HomeMy WebLinkAbout0072 BLACKBERRY LANE (2) 1 SA l
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�^ AMPAD 23-021-200 SETS
J-] EFFICIENCY® 23-421-400 SETS CARBONLESS
Town of Barnstable
BASIM ABLE, ; Regulatory Services
�b059. .�� Thomas F. Geiler,Director
RFD MA'S a
Building Division
Tom Perry Building Commissioner
200 Main Street, Hyannis, MA 02601
Office: 508-862-4038 Fax: 508-790-6230
MEMORANDUM
TO: Tom Perry
FROM: Lois Barry ,
DATE: 9/30/03
RE: 72 Blackberry Lane,Hyannis
This former family apartment has been sold, and the new owner has written that there is
no stove and he is not renting the space (see attached)..
Do we need to have an inspector verify that it is now restored to a single family?
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September 23, 2003
Tom Perry, Building Commissioner
Attn.: Lois Barry
Town of Barnstable
200 Main Street
Hyannis MA 02601
RE: Family Apartment
72 Blackberry Lane, Hyannis
249 080
Dear Commissioner Perry:
I am writing this letter at the suggestion of Lois Barry, following phone conversations
regarding the above matter.
We purchased the property from Douglas Anderson in April of 2001. At that time and
since, the property has a finished basement with some cabinets, a sink and a refrigerator.
There is no stove or oven.
We have not rented the basement or used it as a"family apartment." Our principal use is
as a storage area.
Please make the necessary changes in your records to reflect this status.
Thank you, and please do not hesitate to contact me if you have additional questions or
need anything further.
Sinc
S ott Gladish
72 Blackberry Lane
Hyannis MA02601
508-775-3997
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item 4 if Restricted Delivery is desired. X`"' ',- / ❑Agent
® Print your name and address on the reverse i✓ ��/ ❑Addressee
so that we can return the card to you. e i e Printe ..Na ) C. Date of D,livery
0 Attach this card to the back of the mailpiece, ..Na
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or on the front if space permits.
s delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
3. Servi e Type
9�J rtified Mail ❑ Ex ress Mail
❑.Registered PXeturn Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer from service label) 111 , 17j0 042 r I0 51 Os 0 0 9 3 , 5 4 3 6 18 3 2
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PS;Form 381.1 lAug6St 2001 1 Domestic Return Receipt 102595-02-M-1540
UNITED STATES POSTAL SE -€F_Sti �{�.
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• Sender: Please prin_tf'yc 3r jx me, address; .ate+R _.in.this-box-*---_
TOWN OF BARNSTABLE
BUILDING DIVISION
200 MAIN ST.
HYANNIS,MA 02601
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Return Receipt Fee 9 Here }^
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O Restricted Delivery Fee
O O (Endorsement Required) C �y
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p Total Postage 8 Fees $ C
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Street,Apt.No.;
r1J or PO Box No. 7
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o A mailing receipt
o A unique identifier for your mailpiece
o A signature upon delivery
o A record of delivery kept by the Postal Service for two years
Important Reminders:
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e Certified Mail is not available for any class of international mail.
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valuables,please consider Insured or Registered Mail.
o For an additional fee,a Retum Receipt may 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.Endorse 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 additional 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".
n 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
�tME A Town of Barnstable
BARNSTABM : Regulatory Services
9Q sMASS.
D'°rEc n+a+" Thomas F. Geiler,Director
Building Division
Tom Perry Building Commissioner
200 Main Street, Hyannis, MA 02601
Office: 508-8624038 Fax: 508-790-6230
August 12, 2003
Mr. Douglass Anderson
7 Arlington Avenue
Beverly,MA 01915
Re : Family Apartment
72 Blackberry Lane,Hyannis
Dear Mr. Anderson:
We have not received a response to our letter of April 3, 2003 (copy enclosed). We are
song you have chosen not to cooperate with this office regarding this former family
apartment. If we do not hear from you by August 26, we will be forced to start daily
fines.
If you have any questions, call Lois Barry,Division Assistant, at 508 862-4039.
Sincerely,
t
Thomas Perry
Building Commissioner r
TP/lb
CERTIFIED.MAIL 7002 0510 0003 5436 1832
g030812a
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oFE r Town of Barnstable
BARNSTABM : Regulatory Services
MAM
Ar f p 9.
►nn�" 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
Mr. Douglass Anderson
7 Arlington Avenue
Beverly,MA 01915
RE: Family Apartment
72 Blackberry Lane,Hyannis
249 080
Dear Mr. Anderson:
Our records indicate that you no longer reside at the above address. Therefore, the family
apartment special permit approved by Zoning Board of Appeals, 1997-104, is void. What
is the status of this area of the property?
Please contact this office as soon as possible to: `
• Apply for a building permit to.restore the property to a single-familyhome.
• Apply to the Zoning Board of Appeals for a variance, or
• Apply to the Amnesty Program.
Please call Lois Barry,Division Assistant, 508 862-4039 to discuss the necessary steps
towards compliance with the Town of Barnstable Zoning Ordinance.
Sincerely,
Tom Perry
Building Commissioner'
;nzmns, _ •
102232 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
- r
Map L Parcel Application #
Health Division Date Issued 5
Conservation Division Application Fee
Planning Dept. Permit Fees
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address 72 Blackberry lane
Village 44v wa.,s
Owner Nancy Schaefer Address same
Telephone508775-3997
Permit Request air sealing, add insulation to attic space, install 12 soffit vents
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 9n27 Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing —new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Z =�
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
C -n
Commercial ❑Yes ❑ No If yes, site plan review# " g rJ rz
Current Use Proposed Use ='
N e�a-a
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name RISE Engineering Telephone Number �0�3-775-3997
Address 1341 Elmwood Ave, CRanston, RI 02910 License # 100495
Home Improvement Contractor# 120979
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
Erik Nerstheimer for RISE
FOR OFFICIAL USE ONLY
c
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
F
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
4• '
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
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RISE ENGINEERING Federal ID a 05-0405629
_ RI Contractor Registration No 8186
A division of Thielseh Engineering MA Contractor Registration No 120979
!!! CT Contractor Registration No 620120
1341 Elmwood Avenue,Cranston,R102910 A''
(401)784-3700 FAX(401)784-3710 CONTRACT
Page 1
THIS CONTRACT IS ENTERED INTO BETWEEN RISE
ENGINEERING AND THE CUSTOMER FOR WORK AS
ENGINEERING � r�R DESCRIBED BELOW
Fr
�� -
CUSTOMER - - PHONE -DATE Client 0.
Nancy Schaefer (508)775-3997 02/14/2010 102232
SERVICE STREET YI1!; BILLING STREET -
72 Blackberry Lane _ 72 Blackberry Ln
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP, -'- --- -
Centerville,MA 0263 Centervil. MA 02632
JOB DESCRIPTION
RISE Engineering will provide labor and materials to seal areas of your home against wasteful excess air:leakage.This work will be
performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air
exchange and indoor air quality.Materials to be used to seal your home can nclude caulks,foams,weatherstripping and other products.
Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.)This work
will be performed at the rate of$66 per man per hour,which includes materials and testing. 13 man hours.
$858.00
RISE Engineering will provide labor and materials to install a 6"layer of R-19 Class 1 Cellulose added to 800 square feet of open attic space.
$720.00
RISE Engineering will provide labor and materials to insulate the back of I existing kneewall access hatch(es)with 1"rigid foam board
insulation,and seal the edge of the hatch with weatherstripping.
$85.00
RISE Engineering will provide labor and materials to install an easily moved,rigid foam insulating cover for the attic access folding stair. The
cover has integral weatherstripp ing to restrict air leakage. `,
$160.00
RISE Engineering will provide labor and materials to install(12 4" X 16"rectangular white aluminum soffit vents to increase ventilation in
attic areas.
