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0099 ARROWHEAD DRIVE
� 71 - Ix- 0 C� 1�► i I i i xa 4 �� \`.1 1 �. p� `J 1 Town of Barnstable Regulatory Services CF THE l� o Richard V. Scali, Director Building Division BARNSTABLE. ; 9 MASS'. Thomas Perry, CBO,Building Commissioner i639 �� A'F 200 Main Street, Hyannis, MA 02601 www.town.barns,table.ma.us Office: 508-862-4038 Fax: 508-790-6230 THIRD NOTICE April 8, 2015 Eda C. Smith L 99 Arrowhead Drive Hyannis, MA 02601 Re: Family Apartment Dear Property Owner, Our records indicate that you have not responded to our letters dated January 2, 2015 and February 23, 2015 requesting you to complete and return the Family Apartment Affidavit. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. Please return the enclosed affidavit as soon as.possible. If you no longer have a family member residing in the family apartment;please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home, or Apply to the Amnesty Program. If you have any questions,,please call Brenda Coyle,Principal Division Assistant,at 508-862- . 4039. Sincerely, - - Tom Perry _ Building Commissioner /blc ._5 Town of Barnstable Regulatory Services GF tME 1p� Richard V. Scali,Director Building Division * BARNSTABLE, "'"� Thomas Perry, CBO, Building Commissioner 1639• �� , AIFo3.A 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 SECOND NOTICE February 23, 2015 Eda C. Smith 99 Arrowhead Drive Hyannis,MA 02601 Re: Family Apartment Dear Property Owner: Our records indicate that you have not responded to our letter dated January 2,2015 requesting you to complete and return the Family Apartment Affidavit. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. Please return the enclosed affidavit as soon as possible. If you no longer have a family member residing in the family apartment,please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home, or Apply to the Amnesty Program. , If you have any questions,please call Brenda Coyle,Principal Division Assistant, at 508-862- 4039. , Sincerely, { Tom Perry Building Commissioner /blc .tA y f �"E Town of Barnstable Regulatory Services a BARNSTABLE, � .. Richard V.Scali,`Director 1639. C Building Division Thomas Perry, CBO, Building Commissioner ' g 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax:508-790-6230 January 2,2015 V Eda C.Smith 99 Arrowhead Drive Hyannis, MA 02601 Re: Family Apartment Dear Property Owner, Please complete the enclosed Family Apartment Affidavit and return it to the Building Commissioner's Office by February 19,2015. 4 You are required under Section 240-47.1 of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the Family Apartment. Failure to submit the affidavit is a violation-of your Family Apartment approval and may result in the loss of your rights. 0. If you have any questions, please call Brenda Coyle, Principal Division Assistant,at 508-862-4039. Sincerely, Tom Perry . Building Commissioner Enclosure a s :Y p s 36< �"."' F t"s '` '�`, ;.S :r E (*:�r c k .,'ti• :s5`"',`e;. F ; h: #.. nr.barnstable triotcom" ni 21;r s�,x. h ?e� tir n-errrtnxt t , r Pa P R PEA CC1 The t3amstablePatn x .. �.. . € close friend Bridgette Schiffer of Cleveland, Ohio;brother Duane Lopes-sister Jacqueline Lopes;grandson j Aiden Simmons;and close friend Shirley Lynch of Browns Summit, N.C. Very much a family person,.she especially enjoyed spending time with her grandson Aiden. She will be remembered as a loving,giving,gregarious person who always showed a deep concern for others. A memorial funeral service was held at Doane; Beal&Ames in Hyannis. Interment will be private. ! Memorial donations may be made to: Future Scholar 529 College Savings Plan; memo-FBO Aiden Simmons,mail to Merrill Lynch:Attn.Ann Messer, 1545 lyannough Road; Hyannis;MA 02601. � i Eric N.Smith,45 Milford,N.H.—Eric N. Smith,45,resident of.Milford, N.H.,died suddenly on Aug. 18;20117 at the Milford Medical Center in Milford- Born in Hyannis on Aug. 15.. 1966,a son of Gordon Smith of Dennis and Yvonne Dupuis, Eric was raised !!! and educated on Cape Cod and resided in Hyannis for many years. He also lived in Haverhill for several l years and more recently in Milford; N.H. He enjoyed building things,working in the yard and landscaping.In addition, he was a devoted New York Yankees fan. In addition to his father,family members include his wife.,Jeannine(Bunnell)Smith of Milford-,four children. Timmy R. Conn, Rebecca M.Bunnell,Amanda M. Bunnell and Hannah M. Bunnell;all of Milford,three sisters;Tammy Choiniere of Chester,N.H.,Angela Smith-Arthur of Sandwich;and Michelle Spence',a brother; Kenny Smith of Yarmouth; his father-in-law;Paul Bunnell;and a brother-in-law. Matthew Bunnell; i 1 [, both of Milford,two nieces;three nephews;and his beloved dog, Chico. E f bs , -Al�ai)C �i` '� g 3 .,. 3 ,:«^, u,E3t'✓'«i ,"w�✓ w, x .� Click HERE to,subscribe to:e-mail'updates from barnstablepatriot.com: :ai---� 'lam. ry, .:MW �ffiz-,TA ,.... sue..::.. .. .'S.... ... ,xx, .,,. ........ ..,..,:,. ,n ..::, .. O -,:...-s , •i; Y:: `:: ?r' .. tE;., ,.... :.: ,:, 5:..,. , ,fin` h .., sue",.. gx,f; �. , _ ,[.,i. lhe-Barrtab _... .. ., , ,Mom: ernM... Entr... Inbax<--_t7�cr€ua.. .:Fourrtler"Eu e U. .. 1 . .Apt ?ip_ . 9 . t fi..,,... t.. E.. .... :., E l.,,,.,a,,. ,_.,. ...... .E-: .. ,,.: r. ,� fit... ..�..,:.-.�. �(`E€�`EEE x': .'�:.:.�...�.. ..:��:,:r�'" '� -E Joshua le' J-o)' ddo oCS� Je n n i fe r �i � n� �Il� I� ju3h I ne., Wo,-ldrion ance,lQ � r-�-hcJY- �Iyan n is c31 6os-e Lomas 0 Ind uj'\c v) fnc. i roarn, e d -ta 0*'� l i 150 w��� � Lane ell Ceti Ile. OL oS c(tr(elTf 4?v,( on GUl'Owhe��ll' Ltju)jo 011 ) Sb ( c)arcco: �n�ekli tic oviro � �� � _ _ �� �� ��-rr-,rs��3 !/3 OFIKE�p� Town of Barnstable ,AMST,BLF. ; Regulatory Services 9Q iMA3 ,fig OAlfD MA'S A Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 3, 2003 Eda C. Smith 99 Arrowhead Drive Hyannis, MA 02601 Re: Family Apartment(1996-103) 99 Arrowhead Drive Dear Ms. Smith: We have received information that you have chosen to withdraw from the Amnesty Program. This letter is to inform you that you must restore the property to single-family use or apply to the Zoning Board of Appeals fora variance. Please call Lois Barry,Division Assistant, at 508 862 4039 to discuss the necessary-steps towards compliance with the Town of Barnstable Zoning Ordinance. Sincerely, Tom Perry Building Commissioner Enclosure J030403a �IHIE to Town of Barnstable BARNffB,,E, : Regulatory Services 9� S. 039 ''rEo►�'�" Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 July 7, 2003 Eda C. Smith 99 Arrowhead Drive Hyannis, MA 02601 Re : Family Apartment Dear Ms. Smith: Please complete the enclosed Family Apartment Affidavit and return it to the Building Commissioner's Office by July 15, 2003. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning 4 Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of your Special Permit and may result in your loss of the rights granted therein. If you have any questions, please call Lois Barry, Division Assistant, at 508-862-4039. Sincerely, Tom Perry Building Commissioner -Enclosure jfamapt q�'pEt col,, Town of Barnstable �7 �p BARNSTABLE, Regulatory Services 9�6 16 q ,•� Thomas F. Geiler'Director iOrFn Meg° Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: Paulette McAuliffe FROM: Lois Barry DATE: 8/6/03 RE: Eda C. Smith Eda Smith, 99 Arrowhead Drive,Fly, 1996-103. After receiving Tom Perry's 7/30/03 certified letter,Ms. Smith submitted a family apartment affidavit form 8/6/03. (attached) T. Perry approved the return of the property to our active family apartment list. F �tNME r Town of Barnstable • Regulatory Services MAM snxxsrnai.e, '0>ED MA'S Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 June 24, 2003 Eda C. Smith 99 Arrowhead Drive Hyannis,MA 02601 Re: 99 Arrowhead Drive,Hyannis R Dear Ms. Smith: We have been notified by Paulette Theresa McAuliffe at the accessory affordable housing program that you have opted out of the program. Therefore, you are hereby ordered to discontinue the use of the above-referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within fourteen (14) days of receipt of this letter. A building permit must be applied for to restore the layout to accommodate the conversion. You must do this before you make any changes. If you have any further questions, please call Lois Barry,Division Assistant, at 508 862-4039. Sincerely, Thomas Perry Building Commissioner TP/lb -0 ' CERTIFIED MAIL 7002 0510 0003 5436 1948 J030624A -- 3 -� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION #►� Map Parcel / ,� � �,�':� � Application# 9 O 6 06/ Health Division +"; i f7 ;_ Conservation Division Permit# r���06 � "`" �;'f�� Cr Date Issued Tax Collector /i°�,zz� � Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis _ ((ham yYl l Z Project Street Address 4' /f4 cLn n `5 Village Owner 6A ��'� Address qR Telephone Permit Request �,y �;Vvmr_^V, �u _ J�S�� � t,��i��orL.. -- -y�,t�►�.�. ,t�G�.:►� 1-�v�s� Ada.._ �I-c.fJ� Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District C" / Flood Plain F Groundwater Overlay l� Project Valuation Construction Type Lot Size 1161 k SQ ! Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 21 Two Family ❑ Multi-Family(#units) Age of Existing Structure b Historic House: ❑Yes Wo On Old King's Highway: ❑Yes XNo Basement Type: Full ❑Crawl ❑Walkout ❑Other ` o 1,17 Basement Finished Area(sq.ft.) nn �5 Basement Unfinished Area(sq.ft) aQ V Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ` Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes 'X No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ;dNo Detached garage:❑existin ❑ e size Pool:❑existing ❑new siz t Barn:❑existing ❑new size Attached garage:❑existing ❑ ew size Shed:❑existing ❑new siz Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name a w ,:z ,, Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ��, ��- V E FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED , MAP/PARCEL NO. A ADDRESS VILLAGE OWNER , DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE 3_ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s FINAL BUILDING e DATE CLOSED OUT ASSOCIATION PLAN NO. i f Bk 21086 P•s 72 6278 1. 