itnlicr a
[] I am a sole proprietor. general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers' compensation polices:
comennv nnmc:
• atitlresc:
cloy' � nhonc tt:
insnrincr rn. - - nniicw a -
emmnnn%, name:
atltlress•
ritvc nhonc 9:
insurance co. noiicti•d
Attach additi secuonal sheet if neces'_sary �__ -_ _ --+% y;L.- __�•- •' ^''= �-+-- <' - -- —_-'
F:lilura to re coverage as required under Section SA of NIGL 152 can lead to the imposition of criminal penalties of a line up t 51.500.UU odiur
unc\cars'imprisonment as well-as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a dad•against me. 1 understand that a
cope of Utis statement mar be funvardcd to the Orrice of Investigations of the DIA for coverage veri6eation.
I do herehr cerrifi�111111etepit' and pert /lies of rt•t/rat the information provided above is true and correct.
Skmature Datc J/!�1
Print name t�S `�S Phone* 7�����/�
' official use only do not write in this area to be completed by tiny or town otricial •+
. citl•or town: permit/license ff t•911uilding Department
Licensing Board f
I]check if imtncdiatc response is required OScleetmen's Ufficc i
• �ttealth Department
contact person; phone tY: nUther
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Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers',conipensation for the
employees. As quoted from the "law". an enrphi gee is defined as every person in the service of anoflier under any
contract of hire, express or implied. oral or written.
An emploaer is defined as an individual• partnership, association. corporation or other legal entity. or any two or non
the foregoing cnuaged in a joint enterprise, and including:the legal representatives of a deceased employer. or the
recciver or trustee of an individual , partnership. association or other legal entity, employing employees. However th
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 d��ielling ho
or oil the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe
MGL chapter 152 section 25 also states that every state or local licensing agency sliall withhold the issuance or
-- rene�.al ol':a license or permit to operate a business or to construct buildings in the commonwealth for any
:applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter
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 as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The
affidavit should be returned to the city or town that the application for the permit or license is being requested-
not the Departntent of Industrial Accidents. Should you have any questions regarding the "law' or if you are require--
to obtain a %vorkers• compensation police. please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom c
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding tlae applicant. Pie
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned
the Department by mail or FAX unless other arrangements have been made.
The Office of Investi=ations would like to thank you in advance for you cooperation and should you have any question
please do not hesitate to give us a call.
�...yv,, r+• -. ...�..�•v.-. ..�.-..w. � �. ... •�..�.+r raw..•..-+�.s.�.�.xv., _ _ .�..w....,w..r�o.nlr�r'•.r. v.��+s.w-�-
The Department's address. telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents4
Office of Investigations
600 Washington Street �-
Boston,Ma. 02111
fax #: (617) 727-7749
phone #: (617) 727-4900 ext. 406, 409 or 375
` MCUR Appom to J
Table J=b(Condoned)
Pima pdre PackaW for One and Two-Family ReddwtW BatldbW Heated with Fong Fads
MAJQMUM I MINIMUM
of g pig Ceiling wall Floor Baste slab Heaoag/Cooliag
Ana'(%) U-value R value' R value' R values R/aU pbft a �Pm= � �a
p� R.vaiur' R value
5/01 to 6300 Hmdng Degree DayO
Q 12'/. 0.40 3S 13 19 10 6 Normal
R IrA 0.52 30 19 19 10 6 Normal
S 12-A 0-50 1 39 1 13 19 10 6 tS AFVE
T 15% 0.36 38 13 23 WA WA Noma!
U 136A 0.46 38 19 19 10 6 Normal
-�V 13 0.44 38 13 23 WA WA CAME
w 13% GM 30 19 19 10 6 SS AFUE
X ISM. 0.32 38 13 23 1 WA WA Nomw
Y 18% 042 39 19 25 WA WA Noma!
Z 13% 0.42 31 13 19 10 6 90 AFUE
AA 1S% 0.50 30 19 19 10 6 90 AFUE
1. ADDRESS OF PROPERTY:
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS:
3. SQUARE FOOTAGE OF ALL GLAZING:
4. %GLAZING AREA(#3 DIVIDED BY#2):
S. SELECT PACKAGE(Q—AA-see chart above):
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
q-forms-080303a
e
780 CMR Appendix J
Footnotes to Table J5.7—1 b:
' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall
area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft of decorative glass may be excluded from a building design with 300 ft2 of glazing area.
2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for
whole units:center-of-glass U-values cannot be used.
' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the'sum of cavity
insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between
the conditioned space and the ventilated portion of the roof.
•Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include
exterior siding, structural sheathing, and interior drywall. For example,an R-19 requirement could be met EITHER
by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-frame or mass(concrete,masonry,log)wall constructions, but do not apply to metal-frame construction.
'The floor requirements apply to floors over unconditioned spaces (such as unconditioned crawlspaces, basements,
or garages). Floors over outside air must meet the ceiling requirements.
`The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned
j basements must be included with the other glazing. Basement doors must meet the door U-value requirement
described in Note b.
'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs.
' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest
efficiency must meet or exceed the efficiency required by the selected package.
'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a
NOTES:
a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35).
c) If a ceiling, wall, floor, basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).
CONSrpoc SAFr.7
• � r10N
N0* ` SUPERVISOR
BB6 'Expires.
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BARNSTABM
059.
Town of Barnstable
Zoning Board of Appeals
Decision and Notice
Appeal No. 1997-55 Koppen
Special Permit Pursuant to Section Family Apartment
Summary Granted with Conditions
Applicant: Jane R. Koppen .
Property Address: 338 Pleasant Pines Ave., Centerville-
Assessor's Map/Parcel Map 214, Parcel 70 Area 1.0 ac.
Zoning: RF-1 Residential F-1 Zoning District
Groundwater Overlay: GP Groundwater Protection District
Background:
The property that is the subject of this appeal is a one acre lot improved with a 1,656 sq. ft. single family
house which contains living space previously approved as a Family Apartment under Special Permit 1992-
60. The property is commonly addressed as 338 Pleasant Pines Ave., Centerville and is located in the
RF-1 Residential F-1 Zoning District and GP Groundwater Protection District. The applicant is seeking
permission to again use this living space as a Family Apartment. A Special Permit is required for a Family
Apartment in this Zoning District. The applicant does not yet own the property but the application states
she intends to purchase it on June 16, 1997.
Procedural Summary:
This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on April
24, 1997. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to
all abutters in accordance with MGL Chapter 40A. The hearing was opened May 28, 1997, at which time
the Board granted the family apartment with conditions.
Board Members hearing this appeal were Gene Burman, Richard Boy, Tom DeRiemer, William Garreffi,
and Chairman Gail Nightingale. Thomas Koppen represented himself before the Board.
Hearing Summary:
Thomas Koppen explained to the Board that he and his wife (Jennifer Koppen) plan to occupy the family
apartment while his mother.(Jane Koppen) and grandmother(Janet Reed)will occupy the main dwelling.
He submitted the signed Purchase and Sales Agreement to establish standing. Mr. Koppen stated he
understands the criteria and is in compliance with all the requirements of a Family Apartment pursuant to
Section 3-1.1(3)(D) of the Zoning Ordinance.
Public Comments: No one spoke in favor or in opposition to this appeal.
Findings of Fact:
At the Hearing of May 28, 1997, the Board unanimously found the following findings of fact as related to
Appeal Number 1997-55:
1. The property address is 338 Pleasant Pines Avenue, Centerville, MA, as shown on Assessor's Map
214, Parcel 70, with an area of 1.0 acres of land in the RF-1 Residential F-1 Zoning District.
2. The applicant is requesting a Family Apartment pursuant to Section 3-1.1(3)(D) of the Zoning
Ordinance.
Town of Barnstable-Zoning Board of Appeals-Decision and Notice
Appeal No. 1997-55 Koppen-Special Permit Pursuant to Section Family Apartment
3. The property in issue was granted a Special Permit for a Family Apartment in 1992 (Appeal Number
1992-60)for the prior owner. There does not appear to have been any unusual conditions on the
apartment, nor is there a record of any complaints to the Building Division. The applicant is seeking
permission to again use this living space as a Family Apartment. The applicant does not yet own the
property but stated his mother intends to purchase it on June 16, 1997, as demonstrated by the
Purchase and Sales Agreement submitted to the Board.
4. In the Zoning Ordinance for the Town of Barnstable under Section 3-1.1(3)(D), a family apartment is
allowed by virtue of a Special Permit.
5. Granting the petitioner the Special Permit being sought would not be in derogation of the spirit and
intent of the Zoning Ordinance nor would it be detrimental to the neighborhood affected.
Decision:
Based upon the findings a motion was duly made and seconded to grant the Petitioner the relief being
sought with the following terms and conditions:
1. The Family Apartment shall not be utilized until Mrs. Jane Koppen occupies the principal dwelling as
her full time residence.
2. The family apartment is to be used as per the existing layout and building and floor plans submitted
with the application.