$204.00
RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible
measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year.Includes 100%of air sealing
$1,734.70
i
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***Two Hundred NinetyeTtivo& 30/100 Dollars $292.30
UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY
UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
AUTHORIZED SIGNAT ICE-RISE ENGINEERING -
/ ,U .CUSTOMER ACCEPTANCE
NOTE THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE�. �
ACCEPTANCE OF CONT CT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE
SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK
DAYS: - AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE -
w _ The Commortivealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,Mass. 02111
www.rnass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
l
Name(Business/Organization/Individual): RISE Engineering a division of Thiel ch Engineering
Address: 1341 Elmwood Avenue
City/State/Zip: Cranston, RI 02910 Phone#: (401)784-3700 or 1-800-422-5365
Are you an employer? Check the appropriate box: Type of project(required):
1. N I am an employer with 4. ❑ I am a general contractor and I 6. 0 New construction
employees (full and/or part time).* have hired the sub-contractors7., ❑Remodeling
2. 0 I am a sole proprietor or partner- listed on the attached sheet.
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have workers' 9. 0 Building addition
[No workers'comp.insurance comp.insurance. $
required] 5.0 We are a corporation and its 10. 0 Electrical repairs or additions
3. 0 I am a homeowner doing all work officers have exercised their
myself [No workers' comp. right of exemption perm MGL 11. ❑Plumbing repairs or additions
insurance required] t c. 152, § 1(4),and we have no = 12. 0 Roof repairs..
employees. [no workers' 13. TS Other Insulate
comp.insurance required.].
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If
the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that isproviding workers'compensation insurance for my employees.Below is thepolicy and job site
information. ..
Insurance Company Name: The Preston Agency '
Policy#or Self-ins.Lic.#: 3730961-00 Expiration Date: 1/1/11
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration(date).
Failure to secure coverage as required under Section 25a of MGL 152 can-lead to the imposition of criminal penalties of a fine
up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of
$250.00 a.day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the
DIA for coverage verification. '
I do herby certi and fhe ins enalties ofperjury that the information provided above is true and.correct.
b'i nature: '� Dater
Print Name: Erik Nerstheimer ' Phone#:(401)784-3700 or' 1-800-422— 365 x 1 -11
Official use only Do not write in this area to be-completed by city or town official
City or Town: Permit/license#:
Issuing Authority(circle one):
LBoard of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector.: 5.Plumbing Inspector
6.Other
Contact person: Phone#:
ACORD, CERTIFICATE OF LIABILITY INSURANCE CPID 47 DATE(MM/DDlYYYY)
THIEL-1 04113,10
PRoOucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1350 Division Rd Suite 303 _ HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
East Greenwich RI 02818-0810
Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDINGCOVERAGE NAIC�
INSURED INSURERA: Zurich-Amerlcan Ins Co,`
Thielsch Engineering, Inc INSURER B:. war.lc.n r-ir nt.. s L1.blllty
HiTech 6aityoup Inc. INSURERC: NOXth American Capacity
Ni Tech Realty Inc,
195 Frances Avenue INSURERD: Hartford Insurance Company --
Cranston RI 0291.0
INSURER E.'.
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED"ED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMEN TWITH RESPECT TO"11CH THIS CERTIFICATE FMY BE ISSUED OR -
W,Y PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS S AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -
LTR INSR TrPE OF INSURANCE POLICY NUMBER DATE IMM/DOW) DATE(h DfYY))� LIMITS
_ GENERAL LIABILITY EACH OCCURRENCE (S 1,000,0 O.Q
A I X COMMERCIAL GENERAL LIABILITY 3730962-00 04/01/'10 O1/01/11 �
PREIdISES(Ea occureme) T300,000
CLAIMS MADE �OCCUR. �MEO EXP(,Any.one person) T.10'000
'
PERSONAL$ADV INJURY Y 11000,000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPlOP AGG 5 2,000,000
POLICY X jEa LOC * - -
Emp Ben. 1,000,000
AUTOMOBILE LIABILTTY
n X ANY AUTO 3730963-00 04/01/10 O1/O1/11 COMBINED'SINGLE LIIHIT Y 2,000,000
(Ea accident)
ALL OWNED AUTOS -
_ BODILY IpJ.NRY t
SCHEDULED AUTOS - (Per person)
HIRED AUTOS —
BODILY INJURY
NON-OVMED AUTOS (Per acc-de_nl),
PROPERTY DAMAGE E
?Per acciaenf)
GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT T
ANY AUTO -
OTHER THApi EA ACC Y-
A.UTO.ONLY: AGG 5
EXCESS/UMBRELLA LIABILfTY - EACH OCCURRENCE $ 10,0 0 0,0 0 0
B X OCCUR CLAIMS MADE U.MB 9 2 6 3 6 3 7-0 0 0 4/01/10 0 T/01/11 AGGREGATE S 10,000,000
0DEDUCTIBLE
Y
X RETENTION 410,1000
5
WORKERS COMPENSATION AND TORY I>IIdITS EREMP LOYERS'LIABILITY - -
A. VJI'PROPRIETOR/PARTNEP.fEY.ECUTIVE 3 730961-00 04/01/.10 01/01/11. E.L.EACH ACCIDENT s 1,000,000
F _
OFFICER/MEMBER EXCLUDED? - - - ---If yes,oescfibe under -
E.L DISEASE-EA EMPLOYEE $1,000,000
-
SPECIAL PROVISIONS below E.L.DISEASE-PILIC'Y LIMIT :f 1,000,000,
OTHER - - -
C � Professional L'iab DVL000026800 04/01/10 04/01/11 Prof Liab 2,.000,000
DlLeased/Rented Eqp 02UUNTD5678 04/01/10 04/01%11 Equipment 100,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT CSPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF ME.ABOvE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION-
_ DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 O:.YS WRITTEN
. • NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY.HINO UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES. .
" AUTHORIZED REPRESE V - -
ACORD 25(2001108) @ ACORD CORPORATION 1988
.i,. yr
($t�l THIETi-1 a PAGE 2
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NO �rA®.x' N$U�ED�5INJ►ME + TH'ielsch,Lki YneenYiJ{ n¢ 6 ;f1t i� ` a€OP ID 27t� f , DATE 04/12/10
5 iF 19 }R}�St..,
Also for
RISE Engineering, a division .of Thielech Engineering, Inc. ` '
Gaskell Associates,; a division of Thielech Engineering,. Inc.
BAL Laboratory; a division of Thielech Engineering, Inc.
ESS Laboratory, .a division of, Thielech Engineering, Ind,." e
ALCO Engineering, a division of .Thiel,sch Engineering, Inc.
Water Management Services, a division of Thielech Engineering, Inc. '
rage 1 Or a
The Official Website of the Executive Office of Public Safety and Security (FOPS)
Mass,Gov Home
Public Safety
Department of Public Safety Licensee Complaints b
License Type Construction Supervisor {
License#I 100459 —
Restriction 'ws'lC
Name Erik Nerstheimer
City, State, Zip North Scituate,.Rl, 02857
Expiration Date 3/28/2012
Status Current
No complaints found for this Licensee.
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��ie Zoo�nimo�rzusecz�� o�✓J�Cadaa:c;�cc�eC�e I _ .- _ ..... .
Board of Building Regulations and Standaril3
I HOME IMPROVEMENT CONTRACTOR Li.eense or registration valid for individul use on)},
i, before the expiration date. If found return to:
i
Registration,: 120979 Board of Building Regulations and Standards
—F6ExplraUon 3/25/2010 I. One Ashburton Place Rm 1301
T; e_Sv lement Card T�c?'stc ti la la. 021.08
yP .a .PP
ELSCH ENGINEERI: 'Mi-^:=N� _
K NERSTHEIMER
1 ELMWOOD, E,L
\NSTON, RI 02910
Not valid without sign lCre
Admin.isti.:ttor ---- is
http://db.state.ma.us/dps/licdetails.asti?txt,�Pa-rr1iT >\T—rQr , nO ,�n
is o nsumer f'ai�(ath d usmess a �on
9/t e O e og
10 Park Plaza - Suite 5170
f Boston, ssachusetts 02116
Home, Improve ontractor Registration .