6--12—?006 a 01 = 19P JPr • Town of Barnstable Regulatory Services • Thomas F.Geiler,Director BARMABIA MAS' Building Division rFnrM�a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT l(We), the undersigned, being the owner(s) of property situated at 99 ARROWHEAD DRIVE in HYANNIS, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable � q or as Document No. Coun�DRegistry of the Land Court in Bookf�a®1�'9 , Page herbjree ces , warrant and , being shown on Assessors' Map 271 as Parcel 128, y g fy, represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended for use as a family apartment,for year-round occupancy. The intended and authorized'use is for JUSTINE WALDRON, NIECE OF OWNER EDA SMITH associated with the residential use on the same premises. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall'. be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this a day of 200 t�. TOWN OF BARNSTABLE OWNER(S) By: ing Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date atrd.., Then personally appeared the above-named (owner made oath as to the truth of the foregoing instrument,b or me. ; '�;�tN OR.'••.'/ ��•s. motary � t o s My Commiss' n Expires: SANDR4 R j��,: NOTAt IC `" �c, 'A. My CommFn'E1cp�MA3�,••P� 01 BARNSTABLE REGISTRY OF DEEDS ArrowheadDr99 Si�t7.���i)u PoJJuioJL.Sl�r1�f'UC�iVi:i.intr;V wt�{f�� �)l -7 llli s�°�FIT , ii o t��ay FOR fJEI u:I r GI�IL�''y , FIT :a1Rh1`TFB' l 43fC;1S7�4'1;'LI�LI� ��� r r �.. �{}���''{` P�I� 4"if✓�Z ��k�J,�?;.5`T-F'P"' �'�� iln f� �-r F'U`171k4� z I�f1(� ��.f� $;tF�Sr{ryi-L-I�f+I�T.Ir.l I11F1 (nLY7Hk:.�JVd�,�1�'� �r�q� .� 1 SnS,dr,�r Y f�M X 1 �n'�t '� I .�t �1•i�� ,- r`' 4�,. I rr rat, (••{[� + r � i S.'F���i�YNL1,i''t�,J""r 7�r a �"'°�-µ.��a4� �i�'•'�� ,, �'�1 I 1 s � •✓N a ST �f 5y A � E 5 12, -__--' .....>.........�......,..,a-.M...e...»....,.......�,......-...m.�.«.«_-.e.,._..._...-,.�.,a....,..�.....a......,-_.. - �.. .re .is m m. �- � +�r � ,,,® -ram. i. � yo ? U s �`CX SINE Town of Barnstable o� Building Department - 200 Main Street * ASTABLE, * Hyannis, MA 02601 9 MASS. (508 i639' ) 862-4038 ♦� Certificate of Occupancy Application Number: 20060617 CO Number: 20060055 Parcel ID: 271128 CO Issue Date: 06/19106 Location: 99 ARROWHEAD DRIVE Zoning Classification: RESIDENCE B DISTRICT Owner: SMITH, EDA G Proposed Use: RESIDENTIAL 99 ARROWHEAD DR HYANNIS, MA 02601 Village: HYANNIS Gen Contractor: HOMEOWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: FAMILY APARTMENT CERTIFICATE OF OCCUPANCY Building Department Signature ate 49ned mot ,, TOWN OF BARNSTABLE Building Application Ref: 20060617 BARNSTABLE, Issue Date: 06/12/06 Permit 9 MASS. �p 1639• �� Applicant: SMITH EDA G rF0 MAC A Permit Number: B 20060374 . Proposed Use: RESIDENTIAL Expiration Date: 12/10/06 Location 99 ARROWHEAD DRIVE Zoning District RB Permit Type: FAMILY APT W/NO CONST Map Parcel 271128 Permit Fee$ 25.00 Contractor HOMEOWNER Village HYANNIS App Fee$ License Num Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND FAMILY APARTMENT,EXISTING BASEMENT APT,NO CONSTRUCI IONfHIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: SMITH, EDA G BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 99 ARROWHEAD DR INSPECTION HAS BEEN ADE. HYANNIS,MA 02601 Application Entered by: LB Building Permit Issued By: 11- THISPERMIT CONVEYS N1. 1O,RIGHT TO OCCUPY ANY BTREET;ALLY;OR SIDEWALK`OR ANY-PART THEREOF,EITHER TEMPORARILY'O ERMANENTLY ENCROACHEIvIENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTEDIUNDER:THE BUILDING`CODE,MUSTBE"APPROVED BY E JURISDICTION. STREET OR ALLY GRADES AS'WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS'MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC•WORKS. E I THSSUANCE`OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM,THE CONDITIONS OF"ANY APPLICABLE SUBDIVISION RESTRICTIONS. . MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). 1 tov, BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health oFt iq,,, Town of Barnstable Regulatory Services i s * BARNSI'ABLE, MASS. Thomas F. Geiler, Director9.1639.,step Building Division 'Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 May 11, 2006 Ms. Eda Smith 99 Arrowhead Drive Hyannis, MA 02601 Dear Ms. Smith: Enclosed is a building permit application for a family apartment. Please complete the application, obtain the Board of Health approval, and submit the application with floor plans and the $25 fee. The "Permit Request"must include the names of the residents of the main house and the apartment. Please call me if you have any questions. Sincerely, Lois Barry `I Division Assistant Enclosure . j Jarrowheaddr99 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t' Map Parcel Permit# 455 Health.Division MCY2C � � Date IssuedD(5) Conservation Division b Application Fee ,`C� Tax Collector �,�,�/1� 9) ?�` Permit Fee I`i Treasurer SA/ �n Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Ei9 U „!//L 1 V Village Y)9 // a /�� Owner _,c M t r// Address Telephone - S"O 7 Permit Reque 1^/� l9 /y G ,l I�O V�C. I PL/&� e- P�c.�Wl� TS J? IW( / w i�Ac, 2 Square feet: 1 st floor: existing J� proposed 2nd floor:existing proposed Total new d Zoning District Flood Plain Groundwater Overlay Project Val uatioh"�,��,S 000 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ - Multi-Family(#units) Age of Existing Structur / Historic House: ❑Yes ❑No On Old King's Highway: El Yes ❑No Basement Type: dul ❑Crawl ®'Walkout ❑Other Basement Fin shed Are (sq.ft.) GU C, Basement Unfinished Area(sq.ft) 067 Number.of Baths: Full,:existing 2 new Half:existing CJ new LO {c�7 Number-of Bedrooms: ,existing new d Total Room Count(not including baths):existing new First Floor Room Count �j� Heat Type and Fuel: IrGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes 0-90 Detached garage:O existing ❑new size_ Pool:❑existing ❑new size © Barn:❑existing ❑new size Attached garage:❑existing ❑new size C9 Shed:❑existing ❑new size__Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# # --Current-Us-e ProP- -- _ : _,, osed'Use BUILDER INFORMATION Name-WI) ,S C a t � n/ � ►� 'j'/� rt-� Telephone Number Address 2� 6 M 1F_/L 1 l n ry 1,✓ _ License# 0 7 E a U Yv!ti b /L-f r 6 2G 0 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Y19LIVOLIT1154 SIGNATURE �� `'�2. ?J ;6'1 &�iJM DATE �� FOR OFFICIAL USE ONLY &I"IRMIT NO. DATE ISSUED - MAP/PARCEL NO. ADDRESS VILLAGE OWNER r ` DATE OF INSPECTION: , FOUNDATION , �� FRAME I�7t`r�`� ,pt- L.C>wQF-LeVtL- INSULATION r FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH/ FINAL FINAL BUILDING 0(.� �iz- ._ DATE CLOSED OUT _ x ASSOCIATION PLAN NO. , o� E �w Town of Barnstable 41 Regulatory Services " r saxrtsraBrS. Thomas F.Geller,Director mass. p�bp 0119. A�� Building Division QED MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. -- Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other . requirements. Type of Work:"' ' Estimated Cost Address of Work: r1f ���wf�G ► . Owner's Name: Date of Application'.—Y=23 I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL 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 Q:forms:homeafFidav i r . OF{FIE, ti Town of Barnstable Regulatory Services s�itrtsrt►ats, _ Thomas F:Geiler,Director WkSM& 9�'tia0 �`�� Building Division Tom Perry, Building COMMISsioner 200 Main Street, liyannis,MA 02601 Www.town,barnstable;ma.us office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize: i �, ��Q _c�:_: �1 to-act on mybeh�lf, in all matters relative to work authorized by this building permit application for; (Address of Job) Signature of Owner Dat Print Name €�961i3Jf7.f//1� ''rtr i E BOARD OF BUILDING.REGULATIONS License: CONSTRUCTION SUPERVISOR Number ;CS. 074928_ Birth&1:6 08/.1011961 Expires 08/10/2006 Tr.no: 1283.0 Restnc#ed OO WILLIAM WHALEN 122 POND STREET C BREWSTER, MA 02631 Commissioner F t M1 - Board of Building Regulations and Standards Y HOME IMPROVEMENT CONTRACTOR Nrl Registration: 129244 Expiration: 7/30/2007 Type: Private Corporation Whalen Restoration Services Inc. William Whalen 22 American Ways South Dennis,MA 02660 Administrator , d SENDER: I also wish to receive the ;o ■Complete items 1 and/or 2 for additional services. a► ■Complete items 3,4a,and eb. -- following services(for an at ■Print your name and address on the reverse of this torn so that we can return this extra fee): card to you. ■Atttacc this forth to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address permit. � ■Wdte'Retum Receipt Re uested'on the mail piece below the article number. d ■The Return Receipt will show to whom the article was delivered and the date 2.❑ Restricted Delivery a delivered. Consult postmaster for fee. o $__ •0 3.Article Addressed to: d 7002 0510 0003 5436 1924 -- E //k ✓� j r[3 Service Type « i 0 �j Registered �ertified W ��r Express Mail ❑ Insured 5 Return Receipt for Merchandise ❑ COD 7.Date of Delivery z 0 ec ed :(Print Name 8.Addressee's Address(Only if requested and fee is paid) W 6. :(Addressee or Agent ° 3811, December 1994 102595-97-a-0179 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Print your name, address, and ZIP Code in this box• TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. HYANNIS,MA 02601 i r� f Town of Barnstable Regulatory Services AlED IAA A Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 July 30, 2003 Eda C. Smith 99 Arrowhead Drive Hyannis,MA 02601 Re : 99 Arrowhead Drive,Hyannis Dear Ms Smith: We have not received a response to our certified letter of June 24, 2003 (copy enclosed). We are sorry you have chosen not to proceed with t e Amnesty Program and not to cooperate with this office regarding this former family apartment. If we do not hear from you by August 13 to arrange for an inspection of your property, we will be forced to start daily fines. If you have any questions, call Lois Barry,Division Assistant, at 508 862-4039. Sincerely, Thomas Perry Building Commissioner TP/lb cc: P. McAuliffe CERTIFIED MAIL 7002 0510 0003 543,E 1924 y g03O730b ° SENDER: I also wish to receive the 1 'o ■Complete items 1 and/or 2 for additional services. ■Complete items 3,4a,and 4b. following services(for an ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. �9 ■Attach this form to the front of the mailpieoe,or on the bads if space does not permit. 