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0533 LINCOLN ROAD EXTENSION
t' ! � .:_ `i �% 11 �F r A { i 4 �� I' S '�. L Application number.... .'..�...1.......j. . ® 00 Qa Fee................... S o .......................................................... C �`gs, � Building Inspectors Initials.......... .................... �� q Date Issued..........................�..�.�.2.�..�....\............ Map/Parcel............. .. ..�.S.J., ................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 5-'n L"toGO1lu go is\�T NUMBER STREET VILLAGE Owner's Name: ent,i ( xy9 Ij.:1�,.-t1A-N' Phone Number J 't -3(,q - o d*;-o Email Address: S�3) Cell Phone Number 46q-34g ` D 69 o Project cost$ 3 OD 0 e;- 6 Check one Residential ✓ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize 6 w -2 0-- to make application for a building permit in accordance with 780 CMR Owner Signature: Date: q- 1 k- k i TYPE OF WORK ffSiding 0 Windows (no header change)# Q Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to �N \Ouly% (,, A00 C-k� CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) 4 Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTYIS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. JIF APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on , number of tents total Does the tent have sides?Yes No ' (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No_____, if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-d:30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: CSA3 L -42O W[P (A N Telephone Number S a $- 6o'2 c Cell or Work number 562S- 3G u-ao't.C1 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. f Signature ``--�1�. �J Date APPLICANT'S SIGNATURE Signature y Date q—U —6 All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents -- Office of Investigations 600 Washington Street Boston,ALL 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): L 0 ty Address: S�� �, b✓Cvlk- /Z/� C x ��y 64wa��S dyl b� C a i City/State/Zip: AA_ ate a � 34 o.7 b 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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.r ired] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.LIYI am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] '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 anew 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 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct: Signature: 1� Date: Phone#: - 3 H— y 6 a U Official use only. Do not write in this area,to be completed by city or town official NCity or Town: Permit/License# I 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#: 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 compliance 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-contractor(s)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 permit/license 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 N Department of Industrial Accidents Office of lavestxgations 600 Washington,Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07' Fax#617-727-7749 www.mass.gov/dia t - ?' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 17A Parcel 3 y a5 kK. �.`I "Permit# �Q Health Division _�-f -Yy\ \1 WITH TITLE 5 OTAPUAN Re Issued 6 Conservation Division EV9fl1z %1L W Tax Collector ' r , _Treasurer 41Y f Planning Dept. Date'Definitive Plan Approved by Planning Board r -.. Historic-OKH Preservation/Hyannis Project Street Address 533 4 l Ai C otl N ko• F)X 1-elys%o/V Village ' Owner s (it✓t>Ct 4l-N J P_ Address 53 3 /ti'C v Telephone _ 790 - 3LI90 ' ? a , Permit Request / N_S T4L_L 1 t, 9Y- 3 2 ' wt I l6 o ® �— Square feet: 1 st floor: existing - proposed 2nd floor: existing proposed Total new Estimated Project Cost I V1 d(70.O Zoning District Flood Plain Groundwater Overlay Construction Type 37ed_ (v A4 t o Kt v 4- .L/,4J -e 10 Lot Size 5-00 Grandfathered: ❑Yes . ❑No If yes,attach supporting documentation. w Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 2 Historic House: O Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: Ql(Full ❑Crawl ❑Walkout , ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) � Number of Baths: Full: existing - new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths):existing -new First Floor.,Room Count4 Heat Type and Fuel: was ❑Oil ❑Electric ❑Other Central Air: ❑Yes Flo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing O 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 r BUILDER INFORMATION �5 Name e�1&44Ro ��,Vasb' Telephone*Number Address l Pe-e-P 41�0 /Z�) License# 6og6 3�� Home Improvement Contractor# 106002 Worker's Compensation# - ALL CONSTRUCTION DEBRIS RESULTI G FROM THIS PRO;ECT WILL BE TAKEN TO - � SIGNATURE DATE _ 9 tl/ �� " FOR OFFICIAL USE ONLY PERMIT'NO. DATE ISSUED. MAP/PARCEL NO: ADDRESS ! ` ' VILLAGE OWNER DATE OF INSPECTION:'; " t FOUNDATION , FRAME. R INSULATION a r'•- FIREPLACE ELECTRICAL: ROUGH y` FINAL' { PLUMBING: s ROUGH r FINAL s s GAS: ROUGH 1— '� FINAL w =t r FINAL BUILDING � T r DATE CLOSED OUT ASSOCIATION PLAN NO. 15� • ti . ... ..._ The Commonwealth of Massachusetts Department of Industrial Accidents �`�-~ , =_ ; Olflce ollmrestigalloos 600 Washington Street Boston,Mass. 02111 Workers' CoTVensation Insurance davit name: location: 3.3 1y Co W city 14 j A_rjtj l's k phone# �4 2 k K5 Cl�Z ❑ I am a homeowner performing all work myself. �,I am a sole rietor and have no one worldn in aav ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. :..::.. comnanv name: ::;: address: dtv: phone# Insurance co. olicy#- ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: companvname: address: :. .:....:..........:,... phone#: ..::... . . . city ...::.':... ,' ... /O/DVffzl :. eompan v name :::..........::.:::::..:::..::,..:.>.::::::::::..:;:;.;::<.;;>,:;<.:;...:..•::.:.::<:<.... ::;:<...... ..:. address: v:Yx .....:::::: ...........:.:... ..........nr.:....................... ...:::v:.::.:::i .. ....iiii:�::'}'{:+'>GiiY:Jii :v.v:,:�{±:.-:': insntanceco:. :..�.:.... .......::.:.:.:... .:<::.::...>:.�::,,:.;::;;:;:.;::..;;::,.,•:,:;»::. olicv#.,.:._: :.,.::;,:.>;:::::::.:.;:.�:<::<;:.:<{:.;:;;::::;>::;:::<::� :>::.;..:;>;::..;;:,.;:,:.:.:::::,..: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to SIA0.