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0042 BLUEBERRY HILL ROAD
Will / s l- � r oFZHEr , Town of Barnstable ti Inspectional Services ` BAxrrSTABLE. ' Brian Florence,CBO' y HA & �a �A i639• . �0 Building Commissioner TfD.M 200 Main Street,Hyannis,MA 02601 www.towfi.barnstable.ma.us INSPECTION REPORT Address : 42 BLUEBERRY HILL ROAD, HYANNIS Case# C-19-292 Inspection Type : Violation Inspector: lauzonj _ -- _....._......... . Description Date Unit Status Comment Violation 01/02/2020 PASS 1/2/20 SITE INSPECTION OBSERVED NO VIOLATIONS. NO EVIDENCE OF BUSINESS. THIS IS A FOLLOW UP INSPECTION FROM 5/2/1 9. C a 3 4-6 a� oFzKE,� Town of Barnstable Regulatory Services BAMSPABLE, r Thomas F.Geiler,Director MAW. 'gyp z639. Building Division �fD NU►'1 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 42 BLUEBERRY HILL ROAD in HYANNIS, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book --+I I a I ; Page 17 1 , or as Document. No. , being shown on Assessors' Map 249 as Parcel 068, 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 NEULI MENDES, SISTER, AND FERNANDO MENDES, NEPHEW, OF OWNER, MARCOS MEIRA,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 -7 day of "T—De TOWN OF BARNSTABLE OW ER By: ding Commissions THE COMMONWEALTH OF SSACHUSETT BARNSTABLE COUNTY, SS Date O J 111 :1 Then.personally appeared the above-named (owner), /4A QcfDS c" J// 1 and made oath as to the truth of the foregoing instrument, before me. Notary Public , My Commission GUSTAV'- �,PES CORREA SANTOS taolaty Public __._.......,: +• t OMMONWEALTH OF MASSACHUSETTS Commission E Oes ? it January 17,4014 1. FalmouthRW30 T Ile ',t "Pi Bk 30886 PS 132 057338 QUITCLAIM DEED We,'MARCOS C. MEIRA, and SILVIA F. MEIRA,of 42 Blueberry Hill Road, Barnstable (Hyannis),Massachusetts, inconsideration of one dollar($1.00), grant to SAMILLE ROSSEGALE,of 67 Sea Street,Apartment 3C,Barnstable(Hyannis), Massachusetts, WITH QUITCLAIM COVENANTS all of our right,title,and interest in the land,together with the buildings thereon, situated in Barnstable(Hyannis),Barnstable County,Massachusetts, shown as LOT 6 on a plan of land entitled"'Blueberry Hill' Subdivision Plan of Land in Centerville-Hyannis-Barnstable,Mass. for n-� Robert S. Elliott"dated June 18, 1964,drawn by J.R.S. Charles N.Savery,Inc.,Registered S Engineers, Surveyors,Cotuit,Falmouth, Cape Cod,which is duly recorded with the Barnstable County Registry of Deeds in Plan Book 187,Page 51. The premises are conveyed subject to and together with the benefit of all rights,reservations, veasements and restrictions of record,so far as the same are in force and applicable. A) Grantors release any and all homestead rights to the within premises, whether created by I declaration or operation of law, and further state under the pains and penalties of perjury that 1 there are not other individuals entitled to homestead rights to the property being conveyed. For our title see the Quitclaim Deed dated June 23,2006,and recorded with the Barnstable d County Registry of Deeds in Book 21137,Page 171,on June 28,2006. PROPERTY ADDRESS:42 Blueberry Lane,Barnstable(Hyannis), Barnstable County, MA. `qS Executed as a sealed instrument this day of OV eir, 2017. N arcos C. Meira Silvia F. Meira Page 1 of 2 Bk 30886 Pg133 #57338 COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,SS On this day of 1�1E , 2017, before me, the undersigned notary public, personally appeared Marcos C. lvieira, wh proved to me through satisfactory evidence of identification, which was ti.v , to be the person whose name is signed on the preceding document, and. acknowledged to me that he signed it 7k" voluntarily for its stated purpose. ,S *Ny blicission Expires: p 23 1-5 COMMONWEALTH OF MASSACHUSETTS = BARNSTABLE,SS S `'/� sl On this day of �UVC. kt v-,-2017 before me, the undersigned`•notar" public, personally appeared Silvia F. eira, who proved to me through satisfactory evidence of identification, which was , to be the person whose name is signed on the preceding document, and acknowledged to me that she signed it voluntarily for its stated purpose. " No Public My Commission Expires: r � -ARWABLE REGISTRY OF DEEDS John F. Meade, Register Page 2 of 2 Parcel Detail Page 1 of 5 X 'r Logged In As Parcel De to Monday, March 11 2019 Parcel Lookup Par -.... .... . ..... . ....... .._..... Parcel ID 308-170 Developer Lot LOTS 1,2,3,4 5 6 7 UNN� Location 7 SEA STREETN " Pri Frontage 480 �1 Sec Road SOUTH STREET Sec Frontage 255 Village nn Fire Distract HYANNIS Hya is 1 Town sewer exists at this address Yes � Road Index1�447 � ri Interactive Map Owner Info _,.....,_._ _... _._. ...._._._._..__........--- --------,. ............... - --- Owner HAJJAR,�CHARLES C& C0 Owner67 SEA STREET REALA Streets f30 ADAMS STREET Street2 .. City'MILTONu State AMA Zip,02186 Fx"L a Country Land Info Acres;!3 51 Use$ ver 8 Urnts MDL-01 zoning RBA Nghbd CI13 �' Topography Road . Utilities " I Location Construction Info ... ......... ....:.:. ................................................ . .. ........ ... ........ ............... Building 1 ®f 4 9 Year�1973 ,�sRuoe Flat ,, WExt all Wood Shingle Built a Living 27600 � Roof,a AC r&Gravel None µµ Area Cover� Type" I style�Apartments,:.� Int'D all Bed '. I .... Wall� � R ooms s, .� .. M, Model Int Bath 'Residential Floor)Carpet Rooms 10 Full-0 Half Heat Total Grade iAverage 1 Type,:Hot Air (Rooms Stones 2 StorieS Fuei 12as Found- re anon PoudConc. Gross 29140 Area I Building 2 of 4 � Year 1973 Roof Flat «m � Ext 1Wood Shingle Built Struct Wall !,Wood Roof fTar&Gravel AC Nohe Area Coveri Type sBed tyle 3Apartments wal� Drywall J Rooms Model"Residential Int 1Carp et Bath Full-0 Half Floor Rooms . http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=25029 3/11/2019 r Parcel Detail Page 2 of 5 r Grade Average j Heat H ot Air Total'0 Type Rooms _ K b stories2 Stories Heat"Gas�.��"- ... I Found °Poured�Conc. Fuel l ation Gross 29140 Area Building 3 of 4 pb v ood l u a Year V- J Roof Flat Ext W Built Struct Wall , Living r" """ Roof t .` AC ` Area E34500 cover Tar&Gravel � Type None -Bed Kam Int Style JApartments Wallall RoomsIntf model?Residential Floor Bath " arpet Rooms ro uii-0 Half �',e_-<�,",. >_ Heath" �w� a, Total Grade Average Type iHot Air Rooms 0. Stories f2 Stories �� Heat Gas f Foundpoured Conc. Fuel ation Gross 36424 1 Area a Building 4 of 4 Year 19 11 rucRoot f"able/Hip all. ood Shingle Ext Built• _J Struct Wall� � Living ,,,y ..,. �. Roof .,,,,, AC; Area 1354 Cover§Asph/F GIs/Cmp ( Type None ( s Bed Style Ranch J Wall Plastered Rooms Bedrooms v Model Residential o Pine/Soft Wood Bath Floor Rooms 1 Full-0 Half 12 r . .. ...> Heat ..,� „...., Total Grade!Average Type Elec Baseboard Rooms 6 Rooms Stories 1�3 � Heat lectric %u�Found tone"Ftgs Fuel ation Gross[2842 Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 10/31/1996 New Siding 18975. $64,750 AM 1997 12:00:00 3 bldgs 6/1/1994 Demolish B36748 $0 AM5/199512:00:00 HY 1/15/199512:00:00 6/1/1994 Demolish B36740 $0 AM HY 12/1/1971 lCommercial B14590 $0 I I HY APTS. VisitHistory .. _....... ...•..•............................ .... .., ... ., .......... Date Who Purpose 6/17/2009 12:00:00 AM Jeff Rudziak In Office'Review , 3/27/2008 12:00:00 AM Michele Arigo Change of Address 7/30/2007 12:00:00 AM Karen Perry In Office Review 7/24/2007 12:00:00 AM Jeff Rudziak Abatement Review 5/15/1988 12:00:00 AM ME Meas/Est http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=2502.9 3/11/2019 Parcel Detail Page 3 of 5 Sales History Line Sale Date Owner Book/Page Sale Price 1 6/22/2001 HAJJAR, CHARLES C &ANNE T TRS C161932 $10 2 10/27/1998 SEA STREET APARTMENTS LLC C150605 $3,500,000 3 1/15/1996 SEA ST LTD PRTNRSHP C139493 $1 4 6/15/1972 GREEN, ALAN J I C55001 $0 Assessment History Save Year Building XE Value OB Value Land Value Total Parcel # Value Value 1 2019 $4,686,600 $2,400 $107,700 $563,800 $5,360,500 2 2018 $4,547,400 $2,400 $112,900 $563,800 $5,226,500 3 2017 $4,544,400 $2,300 $116,000 $563,800 $5,226,500 4 2016 $4,545,500 $2,300 $114,900 $563,800 $5,226,500 5 2015 $4,359,300 $2,600 $100,800. $322,200 $4,784,900 6 2014 $4,357,100 $0 $105,600 $322,200 $4,784,900 7 2013 $4,352,300 $0 $110,400 $322,200 $4,784,900 8 2012 $3,839,500 $0 $70,900 $322,200 $4,232,600 9 2011 $3,860,600 $0 $49,800 $322,200 $4,232,600 10 2010 $3,896,000 $0 $53,200 $322,200 $4,271,400 11 2009 $4,253,600 $0 $51,300 $238,800 $4,543,700 12 2008 $4,858,300 $0 $92,700 $261,300 $5,212,300 14 2007 $6,109,800 $0 $92,700 $261,300 $6,463,800 15 2006 $5,219,400 $0 $27,100 $287,000 $5,533,500 16 2005 $5,171,100 $0 $27,300 $2,705,300 $7,903,700 17 2004 $3,183,800 $0 $27,600 $1,179,200 $4,390,600 18 2003 $2,988,200 $0 $27,800 $593,200 $3,609,200 19 . 2002 $2,988,200 $0 $271800 $593,400 $3,609,400 20 2001 $2,988,200 $0 $27,800 $593,400 $3,609,400 21 2000 $1,841,800 $0 $27,300 $634,500 $2,503,600 22 1999 $1,841,800 $0 $25,400 $634,500 $2,501,700 23 1998 $1,841,800 $0 $25,400 $634,500 $2,501,700 24 1997 $2,496,100 $0 $0 $632,600 $3,128,700 25 1996 $2,496,100 $0 $0 $632,600 $3,128,700 26 1995 $2,496,1.00 $0 $0 $632,600 $3,128,700 27 1994 $2,263,900 $0 $0 $801,300 $3,065,200 28 1993 $2,263,900 $0 $0 $801,300 $3,065,200 29 1992 $2,174,900 $0 $0 $890,300 $3,065,200 30 1991 $1,811,400 $0 $0 $1,288,600 $3,100,000 31 1990 $4,080,400 $0 $0 $1,288,600 $5,405,200 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=25029 3/11/2019 f 4 46 p F a ux* �11 acroazwe a�i�,�r, �.` � � � y����vQ���V vCad \v�•��v���w�v�\v .� �.. It FM RZ IN \p \ Parcel Detail . . Page 5 of 5 2 k! \Z \ \ \\ 2 ^ ^» d~ ? � � � � � � . � � � • � � y . . . - , h#p://issql 2/int£anet/pro pdaa/Par celDet a!{as px?I D=25029 . � / 3/11/2§}9 41 ca _ 132 1 O� a QUITCLAIM DEED We,MARCOS C. MEIRA, and SILVIA F.MEIRA,of 42 Blueberry Hill Road,Barnstable (Hyannis),Massachusetts, in consideration of one dollar($1.00)7 grant to SAMILLE ROSSEGALE,of 67 Sea Street,Apartment 3C,Barnstable(Hyannis), Massachusetts, WITH QUITCLAIM COVENANTS all of our right,title,and interest in the land,together with the buildings thereon, situated in Barnstable(Hyannis),Barnstable County,Massachusetts,shown as LOT 6 on a plan of land entitled"'Blueberry Hill' Subdivision Plan of Land in Centerville-Hyannis-Barnstable,Mass.for,. ^-� Robert S.Elliott"dated June 18; 1964,. drawn by J.R.S. Charles N.Savery,Inc.,Registered . s Engineers, Surveyors,Cotuit,Falmouth,Cape Cod,which is duly recorded with the Barnstable County Registry of Deeds in Plan Book 187,Page 51. 7— conveyed subject to and together with the benefit all rights;reservations, The premises are veasements and restrictions of record,so far as the same are in force and applicable. 91 Grantors. release any and all homestead rights to the within- premises, whether created by declaration or operation of law, and further state under the pains and penalties of perjury that there are not other individuals entitled to homestead rights to the property being conveyed. For our title seethe Quitclaim Deed dated June 23;2006,and recorded with the Barnstable d County Registry of Deeds in Book 21137,Page 171,on June 28,2006. PROPERTY ADDRESS: 42 Blueberry Lane,Bamstable"(Hyannis),Barnstable County,MA. Executed..as a sealed instrument this day of 2017. arcos C. Meira Silvia F. Meira Page 1 of 2 L s� Bk .30886 Pg133: #57338- COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,SS On this day of 1�1! ; 20i 7, before me, the undersigned notary . public, personally appeared Marcos C. Meira; wh proved to me through satisfactory evidence of identification, which was Gv to be the person whose name' is signed on the preceding document, and acknowledged to me that he signed it voluntarily for its stated purpose. s Q �. N y.Public � y Commission Expires: , 2 23 v COMMONWEALTH OF MASSACHUSETTS r , BARNSTABLE,SS sl On this ��day of �U�� r2017 before me, the undersigned'notary public, personally appeared Silvia F. eira, who proved to me through satisfactory evidence of identification, which was , to be the person whose name As signed on the preceding document, and acknowledged to me that she signed it voluntarily for its stated purpose. Tl No Public 3 My Commission Expires: -ARN� ABLE REGISTRY 4F DEEDS John F. Meade, Register. Page 2 of 2 Town of Barnstable OF THE Tp� ` do Building Department Services B Brian Florence,CBO �Y4, f * swaxsrnaLE. • �✓�. v� MASS& g. Building Commissioner i639 �FB♦� ATFo 39 ° 200 Main e Street, Hyannis, MA 0260 ta ®� Z www.town.barnstable.maus wrv.v� ?®,9 Office: 508-862-4038 Fax 4,08-790-6230 F Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: MY name is Hum Oyo_ I am the owner/resident of the property located at: W Q �rl ` l f W ��: MAN 15 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: as Name &relationship to owner: NOW CNN - CN 7 HIV"�AW 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 Swo e ins and penalties of perjury this ILA day of 2019. n ` e Phone Number Print Name �VJ��0S ka q:forms/famaffid.doc rev 11/08/13 Town of Barnstable Building Department . Brian Florence, CBO &UMSTABt MAS&$ Building Commissioner U1(DIN(; s63q. ♦0 RFD► 200 Main Street,Hyannis, MA 02601 FEB 15 www.town.barnstable.maxs Z��� Office: 508-862-4038 TORN OFa�x4P 6230 Town of Bamstable 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: `I Name &relationship to owner: A�-- &` VycL— 0 tkW Name &relationship to owner: �"Ion�. T�' V I�Wbm— owct The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to un a a' penalties of perjury this C� day of �� ���'\ 2018. Si Phone Number Print Name q:forms/famaffi d.do c rev 11/22/2017 Town of Barnstable Regulatory Services of Richard V. Scali,-Director Building Division '"M,, Paul Roma,Building Commissioner 200 Main Street, Hyannis,MA 02601 _ 0 n www.town.barnstable.ma.us' Office: 508-862-4038 Fax: 5084U790-6230 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 .properly located at _ 4.1 �. 