1. ❑ Addressee's Address � � d ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery y C ■The Return Receipt will show to whom the article was delivered and the date delivered. c Consult postmaster for fee. v 3.Article Addressed to: d � y_ � �� 7002 0510 0003 5436 ],948 CL E c.�-f�- 4b.Service Type �4I 0 ❑ Registered Certified a ❑ Express Mail ❑ Insured E-fetum Receipt for Merchandise ❑ COD 7.Date of Delivery w 0 z p `x.Received By:(Ptint Name) 8.Addressee's Address(Only if requested LU ` and fee is paid) i` g 6.Signature:(Addressee or Age X ' zap �_. - Ps Form 3811, December 1994 102595-97-B-0179 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Print your name, address, and ZIP Code in this box• TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. HYANNIS,MA 02601 is CO ,,r, OFFICIAL USE —0 Postage $ M -r Certified Fee 04, (0 tmark Return Receipt Fee C\1 A rn (Endorsement Required) 0 C3 C3 Restricted Delivery Fee C:, (Endorsement Required) C3 Total Postage&Fees $ rq Ln Sent To C3 - --------------- ................---------------------------------- - Street'Apt. No.; rU or PO Box No. M ---- ()........__t................. c:l City,State,ZIP+4 Certified Mail Provides: o A mailing receipt_ .a n A uniqueidentifier for your mailpiece o A signature upon delivery o A record of delivery kept by the Postal Service for two years Important Reminders: G Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. o Certified Mail is not available for any class of international mail. o N61'I48URANCEa,,COVERAGE IS PROVIDED with Certified Mail. For valuables,plea42-*ponsider Insured or Registered Mail. o Fogy an additio alfee,%_Return Receipt mayy be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endo`.se mailpiece 'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. / o For an additio fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry! . PS Form 3800,January 2001 (Reverse) 102595-02-M-0452 T Town of Barnstable • Regulatory Services sAxxsrABi.E. MAM i639• $' Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 a Office: 508-862-4038 Fax: 508-790-6230 June 24, 2003 Eda C. Smith 99 Arrowhead Drive Hyannis,MA 02601 Re: 99 Arrowhead Drive,Hyannis Dear Ms. Smith: , We have been notified by Paulette Theresa McAuliffe at the accessory affordable housing program that you have opted out of the program. Therefore, you are hereby ordered to discontinue the use of the above-referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within fourteen (14) days,of receipt of this letter. A building permit must be applied for to restore the layout to accommodate the conversion. You must do this before you make any changes. ` If you have any further questions, please call Lois Barry,Division Assistant, at 508 862-4039. Sincerely, ` .,Thomas Perry . Building Commissioner TP/lb - CERTIFIED MAIL 7002 05.10 0003 5436 1948. J030624A - FTHE Tp Town of Barnstable BmwrABLE, : Regulatory Services 9� MASS. .oIFDNw+A Thomas F. Geiler,Director Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 3, 2003 Eda C. Smith 99 Arrowhead Drive Hyannis,MA 02601 Re: Family Apartment (1996-103) 99 Arrowhead Drive Dear Ms. Smith: We have received information that you have chosen to withdraw from the Amnesty Program. This letter is to inform you that you must restore the property to single-family use or apply to the Zoning Board of Appeals fora variance. Please call Lois Barry,Division Assistant, at 508 862 4039 to discuss the necessary steps towards compliance with the Town of Barnstable Zoning Ordinance. Sincerely, Tom Perry Building Commissioner Enclosure J030403a I Appeal�Ho 96 103 A peal Special PermitStafiu� Pending / /yr ' �'dSfiaE uNg §%/„ A hcanf Smith Eda C. s " /Addy 99 Arrowhead Drive { \/illage Hyannis MA 02601 �/ AffR�celued Ol/30/2001 �Mdp arm 271128Zaning RC 1 y � Notes 'Amnesty approval 1/23/02. OPTED OUT OF AMNESTY PROGRAM. / x3 is � E f / z!i I .=sue Barry, Lois From: Mcauliffe, Paulette Sent: Thursday, March 27, 2003 11:30 AM To: Barry, Lois Subject: . RE: Amnesty wV" Dear Lois, p I know it's bee while. What I told you is that both Jais and Smith decided to use their units for family that needs housing. Bis ett decided to wait-a while and not put anyone in the unit as they have two very small children, and feel uncomfortable with tenants on their property yet. I told them to contact the Building Department. But I do not suspect that they did. By written Decision,they are also suppose to contact the Barnstable Housing Authority. But I told BHA directly as I doubt the property owners followed up on that either. Re: 485 Pine, Bob Shea, Kevin and I all saw this property. We told Dan that the way it's structured, combined with what he wants to do at the location it does not qualify under the current requirements of the Amnesty ordinance. Thanks. PT -----Original Message----- From: Barry,Lois Sent: Thursday,March 27,2003 10:41 AM To: Mcauliffe, Paulette Subject: Amnesty Hi Paulette, I'm just now starting to work with the lists and decisions you sent me. I have decisions for Jais and Bissett, but have a note that Jais and Bissett have opted out of the program. Please clarify status for me. Also have a note that Eda Smith opted out, but see Eda Smith's name on the list as "true amnesty." Please clarify. Do you have anything on 485 Pine Street? There is a letter (dated 1/17/02) in our street address file from Daniel Hostetter saying his son would be contacting you re amnesty for former owner's family apartment. 1 Town of Barnstable Zoning Board of Appeals Decision and Notice Appeal No. 1996-103-Smith Section 3-1.1(3)(D)Special Permit-Family Apartment Summary: Granted with Conditions Applicant: Eda C. Smith Property Address: 99 Arrowhead Dr., Hyannis,MA Assessor's Map/Parcel 271/128 Area 0.25 Acres Zoning: RB-Residential B District Groundwater Overlay: GP Groundwater Protection District Appeal No 1996-103: Special Permit for a Family Apartment pursuant to Section 3-1.1(3)(D) Background: The property is addressed as 99 Arrowhead Drive and is shown on Assessor's Maps as Map 271, Lot 128. The property is located in the RB Residential B Zoning District. It is improved with a single family house, owned and occupied by Eda Smith. According to Assessor's records, the lot is 0.25 acres and the house is 1,120 sq.ft. Mrs. Smith is applying to the Zoning Board of Appeals pursuant to Section 3- 1.1(3)(D)of the Zoning Ordinance for a Special Permit for a Family Apartment. According to the application, the family apartment will be located in the basement of the existing house and will be occupied by James Seaman, a nephew of Mrs. Smith. Procedural Summary This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on July 11, 1996. 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 August 7, 1996, at which time the Board found to grant the appeal with conditions. Board members hearing this appeal were Ron Jansson, Richard Boy, Emmett Glynn, Gene Burman, and Chairman Gail Nightingale. Eda Smith represented herself. Ms. Smith told the Board that the family apartment would be occupied by her nephew, Jim Seaman,who was also present. The Board was concerned with the size of the family apartment as it is larger than the maximum 50% allowed in the Zoning Ordinance. Ms. Smith explained that the apartment is already there and had been occupied by people not related to her. She did not realize she was in violation of the Ordinance. She said the apartment will now only be occupied by a family member and she is seeking to legalize the use and the apartment can be reduced to conform to the size limitations. Public Comment: The applicant's mother spoke in favor of the appeal. No one else spoke in favor or in opposition. Findings of Fact: Based on testimony given during the Public Hearing on August 7, 1996, the Board unanimously found the following are the findings of fact with reference to Appeal Number 1996-103: 1. The petitioner, Eda Smith, is the owner of the property located at 99 Arrowhead Drive, Hyannis, MA in an RB Residential B Zoning District. The locus is 1/4 acre. i Zoning Board of Appeals-Decision and Notice Appeal No.1996-103 Smith 2. The applicant is seeking a Special Permit for a Family Apartment under Section 3-1.1(3)(D)of the Town of Barnstable Zoning Ordinance. 3. The requirements for the Conditional Use under Section 3-1.1(3)(D) have been met or can be conditioned so as to conform. 4. Granting the relief being sought would not be in derogation from the spirit and intent of the Zoning Ordinance nor would it be detrimental to the neighborhood affected. DECISION: Based on the positive findings of fact in Appeal Number 1996-103, a motion was duly made and seconded to grant the Special Permit for a Family Apartment with the following terms and conditions: 1. The petitioner must at all times comply with the provisions of Section 3-1.1(3)(D)of the Town of Barnstable Zoning Ordinance. 