3. The family apartment unit is to be limited to no more than 1,560 sq.ft. located in the exposed
basement level of the dwelling and shall contain no more than one bedroom.
4. This Special Permit is not transferable to other owners or occupants.
5. The Family Apartment shall comply with the restrictions of Section 3-1.1(3)(D). Affidavits reciting the
names of family relationships among the parties seeking approval shall be signed annually for the
duration of such occupancy.
6. Prior to occupancy, an occupancy permit shall be obtained from the Building Commissioner. Within
60 days from the date the family member vacates the premises, the owner shall remove the kitchen
facilities and notify the Building Commissioner.
7. The locus shall comply with all Town of Barnstable Building and Health Departments regulations.
The Vote was as follows:
AYE: Gene Burman, Richard Boy, Thomas DeRiemer, William Garreffi, and Chairman Gail Nightingale.
NAY: None
Order:
Special Permit Number 1997-55 has been Granted with Conditions.
This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this
decision must be exercised in one year.
Appeals of this decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL Chapter
40A, Section 17, within twenty (20) days after the date of the filing of this decision in the office of the Town
Clerk.
1997
Gail Nightingale, Chairman 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 been filed in the office of the Town Clerk.
Signed and sealed this day of 1997 under the pains and penalties of perjury.
Linda Hutchenrider, Town Clerk
2
oFTMF The Town of Barnstable
Department of Health Safety and Environmental Services
$ B,,,9ffrAMBL : Building Division
&� 16J¢ �� 367 Main Street, Hyannis MA 02601
Office: 508-790-6227 Ralph M. Crossen
Fax: 508-790-6230 Building Commissione
January 21, 1998
The Allain Residence
338 Pleasant Pines Avenue
Centerville, MA 02632
Re: Family Apartment located at the above address
Dear Mr./Ms.Allain,
Our records indicate you have not filed an affidavit regarding the above referenced family
apartment in quite some some. It is required under Section 3-1.1 (3) (D) (1) of the Town
of Barnstable Zoning Ordinance that an affidavit be submitted annually for the duration of
such occupancy. Please indicate the status of the family apartment on the enclosed affidavit
return to this office by February 15, 1998.
Enclosed is an affidavit for your convenience.
Thank you in advance,
Ralph Crossen
Building Commissioner
r
COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, ss: AFFIDAVIT
A`// being on oath, depose
and state as f lows : '
1'. ) I reside at .3j?� Plea sa�7L � e_r
2 . ) I am the owner of the p operty located at
J�3� ���sa�f` /�•�o> / (
,
�< 2 ffi
Ceb ey
shown on Barnstable Asce� �5' ��� Z
� �or� Maps as : '
Map Lot �
3 . ) On uaL' , 19 the Zoning Board of
Appeals, on Appeal o. S G a 4b
granted me a special
Permit to maintain a family apartmen at the above address.
9 . ) I understand that the family apartment. may only be
occupied by .members of my family who are persons related to
me by blood or by marriage.
5 . ) The following members of my family will be the
sole occupant; of the family apartment at the above address:
(1) Name: IfOdeJ--� p� z
Relation:l)ip to O ner: o -
(2) Name: `l-e
Relationship to Owner: 2u
6 . ) The famil a
Y partment wil be the primary year
round residence for the above-identified family members .
7 . ) In the event that the above-listed relative(s)
Vacate said apartment, I will immediately notify the
Building Commissioner in writing.
8• ) I understand that no subletting or subleasing of
said family apartment is permitted.
9• ) I understand that I am required to annually file
an Affidavit with the Building Commissioner listing the
names and relationship of my family members occupying said
family apartment.
10 . ) I understand that I am required to•.comply with
all conditions imposed by the Board of Appeals in Appeal No.
10. ) I .agree to immediately notify the Building
Commissioner in the event of the sale of the above-listed
Property.
� Sworn to �:erins andday of Penalties of perjury this
i
4
( ig Na
PLAN (Please Print Name) .
JUN �� a oj-
1 3 1994
-COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, ss: AFFIDAVIT
h
I , �� being on oath, depose
as f
and state llows : DJ
1 ) I reside at �� CPA- c'���
2 I am th ej //owner of the property located at
�� oCQhe S S
sho;13
�- On
able Assessors , Maps as :
Map2 Lot
19 the Zoning Board of
Appeals, on Appeal -0. �� _
granted me a special
permit to maintain a family apartment at the above address.
4 . ) I understand that the family apartment may only be
occupied by ,members of my family who are persons related to
me by blood or by marriage.
5 . ) The following members of my family. will be the
sole occup ts of he f it ap rt ant at the above a dress:
(1) Name: 1, J^ . J� I ,,,,",at
l.c A.14
Relati nship to Owner: - ° '
(2) Name:
Relationship to Owner: 9 -ek '
6 . ) The family -apartment will be the primary year-
round residence for the above-identified family members.
7 . ) In the event that the above-listed relative(s)
vacate said- apartment, I will immediately notify the
Building Commissioner in writing .
8. ) I understand that no subletting or subleasing of
said family apartment is permitted.
9. ) I understand that I am required to annually file
an Affidavit with the Building Commissioner listing the
names and relationship of my family members occupying said
family apartment .
10 . ) I understand that I am required to•.comply with
all conditions imposed by the Board of Appeals in Appeal No.
agree to immediately notify the Building
Commissioner in the event of the sale of the above-listed
property.
• Sworn to un r the pains an
— _ day of �� 19 •penaltie.�•
Of perjury this
. h
( nature)
( lease Pri t Name) :
eoh e AarP �
Town of Barnstable
Zoning Board of Appeals T�� !! !^C _ERK
BAR S ; .=::s.._:.. LASS.
Family Apartment
Decision and Notice V MT 30 P4 '01
Appeal No. 1992-60
Summary Granted with conditions
Appeal No. 1992-60
Applicant: George Allain
Address: 338 Pleasant Pines Avenue, Centerville, MA
02632
Assessors Map/Parcel: 214/070
zoning: RD-1 Residential D-1 District
Applicants Request: special Permit - Section 3-1.1(3) (D) Family
Apartment
Activity Request: To convert first floor of the structure into a
family apartment by installing a kitchen.
Procedural Provisions: Section 5-3.3 Special Permit Provisions.
Background:
This decision concerns the appeal submitted by George Allain to the Zoning
Board of Appeals for a special permit to allow for a family apartment to be
located at 338 Pleasant Pines Avenue, Centerville, MA. The request was made
in accordance with section 3-1.1(3) (D) , "Family Apartments" of the Zoning
ordinance.
The family apartment unit is located in the lower, first floor level of the
structure. From plans submitted with the application, the apartment will
occupy the entire level, (estimated at 1,560 gross sq.ft) and will contain two
bedrooms, one bathroom, a living room and a kitchen.
Procedural Summary:
The application was filed in the office of the Town Clerk and at the Zoning
Board of Appeals office on September 22, 1992. A public hearing, duly noticed
under M.G.L. Chapter 40-A, was opened, closed and a decision rendered by the
Board on October 22, 1992. The petition was heard by Board Members: Gail
Nightingale, Ron Jansson, Luke Lally, Dexter Bliss and Chairman Richard Boy.
The applicant represented himself before the Board and explained the intent of
his proposal to have a Family Apartment within the first floor of the dwelling
which is a raised ranch style home. The apartment, is to be occupied by his
daughter and son-in-law and their child. Layout plans were presented and
discussed.
The public was invited to speak. No one spoke in favor or in opposition to
the application for the family apartment unit.
`aMilF Apartment - Deci4 or and -Notice
Appeal No. 1992-60
i
Finding of Fact:
Based upon the evidence submitted and testimony
Of October 22, 1992, the Zoning Board of Appeals
given, at the public hearing
follows: unanimously finds, as
1. The applicant has met all of the requirements for issuing a special
Permit in accordance with Section 3-1.1(3) (D) Family Apartment of
the Zoning ordinance; and
2. The applicant, who is the present owner, has agreed to maintain the
property in accordance with the provisions of that Section of the
ordinance and to comply with the required yearly Family.Apartment
Affidavit.
Conclusion:
Accordingly based upon the findings, a motion was duly made and seconded that,
Appeal No. 1992-60 be granted a Special Permit for a Family Apartment in
accordance with Section 3-1.1(3) (D) of the Zoning ordinance, as sought and
with the following conditions:
1. The Special Permit is issued only to the owner and resident, George
Allain, for the property, at 338' Pleasant Pines Avenue, Centerville,
MA.
2• The family apartment shall be located as presented in the plans
I
submitted titled: "First Floor Layout (Apartment) ,,.
3. The applicant shall maintain the apartment in compliance with the
requirements of Section 3-1.1 (3) (D) Family Apartments of the
Zoning Ordinance.
4. The applicant shall comply with all of Title v and the Board of
Health requirements.
The vote was as follows:
Aye: Gail Nightingale, Ron ,Tansson, Luke Lally, Dexter Bliss, and
chairman, Richard Boy
Nay: None
Order:
4 Appeal No 1992- 60 has been granted a Family Apartment.
artment.
