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0030 KENT LANE
3 1c, . ,i,own of Bmrnstable g Pkki4fl UARNnABL&KAn 200 Main Street, Hyannis MA 02601 508-862-4038 1619.a, Application for Building Permit Application No: TB-19-2728 Date Recieved: 8/23/2019 Job Location: 30 KENT LANE,HYANNI S Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: PATRICK KENNEY State Lic. No: CS-111045 Address: Forestdale, MA 02644 Applicant Phone: (150) 852-4333 (Home)Owner's Name:. KENNEY,ELEANOR M&DAVID L Phone: (508)737-5339 (Home)Owner's Address: 30 KENT LANE, HYANNIS,MA 02601 Work Description: Strip existing roof& replace VV Ay uc 4W � Total Value Of Work To Be Performed: $5,000.00 Structure Size: 0.00 0.00 Width Depth /LR w 1� T I hereby swear and attest that I will require proof of workers'compensation insurance for eve ntractor,subco t r of rker re he/she engages in work on the above property in accordance;.with the Workers' Compensation A 6 I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a artner p may elect jbbe �d om w erage byfiling a waiver with the appropriate District Office;and that a soleproprietorof a business s no re fired to e unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the autho d agent o t�r4erty owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to procee and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or,statute,regardless of what might be shown or omitted ort'the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Patrick Kenney 8/23/2019 (150)852-4333 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $5,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $35.00 8/23/2019 $35.00 1 XXXX-XXXX XXXX-1 Credit Card 3167 ......... .. Total Permit Fee Paid: $35.00 1/23113 30 kent lane hyannis ma-Google Maps • To see all the details that are visible on the screen, use the"Print' link next to the map. Googly w l y4• r s , IV Or 4- - s https://maps.g oog le.comhraps?hl=en&q=30+kent+lane+hyannis+ma&ie=UTF-8&hq=&hnear=0)69fb311 ad9d92b9b:0xf5b16e2a1fed4160,30+Kent+Ln,+Hyannis... 1/1 f W � t S a s d M 6 1 r Too om x ` a t r r WOO• j ogSSvjdSjjvS*mm Salt Spray Sheds Estimate 235 Great Western Road South Dennis, MA 02660 8 Date Estimate# 1/14/2013 1414 Name/Address Ship To Kenney Dave 30 Kent Street Hyannis,Ma Terms Project Description Qty Cost Total ]0'x 12'Martha's Vineyard Loft. Prices include all Installation 1 3,050.00 3,050.00 costs as well as all Taxes. 3'Beadboard Door Acorn Strap Hinges are recommended Doors 1 185.00 185.00 must be primed and painted on all sides(front,rear,top,bottom and sides or warranty on doors will be voided Double Hung Window True Divided 24'x 41'without window box 1 227.00 227.00 or shutters 10'x4'Loft 1 0.00 2'x 10'Loft 1 71.00 71.00 Frost Blend 3 Tab Asphalt Roof Shingles 25 year 7 0.00 0.00 Demolish existing Shed 1 490.00 490.00 Town Building.Permit 25.00 25.00 Total Signature Phone# Fax# E-mail Web Site 508-398-1900 508-398-1995 saltspraysheds@comcast.net www.saltspraysheds.com Page 1 Salt Spray Sheds Estimate 235 Great Western Road South Dennis, MA 02660 Date Estimate# 1/14/2013 1414 Name/Address Ship To Kenney Dave 30 Kent Street v Hyannis,Ma Terms Project Description Qty Cost Total Prices include all installation costs and taxes.If you would like to 0.00 0.00 order this building please a mail or call at one of the numbers listed below to schedule an installation date and to confirm any specific details that are important to your particular location or request. Thank You Brian Warburton Owner Salt Spray Sheds 508-280-3607 Cell call anytime _T' TOta l $4,048.00 Signature Phone# Fax# E-mail Web Site 508-398-1900 508-398-1995 saltspraysheds@comcast.net www.saitspraysheds.com - Page 2 •u0u■ Town Boundary Parcels FY2012 . a 134 Address Street Numbers 291-125 67 Buildings ,,..,. _— �/t Approximate Locations of tL New Buildings from Plot Plans Decks/Patios Q Above Ground Swimming Pools QaIn Ground Swimming Pools �� 1 , Walkways Improved Walkways Unimproved Paths : r ® Stairways Paved Roads I' ,Z-j Unpaved Roads }. 29 1 4# Paved Driveways t 12`pe � Unpaved Driveways is �?(tS7DJ Painted Lines Paved Parking Lots 4 Unpaved Parking Lots O y � F Bridges Railroad � � �.w;` ' �\• _ y X Fences a 291 128' —0 Guardrails - 30 ,Retaining Walls - - " Stone Walls 0[M Sports Areas Golf Areas Docks/Piers / - Boardwalks Jetties. Streams -- - Drainage Ditches \, Marsh Areas A Water Bodies . X Spot Elevations(NAVD88) �� j ....... Topo ro ft Contours(NAVD88) �Catchbasins x Monuments Lamp Posts J Towers �y311l e t - Manholes (� •-...