2. The family apartment shall not consist of more than 568 square feet. This fact is to be verified by the Building Department upon issuance of the occupancy permit for the unit. 3. If there are any violations of the terms and conditions of this Special Permit, the Zoning Board of Appeals has the right to revoke this Special Permit upon a hearing from notice of any violations of Section 3-1.1(3)(D)of the Town of Barnstable Zoning Ordinance. The vote was as follows: AYE: Richard Boy, Emmett Glynn, Gene Burman, Ron Jansson, and Chairman Gail Nightingale. NAY: None ORDER: Special Permit Number 1996-103,for the Family Apartment, has been Granted with Conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A, Section 17, within twenty(20)days after the date of the filing of this decision in the office of the Town Clerk. , 1996 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 1996 under the pains and penalties of perjury. Linda Hutchenrider, Town Clerk 2. Rt �sz�M Town of Barnstable v� MASS. g ACCESSORY AFFORDABLE HOUSING PROGRAM 059. DOTEDA`e 230 South Street,Hyannis,Massachusetts 02601 (508)8624683 or(508)8624695 Fax(508)8624725 M E M O TO: Tom Perry CC: Lois Barry,Kevin Shea FROM: Paulette Theresa DATE: May 8,2003 RE: Accessory Affordable Housing Update Dear Tom, -- Here's a status report of what's happening with referrals made from your Department to the"Amnesty"Program. A. After receiving Comprehensive Permits, the following property owners have opted out: 1. Lianne Corbiere of 101 Stoney Cliff Rd.,Centerville; - 2. Mark&Jolene Bissett_of 496 Santuit-Newtown_Rd,Marston Mills; 3. Eda Smith of 99 Arrowhead Drive,Hyannis;-and 4. Steve Jais of 97 Sterling Rd., Hyannis. My understanding is: 1. Ms. Corbiere is selling her house; 2. The Bissetts want to wait until their children are older before allowing strangers to stay on 'their property; 3. Ms. Smith wants the space for family use and 4. Mr. Jai's wants the space for family use. To my knowledge,Ms.,Smith was.the only "true Amnesty"on this list, as she had someone living in the unit when -came into the program. B. We were recently asked to follow-up with five individuals: 1: Al Celeste of 60 Shady Lane in Hyannis. There are a couple of concerns: a) On 5/05/03, received memo from Tom McKean that the .26 acre lot is in the zone of contribution. Mr. Celeste accordingly obtained proper permits (from ZBA and Building Dept.) in building the family apartment;plus had two septic systems installed to handle a total of five(5)bedrooms. But it's not certain that the 2 septics can handle 5 bedrooms. Therefore, Tom has requested that Mr. Celeste have two (2) certified DEP eleven -page inspection reports completed before proceeding with his application. We have made Mr. Celeste aware of the Public 1 Ale-- °FS"E r°'y TOWN OF BARNSTABLE snxivsrnsi a Office of Community and Economic Development r MAW. g 367 Main Street,Hyannis,Massachusetts 02601 508 862-4683 or 508 862-4695 Fax 508 862-4725 FDMA MEMO To: Gloria Urenas CC: Kevin Shea, Peter DiMatteo, Lois Barry, Robin Giangregorio, Tom Perry From: Paulette Theresa-McAuliffe Date: March 22, 2002 Re: Update on ZBA Amnesty Comprehensive Permits Dear Gloria, The following property owners were approved for participation in the Amnesty Program, during tke first quarter of the calendar year: 1. Donna Muncherian, 551 Lumbert Mill Road, Centerville—a single-family accessory unit approved on 1/23/02: `case number 2001-35; 2. Eda Smith;.99 Arrowhead Drive;-Hyannis—a single-family accessory unit approved on 1/23/02: case number 2002-10; 3. Victor&Brenda Cillis,2051 Main Street, W. Barnstable—a single-family accessory unit approved on 1/23/02; 4. Muhammad &Mary Abraham, 67 Starlight Drive, Marstons Mills—a single- family accessory unit approved on 2/20/02: case number 2002-09; 5. Mauro Rivera, 34 Stawberry Hill Road, Centerville—a single-family accessory unit approved on 2/20/02:. case number 2002-30 6. Francisco &Ana Toledo, 9 Suffolk Ave., Hyannis—a single-family accessory unit approved on 3/20/02: case number 2002-124; and 7. Thomas Carver, 132 Nickerson Road, Cotuit—a single-family accessory unit approved on 3/20/02: case number 2002-32. There was one Withdrawal: Elizabeth Reney, 24 Old Farm Road, Centerville: case #2001-123. Thanks, Paulette 1 } Map 2 pc,G 1.28 f + .. . . . G : _. L : . : } . . .. . . : 75r oo I Site dwetti rr� ahown on tAi4 .Lan• located 4 aho wn and meaty tfe � of tAe- gown. lot.N11318 - 75 + t - -Z- • 1 , , F ; j dep _ I I + : 1 1 i i- i s , I t I , , �Ipp��Cai area oaf o + t_ 6 81: n : : : : . house at99 Rwtowhead I za f i i T. .' 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Tile Cutnntutt 1t-calth q j?I tassaCh usettti Department of Industrial Accidents � OII/CP01/�JNPSIIydt/OdS . � . 60U �, Street N ` Burton.AM= O2II1 Workers' Compensation Insurance AMdavit A lie f i-formation- Ple�seJ'RiNT legibly --- name C7C!"4 d't"h •,, h�%S Via•- • .f "7'7 � r am a Homeowner performing all work-myself 1 am a sole proprietor and have no one work-in, in any capacity _ � _. ,�,.,•.� I am an emplover providing workers' compensation for my employees working on this job. enfunanv Idrec nhone#- insur-ince co, I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who h� ep the following workers' compensation polices: m anv nn c• idre city! phone#• - noiicv# _ 1nsur•lnce c0 om an•name• •tddre c• in nhone#• insurnnee co. noiicv# Attach additional sheet if tiecessa— * .�-' , '"'� :"�R yc+ j - •tr v ,�~~�„ —— �� J �- failure- secure coverage as required under Scetion:SA of 51GL 152 can lead to the imposition of criminal penalties of a fine up to SLS0o.00 andi+ one rears'imprisonment as ac11 as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a day against me. I understand that copy of this statement ma} be forwarded to the ORcc of investigations of the DIA for cm ecage verifneation. I do hereby cerrify under dtc pains and penalties of peduty that the information provided above is true and correct. Si_cnature Date Phone# Print name - ofrIcial use only do not.write in this area to be completed by city or tow official ' permit/lieettae N. nBuilding Department city or to (31.1censing Board check if immediate response is required �Seleetmen's Ot:cc ClUcatth Department j contact person• phone Mother -err., ,- ...o�..+..+•�.�.�...� - - Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the employees. As quoted from the "law", an emplityce is defined as every person in the service of another under am contract oflire, express or implied, oral or written. An enrplorer is defined as an individual. partnership, association. corporation or other legal emity. or any two or nor the foregoing engaged in a joint enterprise, and including the legal representatives of a dcceased employer.or the receiver or trustee of an individual , association or other legal entity, employing employees. However ill partnership. owner of a dwelling_ house having not more than three apartments and who resides therein. or the occupant of the dwelling, house of another who employs persons to do maintenance, construction or repair work on such dwelling_ he or on the arounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL chapter 152 section 25 also states that even•state or local Iicensing ngenc,% shall withhold the issuance c= renewal of a license or permit to operate a business or to construct buildings in the commoni•ealth 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 full 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 coven-e. Also be sure to sign and elate the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should von have any questions regarding the "law" or if you are requires to obtain a workers' compensation policy, please call the Department at the number listed below. Cin• or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o the affidavit.for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pie: be sure to fill in the permit/license number which will be used as a reference number. The affidavits maybe returned the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any question please do not hesitate to give us a call. . The Department's address. telephone and fax number. 4. The Commonwealth Of Massachusetts Department of Industrial Accidents office of Investigations 600 Washington Street Boston,Ma 02111 fax #: (617) 727-7749 nhnne 9: (61"1 7274900 ext. 406. 409 or 375 . : The Town of Barnstable BARIMAJUX Department of Health Safety and Environmental Services Building Division ` 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: dJ�LCd ��nub "d""� Est.Cost a SDI Address of Work: e Owner's Name 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 U"ROVEMENT 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 0c3 r%e 0 5 -r%avi t OR. Owner's Name TOWN OF BARNSTABLE SU31DING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. .• •'� DATE .. JOB. LOCATION 0 A 61ea GA)V'tEM 'Number Street address Section of .town "HOMEOWNER° C5- 64. •_...� Name Home phone Work phone PRESENT MAILING ADDRESS A _e_o u- k E,, o City town State Zip c: The current exemption for "homeowners" was extended to include owner-occ: dwellings of six units or less and to allow such homeowners to engage an dividual for hire who does not possess a license, provided that the owne: acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends tc side, on which there is, or is intended to be, a one to six family dwell= attached or detached structures accessory to such use and/or farm structL A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner"• shall submit to the Building Of on a form acceptable to the Building Official, that he/she shall be resuc for all such work performed under the building permit. . (Section 109.1.1) The undersigned "homeowner" assumes .responsibility for compliance with the Building Code -and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and'requiremE and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BU=ING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be requir to comply with State Building.