- . shall be made Appeals of this
decision, if any, Pursuant to MGL chapter 40A, Section 17, and
shall be filed within twenty (20) days after the date of the filing of this
decision in the office of the Town Clerk.
Any person aggrieved by this decision may appeal to the Barnstable
Superior Court, as described in Section 17 of Chapter 40A of the
General Laws of the Commonwealth of Massachusetts by bringing:.an
action within twenty days after the decision has been filed in the
office of the Town Clerk.
Chairman
I' Clerk of the Town of Barnstable,
Barnstable County, Massachusetts, hereby certify that twenty (20) days
have elapsed since the Board of Appeals rendered its decision in the
above entitled petition and that no appeal of said decision has been
filed in the office of the Town Clerk.
Signed and Sealed this day of 19 under the
pains and penalties of perjury.
Distribution:
Property Owner
Town Clerk Town Clerk
Applicant
Persons Interested
Building Inspector
Public Information
Board of Appeals
' Town of Barnstable
Zoning Board of Appeals
L
Decision and-Notice "r''' '� " "!;S`'
Appea12001-34 - Burt. LC AiP 17 Rl.
Special Permit - Section 3-1.1(3)(D) Family Apartment
Summary: Granted with Conditions.
Petitioner: Alan R.Burt and Dawn M.Burt
Property Address: 338 Pleasant Pines Ave., Centerville,MA
Assessor's Map/Parcel: Map 214,Parcel 070
Zoning: Residential F-1,Resource Protection Overlay and Groundwater Protection Overlay
Background:
The applicants are requesting a Special Permit under Section 3-1.1(3)(D),to permit the reuse of an existing
family apartment for their daughter.
The property that is the subject of this appeal is a one acre lot improved with a 3,435 gross sq. ft. single
family dwelling which contains living space previously approved as a Family Apartment under Special
Permit 1972-60 and again in Special'Permit 1997-55.
The property is commonly addressed as 338 Pleasant Pines Ave., Centerville and is located in the'
Residential F-1 Zoning District and GP Groundwater Protection District. The applicant is seeking
permission to again use this living space as a Family Apartment.
Procedural &Hearing Summary:
This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on
January 25, 2001. An extension of time for holding the hearing and for filing of the decision was executed
between the applicant and the Board. A public hearing before the Zoning Board of Appeals was duly
advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was
opened April 04, 2001, at which time the Board'found to grant the family apartment special permit with
conditions.
Board Members deciding this appeal were Randy Childs, Dan Creedon, Gail Nightingale,Richard Boy,
and Chairman Ron S.Jansson. Mr. Burt represented himself. He explained the unit existed and that his .
daughter wished to use the unit as her residence. He rioted that he.has read the provisions governing
family apartments and will abide by those requirements.
Findings of Fact:
At the hearing of April 04, 2001,the Board unanimously found the following findings of fact:
1. In Appeal 2001-34,the applicants,Alan R.Burt and Dawn M. Burt are seeking a Special Permit in
accordance with Section 3-1.1(3)(D) for a Family.Apartment. The property is addressed as 338
Pleasant Pines Ave., Centerville, MA,Assessor's Map 214,Parcel 070. It is zoned Residential F-1 and
is in both a,Resource Protection Overlay and Groundwater Protection Overlay Districts.
2. In 1997,the Board did grant a family apartment permit to the previous owners of the property in
Appeal 1997-55. The new owners of the property,Alan R. Burt and Dawn M. Burt wish to keep the
unit for their daughter and have the permit renewed.
3. They have stated that they will abide by all of the provisions of Section 3-1.1(3)(D) for the grant of
the permit.
4. Special Permits pursuant to Section 3-1.1(3)(D) -Family Apartment- are permitted in all residential
Zoning Districts.
5. Upon evaluation of all the evidence presented,the proposal fulfills the spirit and intent of the.Zoning
Ordinance and would not represent a substantial detriment to the public good-or the neighborhood
affected.
i
Decision:
Based on the findings of fact, a motion was duly made and seconded to grant the appeal with the
following conditions:
1. The locus shall comply with, and be maintained in accordance with, all restrictions of Section 3- .
1.1(3)(D) of the Zoning Ordinance and shall be the primary year-round residence of the family
member residing therein.
2. The family apartment shall be maintained in substantial conformance to plans presented to the Board.
Which plans are identical to those presented to the Board in Appeal 1997-55. A copy of which is
entered into the file.
3. The locus shall comply with all State Building Code, Town of Barnstable Board of Health and State
Fire Prevention Regulations.
The vote was as follows
AYE: Dan Creedon,Richard Boy,Randy Childs, Gail Nightingale, Chairman Ron S.Jansson
NAY:
Ordered:
Special Permit 2001-34 is granted.with conditions. This decision must be recorded at the Registry of
Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals
of this decision, if any,shall be made pursuant to MGL Chapter 40A,Section 17,within twenty (20) days
after the date of the filing of this decision. A copy of which must be•filed in the office of the Town
Clerk.
Ron S.Jans , hairman 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 been filed in the office of the Town Clerk.
Signed and sealed this day of A,4 oloa/ under the pains and penalties of perjury.
J
Linda Hutchenrider,Town Clerk
2
t
[ ] [R214 070 . ]
LOC10338 PLEASANT PINES AVE CTY105 TDS] 500 WB KEY] 132662
----MAILING ADDRESS------- PCA11011 PCS100 YR100 PARENT] 0
KOPPEN, JANE R & MAP] AREA] 51BB JV] MTG] 0000
REED, JANET B SP1] SP21 SP31
338 PLEASANT PINES AVENUE UT11 UT21 1 . 00 SQ FT] 1656
CENTERVILLE MA 02632 AYB11985 EYB11985 OBS] CONST]
0000 LAND 45000 IMP 187000 OTHER 800
----LEGAL DESCRIPTION---- TRUE MKT 232800. REA CLASSIFIED
#LAND 1 45, 000 ASD LND 45000 ASD IMP 187000 ASD OTIJ. 800
#BLDG(S) -CARD-1 1 187, 000 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE
#OTHER FEATURE 1 800 TAX EXEMPT
#DL LOT 7 RESIDENT' L 232800 232800 232800
#PL PLEASANT PINES AVE WB OPEN SPACE
#RR 1281 0227 COMMERCIAL
INDUSTRIAL
EXEMPTIONS
SALE] 06/97 PRICE] 195000 ORB] 10802132 AFD] I JT
LAST ACTIVITY] 10/03/97 PCR] N
I
R214 070 . A P P R Al S A L D A T A KEY 132662
KOPPEN, JANE R &
LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=
45, 000 800 187, 000 1 A-COST 232, 800
B-MKT 155, 900
BY 00/ BY HM 8/86 C-INCOME
PCA=1011 PCS=00 SIZE= 1656 JUST-VAL 232, 800
LEV=500 CONST-C 0
----COMPARISON TO CONTROL AREA 51BB -- TREND EXCEEDS STANDARD
NEIGHBORHOOD 51BB CENTERVILLE
PARCEL CONTROL AREA TREND STANDARD
101 10 LAND-TYPE
450001 LAND-MEAN +Oo
2328001 135067 IMPROVED-MEAN +380 2506
] FRONT-FT
1] 100 DEPTH/ACRES TABLE 02
100%] LOCATION-ADJ APPLY-VAL-STAT
LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES
COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC
FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?]
R214 070 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 132662
000000001
PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT
[B27491] [02] [85] [ND] ^ 500001 [ ] [00] [00] [000] [NEW ] [WB J
[B35556] [12] [92] [AD] ^ 60001 [LK] [01] [94] [100] [NEW ] [WB FAM.APT]
t J t J t J t J ^ J t J t ] t J t J t J t J
t J t ] t ] t J ^ ] t J t J t J t J t ] t ]
t ] t J t ] t ] ^ J t J t ] t J t J t J t J
t ] t ] t ] t ] ^ ] t ] t ] t ] t ] t ] t ]
t J t ] t ] t ] ^ ] t ] t ] t ] t ] t ] t ] t?]
of The Town of Barnstable
°.� Department of Health Safety and Environmental Services
Building Division
1639. �e� 367 Main Street, Hyannis MA 02601
QED MA'S A
Office: 508-790-6227 Ralph M. Crossen
Fax: 508-790-6230 Building Commission
February 2, 1998
The Kappen Residence
338 Pleasant Pines Ave
Centerville, MA 02632
Re: Family Apartment located at the above address
Dear Ms. Kappen,
Our records indicate you have not filed an affidavit regarding the above referenced family
apartment. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable
Zoning Ordinance that an affidavit be submitted annually for the duration of such
occupancy. Please indicate the status of the family apartment on the enclosed affidavit
return to this office by March 1, 1998.
Enclosed is an affidavit for your convenience.
Thank you in advance,
0-6
Ralph Crossen
Building Commissioner
anerrsrnsUe.