11 1 The following members of my family will'be the sole occupants of the Family Apartment at the aforementioned address: O�Name &relationship to owner: Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Aff davit annually with the Building Commissioner listing the names and relationship of occupants id 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 Apairtinent at this location;please-explain: = The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. } Other Sworn to i d ena 'es of perjury this ' ai� day of , .Uon 2017. Signature - w Phone Number Print Name ~ q:forms/famaffid.doc rev 11/08/12 Town of Barnstable Regulatory Services oFWE Richard V. Scali,Director Building Division ` �sABM ' Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs < /� �30 Office: 508-862-4038 ,y TOE m08-79%230 Nop 4®, Town of Barnstable family Apartment ent AffiXak' I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: ,q2 13 L U e &l;k y 1/44 -VOIM J4 VI; lyNI6 IY9xg 0.2601 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: JJR1►l PRO c9f. M :aErs 1 ire I eg —" Me b h e Name&relationship to owner:.s r i Ak i�e nl�e. �P C�°i)Tl IU i I-J 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 un a penalties of perjury this day of S 2016. , Signa - Phone Number Print Name• 'M P 2C0S ole I(�)4 q:forms/famaffid.doc rev 11/08/12 I. Town of Barnstable TME r Regulatory Services of �ti g rY o„ Richard V. Scali,Director BARNSPABLE, : Building Division MASS. 9�pr 1639 ,,�•� Thomas Perry, CBO,Building Commissioner Fn►,�r 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affiogvit I, being on oath, depose and state as follows: i Inn My name is COrCO S. L U V I`2 I am the owner/resident;f the property located at: Z, l� iV�L�U \f- Y" 11 14 I L L E VCA'-YIY\ k PA 4 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner:, i? V ► J' _)V'U. N e, Name & relationship to owner:2PA U r C.`q-`v\ l 'Y\, 1 �T W 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 r t e i and alties of perjury this day of 2015. Signature Phone Number Print Name GYCa S C. ,p q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services toyer Richard V. Scali,Interim Director Building Division TOW OF "INST SL E ssB Thomas Perry, CBO,Building Commissioner v t rN2'� PIi12 1 `bA i639 �• 200 Main Street Hyannis, MA 02601 =;11 `' `` TFO N1p`l A , www.town.barnstable.ma.us Office: 508-862-4038 DFiV�� Fax:-508 790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is M O rn HE-1 ro- I am the owner/resident of the property located at: , �jtlj e r h i�� koo o The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: ALU O LI V C I ro R f► w Name &relationship to owner: ivl4 1 � U f CQ i`�'1 Y111 e�h 5 i Q. 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;unrWeli enalties of perjury this -day of 2014. Sign a ' Phone Number Print Name Y'C05* `�' - q:forms/famaffid.doc rev 11/08/11 Town of Barnstable ` Regulatory,Services Thomas F. Geiler,Director TOWN OF R,�PSTA Building DivisionLE &U MSTABLE, ` Thomas Per CBO Building Commissioner, 9 M"Ss. '' ' g `13 F1 ! 9 . `bA 1639. A�• 200.Main Street, Hyannis,MA 02601 �n Mar www.town.barnstable.ma. s Office: 508-862-403840 t '60 Town of Barnstable Family Apartment Affidavit I, being.on oath, depose and state as follows: My name is � :��J �' Y�'"( 6 L I am-the owner/resident of the property located at: :�� Y✓ The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: E/ b n �o�'/ Q Name & relationship to owner: /�}�O n9 A R b N E L/4 5 1 ek 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.r I understand that l 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 240-4.7.1 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 ha�ntr rred to the Amnesty Program(Appeal.No. ) Other Sworn to d pen ties of perjury this, : �, day.of Fe �VA! 2013. 508^ 5. Signatur PhoneNumber 4. Print Name �• /Y/�/ q:forms/fain affid.do c rev l 1/08/11. , x Town of Barnstable Regulatory Services f oFt"E Thomas F. Geiler,Director T 0 Ott , Building Division MSTABIX ass. $ Thomas Perry, CBO,Building Commissioner rgi ] P 1 - 21 0,� 200 Main Street, Hyannis, MA 02661 www.town.barnstable.ma.us Office: 508-862-4038 DIVISIR x: 508-790-6230 Town of Barnstable Family Apartment Affidavit :I, being on oath, depose and state as follows: ' G 1'�Uur My name is I am the owner/resident of the _ property located at: ^I o2 t r The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner:' n Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately 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 fl andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No.- Other Sworn to under t 'e pa' s d? alti s perjury this day 'of �' 012. 44' Signature V, Phone Number Print Name Mate 1' 4: q:forms/famaffid.doc rev 11/08/11 :. Town of Barnstable Regulatory Services pt THE Thomas F. Geiler,Director F` L3f #} -L- Building Division ill i71 ` F ' � - 'M M sad Thomas Perry, CBO, Building Commissioner. ER -¢1_ l= 200 Main Street, Hyannis, MA 02601 ED MA'S - www.town.barnstable.ma.us . �`1:"". Office: 508-862-4038 - ' `� ",t 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: ILUAM �0110 Name & relationship to owner: a.,�3..y)Q. DD16) 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 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to 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 4een transferred'to,the Amnesty Program (Appeal No. ) Other Sworn a' s nd p nal ies of perjury this day oft -IM K 2011. S' Phone Number Print Name~ M Or Town of.Barnstable Regulatory Services oF1He toy, Thomas F.Geiler,Director '✓ti �Q "il at' t,i-P`U&E Building Division anxrrsrnaie, Tom Perry, Building Commissionerlgj.� ,; MASS.1163 . ��� 200 Main Street,Hyannis,MA 02601 . f tFD Mph p www.town.barnstable.ma.us i{}iN Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment artment Affidavit I, being on oath, depose and state as follows: My name is ICI ce) Co ( ro' G/ , I I I"v I amt e 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: e" TrvU c,, -- &t& r '�A` i n eav-] Name & relationship to owner: 5 Y�/� 1 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 notify the Building Commissioner immediately in the event of thesale 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 t n r an pe alties of perjury this a�rC4( day of AbW 2010. 1 . Sig at Phone Number Print Na w�.C/ V ►l e Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services , oF'THE TWy Thomas F. Geiler,Director Toy ,OF �l7 Building Division sa v Mass AN Tom Perry, Building Commissioner ji_, 19 0 1639• 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us t fa33= T Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: MR �My name is R tz � I r//J 6: I am the owner/resident of the property located at: (��°,b� I� L The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: C.Ie/_f0 A/ 4AV I'O f19R 16 - lAdyeiq -I IV ] A VJ Name & relationship to owner: ivjfi C IS-fl W� CLO, l a-4RLLI The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: .The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sw to r e aLdpenalties of perjury this �h day of L 200#q A. Phone Number Print Name Q/bldg/forms/famaffid Rev:l/03 Town of Barnstable Regulatory Services' FTMEYti Thomas F.Geiler,Director Building Division BARNSTABLE, Tom Perry, Building Commissioner 9 MASS. �► Q� 039. 