-.Code Section 127.0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for whicha- bu. permit is required shall be exempt from the provisions of this sectil (Section 109.1.1 - Licensing of Construction Supervisors) ; provided Some Owner engages a persons) for hire to do such work, that such He shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are as: the responsibilities of a supervisor (see Appendix Q, Rules and Regu: for .licensing Construction Supervisors, Section 2.15) . This lack of often results in serious problems, particularly when the Some Owner f unlicensed persons. In this case our Board cannot proceed against tl inlicensed person as it would with licensed Supervisor. The 30m8"Own as supervisor is ultimately tesponsible. :•a. a. To ensure that the Home Owner is fully aware of his/her responsibilit communities require, as part of the permit application, that the Home certify that he/she understands the responsibilities of a supervisor. last page of this issue is a form currently used by several towns. Y care to amend and adopt such a form/certification for use in your com Town of Barnstable Building Department ComplainVInquiry Report ,gam Q , 947• Rec,d by; Assessors No. Complaint Name: Location ���G q C ��ti"A Address: Originator Naine• Street: yam: State: Zip: Telephone• D/L 7 'd - Complaint �. Description: _1�c�.�s` ern �-5 0 -4, E �-� `-mac ��� `� , ti ���� • tits Inquiry Description: t_c�J,i �. �.�l:Ja` ��p�►-��;S Ca(�o S �u.-����.� �-{on�r,�:o� For Office Use Only Inspector's Action/Comments Date: Inspector. Follow-up Action Additional Info. Attached tar Y 41 `) DIN V ..................::::. ....................... ,....... 1 ..97 Zee—ze �xt:it ........................... ..:::....... :gigg N «<: : B L .....€. .......................... mob .... �� O HEAD DR }>..... Y NI, ii.:iiiii.:itt.:t.::.>::.......... ...:. . v.E.........srssi vs�skmmev vtvnvr:::':• ....... v::::}}}:w::.vvtw:::•••••••.::::,:v:.S:iiii4:iitixvnx•.vii: tw;..••��::::::.v.:................................pv.:..-s•msvwrn,ssw.s:::::::::::4::::W:X::,v.:.......ttv::::::::::::::::::•:v:•iv::.t...ttv:::::::::.::{tiiiiiiW:::v.::v::::::::::::::::::::::,• T {;j ;:;v}y;:};:;:ii;:;:>iii�:.?:.:i?iii:iititt v:ti«} .yyy •••.i•'•;:•::'iii{'.',{::;:?M1.,, ''::• 'v.•:tM1::::•viiil ?::::v{Ltii:4:v:.��•+iiiiLi{"4?i4;::: •i::.:::::vi:::v:vw:xivvttt+.tt•i:3:G:G. #i11:1k ......... �.. vvvvw::.vw.v: :t•:ttttt't•:w};{.;;:i•:ii• :v: .••.:v:w:w•ii::i:•':''vv.v::::.xv:::.xv.;::.xtv,v.�v:.:}::::xx:vvxw.v.M1xttvty•.•.:::.v:.::vx:wy:.M1xwntty tp.,•;...n;v::}}ii}`iily: SMITH .................... >:77 M. Whom-MOM 8 1154 ............................. . . . .:.:::...:tttttt. ...................... ................................................... ........................... .:H -�t��: �� 't�� '�`��••`�'��� �:t«�«••>: HOUSE NEXT STORE UN-SAFE-DROP CLOTH FALLIN OFF R G O ROOF-ALS O KIDS PLAYI NG INSIDE HOUSE-VERY ERY DANGEROUS. .<.<> G O US zx .....:::t::s•.::;i::eiiiii:ii.: �• :i•tttt�t t.:::.:•. �. >::::::.>: :.: : • . .: :: r.;: :WILL C HE CK.N ..#>:. Kiiiii xx x> tttt.YY :.......::::.......:... >> : : RE S 1271/128 ..........................................................................:::::::::::::::::::::...:..:.::::::::::.:.::.>:.::.::.>:.:::.::.::.>:.>:.>:.; t s;. x< _:>:::::>:::::>:EDNA SMITH ................. >' »` :.;:ARROWHEAD'' :.�— >:.::.::. fix.. DRIVE .. x » IHYANNS ::::::::::.. :::::. ............. f. ...::t DICK BOY .. ......................... ...::.::::::::.:.::::.:.....:....... ....................... .................................. ..... ...............::..::.............................................. :.::::::............... .. .........::.:.:::::........ ..:..::::::::::::::::::::::.....:.......................................... .......................................................... ::::>ILLEGAL APARTMENT :.. ........::.::.::....................::••:::•:::. ..........:::::.:::.:::. .............................................................. �x :::' ' 6/19/96 GU ON SITE- SPOKE TO MS SMITH - HE WIL L LL ALL 6 2 C 0 TO LET ME KNO W W "WHEN TO INSPECT. DOES CT O S HAVE TE NANTS.S. »72296HA S GONE TO ZBA FOR FAMI LY ILY APAR TMENT. ------------ .::........................................................................ .............................................. .....:::::........:. Town of Barnstable . Building Department Complaint/Inquiry Report Date• `/ �� Rec'd by:�_ Assessor's No.:-,? t� Complaint Name: � - Location Address: Originator Name: Street: y,Lagc: State: Zip: Telephone: D/E -7 G -a U3 <', 77P o Complaint / Description: , Z Inquiry Description: For Office Use Only Inspector's Action/Comments Date: Inspector. 0 m Follow-up Action w�l a� Additional Info. Attached n,n[•nsaibution: FL7ritc•Depar=cnt File To ti Date Time �' ` , !AWHILE YOU WERE OUT M of Q Phone O ®� Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message Operator 0,4h AMPAD 23-021-200 SETS EFRCIENCYe 23-421.400SETS CARBONLESS a9 /`A5sessor'-s Office 1st floor) Map _ �l Parcel l2g - Permit# /�2 Conservation Office(4th floor)(8.30- 9:30/1:00- 2:00) Date Issued v Bard of Health(3rd floor)(8:15 -9:30/1:00-4:45) 9Se y Twt Fee ® 0-2) /Engineering'Dept.(3rd floo House# Planning Dept. 1 NIX '1( •°BARNs9rAm. IJMA Board 19 TOWN OF BARNSTABL Building Permit Applicati Proje tre dress ���v c.�NE ae d Village Owner. ?a&, �7: �S M:4- Address -Telephone 7 5 — / i -¢, , ,Permit Request Ti, _F Ce d CA-2 k nd 0 A 'First Floor '� square feet Second Floor square feet ' Estimated Project Cost Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Y� • Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# 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 SIGNATURE �'G1,rL � - DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/'PARCEL NO + j P ADDRESS k VILLAGE , t OWNER « ±! t r DATE OF INSPECTION: �� { FOUNDATION FRAME INSULATION FIREPLACE. ; t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT � 11 ASSOCIATION PLAN NO. 1 The Conrnrunll'ea1tJ1 of Afassuchuscttt . Dcpartinent of Indtistrial Accidents a At t i� ,;,, � Oflfceol/oYesUgal_/ons - � 600 H'aslthwit)n Street {, M Boston.Alas. l/?Ill ` Workers' Compensation Insurance Affidavit ;�2Diican� t nformation: - Plestse PR1NT'le�j "'��"""` ��'T nam locition- m a homeown r performing all work myself. ❑ a 1 am a sole proprietor and have no one working in any capacity ❑ 1 am an employer providing workers' compensation for my employees working on this job. cmmlinnv name: address: city: nhone#• . insurance co. policy# I:.....j::+....- --•::. .•.. -'w•..........t�.�!�'-�Ms;l►JP^: ""'ww�wwAc "�..�w..`�'f ..�r'e.. ❑ 1 am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: r address• city, nhone#• insurance co. nolicv Al L::.=._ ..1-- ._ .:._:!+cneu:-r.4.•:xwn-=�'�'%"^'T s;�s.. .E .`.R:'+.�' 7F!'^4�5�• - '"'."'ai camnany name: address: city: phone#• insurance co. 12olicy# .Attach additionafsheet if nicessa Euilure to secure coverage as required under Sectionf 25A of A1CL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. l do hereb►•certij• rnder the pants mid penalties of pei juq•that the information provided above is true correct Si_nature r —� ate Q Print nae ra Nt-.f l� Phone ti `7 7�'m / / S Econtact nly do not write in this area to be completed by city or town official permit/license# nBuilding Department ❑Licensing Board mmediate response is required 13Seleetmen's ORcc C311calth Department n: phone#; MOther r- (revised 3;95 PJA) information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an emphtiee is defined as every person in the Service of another UndCr any contract of hire, express or implied, oral or written. An einplover is defined as an individual, partnership, association. corporation or other icgal entity, or any two or more of the foregoing;engagcd in a•joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwcIIin�; house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.. MGL chapter 1'52 section 25 also states that even state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant,who has not produced acceptable evidence of compliance with the in coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter-have been presented to the contracting authority. Poo ' • Z..z{Ai ',.. ..,..:I t/-/../lTw'JTT....'.T�r..w�� 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 Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. _ --svw+wcRTi'srfi^r.rr'. ....,..a�•ew..rsr��1 .�.. .e i ,w•. ' � ¢�� .r F !,fi�lt,�r f.7 `.'��,*�ti,�,._. ,`.':.' - .. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, piease do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street -- Boston,Ma. 02111 fax#: (617) 727-7749 =• ' phone #: (617) 7274900 ext. 406, 409 or 375 CR Z The Town of Barnstable 1eS Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790�ZZ7 Ralph Faac 508 775 3344 Binldiag Cattier For office use only , Permit no. Date ' AFFIDAVIT HOME n"ROVEMENTCONTRACTORLAW SUPPLEMENT TO PERKM APPLICATION MGL c. 142A requires that the"ieoonstruction,alterations,'renovation,repair;modernization,00IMMon, improvement,.=na%-4 demolition. or constriction of an addition to any pm-existing Owna oocuFr'a building containing at least one but not more than four dwelling units or to stint'f r t which ate adjacent to such residence or building be done by registered contractors,with amain Cx4a0'Ls,along with other r Type of Work: `,4 s Cost Address of Work:�� Owaer.Name: r Date of Permit Application: I hereb%,catify that: Registration is not required for the following reason(s): Work excluded by late Job ugder ST,000 . itj •ding not owner-occupied Owner palling own permit Notice is hereby given that: NTRACrORS OWNERS PULLING'THM O PR G r UN N � OOT KAVE .ACCESS T FOR APPLICABLE HONE HE 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 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. ! r JOB LOCATION Number Street address Section of town "HOMEOWNER" -2 Name am- Name Home phone Work phone PRESENT MAILING ADDRESS - City town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will c with said procedures and requirements. HOMEOWNER'S SIGNATURE ompl Gam- e� APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner-actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. I [ -' ][R271 128 . ] LOC] 0099 ARROWHEAD DRIVE CTY] 07 TDS] 400 HY KEY] 180770 ----MAILING ADDRESS------- PCA11011 PCS100 YR100 PARENT] 0 SMITH, EDA G MAP] AREA150AC JV] MTG12006 99 ARROWHEAD DR SP1] SP21 SP31 UT11 UT21 . 