Registration: 120979
Type: Supplement Card . ..
z w Expiration.: 3/25/2012
THIELSCH ENGINEERING
ERIK NERSTHEIMER
1341 ELMWOOD AVE.
CRANSTON, RI 02910
�15 a� "� Update Address and return card.Mark reason for change.
Address Renewal Employment Lost Card
DPS-CAI E'a SOM-04/04-GIO1216
T1. TD eCr��t Oy°//iGCrddac`ttl6e 4 '
Office of Consumer Affairs&Bu iness Regulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
Reg istration• . W979 Type: 10 Park Plaza-Suite 5170
r Expira {112 Supplement Card Boston,MA 02116
THIELSCH ENdl�L
ERIK NERSTH{ - -
1341 ELMWOOD �% °
CRANSTON; RI 029
- Undersecretary Not valid without signature .
L
f
Town of Barnstable *Permit# °
Regulatory ServicesFeees6mo,, romisue �y .
W
snartsTABLE, « Thomas F.Geller,Director
MAn
$ `� .
Building.Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax:508-796-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without.Red X-Press Imprint
Map/parcel Number
Property Address 4AJ >4y,4 JV !t/j_
Residential Value of Work Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address 1'56_ �
Contractor's Name Telephone Number 74---10
Home Improvement Contractor License#_(if applicable)
NWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor 'm
❑ I am the Homeowner P
AI have Workers Compensation Insurance �
Insurance Company Name /\ rGx!� y APR 3 ® 2008
Workman's Comp.Policy# 7.r V 9 TOVVN OF BARNSTAB�-E
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.44)
_ 1,
*Where required: Issuance ofthis permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,i�,tc,
***Note: Property.Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License is required. -
SIGNATURE: s
Q:Forms:bu i l d i ng perm its/expre
Revised 123107
i
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.massgov/dia
Workers' Compensation Insurance Affi" #ii$b1 �a9WAf lEsiElectricians/Plumbers
Applicant Information l6^ wQ114Qy0R Please Print Legibly
Name(Business/Organization/individual): Cotuit, MA 02635
e. 42 518/ 1-800-26M060
Address:
City/State/Zip: Phone#:
Are you an employer?Check the appropriate box: Type of project(required):
l. I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
workingfor me in an capacity. employees and have workers'
Y P ty• t 9. ❑Building addition
[No workers'comp.insurance comp.insurance.
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their ME]Plumbing repairs or additions
myself. [No workers'comp. right of exemption.per MGL 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.❑Other
comp.insurance required.]
'My applicant that checks box#)must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy arraP
information.
Insurance Company Name: '
Policy#or Self-ins.Lic.#: 7'-1 a Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do he�e:
y certify under the pain�an �
ry that the information provided above is true and correct.
Si atu Date:
Phone#: _..._
Official use only. Do not write in this area,to be completed by city or town officlat
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone'#:
Client#:47298 CAPIHOM
ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY)
,2126/2007
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Rogers&Gray Ins.-So. Dennis ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.0. Box 1601
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
South Dennis, MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: NGM Insurance Company -
Capizzi Home Improvement, Inc.Capizzi Enterprises,Inc. NsuRERB: American Home Assurance
1645 Newtown Road INSURER C:
Cotuit,MA 02635 INSURER D:
INSURER E: '
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
DATE MM/DDIYY DATE(MMIDDIYYI LIMITS
A GENERAL LIABILITY MP010707 06/08/07 06/08/08 EACH OCCURRENCE $1 OOOOOO
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED occurrence) $5OO ,
CLAIMS MADE OCCUR PREMISES(Ea 00
MED EXP(Any one person) $1 O 000
PERSONAL&ADV INJURY $1 QQQ 000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: -POLICY f7PRO-
.PRODUCTS•COMP/OP AGG s2,000,000
JECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO '(Ea accident) $
ALL OWNED AUTOS - -
BODILY INJURY. $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: .AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE
$
$DEDUCTIBLE
RETENTION $
B WORKERS COMPENSATION AND WC1764953 12/25/07 12/25/08 TWC STATU- OTH-
EMPLOYERS'LIABILITY - _ -
ORY LIMITS I ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000
If yes,describe under - _
SPECIAL PROVISIONS below - E.L.DISEASE-POLICY LIMIT $500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Corporate officers are included in Workers Compensation coverage.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 n DAYS WRITTEN
200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY.KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25(2001/08) 1 of 2 #S33206/M33205 Kyy 0ACORD CORPORATION 1988
Board of Building Regulations and Standards License or registration valid for individul use only
= HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Board of Building Regulations and Standards
Registration: 100740 One Ashburton Place Rm 1301
-Expiration:. '6/23/2008
Boston,Ma.02108
Type:.:Supplement Card
CAPI=1 HOME IMPROVEMENT, I
NARY GUSTAFSON
1645 Newton Rd. �
Cotuit, MA 026,35 Administrator t valid witbp4i sig tare
Board of Building Regula ions and Standards
�= One Ashburton Place - Room .1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
. . .. . ._.. e; istr-a i ��`100740 � . :•
Type: Supplement Card
• : ' Expiration: 6/23/2008 }
CAR7ZI HOME-IN'4PROVEMFNT, 1NC'' '
GARY GUSTAFSON =
164.5 Newton Rd. =
COtU MA 02635 Update Address'and return card.Mark reason for change.
Address Ej Renewal Employment ❑ Lost Card
fioa'rd.of Building Re 12t30n5 and Sta rds
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—W
Y' GARY GUST .SON
_.
S.S:.HORT
SAND .CH MA_02503 Commissioner
f
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w Page 7 of 7
CAPIZZI HOME IMPROVEMENT INC. .
SPECIFICATIONS AND ESTIMATES
STATE OF MASSACHUSETTS
LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT
I, SCOTT GLADISH, OWN THE PROPERTY LOCATED AT 72 BLACKBERRY-LANE IN..HYANNIS
MASSACHUSETTS.
. .� we
I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR
A BUILDING PERMIT IN ACCORDANCE WITH 780-CMR, THE MASSACHUSETTS STATE BUILDING'
CODE.
I GIVE MY PERMISSION TO LESSEE
TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS .
STATE BUILDING CODE.
SIGNATURE OF OWNER.
OWNER'S ADDRESS: 72 CKBERRY LANE,HYANNIS, MA 02601.
OWNER'S TELEPHONE: 508-775:-3997
LESSEE'S SIGNATURE:
LESSEE'S ADDRESS:
LESSEE'S TELEPHONE:
APLLICANT'S SIGNATURE
---------------
APPLICANT'S ADDRESS: 1645 Newtown Rd.;Cotuit, MA 02635 ' fit. .
APPLICANT'S TELEPHONE 508 428-9518
RESPONSIBLE OFFICER:
RESPONSIBLE.OFFICER ADDRESS:'
{
RESPONSIBLE OFFICER TELEPHONE.
oFtMME T Town of Barnstable
MUMSTABM + Regulatory Services
9�b 69• .�� Thomas F. Geiler,Director
CFO MA'S A
Building Division
Tom Perry Building Commissioner
200 Main Street, Hyannis, MA 02601
Office: 508-862-4038 Fax: 508-790-6230
MEMORANDUM
TO: Tom Perry
FROM: Lois Barry
DATE: 9/30/03
RE: 72 Blackberry Lane, Hyannis
This former family apartment has been sold, and the new owner has written that there is
no stove and he is not renting the space (see attached).
Do we need to have an inspector verify that it is now restored to a single family?
September 23, 2003
Tom Perry, Building Commissioner
Attn.: Lois Barry
Town of Barnstable
200 Main Street
Hyannis MA 02601
RE: Family Apartment
72 Blackberry Lane, Hyannis -=
249 080
Dear Commissioner Perry:
I am writing this letter at the suggestion of Lois Barry, following phone conversations
regarding the above matter.
We purchased the property from Douglas Anderson in April of 2001. At that time and
since,the property has a finished basement with some cabinets, a sink and a refrigerator.
There is no stove or oven.
We have not rented the basement or used it as a"family apartment." Our principal use is
as a storage area.
Please make the necessary changes in your records to reflect this status.