- � 291 123 �J Satellite Dish 3 #47 Q Utility Poles ' t \ 291 129 Signs ® Fuel Tanks t'3 31A, \. n 20 Water Tanks - &— Flagpoles - Utility Boxes _ O Posts a • Pilings Town of Barnstable Data Source Human-made features, Disclaimer This map is for planning purposes only. It is 1 inch=20 feet N hydrography,topography,and vogetation,were Parcel lines on this map are only graphic not adequate for legal hnunrlary rletvrminatino Feet Conservation Division interpreted from 2oo8 aerial photographs and representations of Assessor's tax parcels.They or regulatory interpretation.This map does no O $ 10 20 30 40 W http://w .town.bamstable.ma.us may have been updated from more current are not true property boundaries and do not represent an on-the-ground survey. zoo Main Street,Hyannis,MA ozbol sources. Parcel lines were digitized from represent accurate relationships to physical Enlargements beyond a scale of 1"=too'may _ _ o • �o S�pd .` Town: of]Barnstable �1HE Regulatory Services 3 Q 1-j!w T , - .a,L Thomas F.Geller,Director 1 MAE&BMWMBLE, " BuildingDivision , 23 +� 7 163q 1W� 3' . > iOrEo Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us i Office. 508-862-4038 Fax: 508-790-6230 PERMIT# � . $ FEE. I SHED REGISTRATION ' 200 square feet or less . �3o Vewi c,fb;e� f�iYvr ��S Location of shed((address) Villag e Property owner's-name Telephone number Zr(It zg, , Loy 8 Size of Shed Map/Parcel# " ature Date ' Hyannis Main Street WateifrontHistoric District? . No _ 5 Old King'sZighway Historic District Commission jurisdiction?., No If over 120 square feet,you must file with Old King's Highway *Conservation Commission(signature is required) '< Sign off hours for Conservation 8:00-9:30 &3:304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTIO N OF ANY OF-THE ABOVE OVE COMMISSIONS,THERE MAYBE A:REVIEW PROCESS AND APPLICATION FEE. P,LEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS 'THIS FORM MUST BE ACCOMPANIED BY A PLOY PLAN L Q-forms-shedreg REV:05201 Regulatory Services: ' a ` �me Thomas F:Geiler,Director, ,� yY' Building Division r}�/'V OF D wt�rt raj E t ' aear8rwws = Thomas Perry,CBO-Building Commissioner 9. r 200 Main Street,.Hyannis,MA 02601 1 I113 ,;t iV I I www.town.barnstable.ma.us ` Fax 508 790-6230 ? . jl Office 508,86213038 } j Town of Barnstable Family Apartment.Affidavit i I,being on oath,depose and state as follows: x, I am the owner/resident of the My name is - property located at: l J , The following members of m amily will be the sole.occupants of the Family Apazlment at the aforementioned address: j# Name&relationship to owner: Name&relationship to owner:_ m/ j" The Family Apartment will be the primary year-round residence for the above-identified Ives vacate said apartment,I will immediately' S, event that the listed relatives he eve amyl mem bers. In t , family notify the Building Commissioner in writing.I.understand that no.subletting or subleasing of said Family Apartment s permitted , t I understand that I am required to file an Affidavit annually with the Building I Commissioner listing the names and relationship of occupants in said Family Apartment.I alsoI "I ,.' understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled.. The apartment has been transferred to the Amnesty Program(Appeal No. I Other day of 2013. �. Sworn to,under the pains and penalties of perjury this Y i Phone Number " Signature. . /- Print Name L l�l� :1-4 �\ i giforms/famaffid doc rev 11/08/11, ,e Town of Barnstable tie Building Department Services • BAUMM UM Brian Florence,CB0 100, NAM Building Commissioner 'reoNw+°i 200 Main Street,Hyannis, MA1,QS6 www.town.barnstable.ma.us Office: 508-862-4038 _ Fff.108-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath,depose and state as follows: My name is 4 //V�N<5=7 I am the owner/resident of the property located at: (D-�'C[ L�1��5 �J')f)&3 N S 1m 0 ���C) The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: —NA f IGE sJ rb v' ,�l�,tl Name&relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately notify The Building Commissioner in writing.I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment.I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this O day of 2019. Sign ture Phone Number Print Name VI 4D q:forms/famaffid.doc rev 11/08/13 Town of Barnstable Building Department S A NE® Brian Florence,CBO IL lu * MASS. * Building Commissioner 039. A Fo Mv+ 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 FC 508-79S623� � -n Town of Barnstable Family Apartment W iot'l an I,being on oath, depose and state as follows:My name is �` I am the owner/residee coo 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: y Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartme�as been transferred to the Amnesty Program(AppeAl No. t O Other Sworn to under the pains and penalties of perjury this ' day of 7-4 2018. Signature Phone Number Print Name q:forms/famaffid.doc rev 11/22/2017 Town of