25 SQ FT] 1164 HYANNIS MA 02601 AYB] 1971 EYB] 1975 OBS] CONST] 0000 LAND 25100 IMP 73500 OTHER 900 ----LEGAL DESCRIPTION---- TRUE MKT 99500 REA CLASSIFIED #LAND 1 25, 100 ASD LND 25100 ASD IMP 73500 ASD OTH 900 #BLDG (S) -CARD-1 1 73 , 500 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 900 TAX EXEMPT #PL 99 ARROWHEAD DR RESIDENT' L 99500 99500 99500 #DL LOT 74 OPEN SPACE #RR 0039 0075 COMMERCIAL INDUSTRIAL EXEMPTIONS SALE105/88 PRICE] 1 ORB16249/194 AFD] I LAST ACTIVITY] 06/13/88 PCR] Y �Y v l Engineering Dept.(3rd floor) Map , Parcel ] a-� JS Permit# (6�_6 q I ' House# 9 q F-JS Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) 73-56 5/ftfl) -" Fee �,�� cr6 Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) �. P;Qued by 19 dLLL.0 im PPP, P 9 CPF�R rt:c te3P � v TOWN OF BARNS TA ENTAL �® Building Permit Application Projec Street Address ,eea he&& ap .4,7?L;), Village K Z Owner 232- o. Address O,q Ae_pncp1k-,-� fir_, Telephone ()'6 - -7'7 8— 1 5�{ Permit Request -PTO Gt ►',p( n 1` =c1`= - 0 First Floor / l '7 O square feet Second Floor square feet Construction Type Estimated Project Cost $ 2 2� Zoning District a�o_. _ Flood Plain — Water Protection Lot Size 5' Q.C. . Grandfathered &V�es ❑No Dwelling Type: Single Family &"_ Two Family ❑ Multi-Family(#units) Age of Existing Structure es. Historic House ❑Yes 3-No On Old King's Highway ❑Yes pro Basement Type: Q'full ❑Crawl S alkout ❑Other Basement Finished Area(sq.ft.) -35 Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing c Z New Half: Existing New No.of Bedrooms: Existing ) New Total Room Count(not including baths): Existing 1�5 New First Floor Room Count Heat Type and Fuel: 8 GGas ❑Oil ❑Electric ❑Other Central Air ❑Yes p'lto Fireplaces: Existing New Existing wood/coal stove ❑Yes �No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) tone p'§h�ed(size) AD !Ll y 16 ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use ' Proposed Use Builder Information Name C.P—JA_P_<_ Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPMED§TRUCTLJRES ON THE LOT. ALL COMTRUff PAN REMATINO FROM THIS PROJECT WILL BE TAKEN TO MUM KNIT NNTB FOR THE FOLLOWING REASON(S) 4 FOR OFFICIAL USE ONLY A PERMIT NO. i DATE ISSUED. MAP/PARCEL NO. ADDRESS VILLAGE Y • OWNER 'DATE OF INSPECTION: FOUNDATION - FRAME INSULATION _ FIREPLACE , ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL GAS: ROUGH FINAL FINALBUILDING - f DATE CLOSED OUT ASSOCIATION PLAN NO. TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY - FAMILY APARTMENT ONLY I PARCEL ID 271 128 GEOBASE ID 18077 ADDRESS . 99 ARROWHEAD DRIVE PHONE Hyannis ZIP - LOT 74 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 19685 DESCRIPTION (SPEC_PMT#96-103 - NO BLDG_PMT_ ) PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: �I BOND $_00 CONSTRUCTION COSTS $_00 756 CERTIFICATE OF OCCUPANCY 1ARNSTABI.E, MASS. OWNER SMITH, EDA G 1639. ADDRESS 99 ARROWHEAD DR HYANN I S MA BUILD G I BY � DATE ISSUED 12/03/1996 EXPIRATION DATE ------------------------------I I I i I ! t TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY - FAMILY APARTMENT ONLY PARCEL ID 271 ;128 GEOBASE ID 18077 ADDRESS 99 4RRO941EAD DRIVE, PHONE Hyann i e" ZIP - •.fi ` .Yr , LOT 74 . BLOCK LOT SIZE DBA "` M�`"" ' . DEVELOPMENT DISTRICT DIY PERMIT 19685 DESCRIPTION' (SPEC.PMT#96-103 - NO BLDG.PMT. ) PERMIT TYPE `BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services - TOTAL FEES: THE E, BOND $ 00 CONSTRUCTION COSTS $.00 Q^ 756 CERTIFICATE OF OCCUPANCY BARtvsrAsi.E, MAS& �I► .OWNER SMITH,` EDA G.' ED A ADDRESS 99 ARROWHEAD DR � I�YANN T S MA BUILD Mj DI O BY ..� VU DATE ISSUED 12/03/1996 EXPIRATION DATE THIS PERMIT CONVEYS�NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND I WHERE APPLICABLE, SEPARATE; 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU 2. PRIOR TO COVERING STRUCTURAL MEMBERS ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). FANCY IS REQUIRED,SUCH BUILDING SHALL NOT DE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. I 4.FINAL INSPECTION BEFORE OCCUPANCY. i i • M BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 . 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY '-VARIO,US STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. BUILDING � PERMIT ? TOWN OF BARNSTABLE r BUILDING PERMIT PARCEL ID 271 128 GEOBASE ID 18077 ADDRESS 99 ARROWHEAD DRIVE PHONE Hyannis ZIP - LO' 74 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY *IT 12046 DESCRIPTION REPLACE BAY WINDOW & REPLACE SIDING ! � IT TYPE • BREMOD TITLE RESIDENTIAL ALT/CONY Department of Health, Safety CORACTORS: PROPERTY OWNER and Environmental Services ' AP HITECTS: TOTAL FEES: $50 . 00 BOND 1 $. 00 C(*STRUCTION COSTS $800 .00 e 434 RESID ADD/ALT/CONY 1 PRIVATE PROPERTY * �i#► BARNSTABLE. OMER SMITH, EDA G 1639. A� AI7. RESS 99 ARROWHEAD DR Ep HYANNIS MA DATE ISSUED 12/04/1995 EXPIRATION DATE BSI' CAD SIO � B THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION:STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE.APPL:ICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL'INSPECTION APPROVALS 1 1 1 S t 2 2 2 i 3 _, 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT £ 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATEMITI THE PER S ISSUED AS TELEPHONE OR WRITTE N NOTIFICA- TION. NOTED ABOVE. _ TION. 508-790-6227 Town of Barnstable Approved Regulatory Services Fee a s• 00 Thomas F.Geiler,Director —P A �ro Building Division G a er F.DiMatteo,Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Horne Occupation Registration Date: 08 Name:���/.0 Phone#: � 7 — 00d Address:_g6/Mq)*4 Je' —Village: Name of Business: A� �4iyf�� Type of Business: I`U�'04-_ Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration, smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed-4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have re ' and agree with the above restrictions for my home occupation I am registering. Applicant: (� Date: Homeoc.doc ki 3 i i Ntl All ,k r %wandat �v too f yr y� i miss %q 1 •. 'n t 4 r,� ,/x9- k.3F��..Y�5 c � � ;-µh �, cams 1� x 4 + t � P o' cf to i a;_�.�ra �jEa a �'r�� , x' ;� e1 tT � x r u� �; t r < k a n+ - - lur=" ^a "� v44 trI Mh a k ', t r z v t � 1 "VII0. F "' a a � r � mow.,' ti�� �f �,! 1+ r. u- t � Q d! .d'"✓�=3 � .f�k-�`�d 7, I� � , y�3''�y��. l� .�F�d,vg}�. #�` �.- �,�� � *b s'�`e,--�.d�z •u'$�k . ..,..,y:.,,nv.'�sni���� �4ax_.„ ��cr'-.. �,. �` � � i�'�" Town of Barnstable Op 7HE lQ� do Building Department Services Brian Florence, CBO * IAMSTABLE. MASS' Building Commissioner 1639. 1m Argo nw+" 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 5084 -62�30 Gam', k . Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/residenLf the property located at: CkPk The following members of my family will be the. sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: h 5 \ Oucp Name &relationship to owner: The Family Apartment will be the primary,year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. : I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.I Family Apartments.-I agree to note the Building Commissioner immediately in the event of the'sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this Gg day of 2019. a Signature Phone Number Print Name q:forms/famaffid.do c rev 11/08/13 Town of Barnstable Building Department o oFtHe rqk, Brian Florence, CBO _ Building Commissioner BARNSPABLE. : 200 Main Street, Hyannis, MA 02601 y Mass. aeJ 163g. www.town.barnstable.ma.us .erED .�A C kimuu. ivo-ov2-4038 Fax. 508-79M623 r w M Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �C�d-\ � Lam the owner/resident of the property located at: C1 c.-D�LE'� 'k)& The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: — �Ld`- h� 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.]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. _l Other Sworn to under the pains and penalties of perjury this day of H Aea 2018. IJL Signature Phone Number Print Name q:forms/famaffid.do c rev 11/08/12 . Town of Barnstable `- Regulatory Services . rF oFIHE Richard V. Scali,Director; s Building Division BAMSTABM « Paul Roma Building Commissioner. , g - e 200'Main Street, Hyannis,MA 02601 I ED N1� www.town.barnstable.nia.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment,Affidavit I,being on oath, depose and state,as follows: . t. My name is. I am the,owner/resident of the property.located"at: ct Q 7 Ttg follFg.members of my family will be the sole occupants of the Family Apartment at the a emenntioned dress: - wine &relatio hip to owner:° C dame relatio sip to owner: c) . The°Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will.immediately note the Building Commissioner in writing.(understand that no subletting or subleasing of said Family Apartment is permitted. , I understand that I am required to file an Affidavit annually with the Building. Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. `If there is no•longer-a Family Apartment at this location,please-explain: --The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this;... t 3 day of 0-- 2017. Signature Phone Number o►. Print Name C ' q:forms/famaffid.doc rev 11/08/12 ; Town of Barnstable Regulatory Services o�IKE tWj,� Richard V. Scali,Director r;a Building Division r 9&UWSTABMMass Thomas Perry, CBO,Building Commissioner :, 1639. 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 . Fax 508-790'623 M Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is 1d� I am the owner/resident of the property located at: qCL , The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: I Name &relationship to owner: .��. Name&relationship to owner: The.FamilyApartment_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.' 7 understand that I am required to f le an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. - If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No: ) ` Other Sworn to under the pains and penalties of perjury this day of e.-b: 2016. Signature Phone Number Print Name q:forms/famaffid.doc - rev 11/08/1.2 Ctn c�ej a rVh or- me d -1a Chr� rnstable *Permit# Expires 6 months from issue date erv1Ces Fee irector _. vision ng Commissioner nis, MA 02601 ble.ma.us Fax: 508-790-6230 N - RESIDENTIAL ONLY -Press Imprint e of$35.00 for work under$6000.00 Telephone Number Joshua I'eJgiddo Jenni�et� �iir� � 11�J rya� .Lucas -l-- u It G I ra,bi(2 mS 150 w-e�i � Lane �'enfer'U ale. Town of Barnstable WE Regulatory.Services ti o„ Richard V. Scali,Director' t W ffrAB . 