A, The Town of Barnstable
Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph M. Crossen
Fax: 508-790-6230 Building Commissioner
January 28, 1998
The Kappen/Reed Residence
338 Pleasant Pines Avenue
Centerville, MA 02632
Re: Family Apartment located at the above address
Dear Ms. Kappen and Ms. Reed,
Our records indicate that there has been a change of property ownership since the family
apartment had been approved by the Zoning Board of Appeals. Therefore you must
contact this office as soon as possible to discuss the necessary steps towards compliance
with the Town of Barnstable Zoning Ordinance.
Thank you in advance,
fn
Ralph Crossen
Building Commissioner
�FTME t The Town of Barnstable
Department of Health Safety and Environmental Services
BARNSPABIX 'r Building Division
367 Main Street, Hyannis MA 02601
Office: 508-790-6227 Ralph M. Crossen
Fax: 508-790-6230 Building Commissione
January 21, 1998
The Allain Residence
338 Pleasant Pines Avenue
Centerville, MA 02632
Re: Family Apartment located at the above address
Dear Mr./Ms. Allain,
Our records indicate-you have not filed an affidavit regarding the above referenced family
apartment in quite some some. It is required under Section 3-1.1 (3) (D) (1) of the Town
of Barnstable 7�oning Ordinance that an affidavit be submitted-annually for the duration of
such occupancy. Please indicate the-status of the family apartment on the enclosed affidavit
return to this office by February 15, 1998.
Inclosed is an affidavit for your convenience.
Thank you in advance,
0-06
i'... .�'i !i•F .9�._..`.9°!. ' d :"i,a.. e`a:'q, t, f. a� �: .�`--'7��
:ae 5 �..'+�! �`?�,c ".I.r;`�.rr�(.'at�ti,r.' ��\�c���. ,t•• .,i:t x ,, , .. . .
�Ralph'Crossen
"�
Building Commssioner
COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE AFFIDAVIT
being on oath,
depose and state as follows:
1.) I reside at
2.) I am the owner of the property located
at
-- -- --------- ------ --------------------------
shown on Barnstable Assessors' maps as MAP PARCEL—
3.) I Do —_ --Do not--__ have a Family Apartment at this location.
4.) On _ 199____, the Zoning Board of Appeals, on Appeal No.______
granted me a Special Permit/Variance to maintain a Family Apartment at the above address.
5.) I understand that the Family Apartment may only be occupied by members of my family who
are persons related to me by blood or by marriage.
6.The following members of my family will be the sole occupants of the Family Apartment at the
above address:
a) NAME
Relationship to owner:__ ___—__—______________—_
b) NAME__—
---- --------------------------------------
Relationship to owner: ___-- -
7.) The Family Apartment will be the primary year round residence for the above-identified family
members.
8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the
Building Commissioner in writing.
9.) I understand that no subletting or subleasing of said Family Apartment is permitted.
10.) 1 understand that I-am required to annually file an Affidavit with the Building Commissioner
listing the names and relationship of my family members occupying said Family Apartment.
11.) I understand that I am required to comply with all conditions imposed by the Board of
Appeals in Appeal No.
12.) I agree to immediately notify the building Commissioner in the event of the sale of the above-
listed property.
Sworn to under the pains and penalties of perjury this ------day of ----------- 199___—
Signature
Print Name — — — ----------
P ,
George Allafn . . Romp MAq
87 Joel Rd Gw' 0-1
South Yarmouth,MA 026"1062
CJ
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TO �w� ■+ +� TIME! DATE/ a
WHILE YQUA WERE �1 I ■ ❑ UR6ENTI El Telephoned'
M Q Resumed Called to
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PHONE ❑Will tall 0you'll
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MESSAGE
or
OPERATOR:
7 23-024-400 SETS 23-027-200 SETS
TOWN OF BARNSTABLE 27491
Permit No. -- - - ---
Rum = Building Inspector cash
OCCUPANCY PERMIT Bond __x___ �-'��`�'
Issued to Ca Lode J. A118i n Address
333 pleasant; Pine Avmnr.--, Tit; Barnstabip-
I
Wiring Inspector , Inspection date
Plumbing Inspector ,� '• ( Inspection date
Gas Inspector l� �1/H.� Inspection date
Engineering Department YM i Inspection date
Board of Health Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
../i�...G L y J.'4i/....i � '
Building Inspector
• tom. '
�. Asse*or s map and lot number ..7 �.., /........ F THE T
Sewage Permit number ..........�5. .10'T.741...........—z7;A, INSTALLED IN CCa�lr�LI
��lG SYSTEM MUST .
Z STAXLE,
i
UV1�"34 TlyLE BJSHMAO&
.. . +�r�l p� �
House number ................... 3............................................. .pp,�TT C o s
Ar
TOWN OF BARNSTABLE r.
BUILDING SPECTOR'+
APPLICATION FOR PERMIT TO ............:/... �Ar"?...........flL..�!/G.:` ..:...... .:.............................
TYPE OF CONSTRUCTION ...l�t�Qt�t ...... /'? ..r.:........................ Z
l ......Z&vC.....Z...................1aT-
1
TO THE INSPECTOR OF BUILDINGS:'
The undersigned hereby applies 'for a permit according to the following information:
Location .3 �9SAilJ j" WINE ........ �C
Proposed Use .....9r.S.1Pe aA4
......................................................................................................................................
ZoningDistrict ....................................................Fire District ... .. ...../......................................................
Name of Owner ...� o..IV �r. � ��..........Address �3/ �GN6 U/Eu> P. . c�iIJTEKV/LLC—
........... .................. ................................. ......:..............
Name of Builder ........Address .....
............................... ............................ ...... ................ .....................................................
Name of Architect .,/Ll YfJ r1/....jq. ...... .........Address .... .. .. .l! J............ ... .�c ..4.................................
Number of Rooms ................................................Foundation
/�f/ t!F ...Roofin f*-101�/
Exterior ....... g ....................................................................................
Floors /} �GvoO D '�" .lGs............................Interior ..........�Af9�. Z?0! /4 ............................
Fi eating ........
�. ...... f TCP....................................Plumbing ...... .. �..........................
... -..
i
Fireplace ................/...............................c.......:......:................Approximate.Cost .........J�-�! '...`. ...�.............
` ........ j FFes�.... 6 ...! '
Definitive Plan Approved by Planning Board .__.__.___________.._________19________. Area ...1..�
Diagram of Lot and Building with Dimensions Fee ...... D!.. .............
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I,
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 ... ....... `"..............
j
Construction Supervisor's License .0�.6..�.,1 .f�..........
AKIN, GEORGE J.
274.91. Permit for ..A2.§j;PXY................
........sipg.10JF ly..Dwelling......................
Location -338-131eazAnt...Pine-Avemip..........
West.Barnstabl .............................
Owner ......Geo.rge...J....Al.l.ain...........................
...... ...... .... .... . ......
Type of Construction ....Frame......................................
................................................................................
Plot ............................ Lot ....................
Permit,-Granted ............................February 6,. ............1/9 85
Date of Inspection'._.. .......................... ,:19
.. .
Date Complete19 96
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1a3,590t',F 2
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i�tin �. • ' i I� I G:'S..T.. (.•;._;
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FLAN SCALE '-1 —1,.0 PROFILE
4..: DATE 11/8/84 NO ALE;
All-CaP e--Enriniiering ! !.
49 H,rhor R6nd i m
IIyrnnis, I•iar"•;. 02601 I N fnd'. ,i. n footing : :
4.
.SKETCH- PLAN- OF LAND; IN BARNSTABLE,MA',
for
GEORGE ALLkIN
Being 10tj7 as shoA on a plan for'Erin.Realty Trust- ;
-• �.-b.Y...A..oy3,e:
book 36$• IPIage 55,. I . .
ElevatiohG• shown' ar6. on an: }aps med. dattain.
_��
u^..TE 12113/82 Date: i Barnstabl.b Board of. Health'.':`'::. :: :I
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-CONERV. w
110 WATER ENCOUNTERED 15 MIN.. FER INCH
i
BARNSTABLE BOIpIW CO., INC., a Massachusetts corporation having a usual;`.p1dC ry i }y.;
of business at 100 West Main Street, Hyannis, + +a"
yL
Barnstable `
County Maeaachuse
oftt�� ,ya•
in consideration of NINETEEN THOUSAND EIGHT HUNDRED AND rA/100 ($19.800 00) uF 5 s 5 rf
t
".. `-' }7••� t Frl.Via,. .2
rang to GOORGE ALIAM and FIARINE M. AUM, husband and Wife as.,.tenants by r, '
the.eotirety, both of 37 Dartmouth Street,.Waltham, Massachusetts 02154+ t; '
t f
NX
,yrlth qultrlslm roue' fig
the•land in Barnstable (West), Barnstable County, Massachusetts, bounded described as follows:
>%' 'ts,�t
41rR � '`s t a w x, o
S 'N011fNF5TERLY ,by Lot 6, as shown on plan hereinafter menticned, ,twohundred ,r
fifty and n/l00:(250 00) feed
��'��'�.i���`���
land of Owners Urft-ln, 'as shown one said*plan, two h 9red v
` >° �+ R x n�lnety-seven and no/100.(297 00) feed 'FY'Y j t "
Ly
SWTSERIiY by iani9^niow ter. foxmerlytlof7lN..ttirlsaardd�Huges,.eti unc, arshownU�m a"
-said plan, otie hundred thirty-four and'30/100 '(134 30);18e�rf�®iY9• �'2...