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of 3100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office Pf Investigations of the DIA for coverage verification I do hereby c fy the pains pen es of perjury that the information provided above is�tra:and coned simmture Date f Y q 2 Print name _ I C ��9 4 J0 S'9X�n C�' r^ Phane# oflldal use only do not write in this area to be completed by city or town official city or town: permitilicense 0 E3Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person• phone#; ❑Other. (mired 9/95 P WE . The Town of Barnstable B"NsrnBL& • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date 9 t /�(— q+- AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. /Type of Work: �NS% l f �� �i (�-►�a�e v�1 �i 4Q-L—Estimated Cost I 6(10, .00 Address of Work: �j 3 rry cULii ko I Owner's Name: C Q w l lqd Date of Application: �"� L(" ( 1 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law MJob Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: I`r y - qrc h"o �ubs�, �0 ( 60 Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav IMPR CONTR OVEMENTt� R � Regis�r�xldn < ACTOR 106009 3 ExPira-lot, r. �. k t�• �1/00 SENOSKI Pe ep xoA R � x ADMINIS TRATpq e i ---- ---------------__._------_.____.__.__._-__-.---.--_._.___.._______. -.._. _ 4 1 32 � I i i POO(- 3Z i :381 IN C -)/ l( l� JAI Eft li/t]NO -e[FmOMn Yr a+vm a rauulAc M oalW - •. - ....._____ k]IOMTOE Q M l IR I Y®AE MTI AYMOARAY_ N 6A.fiALM STLI DYBOWL BRACE JAT. TSC m[[Lao ra An n�- - - Gt GALM STEEL �� ._ SEE gS,k.L MMEL PLANS FOR LOCATIONS DT,ER TTEAS N SU•E ! S-W*ALOOL.TS.MTril �N CA.GALY. 1- WASHERS TTNGL ID A 2 YN9ERS M f . I EA.f11/1EL END . v I S-�• ASHES.INlTS - . y EAND 2 PA END TTP `MW Sum STEEL AL AND 2 iT 1 AND 2�TY• J _ - ��`•�µ F MAS.0 �� EA.FaME1 OD R I A 'n —'.TI •I N CA.G1LM STEEL - I - .r '�t1 SHr T CORER F - �� I I N 4 CAI]I STEEL YO NIL.TMCNMESS � NN1'L LNER G 6 4k� IS• �� COR!� I `IL L " 20 IL.7MOOE55 20 YL TMCNNESS /m' SERIES 700 8 750 Ystn LATER vRnl LINER - OCTAGONAL CORNER SERIES 800 8 850190P CORNER SERES 900 a 950(90`CORNER) /1 SERIES 550. 0 81050(TYF CORNER) r f 2 z 100 z z N GA.CALM STEEL 1 S-tiPY a N)LTS.IRKS W To F70 K 1111E1 _ - O CORNER PECE �-7 YD Y w14 NE, MAmes . 1 Ell RYEl F� ®I6RL1OA�KiE��s� - e. N ME SEE STEED ��M� OfIFA REySN STALE 10% PANEL SEE SER. I--� Midi Alt EA EKIIESS �►IMrEl ETDS-lr••LLRpL��NUTS'�I I NGILCALYSTEEL A/O Y MN57ER5 TYR • W '�• IwMEL ErL P111EL EMD 20 n THICKNESS 20 WIR_ Loom S - YFerL S .. 1 p toLM FOR ANGLE.SEE ED= n _ --�,v ka o sEcca \ K FOR IACAT]ONS 4 ®OeBOML SIPAOEI!(: `\ N CA.PM'EL 6ALY STEEL ISA FOR LOCAT LyJ /1 ANta IS AND 2OIR7MOOE.4 O PLANS IONS a YNYL LNETi O ODER ITEMS N BRACE O O 7 m CL — SERIES 1000 8 1050 EL CORNER s SERIES 700 a 750 EL CORNER G 7 T SERIES 700 STAR CORNER • O f 2 f Y Q O I S. N Gil CALM STEEL .�•. N GA.CALM STEEL 1•MRl COI-DECK • - s.d MOwAL 2 m M' WE L T- fYYE1 SEE SECL SEE NS7ALLATIM 4�NO ' -r m O _A NVl TYPICAL NOTE AID SECT LY2 _ _V— d R� apO L �Nsf41AT�lOr«i ..PP" NOTE:NM 3 Eye cGPNc- I-'tef'•r•oLTs" I; °°77 'TVw&L 55 "aER iw 2 E CAE%TTP. or O vFnl LNER NDTc sEE �ETD '•- �--''-- :' " m ` y_AL• - Ro ReL TM30" on FOI aAeoNAL e- �• 312NIN•OiANLE 'ya, •C CAR►aAGE v2N1'L LPEA 6MIIvEnsJ - I a. I IDaRaWILL N 59•ALLTIfEAD°°LTSM7TS RODE PANEL CARFL6E FOO•I TTPKAL GA.CASBOUS, A PANELKL MOEAIL 94061LS M i. WASHE IA4. 2 - ® 9�0 BE [C ; LA�U�It1 %12 GA-GUM A N CA.6ALV.STEEL S-A►••eL•0.T3,NUTS N GI.6ALV.STEEL NM GA.WLM STEEL« SEE PLAN wrFFDm•�7' MOTE NQ 1. 1 . FILLER PECE J AID P IaL9ER5 M FLLER P¢CE y. �i PUEL SEE Si T s-><'.Y Id�pL7� ABOVE any'••r.eoLTs.Mrrs I�ale.i SK.Cam• LLW2 TVTTtAL NUTS EY s0. �I AID 2 ravERs •NG&GMXAhQE SERIES 800 1000 8 s SERIES 600 8 1000 STAIR CORNER Io `"EAOI CAMUesx GE rI TYR EA NYIrEL pDJ I IwIEL ENO CARRIAC#BOLTS I 20 t<.7ItOaE55 f••DEEP CONCRETE COPC ENT MOTES NSTALLATION MOTES 2 Y zo YL T1ACpESS ADD( STFFT]ER) I vwrl LNER S"O6LL �PFFSETER 'oP Pool FULL L ALL A-& sTm E Pglep RI01 WTORd mIROA�to LM rsc NaF+I O THE POOL D PIRaGOID a A TTACAL NeTYLIRg1 VINYL LEER .L-i Y f•Y fi4LM I 1 1 INSTALLATION NOTE NO.I wm1 w-Aa.ATM M/.@D f11LYAIQIID COATMi. NZYM N I N W ccwl RMA NNAIOC G.TL N[AT.MIARN ROIL 011 AT G.OF PAMEL PER TYPICAL N GA. 2 1 _ _ NMYLT DOYRY[So". 2/Y IOANTTED FOR I G1LLV.PANEL E�a ALL Pled AM�t OaIQ sTfPelpls AT IRANt MAm L TYPICAL N CA. AM[ROLLED IN01 Wle]IML COIFOMNwF 10 ARTM w-1R [.IISIALL V['TAR(OMCK'f1 COLLM ATM Y7L OFM WDViJ.RT01 CALM h/El E]D CLA�TI I OEM DPEIISION �- �fTM M ASTY A�Rt 4YLY1N®COATIIL Aw4 UIOIW M PAi Fe11NETUl OF M FOK.Ta 6 sON 01[EAL tlQi E70 DaOt9O11 - I " 2• MFL F11 Y a Ail PQn AFD TNFMwOO mrolorrs AM[wawCT1[la ].RAO[FR.L��alwM[ARrN FIIFL ff IIODrm AID OEAIat Nsnu'LtD M LaToo I 1 ? AO11 WTGIAL OOA'O111K TO ASTY•-]OT AIO AIR 2K FYATL.gPTpIO MILfNDIt A11f iWwD= FILL POOL W1TN YR �P�m�lMa W LEVEL [Yl FLL �—�• ^i,.�": I �. ' FLATeD. 4.All NCR TE /wo1 M F.0 LEVEL n IIOIE 71IAM M 4.A OOI A R MLLl T 01 PMRp M I NWl YDP[INAT FTDY 2 W' _IIT1P.TOP 6 DoT. l ALL 11F]Dm aR1<R AIlL!AF[lQ AMD AOwIfTAN.E OMNA R A RAT1 IDf ALRt TMM IN Pp FOOT. �.' ARAM RRwe2 N.AY:ONTm R1TM AN AIIYARI NYfT ARF1 tIRLDIMa R.THS POOL IIY N]T[mI DEM m r AYMICMARM LOAORL 4=Y 2'[11•[Y'-O•6ALM I S�� I/�x(LEV6v.N4' A rIIOMY a01 eWLLt M1 Rpm PR O00!'Ma9Y[ - aalAC[t1N[MOO�D PDOl A1DOIN IENrr YOVaL TOLYT eDIPINLOR �y[y/��� YAIw,, �-�[yy, T�vI�� UM�� �{O���p Y=0• 1 a• I +1L ANGLE 7 sT1RIN r at>RIL t THE H rYE.uuR p AcnRED NQ to sD Pa[P Lea I I I"CAL WALL SEC 1 M\ I I MCAL MALL S I l�r GIYGOR i 21s•OVE7EJSJi7AM 7 `• %malo'°s uw Ym n "Poo 1L1O1 TI""� FOR 214 PANEL AT MICA PANEL Iz Typr-AL WALL SECTioN AT 'd FRX& I]. z 2 Nt �"� LTSi99 AErA00tCllb6 u OAdttF3 m I--T,[MILIAI• - SIGYTI4'O IN:[itR[R O Nm1A AFt m--.m JAY:. -TJK CVQ«3 f I. I ! i yr• ®LNSF "�1.1�Yz Ate' eB-C aPDTR ��• ore�N n rt - _ �22' i 1� »GAGLTvsrm N�ACEI n �EL fD raea,ur - suR oAGONAL eruct S•3/B�OWBOLYS _ a�ous wr iuro .J 2D NdTNtOOJF55 I L R/sR5�G4G4LV.[J AND 2 wLSNERS ws51♦�RS 7YP i VINYL LINER FLFlANSSECL�IDC�TgNS / - TTRUI _FABRICATED 5-We*Y.0Dt75 N S OTHER ITEMS BRACE STAR LINE STYN eR..wv �. NVrS AND WA9Eit5 1 TYF J 1�SSIDUR� J 2D 1LTHICKNESS 20 HL]MLtIF55 " 501IR LIIE I I Vpm LNER VINYL LINER etLGAue STm STAR LIE r S-3/B1YBOl75 PANEL • - 1A175 AIO2 A9' y„r - . AZ - 1 8A _ SERIES 550 5 650 STAIR CORNER N. SERIES 850,950& 1050 STAIR CORNER- MOTOR R SERIES 750 STAIR CORNER r1 . /1 ' /�J , .� -——►.