1 Building Division ;,� b Q A 15T'A6 �. 'Ar 163� amp Thomas Perry, CBO, Building Commissioner ED MAy 200 Main Street, Hyannis, MA 02601;q r 1P_" 15 pm 3. i www.town.barnstable.ma.us Office: 508-862-4038 F5� 9�0-6230 ° YON Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is �`� / h.'- I am the owner/resident of the property located at:-- The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: (J_r'L- F_L- - Name &.relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: `-- ` - The apartment has been dismantled: The apartment has been transferred to the Amnesty Program(Appeal No. Other Sworn to under the pains and penalties of perjury this day of Q - ° 2015. jo Signature Phone Number Print Name -(GL J q:forms/famaffid.do c rev 11/08/11 Town of Barnstable Regulatory Services oFT"E toy, Richard V. Scali,Interim Director ti Building Division ` Thomas Perry, CBO,Building Comm701-111 i Vier ArE039. t 200 Main`Street, Hyannis, MA 02 www.town.barnstable.maxs Office: 508-862-4038 t - - I � �� ; x3 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is Cam, e ` I am the owner/reside�ntQo�f the p_,. py 17o ert 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: L�6 %t Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to 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 R01 2014. Signature Phone Number Print Name \�\ ' q:forms/famaffid.doc rev I1/08/11 ®wn of Barnstable - Re -gulatory Services ofMrrod, Thomas F. Geiler, Director, Building Division 9BAM,�M Thomas Perry, CBO, Building Commissioner i059 200 Main Street,. Hyannis, MA 02601 QED MA'S A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Farnily Apartment Affidavit I;being on oath, depose and state as follows: My name is i am the.owner/resident of the property located at: Q 1 -�� The following members of my family will be the sole'occupants of the Family'Apartment at the aforementioned address: c Name &relationship to owner: Name&relationship to owner: The Family Apartment will be the primary year-round residence for the�t,ove-iderrt led family members. In the event that the listed relatives vacate said apartment, I w*11 immedidtey note the Building.Commissioner in writing. I understand that no subletting or S;uleasing ofisaid , Family Apartment is permitted. W 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 Ap4tment I ado . understand that I am required to comply with all conditions imposed by the ZBA� ecial Pe mit and/or the Town of Barnstable Zoning Ordinances_Section 240-4.7.1.Family Apartments. I agree ca, to note the Building Commissioner.immediately n.ahe event of the sale of this property. airs Vj If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled.` The apartment has been transferred to the Amnesty Program(Appeal No: ) Other Sworn to under the pains and penalties of perjury this d'ay:of ' 2013: :. Signature _ Phone Number Print Naive AOL , z q .forms/famaffid:doc 1 1 rev 1 /08/ 1 jus ne .: Lk—b-ldron unstable f� -Permit Expires 6 inonths jrom"issue date Services Fee irector ivision ing Commissioner nis,MA 02601 able.ma.us Fax: 508-790-6230 N - RESIDENTIAL ONLY -Press Imprint e of$35.00 for work under$6000.00 Telephone Number jcs)-) oo, le&' ddo Jenn i�'er I� ��n� �J�� . j cufine Wo"Id ron law anc�ejo HyGn n is Q�1 6os-e VA Lomas � �y`� s %nduj�ch MG 4- ulf �nn ed to C1�r�s .e if Lane �enfef-u Ile. mil- �0 f To whom it may concern; I,Justine Waldron have never resided at 99 Arrowhead Drive, Hyannis Mass,02601. 1 have never lived at Eda Smith's property from 2007-current. I currently live in Wareham. I also have never live at her other property who she currently rents out now in Centerville. Any questions please call 508-725-3598 Justine Waldro Cam--_ 2220 Cranberry y Apt C2 West Wareham ma,02576 L(l :01 NV i E_ J0 �tI To whom it may concern: I,James A. Waldron, (Formly known as James A.Seaman) did not reside at 99 Arrowhead Drive, Hyannis Mass. The property is owned by Eda Smith. This is during the time frame from 1998-2001. 1 was married and was living in West Yarmouth Mass. At that time. Any questions please call me at 508-280-6481 Thank-you r Jame. 16 3i-n l 86 Tanbark Rd. Marstons Mills Ma. 02648 1 i NO.N.IAl0 LO .0-1 IRV I E EIQZ 31OVENN'll A NhkOi Town of Barnstable Regulatory Services oxTME Thomas F. Geiler,Director i TOWN Building Division g ARC TMR tE Thomas Perry, CBO,Building Commissioner 200 Main Street Hyannis, MA 026 ID MAY 24 AM 11:, 31 www.town.barnstable.ma.us Office: 508-862-4038 a �508-790-6230 DIVISID 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: .�sv Name &relationship to owner: The Family Apartment will be:the primary year-round residence for the above-'identified_ family members: In the event that the listed relatives vacate said apartment;I will immediately note the Building-Commissioner in writing. I understand that no.subletting or subleasing of said Family Apartment is permitted.' I understand that I am required to file an Affidavit annually with the Building. Commissioner listing the names and relationship of occupants in said Family Apartment.,I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit. and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury.this day of 2013. \� Signature Phone Number Print Name•(. q:forms/famaffid.doc rev 11/08/12 Town of Barnstable Regulatory Services oF �e Thomas F. Geiler,birector� nf1y _ Building Division MAWL Thomas Perry, CBO,Building Commissioner i 1639' 200 Main Street Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - li#,' , s Fax 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is e?A d,_.. I am the owner/resident of the property located at: r _ h • 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 will immediately., note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that-lam required to f le 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 FamilyApartments 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. i The apartment has been transferred to the Amnesty Program (Appeal No. Other ti Sworn to under the pains and penalties of perjury this oQ day o 2012. _Signature ` K Phone Number. Print Name q:forms/famaffid:doc t rev 11/08/11 . Town of Barnstable Regulatory Services of nqk, Thomas F. Geiler, DirictW OF t Ip a Building Division sn[exsrne� "„E C r� €?fit . 00 „� Thomas Perry, CBO, Building Commissioner Ai 1639. ��� 200 Main Street, Hyannis, MA 02601 FD MA'S . www.town.ba rnsta ble fm a.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: 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 ofsaid Family Apartment is permitted. I understand that I am required to f le 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 5' day of Vo_.Q . 2011. Signature Phone Number Print Name Town of Barnstable Regulatory Services pFtHe toy, Thomas F.Geiler,Director TOWN 0I fe R STABLE Building Division snxwsrnatE. Tom Perry, Building Commissioner f li'n a , 9� . ,0$ 200 Main Street,Hyannis,MA 02601 ptBn MA'f s www.town.barnstable.ma.us DIVISION Office: 508-862-4038 Fax: 508-790-6230 9 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: �q �ggo(_�� t2 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Jo5�%�� 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 noti,�,the B..ilding Commissioner immediately in the event of the sale of this Property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2010. Signature _.. Phone Number Print Name �C� ~-\5 Vt. 4� Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services °FINE Thomas F.Geiler,Director .\ �,'� Building Division 'a° ° V • saxxszasi.e,� Tom Perry, Building Commissioner �+ � Mass. 1639• 200 Main Street,Hyannis, MA 02601 � �En Mp't a www.town.barnstable.ma.us 0 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 e! 7 l I am the owner/resident of the property located at: C49 —Aeeo CO)IL 9- rL The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: V AAC L;Da � � �eO " Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA 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 32009. Signature Phone Number Print Named- ° Q/bl dg/forms/famaffi d Rev:12/08 r Town of Barnstable Regulatory Services pF'THE TOk, Thomas F.Geiler,Director ti Building Division sAxivsTAsLe, ' Tom Perry, Building Commissioner y MASS, g . 039. ,� 200 Main Street,Hyannis,MA 02601 Alfp .�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 I am the owner/resident of the property located at: �'� YL)LADkLF-gy-6 �fL �. The following members of my family will be the"sole occupants of the Family Apartment_ at the aforementioned address: Name & relationship to owner: �S�'�� l l���� Ir► C� 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. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit. and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury thist a 7 day of 2008. � 1. 15 Signature Phone Number Print Name 6�6 0. Q/bldg/forms/famaffid Rev:l/03 Town of Barnstable Regulatory Services ' FtNe t°k� Thomas F.Geiler,Director Building Division ,,d,;5~ il BARNSTABLE, Tom Perry, Building Commissioner 9 MASS. a i6g9. 200 Main Street,Hyannis,MA 02601 _ � Y 4 ArEDMp'�A WWW.toWn.barnstable.ma.Us NO, MAR �b ��� � .3 Office: 508-862-4038 � ' } Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is C- 1 am the owner/resident of the property located at: QQ Ae_eou-3k_0'6 ��• 5 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: - Name & relationship to owner: �c'5��.� iV-�a-�c`. w — ►r1 -Cx Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. 