�-60U'14biES'TERAY ;by Pleasant. Pines Avenue, as. shown on said plan,`{�one�hundred�l A
i eighty-three
i .. .. t
Said lot is shown as.LOT 7 on a-plan of land entitled-'Division Plan of,Lpnd in ay g
Barnstable, Mass. for EYE Realty Trust, Scale 1''� 40', Novesber 9,.T98�:.'Doyle �
Engineering Associates, Inc, 31 Tataket Square, Falmouth, Mass.','whicli:`plan`. is; = >`
recorded in the Barnstable County Registry of Deeds in Plan Book 368, Ppge 55i sib
title see deed recorded in the Barnstable County.Registzy of Deedsain'Hook�}
3780,l Page 108.
6 _ '
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TOWN OF BARNSTABLE 27,191
� Permit No. -'---=---
>* I Building Inspector '
cash —- - -
Wa � X d�
OCCUPANCY PERMIT Bond �_•-__
r
Issued to George J. Allain Address
338 vleasant Pine Avenue, West Barnstable
Wiring Inspector i. r �� Inspection date
Plumbing Inspector-
Inspection date
Gas Inspector V /y �� � � Inspection date
}Engineering Department .Inspection date
Board of Health .F2 4wJ / �V) ` Inspection date
_ f _
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING'SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE- WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETI'S STATE
BUILDING CODE.
v Building Inspector
1
}; ��� °•yew TOWN OF BARNSTABLE
BUILDING DEPARTMENT
TOWN OFFICE BUILDING
� rua
°b i639' �� HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has been issued for the building authorized. by
Building Permit .... ..»_....
issued to .......».. �
Please release the performance bond.
TOWN OF BARNSTABLE
Permit -No. ..35556
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
M�
639.
�'�tovr► HYANNIS.MASS.02601 Bond. ................
CERTIFICATE OF USE AND OCCUPANCY
Issued to George Allain (Family Apartment.)
Address 338 Pleasant Pine Avenue
Centerville, Mass.
r"
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
T
February 18� , 19....93.......... ,�5� ....
Building Inspector
r '
.r
t
o`"" Permlt No. .
TOWN OF BARNSTABLE 35556 z.
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash `
.Y•
.6)p•
HYANNIS.MASS.02601 Bond ................
CERTIFICATE OF USE AND OCCUPANCY
Issued to "George Allain (Family Apartment)
Address 338 Pleasant Pine Avenue
Centerville, Mass.
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
-SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
February 18, 19 93 ....� ..................
Building Inspector
TOWN OF BAR.NSTABLE, MASSACHUSETTS BUILDING PER MI,
A=::14-070
ll: C: _ i .:.1.� / � ;% PERMIT NO_h
5:)—
APPLICANT Owner DATE 19 y
ADDRESS +T-�1_;t ed Below #028899
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT 70C'.T11•Ud£:l Gr3rage/I'da-Ci.ti1.'�lA'6T'ORV '�'.1.�1CJ1:.' .T�i1P.l.11f TJ:'1�E:I.�..I.;1 UMBER OF
(TYPE OF IMPROVEMENT) No. IWELLING UNITS
(PROPOSED USE)
AT (LOCATION) J38 Pit iisalvt Pill: Avenue, Cc,-:rtl-crville ZONING RD-1
(NO.) (STREET) DISTRICT_
BETWEEN
C' (CROSS STREET) AND (CROSS STREET)
SUBDIVISION LOT LOT
BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI,
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Sk. Iw LU,_ s84-1074 ,,-xo('_cil ji1.992-00 '
AREA OR
VOLUME iN 1 A:i c it Cai TlC7i: 00o• 00 FEE
MIT $ 5'0. 00
(CUBIC/SO DARE FEET)
ESTIMATED COST y�
)-
OWNER Gc_:,orge
ADDRESS 338 t)i:.'%1s CL11t i�1i<c !.Avc'! il''':, BUILDING DEPT,
I. .. .. BY
f•'
OT:f"TRE�D'E�'A'RYM�•IJ'�6-F OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES ANY APPLICABLE SUBDIVISION RESTRICTIONS. NOT RELEASE THE APPLICANT FROM THE CONDITIO
MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR •APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
PLUMBING
AND
2. PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL IN (RE INSPECTION
TO BEFORE
FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1
1 '/
�Lo v f lT 0 i4l,is 1
•s z
3 HEATING INSPECTION APPROVALS
/q� 1 ENGINEERING DEPARTMENT
L r U « BOARD OF H
OTHER.
L' SITE PLAN REVIEW APPROVAL
L IAe
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION
TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN!
CONSTRUCTION. ARRANGED FOR BY TELEPHONE OR WRITTI
PERMIT IS ISSUED AS NOTED ABOVE.
NOTIFICATION.
J
I
41� 4.e TmnuwnwPaU4 Vt mallgar4tliPtts
_ DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION
1010 COMMONWEALTH AVENUE. BOSTON
West Barnstable 19 Cb
(City or Town) (Date)
CERTIFICATE OF COMPLIANCE
CHAPTER I48, SECTION 26F, M, G , L,
This Certified that the property located at
WEST BARNSTABLE has been equipped with approved smoke
."de-t4ctors and was found to be in compliance with Chapter 148 Section 26F, Massachusetts
General Law.
Inspection/Testing completed on: �� 1 c,�j 19 C'JBy: J
nspector
Fee Paid: $10.00
Receipt # JOHN P. JJ=NS O CHIEF
WEST BARNSTABLE FIRE DEPT,
(Seller's Copy)
HIII;x YOU
M[A f
tlfffjs
8 a 40AM 1e/0'7/9 '
100#8406 E 0001
#007J004
C R+D $10.29
13TTL $10.29
CASH 0.00
CHNG $9.71
Town of Barnstable TOWN CLERK
Zoning Board of Appeals BARNbs, .,U E MASS.
Family Apartment
Decision and Notice V OCT 30 P 4 :01
Appeal No. 1992-60
Summary: Granted with Conditions
Appeal No. 1992-60
Applicant: George Allain
Address:' 338 Pleasant Pines Avenue, Centerville, MA
02632
Assessor's Map/Parcel,: 214/070
Zoning: RD-1 Residential D-1 District
Applicant's Request: Special Permit - Section 3-1.1(3) (D) Family
Apartment
Activity Request: To convert first floor of the structure into a
family apartment by installing a kitchen.
Procedural Provisions: Section 5-3.3 Special Permit Provisions.
Background:
This decision concerns the appeal submitted by George Allain to the Zoning
Board of Appeals for a special permit to allow for a family apartment to be
located at 338 Pleasant Pines Avenue, Centerville, MA. The request was made
in accordance with Section 3-1.1(3) (D) , "Family Apartments" of the Zoning
ordinance.
` I- apartment unit is located in the lower, first floor level of the
structure. From plans submitted with the application, the apartment will
occupy the entire level, (estimated at '.,563 a vas s..ft) and will contain two
bedrooms, one bathroom, a living room and a kitchen.
Procedural Summary:
The application was filed in the office of the Town Clerk and at the Zoning
Board of Appeals office on September 22, 1992. A public hearing, duly noticed
under M.G.L. Chapter 40-A, was opened, closed and a decision osn rendered by the
Board on October 22, 1992. The petition was heard by Board Members: Gail
Nightingale, Ron Jansson, Luke Lally, Dexter Bliss and Chairman Richard Boy.
The applicant represented himself before the Board and explained the intent of
his proposal to have a Family Apartment within the first floor of the dwelling
which is a raised ranch style home. The apartment, is to be occupied by his
daughter and son-in-law and their child. Layout plans were presented and
discussed.
The pubiic was ,invited to speak. No one spoke in favor or in opposition to
the application, for the family apartment unit.
-eemily Apartment .. D.acisi of and Notice
Appeal No. 1992-60
Finding of Fact:
Based upon the 'evidence submitted and testimony given, at the public hearing
of October 22, 1992, the Zoning Board of Appeals unanimously finds, as
follows:
1. The applicant has met all of the requirements for issuing a Special
Permit in accordance with Section 3-1.1(3) (D) Family Apartment of
the Zoning Ordinance; and
2. The applicant, who is the present owner, has agreed to maintain the
property in accordance with the provisions of that section of the
ordinance and to comply with the required yearly Family Apartment
Affidavit.