Barnstable - - - - - y ' Regulatory Services Richard V. Scali,Director" z Building Division * a�ntvsras� Paul Roma,Building Commissioner a � 39 200 MainStreet, Hyannis,MA 02601 wwwaown.barnstable.ma.us o Office': Fax: 508-790-6230 Town of Barnstable Family "Apartment Affidavit I;being on oath, depose,and state as follows: My name is I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family.Apartment at the aforementioned address: Name &relationship to owner: Name&relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately 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 notes the Building Commissioner immediately in the event of the sale of this property. If there is no-longer a Family Apartment at'-this location,,please.explain; The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 20f7 Signature Phone Number Print Name q:forms/famaffid.doc rev 11/08/12 Town of Barnstable Regulatory Services oFt"E r0r�ti Richard V. Scali,Director °^ Building Division Thomas Perry, CBO,Building Commissioner i639. ��� 200 Main Street' Hyannis,MA 02601 rED MA'S 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 4 Jam the owner/resident of the pr; ,rtyqpcated att.: � y 04 J P-1 cc /71 &Zu o )/ Thg(following mernbgrs of my family will be the sole occupants"of the Family Apartment at the aforementioned address: c Nape &-relationshp�-to owner: Name &relationship to owner: © �l The Family_.Apartment.will.h. .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 lam 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: T he apartment has been dismantled.The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this A 1-3. day of 2016. �0 ll Signa a Phone Number Print Name q: orms/famaffid.doc rev 11/68/12 Town of Barnstable P�oFE rOwti Regulatory Services o„ Richard V. Scali,Director Tn_WMOF BARNSTABLE SZAB Building Division ii 1639 Thomas Perry, CBO,Building Commissioner' 11,i ' ED MA'S 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 S 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: 6` The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: I Name &relationship to.owner: �H Name &relationship to owner: �- The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately, note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this ra day o�/" 2015. Q -� i. — � Signature"' Phone Number Print Name q:forms/famaffid.do c rev 11/08/11 Town of Barnstable Regulatory Services roy, Richard V. Scali Interim Director TOWN 01: El, PNISTABLL Building Division v g Thomas Perry, CBO>Building Commissi e�r.10,11 -8 �:B"� "B Mass r i63� 6 200 Main Street, Hyannis, MA 02601 Fp Mp`l www.town.barnstable.mams Office: 508-862-4038TVTSFx: 508�79 -6230 Town of Barnstable Family Apartment Affidavit I, being on oath, de4pose and state as follows: My name is / - / I am the owner/resident of the property Located at; - - - - - - The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name &relationship to owner: 61 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 notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a r amly 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 4"'ll 2014. Signature U Phone Number Print Name q:forms/famaffid.doc rev 11/08/11 °F1HE 1p,�, Town of Barnstable Regulatory Services BARNSTABMASS. Thomas F.Geiler,Director �p i63q. �0 rF1639.(1, Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 June 6 , 2006 Ms. Eleanor Kenney 30 Kent Lane Hyannis, Ma. 02601 Re: Illegal Apartment: 30 Kent LaneHyannis,Ma. 02601 Map: 291 Parcel: 128 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home,which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerely, Linda Edson Amnesty Program Zoning Officer Building Department gfonns:zoning3 Town of Barnstable dy+ Building Department Services Brian Florence,CBarmm Of Building Commissioner u. ` i eo rnn" 200 Main Street,Hyannis,MAIQ2%r I www.town.barnstable.ma.us Office: 508-8624038 ,,,,,,,—,. °-K,---Irix---�08-790-6230 1 being on an depose of Barnstables amity Apartment Affidavit + g P My name is y /=1 Ll�-)Z ,�Ln/N 4= I am the owner/resident of the property located at: ;O 4C r1Ji G ArJ 1),3,1 t The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to"owner:Tn V > 1<E tJ�✓ / S7,262 =- tJ 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 " not -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 f le an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment.I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.I Family Apartments. I agree, / to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2019. �� 5-n T'7 Z ° Si Lure d Phone Number c3 Print Name-Z t11 n- G--NNE/ 1 7 q:forms/famaffiddoc rev 11/08/13 i , Regulatory Services; of Thomas E Geiler,Director Building Division TWIN 'QIF R'?NSTABLE RAIDWABIX ' Thomas Perry,.CBO,Building Commissioner Mass $ i639. ,• 200 Main Street, Hyannis, MA 02601 - ? 