Thank you, and please do not hesitate to contact me if you have additional questions or
need anything further.
Sinc
Scott Gladish
72 Blackberry Lane
Hyannis MA02601
508-775-3997 _ �1,
PIPaCe ,.,ter l ..y.�AN TV a U ' f 7�41(31' r+t�'r•t`'; -`,� `fit;
s
d. ..
[ ] [R249. 080 ] *****ACCOUNT DELE *****
LOC10072 BLACKBERRYkE TDS 07 CTY 4] ] 00 HY H KEY] 158313
----MAILING ADDRESS------- PCA] 1041 PCS] 00 YR] 00 PARENT] 0
ANDERSON, DOUGLASS & ALETA MAP] AREA150AC JV1436987 MTG12012
72 BLACKBERRY LN SP1] SP21 SP31
UT11 UT21 .48 SQ FT] 2004
HYANNIS 'MA 02601 AYB] 1965 EYB] 1975 OBS] CONST]
0000 LAND 29600 IMP 91700 OTHER
----LEGAL DESCRIPTION---- TRUE MKT 121300 REA CLASSIFIED
#LAND 1 29, 600 ASD LND 29600 ASD IMP 91700 ASD OTH
#BLDG (S) —CARD-1 1 91, 700 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE
#PL 72 BLACKBERRY LANE TAX EXEMPT
#RR 0129 0159 RESIDENT'L 121300 121300 121300
OPEN SPACE
COMMERCIAL
INDUSTRIAL
EXEMPTIONS
SALE106/94 PRICE] 140000 ORB19247/086 AFD] TE
LAST ACTIVITY] 09/04/96 PCR] Y
R249 080 . P R A I S A L D A T A! KEY 158313
ANDERSON, DOUGLASS & ALETA
LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB PARCEL DELETED
29, 600 91, 700 1 A-COST 121, 300
B-MKT 118, 600
BY 00/ BY ME 9/89 C-INCOME
PCA=1041 PCS=00 SIZE= 2004 JUST-VAL 121, 300
LEV=400 CONST-C 0
----COMPARISON TO CONTROL AREA 50AC -- TREND EXCEEDS STANDARD
NEIGHBORHOOD 50AC HYANNIS
PARCEL CONTROL AREA TREND STANDARD
101 10 LAND-TYPE
296001 102000 LAND-MEAN -710-.
1213001 75048 IMPROVED-MEAN +220-. 2506
] FRONT-FT
] 100 DEPTH/ACRES TABLE 02
1000] LOCATION-ADJ APPLY-VAL-STAT 1
LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES
COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC
FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?]
2
R249 080 . P E R M I T [PMT] ACTI*R] CARD [000] KEY 158313
000000001
PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT
'A dp i
v! ZZ :
at
f i
9
�3 -+ RESIDENTIAL PROPERTY
z _
' MAP NO. LOT NO. FIRE DISTRICT
;. STREET Blackberry Lane Hyannis SUMMARY
LAND
%}� x`.2Lj9 8O H 11 BLDGS. ` O'.,
rn 5
OWNER
TOTAL
LAND \
RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS:
BLDGS.
Fellows Thomas A. & Marie J. 12/23t6h L28486 TOTALAND
BLDGS.
L
C L.!.I T T 6 . TOTAL
y 6 LAND
BLDGS.
TOTAL
LAND
BLDGS.
} TOTAL
LAND
BLDGS.
TOTAL
LAND
BLDGS.
01
TOTAL
LAND
INTERIOR INSPECTED: �!�/ C - Q�� Q Z�`�-i BLDGS. -
X TOTAL
DATE: /2 - 07 9-- 71 LAND
ACREAGE COMPUTATIONS BLDGS.
LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL
HO ( loq %. B ZOOn B �� LAND
CLEARED FRONT BLDGS.
REAR TOTAL
WOODS&SPROUT FRONT HLANDREAR WASTE FRONT
REAR LAND
aj BLDGS.
TOTAL
LAND
lo. w //+J JO / BLDGS.
LOT COMPUTATIONS LAND FACTORS TOTAL
FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND
Q ROUGH TOWN WATER BLDGS.
HIGH GRAVEL RD. TOTAL
LOW DIRT RD. LAND
SWAMPY NO RD. BLDGS.
1
If.Conc.Walls Fin.Bsmt.Area ALLBath Room Base l,.6 12/(� 0
BLDG.COST
j Conc.Blk.Walls Bsmt.Rec.Room St. Shower BstheeA, Bsmt.
g,Conc.Slab Bsmt.Garage St. Shower Ext PORCH. DATE `
Walls PORCH. PRICE. ?a,
Brick Walls ,_ Attic &Stairs Toilet Room
. Roof RENT
Stone Wells- Fin.Attic Two Fixt.Bath
Floors — y
Piers INTERIOR FINISH lavatory Extra
B.mt. F 1' 2 3 Sink '
s/ rh r/r Plaster Water Clo. Extra Attie f-
EXTERIOR WALLS Knotty Pine Water Only
Double Siding Plywood No Plumbing Bsmt. Fin.
Single Siding Plasterboard Int.Fin.
�j hingles TILING
Cone.Blk. G F PR.O.-
th Fl. Heat 8 ,
Face Brk.On Int.Layout th FI.&Wain.. .2- Auto Ht.Unit -{ a
Veneer. Int.Cond. th FI.&Walls Fireplace +
'Com.brk.On HEATING Toilet Rm.FI.
Plumbing S-0 ,
Solid Com.Brk: Hot Air Toilet Rm.FI.&Wains. '7 t
7fl
' Steam Toilet Rm.FI.&Walls Tiling y
Blanket Ins. / Hot Water d d Fah St.Shower
Roof Ins. Air Cond. Tub Area Total
Floor Furn.
ROOFING 1 Z aA c Jr COMPUTATIONS S' '
'Asph.Shingle Pipeless Furn. S.F. (o Q s z 5 F/Z
Wood Shingle No Heat Ile S. F. /j Q 75 y
j
Asbs.Shingle Oil Burner 57 S.F. /3-,VQ 7
Slate Coal Stoker S.F. j 30 3 O
Tile Gas
S.F. / 5.70 7S OUTBUILDINGS
ROOF TYPE Electric
S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 30 MEASUREP
Gable Flat
Hip Mansard FIREPLACES S.F.
Pier Found. Floor c�
Gambrel Fireplace Stack Wall Found. 0.H.Door LISTED
FLOORS Fireplace Sgle.Sdg. Roll Roofing
Cone. LIGHTING
_ Dble.$dg. Shingle Roof
Earth No Elect. DATE
Shingle Walls Plumbing
Pine
Hardwood I ROOMS Cement Bik. Electric ��
Asph.Tile Bsmt. 1st S�/3 TOTAL / Brick Int.Finish CED
Single 2nd 3rd FACTOR
REPLACEMENT
OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep• PHYS. VALUE Funct.Dep. ACTUAL VAL.
DWLG.
1
2
3
4
5 .
6
7
• B
9
10
TOTAL
T T
9OPERTY ADDRESS I ZONING DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHD KEY NO.