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790=6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I ox C, I am the owner/resident of the propertylocated at: The following members of my family will be the sole occupants of the Family IV rtment� the aforementioned address: cnl co Name & relationship to owner: Name & relationship`to owner: d-9� C �T The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 1 understand that no subletting or.subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names a�7d 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 dis antled. The apartment has been try ed ao the Amnesty Program (Appeal No. ) Other Sworn to e nd'I enaltie of perjury this day of .. 2009. W AN Si Phone Number ro,Print Name ff05 Q/bldg/forms/famaffid,. , Rev:12/08 .-Town of Barnstable Regulatory Services pF1HE Top, Thomas F.Geiler,Director.` Wk 1^l= o 10'11t,l: 30 Building Division i Y ' Tom Perry, Building Commisisione B 19 - �` 23 y asa . MASS. � �A 1639• 200 Main Street,Hyannis,MA 02601 lFD A1A�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 MA R45 � � I am the owner/resident of the r 9 property located at: �� Vie &'rrk/ f 41 l L WJ6 A 0�s The following members of my family will be the sole occupants of the Family Apartment at the . aforementioned address: S 6 Name & relationship to owner: )1 e y Name & relationship to owner: 5f 1'YV A YVD0 �' 1�eiVt�PJSf 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. y I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal.No. ) Other Sworn to under the pains and penalties of perjury this day of 2008. Sin Phone Number Print Name � � l Q/bldg/forms/famaffid Rev:1/03 Bn; 2!-:e2.6 P 248 "701 ems-des 0,FTHE T Town of Barnstable Regulatory Services BAMSTABLE, : Thomas F.Geiler,Director yip MAS S. `�� , f0 AAA'1 A Building Division 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 42 BLUEBERRY HILL ROAD in HYANNIS, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book J Page 1-71 or as Document No. , being shown on Assessors' Map 249 as Parcel 068,.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 NEULI MENDES, SISTER, AND FERNANDO MENDES, NEPHEW, OF OWNER, MARCOS MEIRA, 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. lf WITNESS our hands and seals this `e day of f � TOWN OF BARNSTABLE OW ER By: ding Commissioner/ THE COMMONWEALTH OF. ASSACHUSETT BARNSTABLE COUNTY, SS Date J J Then.personally appeared the above-named (owner), /A LLr—QS C. �C//�; 1 and made oath as to the,truth of the foregoing instrument, before me. Notary.Public , My Commission _:..a .�. GUSTAV e uPES CORREA SANTOS w.... . �1. Nolary Public, OMMONWEALTH OF MASSACHUSETTS H W Corrxnission Expires LP January 17,2014 FalmouthR&130 �f ��� A.�ri ����4, F y a @ r . P E a < , G, r a •r G { - . r 4 fxy " r L` . a g & ^ n" �a t a i - x ` p ti •, n " "y'F'-a. � -. G #,r:,f` ',�" 'uyEsr` F O& 1nfW O o e t , ado` t ' wo F �z`` F� -: r-, K :+�. + ..n "• y11 `�a ok w,,zs§ . nd An rd .' - "' ," z.r m4 a rZZ Nr V, .� ID ,• F§ z{' �' _ w �z s ,a--�,n L1,gt' 0 `" a` $ IT � I 4n ,s c �t•v pa mr,„ • a «� ,v� h s �, a� �t �-, `�, _rix�Y$�"' tP �"�• �• '.tg,�y��' + � r�5' z �3 :mod a kkch` '��' 'y,'v^ '` fi ,' x3. "e ♦w g Y: �, say ^• � �� 1al A,4 as Pa•n� a xi xr " fix sft , , �« TTN x.. r bS + e•von' •; ter" s i 'd`=' S'r .', '°�,",' • + `•t3" -• 3. F'dF� ,,1' _ a^X''n0 `8n ift # ,.„t' t�`Sd 3,+ 5 x: a`^F#r4 'a �,r '�v'.m;' 2 �'5 :.•; r ° E vv r .E it 4`"1 " '�',fi, w`na. r to-'4 '�' •W" y. ` 4, s ;� a �ws *xA sw a k # ' c#c ;� � ° 71 Owl `� u`" ar+ta , s'P w€ � ar',.4 * ds �'' d %, -`d g g .� l .:mA' {• � + L �'+'�'�d.F�� F €'�i G'1'J'��.b,1,Y�'xs4'�� i ^�� A%'V�� '� ice' L� P „ s d s Nlt t V All � '�''•: Via,"?�"OT' his ' tmw,101 t vsu ���.� yxir � r # F kop A a{ � ''+�- z ,h+" " ''�`+ a art s1.Fy,,., ^,r, 'RY.iS&��p K `L� #�� €E 4�` Vist �r�•x�' ,_"rfi 2 �. "E°� 'is & �� `�,� ' `.�' rY k 'J° �• - 3 "hm r y 4 ALI E re g� + y e s-. s "t .,w^&°.. ..F, w• rk.,, t.€ �7- 4 lgy?^? " f YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you do b M.G.L.-it does not give you permission to operate. ou must first obtain the necessary signatures on this form at 200 Main St., Hyannis. must9 y P . . y Certificate that is Take the completed form to the Town Clerk's Oft. ice, 1st Fl., 367 Main St., Hyannis; MA 02601. (Town Hall) and get the Business Certl i required by law. ff11 ( DATE: `1 �°�' Fill in please: ^:ail;tr,c; 6F;t APPLICANT'S. . YOUR NAME QUS NESS YOUR HOME ADDRESS: � TELEPHONE # Ho e Tele ne umber i�cg aH �— E-MAIL: W Cl ICE �S OS L N 0�F�I� C0K E I N #: NAME OF CORPORATION: NAME OF-NEW BUSINESS TYPE OF BUSINESS 15 THIS A HOME OCCUPATION? YES " NO / ADDRESS OF BUSINESS. . �1 Q 2 h MAP/PARCEL NUMBER-0 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regul'ations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO O�in St. (corner of Yarmouth 'Rd. & Main Street)-to make sure yo.0 have the appropriate permits and licenses required to legally operate your business In is town. �. BUILDING COM SIO ER'S OF F CE MUST COMPLY WITH HOME OCCUPATION This iridividua h e info , e of an per i e uire erits that pertain to this type of businatLES AND REGUL.ATIOt`IS. FAILURE TO CQ"PL.`! M/,Y RESULT IN FINES.. 0 MENTS t on Si n * L r)I lit G(3ofnwn �'� y 2. BOARD O EAL H This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** . COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHQRJTY) This individual has been informed of the licensing requirements that.pertain to this type of business. Authorized Signature** COMMENTS: . . • Z Hum sou firankc 6 N u LO-O A-km "q ho"t aS om O i o SiN�S t 1 a k USl NV . URA a Lease S .gin e N o�r�►s , � 1 . Si �a WUM�;� �s -+ • f • • SCALA AUTO CENTER 93 THORNTON DRIVE HYANNIS.MA 02601 508-360-0667 774-470-1400 J' Town of Barnstable Regulatory Services - OFSHE Tp� • _ _ o Richard V. Scali,Director r Building Division s63q - 16 g Paul Roma,Building Commissioner . �0 �j°rFo µKl a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:. 508-790-6230 Approved: _ Fee Permit#: HOME OCCUPATION REGISTRATION Date WNW ` Name: �i W J �' "1 Phone#: (bob)�V O �1 J Address: Village:CV Name of Business: �VW V'v U Il. 'J 1 Ili 1�1� 1 J� J Type of Business: �V 1 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 sdch 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 are no commercial vehicles"related to the Customary Home'Occupation,other than one van or one pick-up truck not to exceed one tan 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 f included • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling twit . r_ .I,the undersigned,have read agr with the above restrictions for my home occupation I am registering. Applicant D I Date: Homeoc.doc Rev.06/20/16 o�6113 Town of Barnstable *Permit# Expires 6 nths from issue date Regulatory Services Fee v� + BAFIWASL&. MASS. � 16 Thomas F.Geiler,Director 39• ♦� prED MAy� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-7.90-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 1 e 0 Not Valid without Red X-Press Imprint Map/parcel Number - .Property Address qj r 1 ll, t Nj,RHidential:..' Value of Work$ 5,©00.00 Minimum fee of$35.00 or w r under$6000.00 Owner's:Name-&Address M UO3S W Q1�br0 `�Q .C►�i rQ. Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable)❑Workman's Compensation Insurance_ X-PRESS PER IT eck one: I am a sole proprietor AUG z�1� 14R F1 I am the Homeowner " 2 ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. - l Permit Request(check box) _ Re-roof(hurricane nailed)(stripping old shingles) All c� onstruction debris w-ill_be__taken to 3arVS-Mle __` ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits require . *Where required: Issuance of this permit does not exempt co li other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property er m t s' Pr a Owner Letter of Permission. A cop of the H e ent ntractors License&Construction Supervisors License is req SIGNATURE:��- Q:\WPFILES\FORMS\buildin PRE o XSS.do Revised 061313 114 The Commonwealth of Massachusetts Department of lndus&ial Accidents 09we of Imestigadons 600 Washington,Street Boston, VIA 02111 nwm mamgov1dia Workers' Compensation Insurance Affidavit Baders/Gontr2cturslEElectricians/Ph tubers Applicant Information Please Print Lezibly Name Address. Ct-�I h�C� row City/State./Zip: o w)k S M 'Od-60 I Phone Are you an employer?Check the appropriate box: Type of project(required: I.❑ I am a employer with I am.a general contractor and I 6_ El New camsttsflu employees(full anidlor part-time).* have hired the sub-contractors 2.❑ I am.a sole proprietor or-partner- listed on the attached sheet. y- ❑Remodeling sbip and have no employees These sub-contractors have g- ❑Demolition working for me in any capacity_ employees and have wwkers' [No workers' comp.insurance comp-inn anml 9. El Building addition 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 11.❑Plumbing repairs or additions s- myself o workers' right of exemption per MGL comp. 152, 1 d and we have no 12..❑Roof repairs insurancec. insu rance required.]T § ( �' 13.❑Other employees.[No workers' j comp-insurance required_] •may apPticanr that checks boa#1 xzm also fill out the section below showi�ngthea wosgexe ca�sadon pohc9 inImmmtion. Ha W=1 wlm submit this affidxvir indicating they era doing aD wo*aod then ham outside conuwwrs nmsx submit a new affidzvk indicating such_ ICoauactors that C heck this boa must gttached an additional slant ehowmg the mane of the sub-cmaxMrs and state whmthu anon ftse entities ham employees. If the subtantaimrs ham employees;fhey must pwvide their worker'comp.policy number. I am an emptier that is providing workers'compensation insurance for my en yAou was. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.:Uc.#: Expiration Date: Job Site Address: City/State/zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number.and expiration date). Failure to secure coverage as required under Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. J3e advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA far co an I do hereby carhfy un a nd apies irry that the informa&n provided abatis is bw and correct Si r-- Date: one, Official use only.. Do not write in this area,to be by city or town.official City or Town: PermitJLicense# Issuing Authority(circle one): 1.Board of Health 2.Ong Department 3.City/raven Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 ?' 'ME Town of Barnstable Regulatory Services s Thomas F. Geiler,Director i639. 10 '�►�r►+' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable-ma.us . f Office: 508-862-4038 Fax 508-790-6230 Property Owner Must.., Complete and p Sign This,Section If Using A Builder' L r ,as Owner of the subject property hereby authorize !/ to act on toY behalf, , in all tnattets relative to work authorized by this building permit A (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be fille&br utilized before fence is installed and all final inspections are performed and accepted. Signature ofrOwner Signature of Applicant .. Print Name Print Natne De QTORM&OWNERPERMISSIONPOOLS 62012 Town of Barnstable Regulatory Services nAzMASSsr.�. ' Thomas F.Geiler,Director Building Division, Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:. U �J 1 J 8 h 1` JOB LOCATION: U U err h ��- o i s number St=t village "HOMEOWNER": Marcos M Qi ro 508 815 4q� name ,i home phone# work phone# CURRENT MAILING ADDRESS: 5 oM� city/town ' - - state zip code, ' The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules ations. i The si meo 'certifies that he/she understands the Town of Barnstable Building Department minimum inspection proc d req ' e and that he/she will comply with said procedures and requirements. Si a ofHomeo er F ,^ App 0 uildm O Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Contiol HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors)-,provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming.the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\E.2RESS.doc Revised 053012 ' Town of Barnstable '11HE ,.� Regulatory Services Thomas F. Geiler,Director " „,�`� ' Building Division �ArEn �a`� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# i3 a FEE: $ SHED REGISTRATION RESIDENTIAL ONLY _ 200 square feet or less '*' co L�Q, � 1 hid a d�'NNis Locaf shed'(addr ss) Vi g zzl a Qre®S b&6 fie. Mega. bob B MI Property o ner's na Telephone_numbe�r'' ; w ION X ws dMo 68 Size-of-S Map/Parceh# K tore; Date Hyannis a aterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission.(signature is required) r-Sign-off hoursafor Conservation 8:00=930&3:30�4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:052813 MLS Page 1 of 3 Listing Summary Listing #20901165 42 Blueberry Hill Rd, Hyannis, MA 02601 * 13 Active (02/08/09) DOM/CDOM:414 $269,000 (LP) Beds: 4 Baths: 2 (2 0) (FH) Sq Ft: 1408* Lot Sz: 20037sgft* Town: Barn Yr: 1966* Remarks Very Spacious home. Located on a Picture Report Listing Violationk�\ corner lot this raised Ranch has 2 fireplaces, separate dining room, and an additional 1000 sf of living space on the lower Ievel.Central location, convenient y�� -,,, • ., ` to shopping, local beaches and ` # . :y� entertainment. Short Sale. Subject toA} "A G lender's approval. Additional Pictures F` 3 Pictures(9) See Map Agent Lori A DeSousa (ID:U3896)Primary:508-360-6816 Office Keller Williams Realty(ID:KELW)Phone:508-534-7200,FAX:508-771-8188 Property Type .Single Family Property Subtype(s) Single Family Status Active(02/08/09),. Town Barnstable Commission Sub Agent Comm. Buyer Agent Comm. Dual Agent Comm. Dual Var Comm 0% 3% 6% No Facilitator Comm 3% Listing Type Excl. Right to Sell Owner Name Samile Rossegale County Barnstable Tax ID 249-68-0-0-BARN Beds 4 Baths (FH) 2(2 0) Approx Square Feet 1408* Sq Ft Source Assessors Records Lot Sq Ft(approx) 20037* Lot Acres(approx) 0.460 Lot Size Source (Assessors Records) Year Built 1966* Listing Date 02/08/09 All Office Remarks Note:Sale is subject to lender's approval.Final commission is to be split 50/50 with cooperating broker as negotiated with lender's final approval. Directions to Property Route 28 to Strawberry Hill Road to Blueberry Hill Rd. Listing Page Commission-Other 0 Showing Instructions Appointment Req.,Call Listing Agent General Page Zoning Res School District Barnstable Year Built Desc. Actual Total Rooms 6 Total Levels 2.0 Basement Baths 0.0 Level 1 Baths 0.0 http://ccimls.rapmls.com/scriots/mgrqispi.dll 2/12/2009 i MLS Page 2 of 3 Level 2 Baths 0.0 Level 3 Baths 0.0 Basement Yes Basement Description Finished,Full, Interior Access,Walk Out Foundation