13 jAp4i ! J ED N1A'� A Nif: 10 t www.town.barnstable.ma us Office: 508-862-4038 € ,r Fax. 508-790-6230 Town ofe 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: TheTollowing members of my family will be the sole occupants of the Family Apartment at the aforementioned address: , Name &relationship to owner: 0 El 1 Name &relationship to owner:—= The Family.Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 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 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 thislocation,please explain: The apartment has been dismantled: The apartment has been transferred to the Amnesty Program(Appeal No. ) Other: Sworn to under the pains and penalties of perjury this day of 2013. aS Signature Phone Number Print Name q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services Thomas F. Geiler, Director W4. Building Division Thomas Perry, CBO,BuildingCommissioner, ?F f $* ° .s , .,t,, t el 3 059. A�� 200 Main Street, Hyannis, MA 02601 o www.town.barnstable.ma.us Office: 508-862-4038 Fax ►508-790-6f3 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: e� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: 5 Name & relationship to owner: Name &relationship to owner: L� 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 notes the Building Commissioner immediately in the event;of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program{Appeal No. ) Other Sworn to under the pains and penalties of perjury this j f, day of 2012. Signature Phone Number Print Name q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services of Thomas F. Geiler, Directorar l t � :MAIL I Building Division ' Thomas Perry, CBO, Building Commissioner i All 8: 59 Ai 1639' 200 Main Street, Hyannis, MA 02601 FD MA'S www.town.barnstable.ma.us Officer 508-862-4038 DIV SUP 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: �v 'The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: G� f t Name & relationship.to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately 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 ftle.an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments, I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is,no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this /0 day of -2--e) 2011. Signature Phone Number Print Name Town of Barnstable Regulatory Services pFIHE Toy, Thomas F.Geiler,Director o Q rIN TAE Building Division TOWN * saxxsTABi e, Tom Perry, Building Commissionq.r,,, 9 MASS. 1639. 200 Main Street,Hyannis,MA 0260'1``'_ 327 �'°rFn Mai A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is ""� I am the owner/resident of the j property located at: X:�L 8 (JL The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: V c� Name & relationship to owner: M 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'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 ��Vday of 2010. Signature _, , - Phone Number Print Name Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services pFTME Thomas F.Geiler,Director Building Division T,0�=�� G?_ 6—ARti IABLE • sARNsrriimE, Tom Perry, Building Commissioner v MASS. $ E1 39. 200 Main Street,Hyannis, MA O/fOla HAR —9 Ph 12: 35 www.town.barnstable.ma.us _ ruIVIS100 Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: _ My name'is � � I am the owner/resident o the t , 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: ✓1 1'���h�/�/ (� �� Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 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 Sworn to under the pains and penalties of perjury this day of 09. Signature Phone Number Print Name 4ff'�_ /Y d Pi L� Q/bldg/forms/famaffi d Rev:12/08 Town of Barnstable Regulatory Services pFIME 1p� Thomas F.Geiler,Director ti Building Division BARNSTABLE, " Tom Perry, Building Commissioner 9 MASS. �A 039• 200 Main Street,Hyannis,MA 02601 TFO MA'S A WWW.town.ba:rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable. Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: -.(2 , i The following members of my-family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner• Iv' Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing:I understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually.with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to noty 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 200`8•' 17�'- Signature - Phone Nu er Print Name Q/bldg/forms/famaffid Rev:l/03 Town of Barnstable C) Regulatory Services pFTHE tOy, Thomas F. Geiler,Director ti Building Division z.; - ,,- snrwsTnst E, * Tom Perry, Building Commissioner MASS. 9QyATE1639. & � 200 Main Street,Hyannis,MA 02601 P �: J www.town.barnstable.ma.us Office: 508-862-403 8 U.1Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as.follows: My nameri, / - I am the owne resident of the property located at: v. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: r i _ Name &'relationship to owner: f C� Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that I am required tofle an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2007. Signature Phone Number - Print Name �- - Q/bld g/forms/famaffid Rev:1/0 3 Town of Barnstable �C Regulatory Services °FtHe t Thomas F.Geiler,Director Building Division RMW ABM ' Tom Perry, Building Commissioner '„ MAW. L 1639• 200 Main Street,Hyannis,MA 02601 AlFo .�s www.town.barnstable.ma.us Office: 508-862-403 8 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: , Map and Parcel Number The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: —7� I Name.&relationship to owner: �$1LL �• ����4� � a 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 notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 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 2006. Ph6ne Nuiikir Print Name Q/bldg/forms/famaffid Rev:1/03 l ® l� Town of Barnstable Regulatory Services °FTHE r° Thomas F. Geiler,Director TOWN i_lF BARNSTABLE Building Division. * BARNSPABLE, * Tom Perry, Building Commissioner 2005 MAR 22 Ali 11: 54 MASS. � 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us . ��Q1VtS1�ll 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' ,__ArY AA,10 I am the owner/resident of the property located at: Map and Parcel Number �- J The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members of my family will be the sole occupants of the Family Apartment at the ' aforementioned address: Name &relationship to owner:, Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. 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 o • 2005. Signa e Phone Number Print Name Q/b1dg/forms/famafd2 Rev:1/03 Town of Barnstable Regulatory Services, � A �A��E oeF`ro�y� Thomas F.Geiler,Director Building DivisionQQy swxrrr ASI Tom Perry, Building Commissioner r� , 1639• ,m�" 200 Main Street,Hyannis,MA 02601 rFo Mai � i4N Office: 508-862-4038 Fax:.508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: Map and Parcel Number The ZBA granted me a Special Permit/, arianwo n Date Appeal o. The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members"of my family will be the sole,occupants of the FamilyApartment at the aforementioned address: Name&relationship to owner:L4i�� AI� Z�� ' Name&relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,-I-will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. =jhe apartment has been transferred to the Amnesty Program(Appeal,No:;: - Other r . Sworn to under the pains and penalties of perjury this" day..of ,200.4. Signature` PhoneNumber Print Name Q/bldg/forms/famaf d Rev:1/03 ' " Town of Barnstable OTC Regulatory Services 4 °FINE tom, Thomas F.Geiler,Director TO bF PiARNS ABLE Building Division Bmwsras F Tom Perry, Building Commissioner MAR 18 AM 11: 13 Mass. 9 039• ♦0� 200 Main Street,Hyannis,MA 02601 �ArEO MA'S A DIVISION Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is Lei 0 - I am the owner/resident of the property located at: ,;7_qr /ate Map and Parcel Number U r fee v The ZBA granted me a Special Permit/Variance on Date Appeal No. The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members of my family will be the sole occupants-of the Family Apartment at the aforementioned address: Name &relationship to owner: ' M JD Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members' In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the'pains"and penalties of perjury this. /j/2*- day,of_46,,- 2003. Signature Phone Number Print Name �-Z�� �J'_ 7Y� V, �cf Y Q/bldg/forms/famaffid Rev:l/03 0 COMMONWEALTH OF MASSACHUSETTS BARNSTABLE E9V 0 1 1999 I � th, ---- -=--------------- - - ------------------ be n depose and state as follows: TOW B�LDINGNDIV BLE 1.) I reside at____ _ 2.) I am the owner of the property located at------------------ - � `_--- --------------------------- shown on Barnstable Assessors' maps as MAP----------___PARCEL—____—______________ 3.) I Do--_ ____Do not_______________have a Family Apartment at this location. 4.) On 199 , the Zoning Board of Appeals, on Appeal No.— granted me a Special Permivyariance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6. The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME----�1_a`�``' — ------------------------------------------- Relationship to owner:_ --------------------------------------------- b) NAME `"k ri - ---=5�v�✓ -- ------------------------------ --- _--_--_----_-- Relationship to`owner: ------------ S.