——— "'I 1•A'FA,WE ASSL'1BLY 's 8 �� FX3 ER RTE7N rrPlcAl MERE sFForFI - T FiTE _-- — — ► �.. /IETUNiM _ ► s YI'FRUE 3 PERYAFEtFTU' - AssE7Aelr I - 1 r,A L :R-�\may/\ _ PERsampeny 1, WN MNE7Zq QD1N]m I 1 _ SAFETY LSE .. _ - Y ?i A. sNADEo =` I rS 1 < � 2 I PORTIDNs I � LF'L.T i hPAP , � 1 m I PRESENTS AWEAS _ [LOC_ I r n NAAY ff .I sIDInAER m SUCmTl S�SI b 32 SF SURF.AREA b.165.Qp�.AI•CJ1P ;9,srn IS T ' _ FBr3659i SF SUREAREAL 2CO2GALCAP X'YOIt2' - �_m -20:10'T9fi SF SUEAREA L co SERIES 2000 S 2050 INGROUND 2 'A'FRAME ASSEMBLY 'O 0 ?_7�Tf"D SUE SHOWN•1� L.4T 78A SF SLXW AREA G,24000 GA CAP TYPICAL WHERE SHOWN- - SWAM ARE OPTI .. PERYAI LINE ATiC10 . ► —~ —� SERIES 2100 8 2150 INGROUND SAFETY LINE ---1 ♦ TtIeF SIZE SHOP" FP26-M 90'EL.822 zF SLOW AREA 1 I - 1 _ _ 6 26928 GAL CAP PERMANENTLY SERIES 2000 9 2050INGROUND t".� ATTACHED - SAFETY LIE 1 r511ADED POiRFOHS — RE7'l1ESLC7S Fta AFtEAS ����Z M,Fys'� 1 IN D I ' • ' = ASSEMBLY L--�---i TwKAI MVE �I�EP�1��\ SIZE SHOWN:19-3r 567 BE SURE AREALL 20720 GA CAP NA ALSO rA ./ti1I'713 SF SURF.AREA L249W GAL.CAP - ZM4V 835 SF SURF.AREAL 29223 GAL CAP SERIES 2100 8 2150 NGROUND V o I G �- � � � � .- �� � �� s o � r �' V � 1 Vv { r � � � i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a-7 a. Parcel Health Division n a°-" �.�1 � X�`ate Issued a Conservation Division �, oZ ��. e"" d nT il Eder" 0- IF Tax Collector (Z — V L B16 a Treasurer k to L y t D , Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village U y AWAZ's MA St Owner EDWAU Jfmu 9-4,Qa4 A)14-1 wAO 5K, Address .633 k';Nco,A2 RIO Fx -t- Telephone .fB r '7 To y'3 y O Permit Request but ir_;.d M �a�,���< Api 0 .400 rri A -L T 2 -ro L< t«cf. r -0 194 1-91 GaAfkt,, A)e' &PS ewt Ttim -e— �+�� AJ t 6 A Square feet: 1st floor: existing 64q proposed I 2nd floor: existing 5� proposed `1 Total new Valuation 901006 Zoning District Flood Plain A10 Groundwater Overlay Construction Type woo b Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family LR" Two Family ❑ Multi-Family(#units) Age of Existing Structure 91 'yA5 Historic House: ❑Yes 2110 On Old King's Highway: ❑Yes UKo ; Basement Type: ❑F4 Cl Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �G y Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing A new ! Total Room Count(not including baths): existing �5 new 3 First Floor Room Count :3 Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes M Flo Fireplaces: Existing NO New Existing wood/coal stove: Yres ❑ No Detached garage:❑existing ❑new size Pool: existing Q new size 14,1j,3Y Barn:❑existing ❑new size Attached garage:❑existing 3 new size Aq Ac 9 Shed: xisting ❑new size 8 x to' Other: F•?C ia' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed.Use _ BUILDER INFORMATION Name 0) 'VAR n R Lk )LlT c , Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE _ � DATE G—2& 0-t FOR OFFICIAL USE ONLY i P . PERMIT-NO. . DATE ISSUED + M:AP/PARCEL NO: ADDRESS r VILLAGE ; OWNER DATE OF INSPECTION: - -� FOUNDATION 9 ? ��' a O �� �'O J✓ !" FRAME r , INSULATION l/7/Q'3 O/� 'G FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH` ' FINAL FINAL BUILDING DATE CLOSED OUT /t Ci - ASSOCIATION PLAN NO.fg- t a t it q The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner ' 200 Main Street,Hyannis MA 02601 Office: 508-862-403 8 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 than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. /J Type of Work: k QOlI Ti 0Ju Estimated Cost b e ti Address of Work: S S`� 4 C o2 n ELL .Owner's Name:' �'�W�✓l� � K e � � Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law FlJob Under$1,000 EJIBWlding not owner-occupied Mid`wner pulling own permit Notice is hereby given.that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ' Date L- Zg-o`"L Contractor Name Registration No. OR q:fo=:Affldav :rev-122001 ___-- 77te Commonweallh of Massachusetts Department of Industrial Accidents ' O117cr ollatartlOa�oas -- - 600 Washington Streat ' Boston,Mast 02II1 Workers' Cam ensati n Insu r=CC AffIdavh naine Co u 2 0 rhanef - -7 7 I am a homrownar pezfc=ing ail work myself ❑ I am a sole progseter and bavc.no one_ wo any Q � �•.:•:x.K`.•..:}..r:.2.,.:•..}:....i...v.....x.-.:..}.....:.x..........:...x.:....:.4.:.,....r.:;:......y..+.a:....:.....,.•..,,{..........:.•,.r:.:.:x....:♦}:.x:.•..E:....r.G:.v....i.....r.v....v,..vvf.....,.Mb....,:......:..+..r...vi.......M.....-.•.T..•:,.n..;:vv..4:..:....X:.vx../•x4.x.,:./?.r-.::v:..•:.-...,n.:::..•..b.r-.....>...,....:v,..F..:.,....;.x..e«:..w....T.}.a:..ex.]->.,%.1}}i•.:,}.':.Yr.w.x..l.>...5,%....r{.:.y^....>w;.!.•.v.,..:.r.!r.:y...:}.:n..:.y:...Y.>'....}......}.v.::»..h.!.:...»C}:.L.r•..:.EvG.;.:.}.:r.w.+...:..%.......:.•....R},...:.v....Mr.•:r..:!...:�r...M,..:.,...x.2..•...,.-..xY;,..,.}:..u.:n..M.,x...A....;....$.b.v........:..}..:.v-x:..............:.A.......;.v:...: .r.\.::..:..:w.wr.:..•..-„:n.v.x..!....M�:l A:,:J:!.WY w.}-+�.,.:..n-...Y•y>•.:?..>n.«ey,a+:-.,n�24.a.,.y.4P}J"�.,..♦..J)..,:v.\w�•>w'.'....>.r.4.....,A..::..,�:f..G�f�v•)v•:.t�i.....-....,w�..r .a1.0..{KiKOaxY�V aC+\.•g.f`.L.�a e*,m t..h.y vthis ...^job. afa CA7m .!r.c }2.r.�sw.':t.•:..}�.v,•{,.2wv{a.`�•.:ev.;:.:!>.-�..v..r:.v:r... : Y..'' .t \ .%J.-,.}'Yi♦.}.•:;h.,iY.,.s�::y`.♦j;.�K.}.N..y':,::.,J}.::�+..,vw:ry.,.:.;;w::{;<>.yi..::"n:•::•..{":4: {.. {:._•Y:S:•>r{::';::..i C::.-:•vv:ifi:+:•}i?.Cx•3�.-'-:i;>}?:yC!. � ..rr•:i:icaa:::.:M2.:2cx:.,4E:^?:' !. �:camaacrrnIDc`rx ,....�,-.... :.�•:�:`• w,:i..n n.Lw.,: ..:.... .....:... r...w v.v.•..r....... r. .... ...v.v... ...:.. .n v v.4xR .....x!.....:.. ....... .......... ., ...J.x ... .3.�\fib ... .X.. \•X?•.,...,: ...... v.xr... }i..v...,w.......n..... r..wrx. x :...v:..!•xZK... .. i :.. :xb.\`. 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Ida harby certify under the pmra mid pataZda of p - ' tt prwidedaboae is trine artd rorred SigQatiae Date d��a O 7 _ print name .�`� n 2 /c4-r✓ — - 5�a 3126 01IIda1 nss only do'aot writa in thb area to be a mgieted b7&y or town ofdd city ar town: P ' ❑BvilIIlat Aeps °cot CLUmsint Board ❑rheckif immediate rmponse is regmred C]Sdectmm's OM= _ ❑HmHh Degac=ca' Contact person• Information and Instructions yiassachu.sectts General Laws chapter 152 section 25 requires all employers to provide workers* compensation forth.