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 Lam 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 HAW-1`- 2007.. Signature . Phone Number Print Name L S $-L,k-\�° Q/bldg/forms/famaffid Rev:1/03 B•k 21086 PS7 -� -•r36`7?8 i�6-12--2006 a 01 m 1'9P Town of Barnstable Regulatory Services Thomas F.Geiler,Director k BAMWABLE, ' `"AS& Building Division teas• ���' AlFOMA'�A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 99 ARROWHEAD DRIVE in HYANNIS, MA, holding title under a deed recorded with the Barnstable County Re istry of Deeds or Barnstable �4� istJr'ct Registry of the Land Court in Booku`f 1 , Pageor as Document No. � being shown on Assessors' Map 271 as Parcel 128, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended for use as a family apartment,for year-round occupancy. The intended and authorized use is for JUSTINE WALDRON, NIECE OF OWNER EDA SMITH associated with the residential use on the same premises. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this jt day of bo irU 200 . TOWN OF BARNSTABLE OWNER(S) By: ing Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date ,,:,: and•:,, . Then personally appeared the above-named (owner made oath as to the truth of the foregoing instrument,b or me. r t14 oR. '•. s ., R� otary _ My Commiss' n Expires: SANODT Ri 1C MY COMM May 010 DPP"'" BARNSTABLE REGISTRY OF DEEDS ArrowheadDM Town of Barnstable Building Department - 200 Main Street ASTABLE. * Hyannis, MA 02601 9 MASS 1639. , (508) 862-4038 RFD MA'S A Certificate of Occupancy Application Number: 20060617 CO Number: 20060055 Parcel ID: 271128 CO Issue Date: 06/19/06 Location: 99 ARROWHEAD DRIVE Zoning Classification: RESIDENCE B DISTRICT Owner: SMITH, EDA G Proposed Use: RESIDENTIAL 99 ARROWHEAD DR HYANNIS, MA 02601 Village: HYANNIS Gen Contractor: HOMEOWNER r Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: FAMILY APARTMENT CERTIFICATE OF OCCUPANCY Building Department Signature ate 49ned _ _ I I1 LLI FT AiAl 777777 4 - flo i -A� - J �. 15,10 1 ti i i Ice, { tF 4a+, 051 3 S S x 1 ` B t. u 6 � � p �4 1£$ 3 E �{ 5, ly �� O� V�� Town of Barnstable © K Regulatory Services F1HE r° Thomas F.Geiler,Director Building Division , BARN3TABLE Tom Perry, Building Commissioner MA39, Ark 639. `0� '200 Main Street,Hymnis,MA 02601 r;?RAP 2-2 Ph 1; f 6 D MA A www.town.barnstable.ma.us, dh' Office: 508-862-4038 DI VFS 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: P a > ' �c� h.�c�cl 1 ,0 :° % Map and Parcel Number t_�?/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 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 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 a day of 2006. Signature Phone Number e= Print Name Q/bldg/forms/famaffid Rev:1/03 9K Town of Barnstable Regulatory Services °FI Me t � Thomas F. Geiler;Director TO Building Division + BARNSTABLE. .i Tom Perry, Building Commissioner 7005 MAR 30 AM 11 31 MASS 9 1639• ,0�' 200 Main Street,Hyannis,MA 02601 �AIEn 1Aor a www.town.barnstable.ma.us. DIVISION Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is G I am the owner/resident of the property located at: Qci �'�'�`"����� fL Map and Parcel Number a The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page / . The following members of my family will bethe soleoccupants 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 I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this JA( —day of Hn&A.;- 2005. -.. ::, ., Signature Phone Number Print Name �� Q/bl dg/forms/famaffid2 Rev:1/03 Town of Barnstable / k I),7 Regulatory Services oFtNet�, Thomas F:Geiler r ti �Director 0F gARIiSTAt3l. Building Division :. aAMSTAaLE, + Tom Perry, Building Commis �4 lAR 31 AM 8' 44 MASS. 019. 200 Main Street,Hyannis,MA 02601 piViStOH 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 e �� I am the owner/resident of the property located at: , Map and Parcel Number The ZBA granted me a Special PermitNariance on 71 1.99 Date Appeal No. The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 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. 12 Signature Phone Number Print Name G- -�- C Q/bldg/fotms/famaffid Rev:1/03 f r )0 Town of Barnstable Regulatory Services T0vj 4 F B A„thST'ABLE EVE rOly,� Thomas F.Geiler,Director Building Division Z Eq! AJIF, laRNSrABLE, ` Tom Perry, Building Commissioner y Mass. i639. ,0� 200 Main Street,Hyannis,MA 02601 rEa w►a�" Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and stateas follows: Y M name is - 9'f Y.: I am the owner//resident of the property%located at: � �'�'��� / �> !� Q-n�15 Map and Parcel Number A f7 / $ 6 The ZBA granted me a Special Permit/Variance on �b �6 q 9 to " /D Date �__._.. M . .. Appeal No. The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book �1 Page _ - ; The following members of my family will be the sole occupants of the Famil"_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 - 4. 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 n; _rat Sworn to under the pains and penalties of perjury this - - day of 2003. Signature _ 3 'a Phone Number- Print Name OCYCL Q/bldgdformsdfamaffid Rev:1/03 COMMONWEALTH OF MASSACHUSETTS , BARNSTABLE AFFIDAVIT 1, - �2�� - , being on oath, �O � depose and state as follows: i G�� cad ` �. /� �r�n� S• 1.) I reside at 2.) I am the owner.of the property located shown on Barnstable Assessors' maps as MAP 7 / PARCEL �� 3.) I Do Do not have a Family Apartment at this location. 4.) On . c:*U , 199 L the Zoning Board of Appeals, on Appeal No.i Q 46—/a3 granted me a S ecial 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.) 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. J 4 Q6- e a 3 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above listed property. moo � Sworn to under the pains and penalties of perjury this 30 day o• ,+99 Signature Print Naive COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT being on oath, depose and state as follows: n 1.) I reside at --- =------------ 2.) I am the owner of the property located shown on Barnstable Assessors' maps as MAP_____ PARCEL ____ 3.) I Do_____ `�— Do not have a Family Apartment at thi 1 caho 8 row 1999 4.) On-O'er —, 199--(a-, the Zoning Board of Appeals, on Appeal / eq" granted me a pe cial Permit/Variance to maintain a Family Apartment at the above address. /VG O L C� / 5.) 1 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-------��µ �----�r -1- rN ---------------------------------- Relationship to owner:----------OgL_p ;,.)----- -------------- b) NAME Relationshipto 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.) 1 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. iRq(�=!OA3__------ 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-Mt- —, 199 Cl _— Signature -------------��=-�=--C�"`--��'------------------------ Print Name I COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT I, ------�r—�=- ��G., ��i ----- ---- being on oath, ---------------------------- depose and state as follows: 1.) I reside at----Q q----1-4-'-' G-' 2.) I am the owner of the property located E_^ at------- -�`- �4�' o yid --�—'P----�'-- -- ✓Ln -- - - - ------------- shown on Barnstable Assessors' maps as MAP_�9 `7( PARCEL____lo? 3.) I Do-- Do not have a Far;iA location. TO f� 1 DING DEFT'4.) On___ 199�p the Zoning Board of A ��s, on APPB,$� �____ granted me a Special Permit/Variance to maintain a Family Ap en Atlh�,a$.ovL���dre D � E� � %0 � 5.) 1 understand that the Family Apartment may only be occupie ; rmenibers of my fa7ni y who are persons related to me by blood or by marriage. �" z 6. The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME----- M _-- � �, _`=---------------- --------------------- Relationship to owner: ---IQ ----------------------------------- b) NAME___— Relationship to owner:---__—_---------------------------------------_-- 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) 1 understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No./CK&_%O�!) 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 �n -day of_!— ------ 199 Signature Print Name ems. _ 'S 1-1 114 1 ---------------------------------------------------------------------- QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 12/22/97 PARCEL ID 271 128 GEO ID 18077 LOT/BLOCK 74 DBA PROPERTY ADDRESS OWNER SMITH 99 ARROWHEAD DRIVE EDA G HYANNIS 99 ARROWHEAD DR HYANNIS MA 02601 PHONE DISTRICT HY DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY(NOTES) ZONING DIST/ZOC RB SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? ## BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 10890 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST SPLIT (N) EXT / (P) REVIOUS / NO (T) ES / PER(M) ITS / (V) IOLATIONS / (G) EOBASE / (E) XIT oFTME rq The Town of Barnstable Department of Health Safety and Environmental Services : .Azt►v9rnst.E, : Building Division MAM 16 9. ,0�' 367 Main Street, Hyannis MA 02601 ArFD MA'S A Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissione December 30, 1997 The Smith Residence 99 Arrowhead Drive Hyannis,.MA 02601 Re: Family Apartment located at above address Dear Mr./Ms. Smith, 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 January 30, 1998. Enclosed is an affidavit for your convenience. Thank you in advance, 1� Ralph Crossen Building Commissioner 16 To whom it may concern; I,Justine Waldron have never resided at 99 Arrowhead Drive, Hyannis Mass,02601. 1 have never lived at Eda Smith's property from 2007-current. I currently live in Wareham. I also have never live at her other property who she currently rents out now in Centerville. Any questions please call 508-725-3598 Justine Waldro - 2220 Cranberry y Apt C2 West Wareham ma,02576 s ,;,y.t.deaIfni EN E COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign ure item 4 if Restricted Delivery is desired. Agent ■ Print your name and address on the reverse X Addressee so that we can return the card to you. B. Received y( rioted Name) ate Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. 3 0 D. Is delivery address different from item 1? ❑Yes 1. Article Address/ed to: If YES,enter delivery address below: ❑ No G�� v �/�?�r'�/✓r W 3. Serv' a Type Certified Mail ❑ Express Mail ❑ Registered El-Keturn Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7002 0510 0003 5436 1870 (Transfer from service label) PS Form 3811,August 2001 + Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. HYANNIS,MA 02601