Concrete Foundation Width 48 Foundation Depth 25 Fndation Wing Width 0 Fndation Wing Depth 0 Irregular No Lot Depth 0 Lot Width 0 Topography/Lot Desc. Cleared,Corner,Level Association No Annual Assoc.Fee $0 Assoc.Fee Year 0 Garage No #of Cars #0 Year Round Yes Separate Living Qtrs No Waterfront No Water View No Convenient To Golf Course,House of Worship,Major Highway,Medical Facility,School,Shopping Miles to Beach 1 to 2 Water Access Beach, Lake/Pond Beach Description Ocean Beach Ownership Public Street Description Paved,Public Interior Page Fireplace Yes Number of Fireplaces #2 Master Bedroom OxO Level: First Floor Bedroom#2 OxO Level:First Floor Dining Room OxO Level:First Floor Other Room 3 OxO Level:Basement Other Room 3 Type Den Other Rm 3 Features Fireplace. Floors Hardwood,Tile,Vinyl,Wall to Wall Carpet Exterior Style Raised Ranch / Pool No Dock No Energy Saving Feat Insulated Windows Exterior Features Deck Roof Description Asphalt Siding Description Shingle Mechanical Heating/Cooling 3+Zone Heat,Natural Gas, Hot Water Water/Sewer/Utility Septic,Gas,Telephone,Town Water Hot Water/Water Heat Natural Gas Legal/Tax Annual Tax $2418 Tax Year 2009 Land Assessments $171900 Improvement Asmt $149600 Other Assessments ' $23700 Total Assessments $345200 Annual Betterment $0.00 Unpaid Betterment $0.00 To Be Assessed Unknown Mass Use Code 101-Single Family Title Reference-Book 21137 Title Reference-Page 171 Land Court Cert# 18051 http://ceimis.rapmis.com/scripts/mgrqispi.dll 2/12/2009 MLS Page 3 of 3 Underground Fuel Tnk No Lead Paint Unknown Asbestos Unknown Flood Zone Unknown The listing contract has not yet been validated by MLS Staff. Denotes information autofilled from tax records. Information has not been verified,is not guaranteed,and is subject to change.Copyright Year—Cape Cod&Islands Multiple Listing Service,Inc.All rights reserved Copyright 02009 Rapattoni Corporation.All rights reserved. Generated:2/12/09 11:18am POWERED B'Y http://ccimis.rapmis.com/scripts/mgrgispi.dll 2/12/2009 Sol 0 } 4 P t- .l iAl ` xI a w � v I I� Town of Barnstable.., Building Department Brian Florence,CBO Building Commissioner 200 Main.Street,.Hyannis,MA 02601 www.town.bamstable.ma.us Pre-application for Business Certificate Date Map Parcel Applicant Information _ Applicants Name Applicants Address -I o2 ��(/� Pii'r �/ Y // Gi=Y1�'1 0.26v � � l� � I. off Email Address O I,A�B' Jam G r o & .g q ��noy' '�Ir►: , . Telephone Number 2 SO SS y Listed ❑ Unlisted (] Business Information New Business? No --------------=------------------= ----� . Business is aregistered corporation?. ------------------ -- --. YesISO If yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? -------_ es ,,. Na If yes then a Home Occupation Registration is required See Building Division Staff Name of Business 1<14A�14 W/�/s 7/�U G �/y s jF k V1 G _5 Business Address !i f ✓ O Type of Business �.9i'?!'' ►�✓G f��6ah Building Commissioner Office Use Only Conditions , Building.Commissioner Date Clerk Office Use Only Town of Barnstable Building Department DFTHE Tp� o Brian Florence,CBp Building Commissioner BARNSTABLE, ► 200 Main Street,Hyannis,MA 02601 MASS. �esv� www.town.barnsiable.nia.us v Office: 508-862-4038 Fax: 508'790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: l/ Name: Phone#: _ 5 v 8— v�Se Address: 3 bar H' /�� Ld Village: rp1r Name of Business: �� CA14 S tr C t/P 71 SA- ill ex- Type of Business: Lon I-t,-r/G`61 12n 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 axesidential 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 are 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 abusiness,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., 1,the undersigned,have read and agree with the above restrictions for my home occupation I.am registering. Applicant: l/a- Date: 03 Homeoc.doc Rev. 10/17 IF TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �' Parcel Application Health Division Date Issued �0 oZ Conservation Division Application Fee 14P Tax Collector Permit Fee -5� Treasurer d V Planning Dept. Date Definitive Plan Approved by Planning Board , Historic-OKH Preservation/Hyannis Project Street Address ` Village d C(AA Owner �� /�l�l Address Telephone � V Permit Request "7�_� iv Uon aN aikAa Square feet: 1 st floor:existing proposed 2nd floor:existing proposed 1 Total new, Zoning District Flood Plain Groundwater Overlay a Project Valuati 4;_C�'0 Construction Type vb Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting ocumee!�tion. o r -._j M Dwellin Type: Single Family Two Family ❑ Multi-Family(#units) Age of Exis ing Stru ure 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 p Total Room Count(not including baths):existing new 1 ,L First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing' ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use f Proposed Use t 1 BUILDER INFORMATION N_ame—cN MOS �' �� �1r1�, Telephone Number Q l I 1 r 5�� Address j V4 1�� License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION CD -REJ17NROM THIS PROJECT WILL BE TAKEN TO SIGNATURE- �D�A_E FOR OFFICIAL USE ONLY , APPLICATION# DATE ISSUED MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 'GAS: ROUGH FINAL FINAL BUILDING s' DATE CLOSED OUT ASSOCIATION PLAN NO. .t i oFIMEr�w. Town of Barnstable Regulatory.Services tnantsresre, : Thomas F. Geiler,Director Ar s MASS. p,�� Building Division FD r+AA'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ------------------- HOMEOWNER LICENSE EXEMPTION o� ��� I�� Please Print ` (DATE* y ' (� ii '10 y ' OB LOCATION: 4� �h V elb nunmbeer(� C ( street ` village L HOMEOWNER": name home phone# work phone# URRENT MAILING ADDRESS: /f city/town state zip code _he-c�urrreent/exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"ho T.rithat he/she understands the Town of Barrtstable.Building Department. minimum inspe r cuirements and that he/she will comply with said procedures and requirements. Signatur meo er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, articular) P particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certification for use in your community. Q:forms:homeexempt �oEIME, ti 'Town of Barnstable regulatory Services BAMSTABLF4 ' Thomas F.Geiler,Director Building Division prf0 MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 509-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more thaw 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. ,,,II innType of Work: � r t�W IaU mom,om, Estimated Cost Address of Work: Owner's Name: I�QxC� Date of Application:�O� I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 OBuilding not owner-occupied [,Owmr pul�.ing oV�upermit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. LO,610J Date' caner' me Q:f0=1omeaffidav • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington.Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information oo Please Print Legibly . Name(Business/Organization/Individual): uco C. C,e r Address: �0'. L'eity/State/Zip: Phone.#: Are you an employer?Check the appropriate box: Type of project(required):, 1.❑ 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 g. ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑Building addition [No workers' comp,insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions f3:,CR I am a homeowner doing all work officers have exercised their 1 L FI Plumbing repairs or additions ! myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs l� insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other Comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $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 and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as re uired 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- a imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a da g ' t olator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of f r' a coverage verification. I do hereby cer d r pa a enalties of perjury that the information provided abov .is true atA corr t. Si ature: Date: D _ Phone#: Offic' se oft4 7D�onor' n this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of con�l auce with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-72.7-4900 ext 406 or 1-977-MASSAFE Fax 4 617-727-77499 Revised I1-22-06 www.mass.gov/dia ' L r SSE' Z7L r s210i,�S i 1 b�d ' V `,12� 00 IV41 jr L� �v � l rl f � cl tyM .ri.'•is g 3 -Vi I lT ecl t `.� - ! ✓Ci rl�Y ��„r�sE•,Sr7 1 tEt ;t- ,�t .} -- V� 17/ .J k: � mL .,• •, t t • .•C�O..`a.�n� t � z I y �s :t. . .., t'r sa �`: titj' -1�_-!�t� �'iy�iiY�aS 'Y �,y:"!' t5 t i,I1,fIFt,Gt Sfi4..-;l•3' t f)t{(.s.}. S,•�f:#}`.�-_t/�1 'stJ:r.4 1a '1.�ES / r Driving Directions from 42 Blueberry Hill Rd, Hyannis,MA to Brazil Consulate General,... Page 1 of 4 L_. 1: Start out going SOUTHWEST on BLUEBERRY,HILL RD toward BLACKBERRY LN.<0.1_miles 0EEEEHEEP162ft54m W � dlid ( 2 h' i'e T7•t Gt:noQucea.Inr: �02007 NAVTEQ 3 O2: Turn RIGHT onto STRAWBERRY HILL RD. 0.1 miles © � 0�275ft .28 wy N. �t�mod` ti Sri - *I 7.7L•t Li::aQna�a.Ins: ..'O 02007N'AVTEn O3: Stay STRAIGHT to go onto WEQUAQUET LN. 0.3 miles 0 o�2oorn .n t .S}�.r� �Y . �r• .: tc :•7•;=•t t t x:rQuae:l.inc: 02007 N-AVTEO O4: Turn SLIGHT RIGHT onto PHINNEY'S LN/PHINNEYS LN. 1.1 miles (.ap[rnr ;iorc t �. 504rn PNyes Peek Rd Allyd ti 2M ttanQ:.1e;t,hr^ 02007NAVTEO O5: Turn LEFT onto MA-132/IYANNOUGH RD. 1.4 miles I L http://www.mapquest.com/directions/main.adp?do=nw&go=l&r=f&aoh=&aot=&aof--&1... 6/26/2007 -1-e • ^ I z 7,� t, c: ,4 Rt - VIS V! ^ f 1 �- ��. �� � S -- I � � �, o `� � � D _ � � , � _ „ - �� ,� � � � � ;. `�.? �� �� ��� �O O� �ijj � .` 5, >- i a �-- i �� � i �� �� � l ] it rt _ r... � � cl C� h �, �j, � � oo � � '� � � ,� , . r; . . .. .*r .. ..♦ ., .. a rN i�"''-,'�;.,i�_'y �"'{; ''a. ."H'+r�N-;5.,-,-wi,i?r..�'.-'» ••P .:ijy, .°'a,:�.,,.,,.�.a f .,. TOWN OF BARNSTABLE BUILDING PERMIT•APPL_ICATION;- Map Parcel ,Application# an Zq Health Division Date Issued // 0 Conservation Division Application Fe Tax Collector Permit Fee d ' Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address , Village Vl S Owner /// 4�(,�� ///�/ Address t-14 C Telephone 9 '- Permit Request 0.6 r Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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) 4 Number of Baths: Full:existing new Half:existing t new Number of Bedrooms: existing new w v, Total Room Count(not including baths):existing new First Floor Room ount 4' Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other iv r" Central Air: ❑Yes ❑No Fireplaces: Existing New Existing'wood/coal st ve: ❑Yes ❑ No Detached garage:❑existing t❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review,# _ Current Use Proposed Use BUILDER INFORMATION Name �aw S ��r� Telephone Number Address 'd�� ».4��=r�� �� �`1� License# � J Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION EB S-RESALTING�FROM THIS PROJECT WILL BE TAKEN TO SIG -01RE %"/,1� "��.. DATE E Z;Z g�� [ FOR OFFICIAL USE ONLY t. APPLICATION# z DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE -;? ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL in r. FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. r - Bk ?'526 Pam`—48 0_70146 �1HE r Town of Barnstable Regulatory Services F.F aARNSI'AaLE, Thomas: Gei ler,Director 039. .0� g Buildin Division teo rye+° 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 42 BLUEBERRY HILL ROAD in HYANNIS, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book'Q J 2 7 , Page 1-7 , or as Document No. , being shown on Assessors' Map 249 as Parcel 068, 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.NEULI MENDES, SISTER, AND FERNANDO MENDES, NEPHEW, OF OWNER, MARCOS MEIRA,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 �� day of l — TOWN OF BARNSTABLE OW ER By: ding CommissionetASSACHUSETT _ THE COMMONWEALTH OF BARNSTABLE COUNTY, SS Date Then personally appeared the above-named (owner), / -Aa-CAS .� 1 /� I1A and made oath as to the truth of the foregoing instrument, before me. • (;,U SSA UlJ A JIB S Notary Public My Commission GUSTAV,--�rES CORREA SANMS ��_ >,♦�` Nolary Public "r: +• t OMMONWEAITH OF MASSACHUSETTS My Corruninim Ewes d January 17,2014 FalmouthRd14130 h p 3 W OD m 3!c T r ram' �YF-772 77�3-j ,. t, l . oFtr Town of Barnstable s Regulatory Services BAMSrnsi.e. „� Thomas F. Geiler,Director i639• 10 ArEDMA'�A 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 a January 15, 2008 Marcos Meira 42 Blueberry Hill Road Hyannis,MA 02601 Dear Mr. Meira: Enclosed is the Certificate of Occupancy for your family apartment. Sincerely, Lois Barry Division Assistant Enclosure faco Town of Barnstable Building Department - 200 Main Street EARMSTABLE, * Hyannis, MA 02601 MASS 1639. . (508) 862-4038 rF0 MA'i A Certif icate of Occupancy Application Number: 200704829 CO Number: 20080008 Parcel ID: 249068 CO Issue Date: 01/09108 Location: 42 BLUEBERRY HILL ROAD Zoning Classification: RESIDENCE D-1 DISTRICT Village: HYANNIS Gen Contractor: PROPERTY OWNER Permit Type: RC00 Qw CERTIFICATE OF OCCUPANCY RES , Comments: FAMILY APT ISSUED TO MARCOS MEIRA FOR NEULI MENDES, SISTER + SON © 0 Building Department Signature Date Signed IKEl , TOWN OF BARNSTABLE Building Application Ref: 200704829* aAxlvsTASLE, Issue Date: 12/11/07 Permit y MASS. $prFO 3NI9. A�� Applicant: GAMMONS,JOHN H Permit Number: B 20073053 Proposed Use: SINGLE FAMILY HOME Expiration Date: 06/09/08 Location 42 BLUEBERRY HILL ROAD Zoning District. RD-1 Permit Type: FAMILY APT W/NO CONST Map Parcel 249068 Permit Fee$ 25.00 Contractor PROPERTY OWNER Village HYANNIS App Fee$ License Num Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND FAMILY APARTMENT FOR NEULI MENDES SISTER AND THIS CARD MUST BE KEPT POSTED UNTIL FINAL FERNANDO MENDES NEPHEW INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: GAMMONS,JOHN H BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 42 BLUEBERRY HILL RD INSPECTION HAS BE ADE. HYANNIS, MA 02601 Application Entered by: LB Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET;ALLY OR SIDEWALK OR ANYP,ART THEREOF,EI I THER I TEMPORARILYORPEFXANENTLY.- ENCROACH EMENTSYON PUBLIC PROPERTY;.NOT SPBCIFICALLY:PERMITTED UNDER THE BUILDING CODE;MUST,BE APPROVED BY T14E JURISDICTION. STREET ORAL LYGRADES'AS WELL AS DEPTH AND.LOCATION OF PUBLIC,SEWERS MAY BE,OBTAINED FROM THEDEPARTMENT OF PUBLIC`WORKS: THE ISSUANCE OF;THIS PERMIT'DOES NOT RELEASE THE.APPLICANT FROM THE CONDITIONS OF'ANX 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.I42A). .A�✓r kF�`d'gz„ro�`r". `�,.