�_r ;mployees. As quoted from the "law", an emptoyee is defined as every person in the service of another under any cow of hire. e1press or implied, oral or written. An employer— define , par d as an individualtnership, association, corporation or other legal entity, or any two or more of ed is a joint enterprise, and inciudin the legal rcprrseamtives of a deceased emplover, orthc rec.-tver the-foregoing engag J r g to truster of an individual., partnership, association or other legal endty, employing soup yees. However the owner of a dwelling house having not more than three apatmicats and who rcmrlcs therein,or the occupant of the dwelling house of another who employs persons to do maintenance, ca rinse ian or repair wane on such dwelling house or on the grounds.cr thereto shall not because of such employment be deemed to be an employer. building appurtenant . MGL chapter 152 section 25 also states that every state or local.licensing agenep shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the coic�t who has mmonwealth for any appl not produced acceptable evideaoe of compliance with the insurance coverage required. Additionally, rci+ the commonwealth nor any of its political subdivisions shall etrsct into any contract for tine performs=of public work anal „eptable evidence of compliance with the insurance rzgmr=mts of this chapter have bees presented to the cortua : authority. - APpiicaats ensafion affidavit completely,.by chccldg the.box that applies to:pour situate and Please fill nm the woriccrs' � . sttgplviag coMpaay names,address and phone mmzbers along with a -of insurm=as an affidavits maybe submitted to the Department of Industrial Accidents for cm�mazima of insuraacxS°. Also be sere to sign and date the affidavit The affidavit should be.retained to the chy crtawathatthC appii�for the permit or license is being zegnested,not the Departsae�of Industrial Accidents- .Should yua have 27F q=d=regarding the"law"or if 3•cu are required to obtain a wo6=3' compensation policy,please cin the Departure atthe number listed below. . i City or Towns _ _.. _. .... . l This D as==bas ded a space atthc bottom of th Please be sutrz that the off davit is complete and printed Iegib.y. � P� � licaza. *FIm.Te a$rdavit for you to fill out in the event the Office of has to contact you regarding aPP be saute to fill is the p�.,,,,rA, e nuzmber whtch wd1 be tLsed as a reference nibe3. The affidavits may be rcnaa t" the Department by maul or FAX unless other arrzog= have beearaade. The Office of eons would h1c to thank you in advance for you cooPeratica and should you have any questions. please do not hesitate to&C us a call. The Deparancat's address,telephone and faxmunbar: The Commonwealth Of Massachusetts Department of Industrial Accidents amce 01 Imtestluatlons 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r Table Jl=b(eaadaamd) . • Praeriptfre Paekzga for Oam mad TwaFxn*Reaidddd Ruddh W Seated with Ftxd Faab MAXIMUM Glazing Glaring Ceding Wall Floor Bnameia Stab Area'(%) U-value R-value R valuo' Rivaled Wau P Pacl=e R.vains' R.valad 5701 to 6500 Ham De6ree DXW Normal Q 124'. 0.40 38 13 19 10 6 aromd R 12% U2 30 19 19 10 6 NAFU 9 12!'. . 0.50 38 13 19 to. 6 85 rm2l T !S•/. 036. 38 13 u WA wA N� U 15% 0.46 38 19 19 10 6 Normal V WK 0.44 38 13 25 WA WA 15 AFUE W 15% 032 30 19 19 10 6 83 AFUE X 18% 0.32 38 13 25 WA WA Noma! Y 18•/. 0.42 38 19 ZS WA WA. Aloetied Z I S•/. 0.42 38 13 19 10 6 90 AM AA 19% OJO 30 19 19 10 6 90 AFUE 1'. ADDRESS OF PROPERTY: 3 C`)�"' MA-6 S 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 8 3. SQUARE FOOTAGE OF ALL GLAZING: 117 4. %GLAZING AREA(#3 DIVIDED BY#2): Jr 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERUMMG ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION- BUILDING INSPECTOR APPROVAL: YES: NO: q•form-f980303 a 1 Footnotes to Table J5.2.1 b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and ' basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area. expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example.3 ft'of decorative glass may be excluded from a building design with 300 it'of glazing area. z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken'from Table J1.5.3a U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness. over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R.19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to fra wood- me or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned cnawlspaces,basements, or garages).FIoors over outside air must meet the ceiling requirements. lire entire opaque portion of any individual basement wall with an average depth Iess.than 50%below grade must mc_t the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned br.,ements must be included with the other glazing. Basement doors must meet the door U•value requirement d_scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment,the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2-la NOTES: a)Glazing areas and U•vaIues are maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include strueunal components. b) Opaque doors in the building envelope must have a U-value no greater than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One.door may be excluded from this requirement(Le.,may have a U-value greater than 035). c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: (o— Z 4'i—o-L JOB LOCATION: '�3 3 l^ �Co1 2 SxT c(l�111J i S number street village "HOMEOWNER': 0W,441) tit !,J�A u name // home phone# work phone# CURRENT MAILING ADDRESS:_�� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow 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"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of omeowner 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 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. Q:FORMS:EXEMPTN `ae N } nor 47 ' /ao• oo ' 4(o h Ex IS s FOUjA �T J 90 o L o T 45 TM/S 4-07 /S ,moo 7- /N THE ALOOD ' Re-191AJ ZOAJ6 . PfJ2iTF3n/ 13C.D . GA. . &2 ge&!= &,4. 