0372 DLACKlERRY LANE 07 RE 400 07HY 0-7/09/95 104 0 `; , i
LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS L-d BylDate n LOC./YR.SPEC.CLASS ADJ. COND. Y P UNIT ADJD.UNIT
ACRES/UNITS VALUE Dec6plion A N D E R S O N i D O U G L A S S 9 A L E T A MAP-
res PRICE
CD. SfDe hAc PRICE
J L AN D 1 2 9,6 0 0 CARDS IN ACCOUNT -
10 1BLDG_SIT 1 x .4 =10C 154 39999.99 61599.99 .48 2.9600 4, 3LDG(S)-CARD-1 1 911700 01 OF 01
#DL 72 BLACKBERRY LANE COST 121300
BATHS 2 .0 U x C= 100 7000.0 7D00.00 1.D0 700c) :J ilRk C12Y C159 MARKET 118600
c SEC RCI S X C 100 11 .25 11.25 65 74JU 3 4rt1F' FYrir, 1 N C G N E
A F LACE U x C= 100 31G0.0 31 CO.00 1_QL 3100 s USE
APPRAISED VALUE
D
A. 121.300
PARCEL SUMMARY
U S AND 29600
T LDGS 91700
IF'ipS
N1
E 0 GTAL 12130
N d CNS3
DEED REFERENCE Type DATE Rao-d 0 R I O R YEAR VALUE
T Book Page Ins,. MO. Vr.D Si-Pnce A N D 29600
S a24?/C'S61TL 06/94 140000 3LDGS 9170C
I I
3 ;4'1/01261 1(,)4/93 H 1 0 r A L 121.30C
1264/986- lie/00
I I
BUILDING PERMIT N+C D:-ROOF. 121 a
Number Date Type Amoum
LAND LAND-ADJ INCOME SE SP-ELDS FEATURES 6LD-ADJS Ud1Ti
tiuu�� I 1 7500
Class Const. Total Base Rale Aear Atll.Pale y Buil,f Age Norm. Ob%v CND L °k R G Rep, ew Cost N A0, Repl ValueSn Height Rooms Rms Baths /'Fia. Pen .11 F.c.
Units Units Dep,. Contl, oc
0- v'u:i 1:30 100 62.4.5 62.45 65 75 19 80 90 70 131062 917Ju 2. ) 7 4 2_u 7.0
rapt ion Rate Square Feel Repl,Cost MKT.INDEX: 1 IMP.BV/DATE: ME y/�'9 SCALE: 1/ Ii.6 2 ELEMENTS CODE CONSTRUCTION DETAIL
u. 10U 62.45 7.6 47962 AREA L ( TWO FAMILY D'IWELLING C`NST GP:C)0
UFO 0 37.47 64 2393 *--- *
UFO 60 37.47 64 2398 ! UFO *----17---*------24------* cSIr3N ;aD.ii'%1T Jv -- 0.0
-- - --- - -
l56 1 i0 62.45 340 2123.3 ! 820 ! 1SE ! F F G ! (Tc !_sltlL l_$ 11 :�OO- -S-H-
D INGL- -ES----- 0-.n
' - - --------------------
FFG 30 1 .74 576 10794 ! I I ! 2-A IAC TYPE J4 IL 0.G
;V - ----- ----
620 60 37.47 768 28777 24 BASE 24 ! ! ITr!2.FIN:ISH (J4 RY- ------- -WALL 0.0
20 24 24 1 WTI:i2 L_AYJJ1 12AVER-PNORWAL O.I0
! ! !
I=NT�t � µLTY IZA?(c-AS EXTER.
r ou ,-r-�tJCT Jz JOIST7 -E---M -
:')
D W! UFO ! ! ! = L J;J F s)1(.=.? -1 A k P E T T I l- '_ ,
*------- _ p C
E Total Areas Au. a .5 5 Base= 11 8 32-------- ----17 k 1 iu OF I(P - ./t�l A L E-AJP1 JT�
*------ ---- * * --- ------/r p I l li - - f--- -----
BUILDING DIMENSIONS --.i 2--- - -2 Y _L=(, ! h =j t 4V E 2 a
T 8AS W 5 2 UFU S 02 E32 NO2 W32 F JJv")ArtCrti -lt Ju D CJ'jC--- -97�-
A SAS N24 UFO NO2 E32 S02 W32 ._ ------------ -- ---, -----------------
i BAS E32 SU2 1SO Ell FFG E24 S2_4 ------------
L ---- VcI'ini kHJUG >�4I 1YANNIS
W24 N24 _. 1S6 S20 W17 N20 .. LAND TOTAL MARKET
BAS 522 .. E120 ,Y24 W32 S24 E32 PARCEL 29600 121300
-- ARizA 10200C 657
4A'2IAACE -71 +13361
.;T A'q fl,A RD 25
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1.
; SENDER: I also wish to receive the
'a ■Complete items 1 and/or 2 for additional services:
in ■Complete items 3,4a,and 4b. following services(for an
H ■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you. ai
■Attach this form to the front of the mailpiece,or on the back if space does not
permit. 1. El Addressee's Address
d ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Dellverv. )
t ■The Return Receipt will show to whom the article was delivered and the date yw
e delivered. Consult postmaster for fee:'' .�I
3.ArticlesAddr ss tof� Article Number '
d �C 2 /c
46.Service Type
u ❑ Registeredi❑ C tied °C
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N h. ❑ Express Mail nsured c
W I e�D Q 60 7 ❑ Return Receipt for Merchandis ❑ COD u i
a / .7.Date.of Delivery
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p 5.Received By:(Print Name) 8.Addressee's Add res (Only if requested
W and fee is paid) t
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6.Signatur, : ressee o gent)
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PS Form:3814;December 1994 � �!� i Domestic Return Receipt
1(it n ttittitl l r 1 r - --
I
UNITED STATES POSTAL SERVICE First-Class Mail I
Postage&Fees Paid I
USPS I
Permit No.G-10 I
' I
6 • Print your name, address, and ZIP Code in this box •
p I
Town of Barnstable
e Building Division
367 Main St.
Hyannis, MA 02601
f
i
I
i
I
i
i
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t
P 339 592 358
QJS Postal Service
Receipt for Certified Mail
No Insurance Coverage Provided.
Do not use for International Mail See reverse
Se o
Street&NumtWr
Post ce,State,&ZIP C e
Posta
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
LO
Return Receipt Showing to
Whom&Date Delivered
n Return Receipt Showing to Whom,
Q Date,&Addressee's Address
TOTAL Postage&Fees $ '7 7
M Postmark or Date
t10
C
Q.
Stick postage stamps to article to cover First-Class postage,certified mail fee,and
charges for any selected optional services(See front).
1. If you want this receipt postmarked,stick the gummed stub to the right of the return
address leaving the receipt attached, and present the article at a post office service m
window or hand it to your rural carrier(no extra charge). ' m
Q)
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the a)
return address of the article,date,detach,and retain the receipt,and mail the article.
u)
3. If you want a return receipt,write the certified mail number and your name and address rn
on a return receipt card,Form 3811,and attach it to the front of the article by means of the
gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article
RETURN RECEIPT REQUESTED adjacent to the number. '.
4. If you want delivery restricted to the addressee, or to an authorized agent of the O
O
addressee,endorse RESTRICTED DELIVERY on the front of the article. M
5. Enter fees for the services requested in the appropriate spaces on the front of this
receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. to
6. Save this receipt and present it if you make an inquiry. y a
tHE
+ BARNSTABLE, •
9�ArE A � The Town of Barnstable
Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
June 27, 1997
Mr.Douglas Anderson
72 Blackberry Lane
Hyannis,MA 02601
RE: M-249/P-080
Dear Property Owner:
Our records indicate that your house at,72 Blackberry Lane, is currently being used as a two-family home
contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to either:
1) apply for a building permit to restore the property to a single-family home
2) apply to the Zoning Board of Appeals for a variance
3) prove that this is a legal two-family
You must contact this office immediately to tell us what direction you wish to take.
Sincerely,
Gloria M.Urenas
Zoning Enforcement Officer
GMU:Ib
CERTIFIED MAIL-P 339 592 308
f970311a
Town of Barnstable
Planning Department
Staff Report
Appeal Number 1997-104 - Anderson
Special Permit-Family Apartment-Section 3-1.1(3)(D)
Date: October 02, 1997
To: Zoning Board of Appeals
From:
Robert P. Schernig, Director
Art Traczyk, Principal.Planner
Applicant:........................................Douglass R.&Aleta R.Anderson
Property Address.........................72 Blackberry Lane, Hyannis, MA
Assessor's Map/Parcel............... 249, Parcel 080
Area.....".......... ................... 0.48 ac.....Building Area......................2,004 sf.