- 1 7.)The Faniify Apartment will be the primary year round residence for the above-identified family members.f 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names.and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. '_----------___-------------------------------------------- 12.) I agree,to.immediately notify the Building.Commissioner in the event of the sale of the above- listed property. ' Sworn to under-ahe x art ___ _ .199 pmns.and;penalties of perjury this day of-__ .�'__=__,. Signature Lie- ------------------------------ Print Name _ COMMONWEALTH OF MASSACHUSETTS 70tr BARNSTABLE ,AFFI9WV-1TB E" depose and state as follows: 1.) I reside at--------3 - U J 2.) I am the owner of the property located . shown on Barnstab e Assessors' maps as P '� �1-----PARCEL----- ' ----------- ----Do not __have a Family Apartment at this location. 4.) On___ ` —__ —_—, 199_L---, the Zoning Board of Appeals, on Appeal No.-'--" [/ granted me a Special Permit Variance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6. The following members of my family will be the sole occupants of the Family Apartment at the above address: 7ba .� a) NAME---- •�[6(_---��---- Relationship to owner:--- r=----------------- b) NAME Relationship to owner: _ -------------------------------- 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am re ed to comply with all conditions imposed by the Board of Appeals in Appeal No. ----------------------------------------------------------- 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. 2 Sworn to under the pains and penalties of perjury this_��__day of� 99 Signature 6—A ---- i4 -- -----v-------- �' -� / ` j— Print Name U ./ ----- ----- -- -- -- ---------------- P-Ad, SAP- ls)-� V Town of Barnstable r Zoning PP Board of Appeals . Special Permit , Decision and Notice "' __ 4 Application: #1991-59 Applicant: Eleanor Kenney At a regularly scheduled hearing of the Zoning Board of Appeals, held on December 12, 1991 notice of which was duly published in the Barnstable Patriot and forwarded to all interested parties pursuant to MGL, Chapter 40A, the applicant, Eleanor Kenney appealed to the Zoning Board of Appeals for a Special Permit to allow a family apartment within an existing residence pursuant to Barnstable Zoning Ordinance Section 3-1. 1 3 (D) . The applicant's site is shown on Assessor's Map/Parcel Number 291/128 and more commonly addressed as 30 Kent Lane . H annis MA, and is zoned RB Residential District. Y The following Board members heard the petition: Luke Lally, Ron Jansson, Gail Nightingale, Richard Boy and Chairman Dexter Bliss. Summary of Evidence: The applicant, Eleanor Kenney, presented her request to the Board for a Special Permit. Ms. Kenney explained that her daughter had moved back home and needs her own privacy. Ms. Kenney stated that her daughter will be residing in the basement of the house which has always been used by her children while growing up. Ms. Kenney stated that she has owned and lived at the property for 25 years. She further stated that a kitchen will be added and other necessary cosmetic renovations due to water damage and termite rot. Mr Kenney stated that she can meet the requirements of the ordinance. The Board asked the applicant if the proposed family apartment complies with all the provisions of the Zoning regulations regarding family apartment. Ms. Kenney replied yes. The Board asked Ms. Kenney if her daughter would reside in this basement unit on year-round basis. Ms. Kenney replied yes. The Board informed Ms. Kenney about requirements of Zoning Ordinance Section 3-1. 1 (3) (D) that the kitchen would have to be removed if apartment was not occupied by a family member. Also, the Building Inspector would have to be s y y notified once a year as to who is living in the unit. Ms. Kenney responded that she understood the zoning ordinance requirements for a family apartment. The following public comments were made for the petition: Bill Elkins, an abutter, stated that he does not oppose the petition but commented that he had general concerns for more such requests for family apartments in his neighborhood. Gerald Pass, an abutter at 47 Suffolk Ave. , had concerns with illegal apartments in the neighborhood. Rodman Scace, an abutter from 127 Bristol Ave. , Hyannis, did not understand the necessity of making it known with the advertisement. Chairman Bliss mentioned that he had received a letter in opposition from abutters Janice & Lawrence Eklund of 57 Suffolk Ave. , Hyannis. Due to the contents of letter not specifically pertaining to zoning matters, the letter was not read but remained in file for record. , Finding of Facts: At the meeting of December 12, 1991, the Zoning Board of Appeal made the following finding of facts as related to Appeal # 1991-59: 1. The petitioner has provided evidence that she complied with all the provisions of Section 3-1. 