Conclusion:
Accordingly based upon the findings, a motion was duly made and seconded that,
Appeal No. 1992-60 be granted a special Permit for a Family Apartment in
accordance with Section 3-1.1(3) (D) of the Zoning Ordinance, as sought and
with the following conditions:
- 1. The special Permit is issued only to the owner and resident, George
Allain, for the property, at 338 Pleasant Pines Avenue, Centerville,
MA
2. The family apartment shall be located as presented in the plans
submitted titled: "First Floor Layout (Apartment)".
3. The applicant shall maintain the apartment in compliance with the
requirements of Section 3-1.1 (3) (D) Family Apartments of the
Zoning Ordinance.
4. Tr.3 applicant shall ccmnly_ with all of Title v and the Board of
Health requirements.
The vote.was as follows:
Aye: Gail Nightingale, Ron Jansson, Luke Lally, Dexter Bliss, and
Chairman, Richard Boy
Nay: None
Order:
Appeal No 1992- 60 has been granted a Family Apartment. Appeals of this
decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, and
shall be filed within twenty (20) days after the date of the filing of this
decision in the office of the Town Clerk.
t
Any person aggrieved by this decision may appeal to the Barnstable
Superior Court, as described in Section 17 of Chapter 40A2of the .
General Laws of the Commonwealth of Massachusetts by bringing:.an
action within twenty days after the decision has been filed in the
office of the Town Clerk.
Chairman
I, Clerk of the Town of Barnstable,
Barnstable County, Massachusetts, hereby certify that twenty (20) days
have elapsed since the Board of Appeals rendered its decision in the
above entitled petition and that no appeal of said decision has been
filed in the office of the Town Clerk.
.Signed and Sealed this day of 19 under the
pains and penalties of perjury.
Distribution:
Property Owner
Town Clerk Town Clerk
Applicant
Persons Interested
Building Inspector
Public Information
Board of Appeals
V
I
Y
.�
1
I II
I
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I
1
T"
' - � I - � - - - -_
Assessor's office(1st Floor): /,(l _ /��'7/) "" m' t �'� i�id
Assessor's map and lot number -j V /(/ .;Z4 ,LLED IN COMPUANC �o� tMtj'to`
Conservation —�- WITH TrMe 5 `�Q+� •:
Board.bf Health(3r ,loor). " `vVIRON ENTAL CODE AND •
Sewage Permit number ZLO 'OWNREGU ATIONS urEngineering Department(3rd floor): '���'
House number �o rsr
Definitive Plan Approved by Planning Board
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-i00 P.M.only
TOWN - OF BARNSTABLE
BUILDING INSPECTOR ,HMO //
bEL �i4ogG SE 7�
APPLICATION FOR PERMIT TO a a d"/f
TYPE OF CONSTRUCTION =
42-e_ 1 s 9A.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location 3 �" lea A L-P C //1
Proposed Use j ifn^e-
Zoning District ��j e Si�eti 7`i J ( U " Fire District
i Name of Owner a e o j-5 — Tel l a Gl Address lea 1;d4,24— l' 4G,-p
/
Name of Builder �d VY) Address
Name of Architect Address
Number of Rooms
✓ Foundation
Exterior �`� 4 S /'e Roofing —�
Floors Interior
Heating t0 L ` C "j, P�. Plumbing
Fireplaces P Approximate Cost r O U d
Area
Diagram of Lot and Building with Dimensions Fee S/1,
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name
Construction Supervisor's License 9 9
ALLAIN, GEORGE /II�
' NQ 3 5 5 5 6 Permit For REMODEL GARAGE/FAMILY APT.
Single Family nwi-Ming
�T
Location 338 Pleasant Pine Avenue
Centc-rvi 1 I
Owner George Allain -
Type of Construction Frame
Plot Lot s
Permit Granted December 7, '� 1,9 92
Date of Inspection 19
Date Completed od7IR-3 19
0A . t
4 1•`
y
Y
Town of Barnstable
of r Regulatory Services
ti
o„ Richard V. Scali,Director
i BA NS'PABLE. : Building Division
` a.0� Thomas Perry, CBO, Building Commissioner
Ep Mp'l
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is �1/GawV1 'W' �30IQ I I am the owner/resident of the
property located at:
.S 2-j
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner:
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the_above-ident f ed
family members. In the event that the listed relatives vacate said apartment, I wi mmediat p
notes the Building Commissioner in writing. I understand that no subletting or leasing of said
Family Apartment is permitted. r
I understand that I am required to file an Affidavit annually with the BIT) ' ng NO -*�
Commissioner listing the names and relationship of occupants in said Family Ap2"tment. IIso
understand that I am required to comply with all conditions imposed by the ZBA . ecial Pertnit -
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apar ents. I_gree�
to notes the Building Commissioner immediately in the event of the sale of this p perry.
If there is no longer a Family Apartment at this location,please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program(Appeal No. )
Other
Sworn to under the pains and penalties of perjury this day of 2015.
21 —
Si afore Phone Number
Print'Name a".,, `�✓) �C}'� I
q:forms/famaffid.do c
rev 11/08/11
i
i
Town of Barnstable
Regulatory Services
�"E rgyti Richard V. Scali,Interim Director
Building Division TOWN OF
g,
BARNS
Thomas Perry, CBO>Building Commissioner TABLE
�"
Mns
1639 p�� 200 Main Street, Hyannis, MA 02601 2CI :q 3; t
FD MA'S
www.town.barnstable.ma.us
Office: 508-862-4038 Fax 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is �G�.?.trr I am the owner/resident of the
property located at;
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner:
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, I will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of said
Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree
to notes the Building Commissioner immediately in the event of the sale of this property.
- - -If there is no longer a Family Apartment at this location, please explain;
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program(Appeal No. )
Other
Sworn to under the pains and penalties of perjury this 3 day of p ;z/ 2014.
S gnature Phone Number
Print Name , C,W11 FYI. S UK,
q:forms/famaff.d.do c
rev 11/08/11
Town of Barnstable
Regulatory Services
ofTME rq�� Thomas F. Geiler, Director
Building Division TOWN OF BARNS
MAM Thomas Perry, CBO,Building Commissioner TALC
039. A�e� 200 Main Street, Hyannis, MA 02601 Z0I3 FER p 4
www.town.barnstable.ma.us P!� (2 3t�
Office: 508-862-4038 •....�, Fax 508-790-6230
DIVIS C
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is VS. ( I am t owner/ esident of the
property located at: l ` - �') ti---
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner: ; �� Inc � I
r
Name &relationship to owner:
The Family Apartment will be the primary year-round,,r,: aLs,�� the above-identified
family mem,hers. In the event that the listed relatives vacate said apartment, I will immediately'
note the Building Commissioner in writing.'I understand that no subletting or subleasing of said 1
Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree
to note the Building Commissioner immediately in the event of the sale of this property.
If there is no longer a Family Apartment at this location,please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to unde a pains and penalties of perjury this day of 2013.
Signature Phone Number
Print Name '
q:forms/famaffid.doc
rev 11/08/11
Town of Barnstable
Regulatory Services
oF ' Thomas F. Geiler, Director
Building Division
Thomas Perry, CBO,Building Commissioner
59. .�0� 200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name i W n ' I am the owner/resident of the
property located at: �j F/ee 5c?
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner:
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified a .
family members. In the event that the listed relatives vacate said apartment, I will imme&00y �
note the Building Commissioner in writing. I understand that no subletting oejyubleasing`gf,said'
Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Pd`rmit '
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree
to notes the Building Commissioner immediately in the event of the sale of this property. w ,
If there is no longer a Family Apartment at this location,please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program(Appeal No. )
Other
Sworn to under the pains and penalties of perjury this G day of 2012.
Sigfiature Phone Number
Print Name e W x—)ii
q:forms/famaffi d.do c
rev 11/08/11
Town of Barnstable
Regulatory Services
°FINE rod, Thomas F. Geiler, Director
ti
Building Division
' �n LE. ' Thomas Perry, CBO, Building Commissioner
°t i639. p�0� 200 Main Street, Hyannis, MA 02601
www.town.ba rnsta ble.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable, Family/ Apartment Affidavit
I, being on oath, depose and state as follows:
My name is ��� �U�
I am the owner/resident of the
property located at:
Z (03 Z
The following members of my family will be the sole occupants of the Family Apartment at the.
aforementioned address:
Name & relationship to owner:
Name & relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, 1 will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of said
Family Apartment is permitted.
1 understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.I Family Apartments. I agree
to note the Building Commissioner immediately in the event of the sale of this property. o
If there is no longer a Family Apartment at this location, please explain: = _ =
The apartment has been dismantled..
The apartment has been transferred to the Amnesty Program (Appeal No - CLI )G?