Zoning:............ .....................RB-Residential B Zoning District
Groundwater Overlay....................GP-.Groundwater Protection Overlay District
Filed:August 11, 1997 Hearing: October 08, 1997 Decision Due: November 17, 1997
Background:
The applicants are requesting a Special Permit for a Family Apartment. The property is addressed as 72
Blackberry.Lane in Hyannis and is located between West Main Street and Route 28 accessed off of
Strawberry Hill Road. The 0.48 acre lot was developed in 1965 with a 2 story, 2,004 sq.ft. dwelling and is
listed by the Assessors office as being used as a"two-family dwelling". '
The Building Department notified the applicant in June that the use of the structure as a two-family dwelling
was considered illegal.use of the premises and ordered that appropriate action be taken to restore the
structure to a single-family dwelling or seek appropriate relief from the Board (See letter of June 27, 1997
from the.Building Division.of the Town of Barnstable). Apparently the applicant has chosen to legitimacy the
use by converting the unit to a Family Apartment.
Staff Review:
Aleta R. Anderson is the onlyresident listed at 72 Blackberry Lane, Hyannis, MA, but is not cited as a
registered voter in the Town
According to the plot plan presented with the application, the building conforms to all required setbacks for
the district. A family apartment of 768 sq.ft. is within the 50% limitation set within the Ordinance for a family
apartment unit.
The figure of 768 sq.ft. for the family apartment is based upon the assumption that only one floor is.used for
the apartment unit. Does the family apartment have a second floor to it?
Special Permit Findings:
In addition to meeting all of the provisions of Section 3-1.1(3)(D), the granting of a Special Permit requires
the following .finding of facts to be made by the Board (as required under Section 5-3.3(2)):
that the application falls within a category specifically excepted in the ordinance for a grant of a Special
Permit, (Special Permit pursuant to Section 3-1.1(3)(D)-Family Apartment-is permitted in all residential
Zoning District provided all criteria is met.),
Source-Town of Barnstable-Assessor's Records
2 Source.-Town of Barnstable,List of Persons Seventeen Years.of Age and Older 1997.
Town of Barnstable-Planning Department-Staff Report
Appeal Number 1997-104 - Anderson
Special Permit-Family Apartment-Section 3-1.1(3)(D)
• that a site plan has been reviewed and found approvable in accordance with Section 4-7 (Single and
two-family dwellings are exempt from the provisions of site plan review according to section 4-7.3 (2)),
and,
that after evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the zoning
ordinance and would not represent a substantial detriment to the public good or the neighborhood
affected.
Staff Recommendations:
If the Board should find to grant relief in this instance, it may wish to consider some of the following
conditions and staff recommendations:
1. No future expansion of the structure in terms of footprint or total gross floor area shall be permitted
during the duration of this Special Permit.
2. This Special Permit is not transferable.
3. The structure is, and shall remain, a single family dwelling.
4. Renting, leasing or subleasing of the unit to any other non-family member is not permitted. The annual-
affidavit must be submitted and the Building Commissioner may require additional proof of kinship and
residence requirements as necessary to assure the apartment unit is maintained as a Family Apartment
consistent with the Zoning Ordinances.
5. The unit shall be maintained in accordance with all requirements of Section 3-1.1(3)(D) - Family
Apartment and in accordance with all conditions within this Special Permit.
Attachments; Assessor's Card
ZBA Application Form
Field Card
Assessor's Map
and Submitted Materials
2
TORN OF BARNSTA=
Zoning Board of Appeals
i AnVlication for Family Apartment Snecial Permit
1997
Date Reciv_ed For office use only:
THE ZONING G SOUGHT HAS
Town clerk office BEEN DETERMINED BY THE ZONING Appeal # /rid -i d
ENFORCEMENT OFFICER TO $wiring Date
BE APPROPRIATE RELIEF GIVEN THESE.
CIRCUMSTANCES, Decision Due
The undersigned hereby applies to the Zoning Board of Appeals for a special
Permit for the development and maintaining of a Family Apartment in accordance
with section 3-1.1(3) (0) of the Zoning ordinance, in the manner and for the
reasons hereinafter not forth:
Applicant Name: Dou64,aCS ,Q, `LJILTA ,A��r--. c�V Phone ?7J-/s1'F7
Applicant Address: -?a /'�C ,�/ �rl•� L:,� ,� i,`�/it .��/f.
Property Location:
Property owner: � L�rPiv>>��aa� Phone
Address of owner: Ly��
If applicant differs from owner, state nature of interest:
Nu.:.ber of Years owned: 12 //
Assessor's Hap/Parcel Number:g g lz ��
Zoning District: RB , RB-1 ( ] , RC ( ] , RC==:I ( ] ; RC-2 ( ] ,
RD [ ] , RD-1 [ ] , RF ( ] , RF:'1 RF-2 [ ] ,
RG [ J � RAH PR ( J • a
Groundwater overlay District: .AP [ ], GP (] , WP (.] .
Apartment:
Hama(s) and relationship of the family members to occupy the Family A p
Name: ji�1jft 641 , Relationship to owners: 44nffi
Name: �iA A , !fN.iW LW , Relationship to owners: �
The Family Apartment is to be developed:
,K within the existing single family structure.
( ] as an addition to the existing single family structure.
( ] in an existing accessory building.
( ] :other - Please Explain: At6 fa2w
Avulication for Family Avartment .special perait
.t
Description of Construction. Activity:_
Proposed Gross Floor Area of the Family Apartment Unit: . . . . . . . . . . sq•ft
The Gross Floor Area of the Existing Single Family Dwelling unit:
Do all structures, existing and proposed, comply with all setback
requirements for the Zoning District in which it is located? Yes , No(
Will this be the permanent address of the occupant(s) of the
Family Apartment: ... . . ...... . .. . . .. .... . . . . . . . .. . . . . . . . . .. . . . . . . . . . Yes No(
Sf no, Please Explain:
Is the property located in an Historic District? Yes[ ] Ntf
If yes ORE Use Only:
No Exterior Changes. . . . . . . . . . . . (,
Plan Review Number
Date Approved
Is the building a designated Historic Landmark? Yes( ] Nk
If yes Historic Denart:nent Use Only:
Date Approved
IsR,the property served by public water supply? Yes K No( ,
Yes No( ;
Is the property on private septic?
If yes Health Department Use On v:
Title V System Yes[ ] No( ;
Date Approved
Signature: Date:
4ppp:211Mcant or Agents Signature ,
Phone:
Agents Address:
Town of narnstabol
Family Apartment Affidavit
f'kL&'77?e/400Z-Neing on oath, depose and state .as follows
,1. I reside at '7�� �( �1L(3�? Zy i h ) that Z have owned
since Z, and which is my domicile and principal residence.. The prope y
shown on Barnstable Assessor's Nap and Parcel Number Mo2L/ / OY7O.
2. on , 19_,the Zoning Board of Appeals, in Appeal No.
granted to me a special Permit to develop and maintain a Family Apartment. in
accordance with Section 3-1.1(3) (D) of the Zoning ordinance and in agreement
condition of that special Permit at the premises above.
3 The following members of my family will be the sole occupant(s) of the Farm
Apartment Unit
Name: !►��q-,t1 ,. )/� � , Relationship to owner: 4r ��
�Name: Tj�dy1 "C 0 Il&_Q-Sch-7 , Relationship to owner:
I understand that the Family Apartment:
* shall only be occupied by members of my .family who are persons related to
by blood or by marriage,
• shall be the primary year-round residence for the identified family member
shall not be sublet or subleased to any other person(s) , and
shall, at all times, be in compliance with all conditions of the special
Permit issued by the Zoning Board of Appeals, including plans and oommitmi
made in the application and approved by the Board.
This affidavit shall be filed annually with the Building inspectors office and
the unit shall be vacated by the above identified family members,? I shall with.