1 (3) (D) of the Zoning Ordinance as far as they relate to family apartments. 2 . Granting of relief sought by the petitioner is not detrimental to the neighborhood effected, or derogation of spirit and intent of the .Zoning Ordinance. The vote was as follows: AYES: LALLY, JANSSON, NIGHTINGALE, BLISS, BOY. Decision: Based on the finding of facts,, at a meeting held on December 12, 1991, by a motion duly made and seconded, the Board voted to grant the Special with the following restrictions: 1) The applicant will comply with all provisions of Zoning Ordinance Section 3-1. 1 (3) (D) , and in case of any violations that will result the applicant a show cause at hearing as to whyspecial permit should not be P revoked. y 2) Family apartment shall be utilized as per the sketch plan, submitted by the applicant, and. within 620 square feet of basement area of the existing house. AYES: LALLY, JANSSON, NIGHINGALE, BLISS, BOY. THE PETITION IS GRANTED. Any person aggrieved by this decisioa may -appeal to the Barnstable Superior Court, as described in Section 17 of Chiapter 40A of the General Laws of the Commonwealth of Hassac husetts by bring-in3..an action within twenty days after the decision has been filed in the office of the Town Clerk. Chairman . I, 1�0 6 n/ Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby cerzIfy .that twenty (20) days r have elapsed since the Board of Appeals rendered its decision in the above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this ! day of 19 r-�Z under the pains and penalties of perjury. Distribution: Property Owner Town Clerk Town Clerk Applicant Persons Interested Building Inspec!ar. Public Information Board of Appeals oFTME The Town of Barnstable Department of Health Safety and Environmental Services BARNSTABIX Building Division NAM 1639. wig 367 Main Street, Hyannis MA 02601 'OrFn Mo'I" Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissione January 6, 1998 The Kenney Residence 30 Kent Lane Hyannis, MA 02601 Re: Family Apartment located at the above address Dear Ms. Kenney, Our records indicate you have not filed an affidavit regarding the above referenced family apartment in quite some time. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable Zoning Ordinance that an affidavit be submitted annually for the duration of such occupancy. Please indicate the status of the family apartment on the enclosed affidavit return to this office by January 30, 1998. Enclosed is an affidavit for your convenience. Thank you in advance, V` Ralph Crossen Building Commissioner QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 01/06/98 PARCEL ID 291 128 GEO ID 19995 , LOT/BLOCK 8 DBA PROPERTY ADDRESS OWNER KENNEY 30 KENT LANE ELEANOR M HYANNIS 30 KENT LN HYANNIS MA 02601 PHONE DISTRICT HY DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY(NOTES) ZONING DIST/ZOC RB SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? ## BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 12196 . 8 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST (N) EXT / (P) REVIOUS / NO (T) ES / PER (M) ITS / (V) IOLATIONS / (G) EOBASE / (E) XIT v-01 SI L y/9 'Town of Barnstable oFINWE Regulatory Services + BARNSTABLE, 9� MAS �e�' Thomas F. Geiler,Director 1 . Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-403 8 Fax: 508-790-623 0 March 9, 2006 Eleanor Kenney 30 Kent Lane Hyannis,MA 02601 Re: Family Apartment Affidavit SECOND REQUEST Dear Ms. Kenney: Our records indicate that you have not responded to our letter of January 11, 2006, requesting you to complete and return the Family Apartment Affidavit. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. Please return the enclosed affidavit as soon as possible. If you no longer have a family member residing in the family apartment,please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home Apply to the Amnesty Program If you have any questions,please call Lois Barry,Division Assistant, at 508-862-4039. Sincerely, Tom Perry Building Commissioner J030403b 0 le Town of Barnstable Regulatory Services aoFt"E T�tl,�o Thomas F.Geiler,Director TOWN OF BARNSTABLE Building Division tARI MBLE, ' Tom Perry, Building Commissioner 205 MAR 22 AM 11: 54 MASS• p a639• ,0� 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us DIVISION Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is 4 I am the owner/resident of the property located at: w Map and Parcel Number c- 1 The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 0 ' Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day or:; . Q,(,�h 2005. Signa e Phone Number Print Name Q/b1dg/forms/famaffid2 Rev:1/03