Others
Sworn to u der the pains and penalties of perjury this day of 20111T. :
,_;.,
Signature Phone Number
Print Name
Town of Barnstable
Regulatory Services _
pF1He tok1 Thomas F. Geiler,Director 0 R��
Building Division
* BARNSTABLE,
vQ MASS. Tom Perry,.Building Commissioner ,)
OA 1639. A10 200 Main Street,Hyannis,MA 02601 '' 1
rEo � www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is �� � _-- 1 am the owner./resident of the
property located at: �D 101 aA) &_W
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name & relationship to owner: QJA/L.G�
Name & relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, I will immediately
notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of
said Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree
io nv^tlfy tlie:Buildllig OliilillSituliel=immediately-=i,-the event of the sale of this property. -^
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
' I
Sworn to under the pains and penalties of perjury this c2/ day of 2010.
Sign Lure Phone Numbe
Print Name �(�GU n !Y 1. 1101R
Q/bldg/forms/famafd
Rev:12/08
Town of Barnstable
Regulatory Services
DIME Thomas F.Geiler,Director
t�V/I' Uf BARNS(ABLE
Building Division
Y BAANSABUF ' Tom Perry, Building Commissioner 2009 JAN Zb
M 3 7
i639 ,0 200 Main Street,Hyannis, MA 02601 3
www.town.barnstable.ma.us
a�v►��oly
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name'is �2W YA I am the owner/resident of the
property located at:
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner: 5 Wh•n P"- &Wr. CZo
Name & relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment; I will immediately
notify the Building Commissioner in writing. 1 understand that no subletting or sgbleasing of
said Family Apartment is permitted.
1 understand that 1 am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree
to notes the Building Commissioner immediately in the event of the sale of this property.
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this day of 2009.
Sign• ure Phone Number
,Q
P int Name 0a(AJA I LV�.j
Q/bldg/forms/famaffid
Rev:12/08
Town of Barnstable
Regulatory Services
oF1He toffy Thomas F.Geiler,Director
ti
Building Division
r r
r r
` � LE. Tom Perry, Building Commissioner
v
1639. 200 Main Street Hyannis,MA 02601
ATFo�,�s Y
www.town.barn-stable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is I am the owner/resident of the
property located at:
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name & relationship to owner:
Name & relationship to owner: S .ems
The Family Apartment will be the primary year-round residence for the a ove-identified
family members. In the event that the listed relatives vacate said apartment, I will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of
said Family Apartment is permitted.
1 understand that 1 am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree
to notify the Building Commissioner immediately in the event of the sale of this property.
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this/;j day of 2008.
NQ4S� .►�
Sigp4ture Phone Number
Print Name
100 UJ� � � Z i gar eo�z
Q/b l d g/fo rm s/fa m a ffi d
Rev:1/03
Town of Barnstable d
Regulatory Services
°@TNE Toy, Thomas F.Geiler,Director
ti
Building Division �m ;a
MANSTABLE, ' Tom Perry, Building Commissioner 1.1 /j" 's1u ,
9�A 1639• `0� 200 Main Street,Hyannis,MA 0260/1Fes
rEn �s , www.town.barnstable.ma.us Fr p 7
i Office: 508-862-4038 �ll"/5/p/, Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is 0-42W f) 22; 1 am the owner/resident of the
property located at: �� �IE(,ysah� r� Gl1G
J .
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address: / I
Name & relationship to owner: T� mr'o- " aU
Name & relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, 1 will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of
said Family Apartment is permitted.
I understand that 1 am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree
to notify the Building Commissioner immediately in the event of the sale of this property.
If there is no longer a Family Apartment at this location,please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this day of 2007.
Sign a Phone NtImber
Print Name
Q/bldg/forms/famaffid
Rev:1/03
Town of Barnstable 0 t4--
Regulatory Services >y
°FtHe lqy Thomas F.Geiler,Director
ti TOWN (_1F BARNSSTABLE
Building Division
RA MASS, Tom Perry, Building Commissioner Z006 JAN I
8 pM i2: 28
0a9• 10$ 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
DIVISION
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
i
My name is Oawy)' �- 1>�n'T� I am the owner/resident of the
property located at: 3 g l E,eCS a �I�-!5 Cc erg. CJ Z 3Z.
Map and Parcel Number a I `1 � J
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner:
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, I will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of
said Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree
to notify the Building Commissioner immediately in the event of the sale of this property.
If there is no longer a Family Apartment at this location,please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this day of 4ewrL. 2006.
_ -3G;7- i
Sign a Phone Number
Print Name Q w� U►R:1
Q/bldg/forms/famaffid
Rev:1/03
Town of Barnstable �6
Regulatory Services
y��OFIKE 1p�o Thomas F.Geiler,Director
ti
Building Division
sAx MASS.tvsTAaLe. Tom Perry, Building Commissioner F3 �' "9: 31
�
i6;q. ,0 200 Main Street,Hyannis,MA 02601
Argo��a www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is Wom IQ, BU� I am the owner/resident of the
�3g ��aS > " ►tAS Q`vC_ r� �IG�SS
property located at: t
oZ&,3Z_
Map and Parcel Number J /
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name & relationship to owner:
w. 1
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, 1 will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of
said Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also`
understand that I am required to comply with all conditions imposed by the ZBA in the Appeal -
No. identified above. I agree to notify the Building Commissioner immediately in the event of the
sale of this property.
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled. t
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this Lt f� day of r-2 L 2005.
� - �3�a , A
Signature o Phone Number �-
Print Name_;
Q/bldg/forms/famaffid
Rev:1/03
a %
T own of Barnstable Id
Regulatory Services
Thomas F.Geiler,.Director_ 3 r��'�- TABLE
p 1 L:
Building Division
BAMSPABM Tom Perry, Building Uffirrdisioner ;i I I = 2-9
MASS. � �-.:
. � 039. 200 Main Street,Hyannis,MA 02601
AjEO MA'1 A
LIVISION
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I,being on oath, depose and state as follows:
My name is \Q lR,� I am the owner/resident of the
property located at: -3 39 S
Map and Parcel Number
The ZBA granted me a Special Permit/Variance on a 0o/ — 5 7
Date Appeal No.
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner: S t4a.tti1 0 h ak 6 LAt W(,(.Uq H&W�
-
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, I will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of
said Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA in the Appeal
No. identified above. I agree to notify the Building Commissioner immediately in the event of the
sale of this property.
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program(Appeal No. )
Other
Sworn to under the pains and penalties of perjury this day of 2004.
c
Signature Phone Number
Print Name Wool u
Q/bldg/forms/famaffid
Rev:l/03
f
Town of Barnstable
Regulatory Services
°EI►IE►qy Thomas F.Geiler,Director r0�,}�
Building Division OF BAk'5TA8LE
iwarrsraBL& Tom Perry, Building Commissioner 2003 FEB 14 Mass.
�Q3' 039. ,0$ 200 Main Street,Hyannis,MA 02601 P� 3� �2
AEC N1A'�� •
Office: 508-862-4038 DIMS 508'79 - 230
Town of Barnstable Family Apartment Affidavit
I,being on'oath, depose and state as follows:
la0 R. �o�r
My name is I am the owner/resident of the
property located at: 559 PIEGtSon-f
• �,as5
Map and Parcel Number G)0
The ZBA granted me a Special Permit/Variance on o? OG/— 3
ate Appeal No.
The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in
Barnstable County: Book Page 6?0 Cn
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
54 Name &relationship to owner: )Ip�►a' 6(Jar�
Name &relationship to owner:
The Family Apartment will be the p mary year-round residence for the above-identified
family members'-'In the event that the listed relatives vacate said apartment, I will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of
said Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA in the Appeal
No. identified above. I agree to notify the Building Commissioner immediately in the event of the
sale of this property.
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this day of 2003.
n If
Signature 1 Phone Number
Print Name /I l _ty k By f ,
Q/bldi/fomvs/famaffid
Rev:1/03
Town of Barnstable G/
t r Reginay Service s o ,v
°e114E roy� Thomas F.Geiler,Director
Building Divit Of- BARpAS'TA9LE
saxrrsrnBz e = Peter F.DiMatteo, Building Commissioner 3 Mass.
039. 200 Main Street,Hyannis, ll Z A!�
ArEo��a /
Office: 508-862-4038
01
Vj Fax:.508-790-6230
•- IS1aN
Town of Barnstable Family Apartment Affidavit
I, being on oath, depose and state as follows:
My name is W�l /�/( A6 0'et I am the owner/resident of the
property located at:.
Map and Parcel Number��l � Ce- ®�
The ZBA granted me a Special Permit/Variance on
Date Appeal No.
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner:_�5h�7. /!/d' A2 46yiw rz9aurk_06.s�)
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment,'I will immediately
notify the Building Commissioner in writing. I understand that no subletting or subleasing of
said Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA in the Appeal
No. identified above. I agree to notify the Building Commissioner immediately in the event of the
sale of this property.
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this--�—day of - 2002.
Signature Phone Number
Print Name
Q/bldg/forms/famaffid
Rev:010702
• oF�► , Town of Barnstable
x
Regulatory Services
* BARNSTABLE,
v Mass. Thomas F.Geiler,Director
�A 1639. `0
1pp ter" Building Division
Elbert C Ulshoeffer,Jr. Building Commissioner
367 Main Street,Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I,being on oath, depose and state as follows:
My name is <-UQ t,UV) �UVI( I am the owner/resident of the
property located at: 3 W 4tQS ad 2:D
Map and Parcel Number c?Z` Q1 20
The ZBA granted me a Special.PermitIVariance on '�—Se'--6V '? — 3
Date . Appeal No.