8EfAl6 LO'r 4 Sf-!awIV o . NINi�g1L11 a Nice ey a�.arr.a�Y rNAr rN� ec,�i,ctr••v� M�.Uti► .VAAOWr.1 ov rN.',a AP4AOA✓ /V ov 7W& Yf�jeriov7'H, ,Ass. f o+*►�� ��. t,�gw�a. auaaa+�-oars 7 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# ` o 13 Health Division 0 ! D �2�/'t Date Issued O Conservation Division Application Feer9-b� Tax Collector J� Permit Fee Treasurer Planning Dept. '!"Pf�TiTa. Date Definitive Plan Approved by Planning Board r"0PE-MTAL CODO MO TO N ftEGULATION13 Historic-OKH Preservation/Hyannis Project Street Address Lcow Yea 6—X t Village Owner L?a�w�ARn L.4 U r ya W k 4 uc( J Address 5-3; L,'c�raiw �cn nR- Telephone _ 4-®2 _ 75 d - ` 1-15 0 1 1 .Permit Request 'A6 X a 4 e�� .Square feet: 1st floor: existing proposed 2nd floor: existing proposed 11,94 Total new ?I d Zoning District Flood Plain Groundwater Overlay Project Valuation 10,000 Construction Type 0000 t Lot Size y �''e5 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 2r Two Family O Multi-Family(#units) Age of Existing Structure ;2k YK S Historic House: ❑Yes L34o On Old King's Highway: LJ Yes t9-No Basement Type: 34115111 ❑Crawl ❑Walkout ❑Other Basement_Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �G Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing_ new Total Room Count(not including baths):existing S new First Floor Room Count Heat Type and Fuel: YGas ❑Oil ❑Electric O Other Central Air: O Yes 344o Fireplaces: Existing X-16 New Existing wood/coal stove: des 0 No Detached garage:❑existing ❑new size Pool: @19xisting ❑new size Barn:O existing O new size Attached garage:Ming ❑new size Shed:2e'x'isting ❑new size Other: Zoning Board of Appeals Authorization 2- Appeal# a-O ba- - 017 Recorded 9-- Commercial ❑Yes 8 o If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name_j>�,�v�q,2© 2 (� �'( Telephone Number Address Xl W-t Qw N Z R— License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY � 1 PERMIT NO. _ DATE ISSUED - MAP/PARCEL'NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - ' PLUMBING: ROUGH x . FINAL GAS: ROUGH k - } FINAL FINAL BUILDING fiii/' L /^Zo 3 61< - DATE CLOSED OUT i t 5 rs x ASSOCIATION PLAN'NO �: a 4 A— The Commonwealth of Massachusetts Department of Industrial Accidents Office offnyesaffalfts 600 Washington Street y Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit ' -name: 2 location 5 J 3 L I AI-C-d t°' X® � ci u /Y1 zK r 6 2G.iS• hone# I am a homeowner performing all work myself. ' I am a sole proprietor and have no one working in any capacity ISBN [] I am an employer providing workers' compensation for my employees working on this fob .tom i,,.e� ;C Vg 1 r.:. t Yiry'c-+.c— ra maga'' 'gfu, :t�'ts�.�.:'+'stl# 'QLsr'3.Y. +..�W, cm..+;,:" :: 'x 's„t3sz.''.� AHdJ '' .s F t t"i' �'r z- r 3 <t,,, v,',k 4 f. \r.-3yi ;'w..d,3y� wC f �K Fa. r'r � 'K7 � >2,YM d { fh.r ty`xr{'22�i `r ^s�t. r' 'sa $r �� :-brit x7 rn'0 >,. 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"i u,^a,,1'+ f fr •}lone� Ya94r''�F4- c3 Y i"i.t �'�Z'�.r',.rc �.'d�,�ul�"t2''�`�% �`�r CI t:; t s 4 "rn9 S sna r x k 1 . p t Rg }.y�''e xz..i"cr+ {'^� ru+f �y:�' 's.�'u t,aT-� p 1�N�4"`'S:L'� '`_�''"•it �' }E�`'4�'7+�; 5 ?tt .7..:..s �PS�'v-��"7 �7��r� v�i..""i '� nf,� 9 4 4 R.{� �.+�f r.7 a Z�} _' � �I .r� � 5 } 7 r lV 1 k J +w 4S�' Ft"•f.W '�Tr. y 6,� .ti+ai;l ry,t,�t".ycl"�J9ypft '�' �� M1�m• � 7�-•fvs,ru s'". s l L a It " `:`°� r� "# 'F {r 1 1 Py! tt��g"1���C��L, N�����'a .IOSUr84CC CO'U�"�''�4��'^t�' r��}' ��"k•r. `,G tJ+ ��M1t ,F, �F� '1 t 1 r S:a'S z PdIIC�v^�-t t.+ ti m s, rx 1.+ Yt �4'i 'kt t�r'� r.. �': 9" [] I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices aVr ry ray M13 rs �I,F� { r,. s r-•^.t, . is ,.y'y�,f,ir� ?-;�} xs•"' ','L'C ti�i-, '- d .a' �!`5 ° ': 'w y'.�7 Ly r s��.SUgsL r.s �yt,r - �`�.`'`5 � ;'o!"ti5k .#�' r.' �r�' '�' '^:tiky _.ice 44. -.`Jr ,1.' t} µ t:r 4t r� ti yLr` m4 it �r ,t�i r.L a^7'�a,fi.0 Wit. 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Md> ..r. ;:�dr'S`"c',ULrli{a' a .J .A�r, r '�'','Y.LY xbwFr -Z' r'4 +�+ Y7w yr fr.�+t`; � '"$4`heasn''�7'*W#' ff"a. r i.-,n t r � it �a;�9F�,ia�„r i„ �t ta'•"��� F ,y..:i.s s! s�l_';. is 9'4ffi t,+t ka�r � s�.7r` wo y,;•+, lk r ass a >t �r .-.�r.rt'N�. r* i � .:s<M y I, •i 4 t+ x. ;+,.r,'S.. ,n-s,� ..{.,r } '^-u' �. au��•��i��,,.#'� ti�tt+<.r t1+r f f,l!` a _y `''r s z y r ti„..`r : r ,,i��5.:. i3�i q,+ ,�1r.�y"hr,(. s 4 +F ys�}F��t �+� y-'Y'y�'�'.' '' '*'Ypr;ias.€`-b:w r� i�} {;rs�•� e�7a $ �? .�z .. + r'i7 �f 3 � f r �i-�'''i4v'i`...''� as , .x sr<S ai 1 ae � i �s�t:�s+-r. S,'f 'i r' "z aa -_<'1•p011��'tr h-' S...r v t"...Fr....�Y. 4'y-G-C� � �'�,a...w,�'�'^..�`F'�?'.p�.�;v tlnSLLranCe CO �'"`� r tL -" Failure to secure coverage as required under Section 25A of MGL 15Z can lead to the imposition of criminalrpena]ties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that th nforrnation provided above is true and correct. Date S ignature I Print name (��w ►� ✓� I J L^ �' I/ Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# FIBuilding Department ❑Licensing Board [�check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; nOther it s (revised 9/95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an 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 section 25 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,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you.have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. 1132 City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out.in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 oFZME�pk Town of Barnstable Regulatory Services sT'BL ' Thomas F.Geiler,Director MASS. 9`bprF0;A�A`'� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 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 than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Work: QT 44 C 4Vi Estimated Cost Address of Work: 1�_Cn it, (ZO Owner's Name: ,, an l v W I Wn. Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []B not owner-occupied caner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME UYIPROVEMENT 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. Date Owner's ame _ RESIDENTIAL BUILDING PERNUT FEES APPLICATION FEE New Buil.dings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSB EET NEW LIVING SPACE / VSO square feet x$96/sq.foot= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft. ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) . Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming-Pool $25.00 % Relocation/Moving $150.00 (plus above if applicable) •� � ' Permit Fee 7r The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 4— 9- o- JOB LOCATION: 5 33 t,i s>✓L o I 4J � (S-X fi ___ A-isy'a number � 0 street vi age "HOMEOWNER': C U-Q ��1 AA, 5za-7 U -5,4Ci (1 5oy-3f-6 to name home phone# work phone# CURRENT MAILING ADDRESS: 5`33 Lt rt-C6 OA/ tee city/town state zip code The current exemption for"homeowners"was extended to include owner-oc'c ied 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"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. A - IAJ 0 Signa 'rofkomeowner 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,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 fomi/certification for use in your community. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �-7 Parcel Health Division `l 9 �; .: �.� .,...;'t�:'a=', . I ��. �a. ate issued `�..— �S', a o� a�.�9 Conservation Division i' 0 t"'UZ. f Fee Tax Collector B/d a Treasurer AQ L Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservgtion/Hyannis Project Street Address Village_ v A0A,S M4:K Owner x eil „L Address 5 3 3 k l"cow R a ac(- Telephone O SI — 7So 9,Vf o Permit Request. 13u;j,K; ` �—_f,�&LAIC it m,.l Q .iCln n��r�.'.�'� i9 0 2,Z 7 2 To K�•.r tk<< P pw 44 11 .S Square feet: t st floor: existing 6 proposed I y 2nd floor: existing G SG proposed `J 9 p Total new (aluation ad o O o O I Zoning District Flood Plain NO Groundwater Overlay ,onstruction Type_ Ao N .ot Size ce,s Grandfathbred: ❑Yes ❑No If yes,attach supporting documentation. )welling Type: Single Family L9�. Two Family ❑ Multi-Family(#units) .ge of Existing Structure_ Historic House: ❑Yes 9110 On Old King's Highway: ❑Yes Cho asement Type: ❑ICI! ❑Crawl ❑Walkout ❑Other asement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �4 y _ umber of Baths: Full: existing new Half:existing new :amber of Bedrooms: existing new ital Room Count(not including baths): existing new ,^ � First Floor Room Count mt Type and Fuel: I9'Gas ❑Oil ❑Electric ❑Other antral Air: ❑Yes &1<0 Fireplaces: Existing ND New Existing wood/coal stove: CRIes ❑No tached garage:❑existing ❑new size Pool:W�dsting ❑new size 1��K;�� Barn:❑existing ❑new size ached garage: existing h9 new size . ay xa y Shed:Ming ❑new size 8 43° Other: r•;eo;j ling Board of Appeals Authorization ❑ Appeal# Recorded❑ mmercial ❑Yes ❑No If yes,site plan review# rent Use Proposed Use BUILDER INFORMATION Telephone Number Iress _ o �� License# Home Improvement Contractor# Worker's Compensation# CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Doc:915 692 04-09-2003 12:34 03BARNSTABLE LAND COURT REGISTRY �F THE►pN, TC V7 CL.E R K 1ABA1SiABLM .. MASK. � f6�9• �0� .:.. i prED MA'S A Town of Barnstable ZoningL Board of Appeals ; Decision and Noticey � Appeal 2002-97 — Whalen Section 3-1.1(3)(D), - Family Apartment Special Permit O U)Tu , Summary: Granted with Conditions ` i Petitioner: Edward Whelan �� Property,Address: 533 Lincoln Road Ext,Hyannis,MA Assessor's Map/Parcel: Map 272,Parcel.183 sc r y Zoning: Residential B and Groundwater Protection Overlay Districts J �. 1 Relief Requested &Background: Appeal 2002-97 is for a Special Permit to allow a family apartment in accordance with Section 3-1.1 (3) (D) of the Zoning Ordinance. The locus is a 0.40-acre lot. The existing dwelling is a one-story,three- bedroom single-family dwelling constructed in 1981. It is serviced by public water and a private septic system. The applicant is seeking a family apartment special permit to allow the development of a studio %,j apartment above the proposed garage and a new kitchen/breezeway. The applicant has identified that the apartment is to be occupied by his nephew, Douglas Williams,Jr. Procedural & Hearing Summary: . .9 This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on July 03, 2002. A public hearing before the Zoning Board of Appeals was duly advertised and notice sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened August 07, 2002, at which o time the Board found to grant the family apartment special permit. , Board members deciding this appeal were Daniel M. Creedon, Gail Nightingale, Richard L. Boy, Ralph Copeland and Chairman, Ron S.Jansson. The applicant, Edward Whelan represented himself before the Board. He explained the apartment unit and proposed construction noting his nephew would occupy the apartment. Chairman Jansson asked Mr. Whelan if he understood all of the requirements and restrictions for a family apartment as itemized in the Zoning Ordinance. Mr. Whelan responded that he did and the O he would abide by all of those restrictions including removal of the apartment unit when it is vacated. The issue of family member was discussed. The Board noted that Douglas Williams,Jr. was a nephew of the applicant. It was determined that the requirements for a family member were met. Public testimony was requested and no one spoke in opposition to the granting of the family apartment permit. Findings of Fact: At the hearing of July 24, 2002, the Board unanimously made the following findings of fact: 1. Appeal 2002-97 is that of Edward Whalen seeking a family apartment special permit in accordance With Section 3-1.1(3)(D) of the Zoning Ordinance. The applicant seeks to add a family apartment of 480 sq. ft. to an existing dwelling. The property is shown on Assessor's Map 272, Parcel 183, addressed as 533 Lincoln Road Ext., Hyannis, MA in a Residential B Zoning District. �- .C- �a 2. The locus is a 0.40-acre lot. The existing dwelling is a single-story, Cape Cod style home constructed in 1981 and consisting of three-bedrooms and two-baths,serviced by public water and a private septic system. 3. The applicant is seeking a family apartment special permit to allow the development,,of;a,stu apartment above a proposed garage. The applicant has identified that the a artment.r3zt i�' pied` s PP p , by.his nephew, Douglas Williams,Jr. 4. The applicant has testified before the Board that he understands all of the requ l'i Ments and y restriction for a family apartment and that he will abide by all of those restrictions include removi r of the apartment unit when it is vacated. y r 5. The applicant and the proposed family apartment unit comply with the requirements Se�cti .1 (3) (D) of the Zoning Ordinance. X �. . 