30 days notify the Building Inspectors office of that and shall immediately
proceed with the removal of the family apartment unit.
in the event of the sale or transfer of ownership of the above property, I sha.
notify the building Inspectors office and shall surrender the special Permit fi
this Family Apartment.
sworn to under the pains and penalties of perjury this. day of Ava ►/ , 19
signature:
(Please Print.) Named s (� � K f I/� %`Lo Phone: T_
Hailing Address:
Receipt for Certified,Mail
No Insurance Coverage Provided.. ,
` B'RNEMAB ' Do not use for International Mail(See reverse
q. �' The Town of Bar ;
10 � Se o
Department of Health Safety and Envu. Street&N.um
Building Division Post State,&Z#8 ,367 Main Street,Hyannis MA 02, ''Ponta7 7
Office: 508-790-6227• Certified Fee
Fax: 508-790-6230 Spedal Delivery Fee
LO Restricted Delivery Fee
(b Return Receipt Showing to
June 27, 1997 = whom&Date Delivered
a Return Receipt stowing to Whom,
Q Date,&Addressee's Address
0 TOTAL Postage&Fees $ a 77
Mr.Douglas Anderson E Postmark or Date
72 Blackberry Lane U
Hyannis,MA 02601 a
RE: M-249/P-080
Dear Property Owner:
Our records indicate that your house at,72 Blackberry Lane, is currently being used as a two-family home
contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to either:
1) apply for a building permit to restore the property to a single-family home
2) apply to the Zoning Board of Appeals for a variance
3) prove that this is a legal two-family
You must contact this office immediately to tell us what direction you wish to take.
Sincerely,
Gloria M.Urenas )TATES P
Zoning Enforcement Officer
GMU:lb
CERTIFIED MAIL-P 339 592 308
f9703 T 1 a
a Vl/rI,V IU:.a IIUUI .VUL :+I' ur,�I,i I—IL I r111�ILUI CLASS I r'VJ I NUI IU 1 .__..__._J.. r. �F_Y NO.
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t.LACKUERRY LANE 07 Rd 400 L'7HY ' -
' _-- AND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS UNIT ADJ'D.UNIT ACRES/UNITS VALUE O.ac�IPnon A N U t:t S U N, D 0 U GL A S S l( AL F T A
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CD FFDe r�lACr.f
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10 1BLDG.SIT 1 X .4 =10 154 39999.9 61599.99 .48 G7oUJ a )LI)G(S)-C4RG-1 1 91.1OD
4 'L 7Z JUAC!dERRY LANE COST 12130C
X C= 10U 7DC0.0 10U0.UC 1.00 7`)JU 4 21. J14Y Ll i4 AkKET 11?600
BATHS 2.0 U a ]f' �Y`i; IIICOME
1-1dNR REC R-1 S X C= 10G 11 .25 11.25 600 74Ju 1 USE
fIREPLr ILE U C= 1CU 31GU.U' 31(1C'.GO 1.CJU 31.)u s PPPRAIrFD VPLUE
A A 121.30C
D PARCEL SUMMARY
AND 296CO
U 3LDGS 9170C
S
t-IF'PS
T TCTAL 1213CC
M J CNST
E DEED REFERENCE T,,q DATE R.cpo.g r P I C R YEAR VALUE
i. N Boo. p.„ 1181 ,AO 11 D .A DU 2 h C 0
T J241/Lo6Tc V0/?4 1400JC :LOGS 9170C
r S 3 41/( 20' I'-)4/ ): H 1 TOTAL 12130C
� 1�E4/S't,c:r ilC/00
:) BUILDING PERMIT N C E D S ROOF .t 2/
Nume.r ON. Try. Am- 0 .j..............
I
LAND LAND-ADJ INCOME SE SP-EILDS FEATURES BL17SDCS UNITS
2a�uJ
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---- Class Cona1' Trrer Base Rare wel Rare w e I w0• O.p Cone
Urals' Unns.
4 2.11 7.0
J2C U0D 1UO 100 62.45 52.45 65 75 19 8U
9D 7G 131062 917JJ. L.J ? .
DBscnpLUn F.7
Sgrare Feel R.PI C... MKT INDEX I•UO IMP BV/OATE. ME 9/a9 SCALE. 1/00.62 ELEMENTSCODE CONSTRUCTION DETAIL
dAS 1JU 769 47962 T W Dw L ING C•J3T uP: 1U-----+ J7 - -------------
�-------UfON " iARRISON 0.0
ufU 60 54 2398 )E O.9UFO 60 h4 239R I ------24------+ Ei[ .iN :1UJ iT )�U 340 1233 ! FFG ! XT�7. [;1L1� 11a --- c-c620 IFFJ30 57.6 10794 ! ! SE _ AE f/fit=. _I4 )IL _- -------- C =b20 oD 763 28777 24 SASE 24 ! ! 1; F [N[;H �4T+r.wALL J.��
T ! 20 G4 24 f1Tc f:LIY IJT- f[ ?Vc f:7}IOIZhAL 'i.I�
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E roar wrea. A.._ 9.ae. _3 2_ + =L C T li J 1 4 J E 3 (i c -
+----_-_-t2------__. +------24------ - -
.:.
BUILDING DIMENSIONS
T b-AS u32 UFO S.U`[ E32. V02 °a32 .. u1dJh---i--- - --- --- `_- COVC ---
A UAS ti24 UFO NO2 E32 S02 F132 .. -- '4EI-i- 1JNH:JJi i7AC .4YANN[5-------
dAS E32 S J 2 1SD Ell FFG E24 S24
LAND TOTAL . MARKET
L W24 N24 .. 1SO S20 V17 N20 .. a 29600 121300
V
UA3 S22 .. 820 N24 a32. S24 E32 AS
1i2'_i. 112000 6.57
-• VAZIAACE -71 �t8351
25
iT•14E:' I
LOT 11
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RES. ZONE.- "RB" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C"
I Bank Use Only
TOWN: .UYMNNIE — — REGISTRY OWNER: MARIE J FELLOWS_ — —
DEED REF: L05-44-126 — — —BUYER: DOULASS R. & 'T�—A1VD-E&SQN — _ .
DATE: —616/94 PLAN REF: 18ZI-51— — — —SCALE:1"= 30 FT•
I HEREBY CERTIFY TO ��,� OF �,��^ YANKEE SURVEY
_F_S_B _ ___________ ______ THAT THE BUILDING �� ����„
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS �o�' PAUL y CONSULTANTS
SHOWN AND THAT ITS POSITION DOES ____ CONFORM A.
`='t' 40B (SUITE 1)
TO THE ZONING LAW SETBACK REQUIREMENTS OF THE MERITHEW
•o No.�20J8 c`r INDUSTRY ROAD
TOWN OF BARNSTABLE_____________AND THAT 9 ��,
IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD '�FcIsrEc�° �v MARSTONS MILL- 02648
AREA AS SHOWN ON THE H.U.D. MAP DATED_6_/_JJ._g�_ s�oNac �ped�s TEL: 4280055
Co nit —Panel # 250001 0005 C FAX: 420-5553
t2L_ _ __ __ THIS PLAN NOT MADE FROM AN INSTRUMENT 15001 BJS
PAUL A. MERITHEW P S SURVEY NOT TO BE USED FOR FENCES iAMETC.