-.. ;:"'r r'','�. `" -'"ee ., x _ t t , �"'r .. �F. �E 1W.110a 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 Barnstable Assessing Search Results Page 1 of 3 Home: Departments:Assessors Division: Property Assessment Search Results New Search New Interactive Maps >> Owner: 2007 Assessed Values: ROSSEGALE, SAMILE ET AL 42 BLUEBERRY HILL ROAD Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $ 148,800 $ 148,800 249./068/ Extra Features: $23,000 $23,000 Outbuildings: $700 $700 Mailing Address Land Value: $ 171,900 $ 171,900 ROSSEGALE,SAMILE ET AL Totals $344,400 $344,400 42 BLUEBERRY HILL RD HYANNIS, MA. 02601 2007 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $45.31 Fire District Rates Town Barnstable-All Classes $2.10 $6.32 C.O.M.M.-All Classes $1.03 Commei Hyannis FD Tax(Residential) $530.38 Cotuit FD-All Classes $1.34 $5.57 Hyannis-Residential $1.54 Persona Town Tax(Residential) $ 1,510.30 Hyannis-Commercial $2.37 $5.57 Hyannis-Personal $2.37 Other R: W Barnstable-Residential $2.02 Commur W Barnstable-Commercial $1.69 W Barnstable-Personal $1.69 Total: $2,085.99 Construction Details Building Pro erty Sketch & ASI Property Sketch Legnd Building value $ 148,800 Interior Floors Carpet Style Raised Ranch Interior Walls Drywall Model Residential Heat Fuel Gas Grade Average Heat Type Hot Water Stories 1 Story AC Type None http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO7map.asp?mappar=24... 7/24/2007 Barnstable Assessing Search Results Page 2 of 3 h Exterior Walls Asbest Shingle Bedrooms 3 Bedrooms Roof Structure Gable/Hip Bathrooms 2 Full rK , Roof Cover Asph/F GIs/Cmp living area 1408 } � Replacement Cost $177177 Year Built 1966 3 Depreciation 16 Total Rooms 5 Rooms Land 3 CODE 1010y'' 1 Lot Size(Acres) 0.46 Appraised Value $ 171,900 AsBuilt Card N/A Assessed Value $ 171,900 View Interactive Maps > Sales History: Owner: Sale Date Book/Page: Sale Price: ROSSEGALE, SAMILE ET AL Jun 28 2006 12:OOAM 21137/171 $358,000 MIRANDA, CLAUDINEI A Jan 20 2006 12:OOAM 20672/026 $325,000 GAMMONS,JOHN H 3334/178 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value SHED Shed 112 $700 $700 BLA Bsmt Liv-Aver 780 $ 16,400 $ 16,400 BGAR Bsmt Garage 1 $3,400 $3,400 FPL1 Fireplace 1 $2,500 $2,500 FPO Ext FP Opening 1 $700 $700 'P'r®perty 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 UST Utility Area(Unfinished) (Finished) 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) http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO7map.asp?mappar=24... 7/24/2007 Map Page 1 of 1 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size Zoom out In y r F le�-1 f+ F*5 JPG Map: 249 L .a t�, 2D08 Location: 2 003: 25D 3 t12 Owner: I ocatior In ` 248DP9 N_ Map &Parce to w � Location Acreage T yN. 726 !Current ®rty " Mailing Addi rx & r, 7>f 42 r AppraisedExtra Featur 32 Out Building Y Y Land PON w, Buildings 249U86 J� era, Total Apprai we,4-15 aw f ASse Extra Featur Out Building Land art 3t � Buildings Total Assess Set Scale 1" = 79 I Apnl 1995 Copyright 2005 Town of Barnstable,MA All rights reserved.Send questions or comment: BarnstableMA vO.2.91 [Production] http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=249068&map... 7/24/2007 AssissorAffice '(,1st floor)::'• �. �• /q O SYSTEM MUST THE T As+�essor's map.and ,lot number .... ................ ...................�.. SEPTIC � COMPLIANCE w�Qyo� ' oho Board of Health (3rd floor): a,K �, INSTALLED IN Sewage Permit. number ........:............................................... WITH TITLE 5 = BA"STSDLE, Engineering'Department 3rd floor):` } E VIRONMENTAL CODE AND 90o Me 9 House number ...... F. Z. :....................... IiI TOWN RE W-ATKN`JS Jul APPLICATIONS PROCESSED 8:30=9:30 A.M. and, 1:00.2:00 P.M. only, TOWN:, OF BARNSTABLE BVILDIHG IHS'PECTOR APPLICATION FOR PERMIT TO ................Zete . ....... .. . . ... ................................................................. TYPE OF CONSTRUCTION ......... ..� L .......... ...............•--- r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby op lies for a permit according to the f Ilowi g information; Location ... .. LiJ, .......... ...... 6 ....... ....�....... ...c.:........................ � t ......................... Proposed Use ............ / >�-----.. ..........................................: .............................................................. Zoning District .. ...... ........�. iu,�........................................Fire District ............ ...... �GlC e Name of Owner ..... .. .0m............Address ....6...... , .. ... 1 Nameof Builder ..............�r-0.-74 t.T...........................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................,.. Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing ..................................................................................... Floors ..................................................................... ................Interior .................................................................................... Heating ..................................Plumbing .......................... Fireplace ..............:...................................................................Approximate Cost .............-�� ..................... Definitive Plan Approved by Planning Board _______________________________19________. Area ......... ...................... .... Diagram of Lot and Building with Dimensions Fee !O SUBJECT TO APPROVAL OF BOARD OF HEA :RPE'S t�,-AR OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of To n f Bar table regarding the above construction. Nam ..j ... . .................. onstruction Supervisor's License ` ........ GAMMONS, JOHN A=249-068 n ANo 9. ..... 34... Permit for .Add deck to _. ,.. ................................... - s'tle family dwelling p�Blueberry Hill Road ' ` Locatio ................................................................. '^ ..H.yannis.. ................................. ........ I j. ;K. . Owner ......Johri'Gammons...... ...;......... w Type of Construction ................ ra ............................. IL �., Po ................................Lot .:.;...................: lt` ....... ' �' •' ~^ -•� i .... r Apri Permit Granted ................ ........l....3........1986 ` Date of Inspection ....................................19 Date Completed ................... ........19 ". K �� - a y t <? cr r. - An , . GAMMONS, JOHN A=349-068 ` l34_. Permit for — _deo}c_to_. _ *noI«y family dwelling --- Location Blueberry..IIi.Il..Roa��____. ._ - ^ - -------------------------- . J��bo (��z�nono Owner ---------_-----_______ ' frame Type of Construction .... ' --------------------------' ^ Plot ............................. Lot ................................ ' = , � 3 O6 PermitGranted ----' ----.]A ` Dote of Inspection ---...--------lA . Dote Completed ------`'-----lP `. ~ . . ` ` - ^ ' ' ` - r � ` ` . . � ^ ` ` _ ` . ' ~ ` ` - `^ ' . - ~ /' . N / .� 1-11.6 /// / !X7