The following members of my family will be the sole occupants of the Family Apartment
at the aforementioned address:
Name &relationship to owner:
Name &relationship to owner:
The Family Apartment will be the primary year round residence for the above-identified family
members. In the event that the listed relatives vacate said apartment, I will immediately notify
the Building Commissioner in writing. I understand that no subletting or subleasing of said
Family Apartments is permitted.
I understand that I am required to annually file an Affidavit with the Building Commissioner
listing the names and relationship of occupants in said Family Apartment. I also understand that
I am required to comply with all conditions imposed by the ZBA in the Appeals No. identified
above. I. agree to immediately notify the building Commissioner in the event of the sale of this
property.
Sworn to under the pains and penalties of this day of 2001.
Sign e
Q/bldg/forms/famaffid
COMMONWEALTH OF MASSACHUSE TTS
BARNSTABLE FIDAVIT
: CE6VE ®
I- -----ja&1_� _A�04jP:r_a------------------------- b ii on oa:
depose and state as follows: FEB 2 3 1999
1.) I reside at 3382Gz54 h p�n�� U�_T-�'-,����� =��ABLE
BUILDING DIV.
2.) I am the owner of the property located
at_ 3�_� en�_n_�-P - u c.------------------------------------------
shown on Barnstable Assessors' maps as MAP__�e_—__ -PARCEL
__7-0______________
3.) I Do____-)C —__Do not __have a Family Apartment at this location.
4.) On__J uM-c__J Q-_______- 199 7 the boning Board of Appeals, on Appeal No. 1 9 Q 7- 5�
granted me a Special Permit/Variance to maintain a Family Apartment at the above address.
5.) I understand that the Family Apartment may only be occupied by members of my family who
are persons related to me by blood or by marriage.
6. The following members of my family will be the sole occupants of the Family Apartment at the
above address:
a) NAME
Relationship to owner:____- —-------------------
b)"NAME_ �t10 1 3r_— DD�L1-- =--�c ' Q -
----------------------
Relationship to owner: r_Lh j ��nrsr� - ---------------
7.) The Family Apartment will be the primary year round residence for the above-identified family
members.
8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the
Building Commissioner in writing.
9.) I understand that no subletting or subleasing of said Family Apartment is permitted.
10.) I understand that I am required to annually file an Affidavit with the Building Commissioner
listing the names and relationship of my family members occupying said Family Apartment.
11.) I understand that I am required to comply with all conditions imposed by the Board of
Appeals in Appeal No. jg7-=-`r-6-------- ------------------------------------
12.) I agree to immediately notify, the Building Commissioner in the event of the sale of the above-
listed property.
Sworn to under the pains and,penalties of perjury this l T___day of-7,brua� 199
Signature,;.-
-------- --------------
Print NanY
---------- 2' = �JC'— ------------------------
-----------------
i
COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE AFFIDAVIT
I, J 0-1) e 0 being on oath,
depose and state as follows:
1.) I reside at— —� � _ e5u e _ Ce �U_Uc _—
� OF BARNST
2.) I am the owner of the property located ,' 13 ABLE
I EPT
at 3,_8_p1&9a A!L e c\e5_��;. -{ e r1-,t e u -
shown on Barnstable Assessors' maps as MAP_ 2!iq PARCEL_ 3
3.) I Do V Do not --
have a Fault Ap at "?.
L6
location.
4.) On tl a 4 a 8 , 199 7 , the Zoning Board of Appeals, on Appeal
No.iIJ- 56-
granted me a Special Permit/Variance to maintain a Family Apartment at the above address.
5.) I understand that the Family Apartment may only be occupied by members of my family who
are persons related to me by blood or by marriage.
6. The following members of my family will be the sole occupants of the Family Apartment at the
above address: .
a) NAME--__rlri -s_---G-- ° - - ---------------------------------
Relationship to owner: S a fl
b) NAME— len n r c-- t o �1
Relationship to owner: rl a ��i-
-I- so o a f-o h.e- b"4—
7.) The Family Apartment will be the primary year round residence for the above-identified family
members.
8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the
Building Commissioner in writing.
9.) I understand that no subletting or subleasing of said Family Apartment is permitted.
10.) I understand that I am required to annually file an Affidavit with the Building Commissioner
listing the names and relationship of my family members occupying said Family Apartment.
11.) I understand that I am required to comply with all conditions imposed by the Board of
Appeals in Appeal No. 199 7 -5 - ---- -
12.) I agree to immediately notify the building Commissioner in the event of the sale of the above-
listed property.
Sworn to under the pains and penalties of perjury rythis ay of_�6 rq t!�os 199,6
Signature vv
Print Name
C , .
' ��✓"�/ � •'r+av is
Town of Barnstable
Building Department
Brian Florence, CBO
• MANSTMM •
� Building Commissioner Dl11LD11�9G pEP7'
'OrF& 39. I, 200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us JAN 17 2018
Office: 508-862-4038 TOWN O)F - .8-790-6230
�TABLr
Town of Bamstable Family Apartment i avit
I, being on oath, depose and state as follows:
My name is 49_ a.(-,Rqz I am the owner/resident of the
O � "
property located at: •J�1� � �Q,�,p Q-( �C4
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name & relationship to owner: /
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the bove-identifled
family members. In the event that the listed relatives vacate said apartment, I will immediately
notes the Building Commissioner in writing. I understand that no subletting or subleasing of said
Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree
to notes the Building Commissioner immediately in the event of the sale of this property.
If there is no longer a Family Apartment at this location,please explain:
Tl,.e apartment has been dismantled.
The apartment has been transferred to the Amnesty Program(Appeal No. )
Other
Sworn to under the pains and penalties of perjury this Zzz�— day of 2018.
c>? -3 —01�e7
ignature Phone Number
Print Name -Y' U�f
q:forms/famaffid.doc
rev 11/22/2017
Town of Barnstable
Regulatory Services
Richard V. Scali,Director
Building Division U,
ILUMSTMIX
Paul Roma,Building Commissioner 0
16s9. .�� 200 Main Street, Hyannis,MA �
02601
Eo�
www.town.barnstable.maxs y
r
Office: 508-862-4038 Fax: 50 790-6ZD
Town of Barnstable Family Apartment Affidavit
I,being on oath, depose and state as follows:
My name is ���� � — I am the owner/resident of the
property located at:
Uv
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner:
Gz �Z,
Name &relationship to owner:
The Family Apartment will be the primary year-round residence for the above-identified
family members. In the event that the listed relatives vacate said apartment, I will immediately
notes the Building Commissioner in writing. I understand that no subletting or subleasing of said
Family Apartment is permitted.
I understand that I am required to file an Affidavit annually with the Building
Commissioner listing the names and relationship of occupants in said Family Apartment. I also
understand that I am required to comply with all conditions imposed by the ZBA Special Permit
andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree
to note the Building Commissioner immediately in the event of the sale of this property.
If there is no longer a Family Apartment at this location,please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program(Appeal No. )
Other
Sworn to under the pains and penalties of perjury this day of 2017.
Si ature Phone Number
Print Name D Q(� �'✓� I >�.(1t
q:forms/famaffid.doc
rev 11/08/12
03/01/2016 15:23 818-842-5291 THE UPS STORE #5817 #6849 P.002 /002
A V TV Al VA LAl MaLalllu
Regulatory Services
Richard V.Scald,Director
Building Division
M" Thomas ferry,CBO,Building Commissioner
'63¢ `�� 200 Main Street, Hyannis,MA 02601 t,
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Town of Barnstable Family Apartment Affidavit
I,being on oath,depose and state as follows:
My name is w I am the owner/resident of the
property located at: PIA,--go�?JCJ�7
The;following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name&relationship to owner:
Name&relationship to owner:
The Family Apartment will be the primm y year-round residence for the.above-identified
family members. In the event that the listed relatives vacate said apartment,I w 11 jimmediately "-1
notify the Building Commissioner in writing.I understand that no subletting or'subleasing of said
Family Apartment is permitted f -
.I understand that I am required to file an Affidavit annually with the Building
Commissioner luting the names and relationship of occupants in said Family Aparhn .!Wso
understand that I am required to comply with all conditions imposed by the ZBAI.Special Permit
and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 FamilyApartments l agrees
to note the Building Commissioner immediately in the event of the sale of this property.C° W
If there is no longer a Family Apartment at this location,please explain:
-The apartmenf has keen dismantled.
The apartment has been transferred to the Amnesty Program(Appeal No. ) .
Other
Sworn to under the pains and penalties of perjury this day of 2016.
_:�)/. G�
Signaft= Phone Number
Print Name_
o
q:forms/famaffid.doc
rev 11/08/12
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