h
�? LOT 11
CB
FND,
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ANDERSON: MAP 249 PARCEL 080
� ��-.. f • �'���� I it
1
I I �/
.Barnstable Assessing Search Results „ Page 1 of 2
Home: Departments:Assessors Division: Property Assessment Search Results
72 BLACKBERRY LANE
2003 Owner information:
Owner Name Property Sketch Legend
ANDERSON, DOUGLASS&ALETA
Map/Parcel/Parcel Extension #
249 /080/ E,
Mailing Address jr
ANDERSON, DOUGLASS&ALETA ' '
72 BLACKBERRY LN �' � "
HYANNIS, MA.02601 '
2004 Owner Information (as of January 1,2003)
Owner Name '
GLADISH,SCOTT P&
Address
72 BLACKBERRY LANE
2004 Total Assessed Value
$281,100
2003 Assessed Values:
Appraised Value Assessed Value
Building Value: $ 126,300 $ 126,300
Extra Features: $ 16,400 $ 16,400
Outbuildings: $0 $0
Land Value: $44,500 $44,500 y Interactive Property Map: ap requires Plug in:
Totals:$ 187,200 $ 187,200 1 have visited the maps before
Show Me The
April 2001 photos available
Sales History:
Owner: Sale Date Book/Page: Sale Price:
ANDERSON, DOUGLASS&ALETA 6/15/1994 9247/086 $ 140,000
FELLOW, MARIE J 4/15/1993 8541/026 $ 1,
FELLOW,THOMAS 1284/986 $0
2003 Tax Information: 'Tax Rates: (per$1,000 of valuation)
Town Tax $ 1,759.68 Town Fire District Rates Other Rates
9.40 Barnstable 2.88 Land Bank 3%of Town Tax
Hyannis FD Tax $541.01 C.O.M.M. 1.54
http://wWw.toWn.bamstable.ma:us/tob02/Depts/AdministrativeS ervices/Finance/Assessing... 8/27/2003
iBarns:able Assessing Search Results Page 2 of 2
Cotuit 1.88
Land Bank Tax $52.79 Hyannis 2.89
West Barnstable 1.96
Total: $2,353.48 Due to rounding differences these values may vary
Land and Building Information
Land Building
Lot Size(Acres) 0.48 Year Built 1965
Appraised Value $44,500 Living Area 2004
Assessed Value $44,500 Replacement Cost$ 154,051
Depreciation 18
Building Value 126,300
Construction Details
Style Colonial Interior Floors Carpet
Model Residential Interior Walls Drywall
Grade Average Grade Heat Fuel Oil
Stories 2 Stories Heat Type Hot Water
Exterior Walls Wood Shingle AC Type None
Roof Structure Gable/Hip Bedrooms 6 Bedrooms
Roof Cover Asph/F GIs/Cmp Bathrooms 3 Bathrooms
Total Rooms 7 Rooms
Extra Building Features
Code Description Units/SQ ft Appraised Value Assessed Value
FPL3 Fireplace 1 $2,500 $2,500
BFA Bsmt Fin-Aver 800 $9,800 $9,800
APTX Extra Apartmt 1 $4,100 $4,100
Property Sketch Legend
BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished)
BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished)
CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished)
FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished)
FCP Carport GRN Greenhouse UUA Unfinished Utility Attic
FEP .Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished)
FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck
FOP Open or Screened in Porch TQS Three Quarters Story(Finished)
http://www.town.bdmstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing... 8/27/2003
Town of Barnstable
Regulatory Services s
R oFt ioti, Thomas F.Geiler,Director
Building Division TpVN OF BRk5�AB1.E \i
r M
MUMSrAsi.s, * Peter F.DiMatteo, Building Commissioner u . 5
9�A 1 a�0� 200 Main Street,Hyannis,MA 02601(tj FEB 2` Ai l
Office: 508-862-4038 -790-6230
-►S►ON
Town of Barnstable Family Apartment Affidavit
I,being on oath, depose and.state as follows:
My name is 1�t�l�C LASS 'E420h �A4 I am the ownedresi nt of the
propeliy located at:.
Map and Parcel Number, C)
The ZBA granted me a Special Permit/Variance on 6'T -
Date Appeal No.
The following members of my family will be the sole occupants of the Family Apartment at the
aforementioned address:
Name &relationship to owner: �).Pt ry� 10�tS 6TZ-I0U
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 1 am required to comply with all conditions imposed by the ZBA in the Appeal
No: identified above. I agree to notify the Building Commissioner immediately in the event of the
sale of this property.
If there is no longer a Family Apartment at this location, please explain:
The apartment has been dismantled.
The apartment has been transferred to the Amnesty Program (Appeal No. )
Other
Sworn to under the pains and penalties of perjury this i day of F6 2002.
Signatu Phone Number
Print Name
Q/bldg/forms/famaffid 3
Rev:010702
d.
A-MDAVIT
BARNSTABLE
' Z�) ,being on oath,
\� I'
depose and state as follows:
1.) I reside
2.) I am the owner of the property located
at � -
shown on Barnstable Assessors' maps as MAP PARCEL 0 U
3.) I Do �S Do not have a Family Apartment at this location.
4.) On (2;C , 199 , the Zoning Board of Appeals, on Appeal No./ 2 7/D y
granted me a Special Permit/Variance to maintain a Family Apartment at the above address.
5.) I understand that the Family Apartment may only be occupied by members of my family wi110
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 ,�AMozr
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 ffle an Aflidavit 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. �/'e�— ZeQ
12.) I agree to immediately notify the building Commissioner in the event of the sale of the above-
listed property. 2
Sworn to under the pains and penalties of perjury this day
of
Signature
Print N ne
COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE AFFIDAVIT
-Lip Fn to
depose acid state as follows:
1.) I reside
MAR 0 1 1999.
at—�i�_s�_`3�-�'���'�,�.=fl`�Ui� - -
OWN OF BARNST
ABLE
2.) I am the owner of the property located BUILDING DIV.
shown on Barnstable Assessors' maps as MAP__ o�._9_ PARCEL- 6 _Q______—
3.) I Do____ ---Do not __have a Family Apartment at this location.
4.) On__Q =_ 1992 , the Zoning Board of Appeals, on Appeal No.,9!27
granted me a Special Permit/Variance to maintain a Family Apartment at the above address.
5.) I understand that the Family Apartment may only be occupied by members of my family who
are persons related to me by blood or by marriage.
6.The following members of my family will be the sole occupants of the Family Apartment at the
above address,
a) NAME--- 1_ --- ------------------------------
Relationship to owner:____—_
b) NAME--- -- G ---- - - —
Relationslup 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 AfI-idavit with the Building Commissioner
listing the names and relationship of my family members occupying said Family Apartment.
11.) I understand that I am required to comply with all conditions imposed by the Board of
Appeals in Appeal No. - �� � ----------- ----------------
12.) I agree to immediately notify the Building Commissioner in the event of the sale of the above-
listed property. ss
fJ...
Sworn to under the pains and penalties of perjury this 9,y_day of 199 _
ignat
Print --
COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE AFFIDAVIT
I, % L� G �'_ •l7 S��-(___, being on oath,
depose and state as follows: Z?�"�
1.) I reside at
-- - - ----- --------
2.) I am the owner of the roperty located Jut
shown on Barnstable Assessors' maps as MAP- PARCEL
_
____Do not __have a Family Apartment at this location.
4.) On_ 3_ --__-_, 199_,--, the Zoning Board of Appeals, on Appeal No.137 AO y
- -
granted me a Special Permit/Variance to maintain a Family Apartment at the above address.
5.) I understand that the Family Apartment may only be occupied by members of my family who
are persons related to me by blood or by marriage.
6. The following members of my family will be the sole occupants of the Family Apartment at the
above addres :
a) NAME ---------- ----------
Relationship to owner:-_ t �� ----__________________________________
b) NAME-- - --------- s �8 ------------------------------------
Relationship to owner:--__ o� ___________________________
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. _� ��-1C�
12.) I agree to immediately notify the building Commissioner in the event of the sale of the above-
listed property.
Sworn to under the pains and penalties of perjury this day of _____, 199_ ___
Sign re
- ----------
am -
Prm e
oFVE The Town of Barnstable
Department of Health Safety and Environmental Services
,AM L& Building Division
MASS
�� 367 Main Street, Hyannis MA 02601
ArFp MA'S A
Office: 508-790-6227 Ralph M. Crossen
Fax: 508-790-6230 Building Commissione
December 30, 1997
The Anderson Residence
72 Blackberry Lane
Hyannis, MA 02601
Re: Family Apartment located at above address
Dear Mr./Ms. Anderson,
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,
Ralph Crossen
Building Commissioner
QUERY PROPERTY: QUERY END
QUERY PROPERTY
PENTAMATION----------------------------------------------------------- 12/30/97
PARCEL ID 249 080 GEO ID 15831
LOT/BLOCK DBA
PROPERTY ADDRESS OWNER ANDERSON
72 BLACKBERRY LANE DOUGLASS & ALETA
HYANNIS 72 BLACKBERRY LN
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 20908 . 8 OPER/MGR NAME
WET LANDS MULT ADDRESS
USE 104 PROTECT DIST GP
(N) EXT / (P) REVIOUS / NO (T) ES / PER(M) ITS /
(V) IOLATIONS / (G) EOBASE / (E) XIT
I
J