6. The application falls within a category specifically accepted in the ordinance for a gran Permit,and after evaluation of all the evidence presented, the proposal fulfills the spirit aid intent of, the Zoning Ordinance and would not represent a substantial detriment to the public good or'11��' neighborhood affected. Decision: Based on the.findings of fact, a motion was duly made and seconded to grant the appeal with the following conditions: 1. The family apartment shall be developed as presented in plans submitted to the Building Division, a copy of which was entered into the Zoning Board's file, entitled; "Whelan Residence", and consisting of 7 sheets. 2. The applicant will have prepared a certified plot plan of the existing and of the proposed addition to assure that the addition will comply with all applicable setbacks. A copy of that plot plan is to be delivered-to the Zoning Board of Appeals Office and to the Building Division to be entered into the files. 3. The apartment unit shall be maintained in accordance with all requirements of Section 3-1.1(3)(D). 4. The family apartment is limited to one-bedroom and shall not exceed 480 sq.ft. 5. The on-site septic system shall meet the requirements of Title V. 6. The property shall be maintained in compliance with all applicable building, health and conservation regulations. 7. Before the Building Commissioner issues an occupancy permit.for the family apartment, he shall confirm, that the required plot plan in condition 2 is on file. The vote was as follows: AYE: Daniel M. Creedon, Gail Nightingale, Richard L. Boy, Ralph Copeland and Ron S.Janson NAY: None Ordered: Special Permit 2002-97 is granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision. A copy of which must be filed in the office of the Town Clerk. 2 6d r. . 4 ZRon S.J , Chairman Date Signe I,Linda Hutchenrider, Clerk of the Town of Barnstable,Barnstable_County, MassachxzseXts, hertz " certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision a�rtd'tlt } no appeal of the decision ha, jen filed in he office of the Town Clerk. _ Signed and sealed this_- _ Y da o, <,- � he ai periGats .fperjury Linda Hutchenrider, Town Clerk',a ..` . ,..... t BARNSTABLE COUNTY REGISTRY OF DEEDS A TRUE COPY,ATTEST MEADE,REGISTER BARNSTABLE REGISTRY OF dEEDS A' New addition Existing House , a o D Effi a0 2 4, 12' Front Elevation DATE 06/10/02 SCALE 1/4' = V WHELAN RESIDENCE . w h. 4' 12' 4' CRAWL• SPACE 10 l 4' slub 2 4' Garage Floor Foundation plan DATE 06/10/02 SCALE 1/4' = 1' ,r S 2 4' ExI&Vng Deck New Deck Kitchen V� Garage existing home xl Main Floor DATE 06/10/02 SCALE 1/4' = 1' �r 2 4' 12' i 4' 5' �1, n l � 9 _ exist ne ho ^ cs 1 r M y ,^ �,J, vp 12' low ' �t DATE 06/10/02 SCALE 1/4' = 1' C)WO Second Floor t?* t Existing House IGUJI New addition 2 2'— 8 " 4 Effl OD OD 12' 23'-7„ .Rear Elevation I DATE 0�7�02V SCALE 1/4 I 3'-8- 3,_2_„ 17'-58" 4 DATE 06/10/02 SCALE 1/4' = 1' I EXTERIOR APPLICATIONS ROOF GAF TIMBERLINE ASPHALT SINGLES WEATHERVOOD BLEND COLOR OR EQUAL SIDEVALLS WHITE CEDAR SHINGLES WINDOWS ANDERSON CO. PEMV.SHIELD INSULTED GLASS FIELD APPLIED 1X5 BOSTON CASING TRIM R2 PINE WITH KNOT SEALER. STAIN WITH TWO COATS DOORS WOOD BY MORGAN OR EQUAL ^2 — TYPICAL FRAMING MEMBERS 8 4 4ff ALL FRAMING LUMBER TO BE #1,k2 or STANDARD GRADE SILL. 22X6 V/1' SILL SEALER FLOOR JIISTS . 2XICe 16'13C SOLID BRIDGING EXTERIOR STUDWALLS 2X4e160c INTERIM STUDWALLS 2X4e16'13C CEILING JOISTS 2X6e16'OO RAFTERS 2X88 16'0C 4 TIES 1XBe32'OO RIDGE 2XW -T VINDOV HEADERS 2.2X8 (22X1D OVER 8'SPAN) �a MAIN FLOOR JMSTS, 2X12 a 16' OCOR 2X3D AS REQUIRED : 12' TYPICAL TRIM MEMBERS FASCIA IX2/1= SOFFIT . 3' SCREEN VENTING SYSTEM RAKERS, 1X2/LU DOORS/WINDOWS, 1X3 CCAULK It SIDING) BOXED WINDOWS. 1X8 CFRONT) 1X4 CSDDING) RIDGE VENT BR@IZE COLOR. VENTING SYS. CORNER BOARDS SX6/IX4 SIDING 6' CLAPBOARDS OR WHITE CEDAR SHINGLES TYPICAL PLYWOOD SUBFLOOR. 3/4' T&G EXT, PLYWOOD ROOF SHEATHING 1/2' CD-X PLYWOOD SIDEVALL SHEATH 1/2' CD-X PLYWOOD DATE 06/10/02 TILE UNDERLAYMENT 1/2' PTS PLYWOOD SCALE 1/4' = 1' VINYL UNDERLAYMENT 3/8' PTS PLYWOOD CARPET UNDERLAYMENT 5/8' VERSABOARD OVERHANGS. 1/2' A-C PLYWOOD a � i t i S- 5 yV ` n 4� '1 x 1 i rr _ 22ti� �'""'• TOWN OF BARNSTABLE • ., Permit No Building'Inspector I ".unuc 3 Cash --- °"pY,> OCCUPANCY 'PERMIT Bond xx "No building nor structure shall be 'erected, and no land, building or structure shall-be, used for a new, different, changed, or enlarged use without a Building Permit therefor a first having been obtained from the Building Inspector. No building shall be occupied'until a certificate of occupancy has been issued by the Building Inspector.". _. Eugene E. Duquette & Wilf `ed R/ -Perron �; Y Issued to Address 'Soutir Yarmouth Lot #46 . 533 Lincoln Road Yt. -Hyannis Wiring Inspector , o Inspection date Plumbing inspectorlr`^ Inspection date Gas Inspector � L -- ? .rt ' Inspection date ,' J Qom.. ._.�-+►.6'� L i/Engineering Department_,.j.� 1 � Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT -BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. %. ....._w 9 _ Building Inspector Msessor's map and lot number ... .../..G .�"r/�/' .d�. �`. P/° �.��.K �^ - �/d I�� �OfTNEtO�I' a Permit number j SEPTIC SYST Sewage , .r .h.:......................... INSTALLED I E House number. .... ......`...........................................7...... WITH ENVIRONMENT EM 9 0�ND r TOWN rOF 'BARNSTABL "N �� �� '® � B 1LDIHG INSPECTOR APPLICATION FOR:PERMIT TO h.f4a ....ONE=...SZtiI..:.�Rj'Z;'„DGI/L;��i:!`� TYPE OR CONSTRUCTION l� A..............19.�J... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location1. .......�4...tx. ......../.1...�/I�.NAI iS......:........:..�.2G®.I....................... ProposedUse ... .1.b. 'nf CE....................... ........................ ../................................................. ............................ Zoning District ...�.^..1.1... .../.................................................Fire District FUGL-'/J� r.�Or�y vatTl�a .............................................................................. Name of Owner ! .!.4 /3 .P... i..h ;resco ell........................Address ..�'LG....N4....... '1.tl..!J ..�......5.6. /1r2 r tout Name of Builder��?3.1T7�N....1 +?.!.L.17 !�$...8��.� Address Aw....N. �"! 1`N S ....... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...............�.......................:.....................Foundation .......... N..°. .GG......................................... Exterior ...................................Roofing ...... 5. �/ .L .....................--_ .... ........ Floors0.04�.........................................................Interior ............ Heating �. .. .1... ..... ........................................Plumbing ........ .`=5.:....: r- _ - ..::...... . . Fireplace ..... ...............................................................Approximate Cost ................04.6 ............................... Definitive Plan Approved by Planning Board ________________________________19________. Area .........�4/. ...................... Diagram of Lot and Building with Dimensions Fee ......... .F.. ..:. � ................... SUBJECT WT "PPROVAL OF BOARD OF HEALTH 14 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... ' ........ .. .......... � EOGENE E. DDODETTE & WILFRED E PEDBON . ~ 22955 Ouf� St .No -.�---- Permit for ----- —���—� ---. r � __S.i___l�.. Family_Dvv�llil� ............... . . . ` Location .I^��t—#4G—. ]3 5 .. i Roa .. � t. ,___..._8�aooi��~.__.___.^.._,____. Eugene E. Duquette & Wilfred E. Pezron Owner —.---------.-----------. � ` . ' Frame Type.of Construction .......................................... ---.-----..�—.--..^`---------~— ' ^ Plot ............................ Lot ................................ ' Permit Granted —.��—� ..�T�--lV 81 Dote of Inspection _—Date --.-- � � . Completed \ . � . / PERMIT REFU SE0 1 ____._.___----.-------.. lg ' ` - -------~^'-`~^--^^--~-------^'' -.'-----^'�''^—'—'-----'—`-----~'- ' ��...—.—.---......—.—~--.---.-�� ^---. rr --' .. ~—`^'r'—~^--^^^---''~'~---`'` .bv6a ��--------------.- lV } � � ` �__..'____,.__~.____ ........... ' | . - ---'�''—�-------~^--'--`-~—`—^^`' | . .. . � . ./ | ` ' | J 1 1 4 LOT 47 / 7, Soof X 80't 0 O �CONc• /� FOUND. N � � Q �v h V TH/S LOT /S NOT PU,eiTelgnAj LiLD,srS . /N THE r-t-OOD 10e-F31,v OCAJ6 . eoZ>, laic . Loc.gTio.v: S� �s ,�EFELtt/CE: - ' BEING Low' q6 AS .sHotvn✓ on,1 �. � HINCIM -� I4L t1�G7 y 2 i�ICGEBY ClO°GT/FY TN�iT THE BviLaivG ro SNON/.V O,V TN/S AL Ail/ /S L.00og7-&O O.V THE v yeovva i48 SNOWN A.vD T'NgT DP S CO,t/P OAffA�r TO TA+,**AL' WO.u/A/G ��'t3 SU y I BY-LgN/S O.= rAVC- 71:PN/N OF �NSTf3BLE_ n/N�.v cov�neucTEa. _ SJfj,e h o U 7-H, M A S S. .3 � �� � �; � t r � _ C� - � !� i� f f J Assessor's map and lot&umber � . HE / : � F r Sewage Permit numberLN� � d Z EAR33TAFILE, i House number NAG 039, NPY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .::'.!!1.L..`.?............................r�1 " n it�* c-�"',- %�'.'r- n�r r. .............................................................................. TYPE OF CONSTRUCTION ......d - ............ .............................. ..4 h!, �'.6..........Z.� .............19.��{. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..^=f......jam :. ...... ..'. `f. . .... .......� .... A.!m j ' C .��,t:1. ...........................................................". ... . . ProposedUse .....—.......................:....................................................................................................................... Zoning District ...... .................................................Fire District ..............................6........................... Name of Owner r?.1.4 r,�l.?'.... :.,..J)L;z.10 1.4 ....................Address .... !/....!t!......: � ! `:!..r1.....1.�.........:... L ... . ........ Name of Builder"',{sr.r' r;..I �, ,r�:. ...�j..�':.": ..� '. ...Address :!�/r.... eta . p` � ' r.a r. .::...'::'. ... .. .......................................................;. . .. . Nameof Architect ..................................................................Address ...........................................:........................................ Number of Rooms .............................................Foundation .......�-`�t`' � r� i............. . .................................................................... Exterior ..`. ........ .!� ..c_ .. ` •� .1 J L?" L �....-:.-.......... Roofing ...............FI... ti ........... . Floors .. 1,',C? t7 Interior f ", r,.................. .. ......... ........................ _.. r7. Ik , 4? Vi i3 f S Heating ......................................�.........................................Plumbing ....... ............ Fire lace > .p �" "..�................................................................Approximate Cost ................:,... ......:��............................... Kc l Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ......................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO•APPROVAL OF BOARD OF HEALTH � (r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name !^'.IJCt .:!'1 ;':..... `.............. =272-6--4"/B3 ' EUGENE E. DUQUETTE &No 22955 Permit for One Story ................ .......... ..................... Single Family Dwelling ...................................................... Location ... Lot #46 533 Lincoln...Rd Ext. Hyannis ............................................................................... "' •Owner ....Eugene. . ....E......Duquette. . . . ....&....Wilfred. E. Perron .. ....... .... .. . .... .. .... .. .... . .... . Type of Construction .... rame ............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted .....March 2 7, 19 81 ............. ............ Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED/ ..................................................1........... 19 ....................................... .z............................ .................................. ............................................ Q �................... ............................... Approved ................................................ 19 ............................................................................... ............................................................................... I Assessor's office(1st Floor): 2h Assessor's map and lot number C slut Bpi Conservation � e%lCr SEP77C SYSTEIIN MU, Board of Health(3rd floor): L� Sewage Permit number ®oil CA '',='saierant t Engineering Department(3rd floor): Sr.- iD Sy � 0639. `��d' House number iALLE®114 COMpL1A o esr Definitive Plan Approved by Planning Board 19 INS VVI-M ynf.5 D� AND APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only ENV'R®NNIENTA e'LI� TIONS APPROvTOWN OF BARNSTWETr'� E Barnstable Conservation Commir gUILDING INSPECTOR It a LIT Off& ATION FOR PERMIj5&{b ,Icy C( 20AlzT)A I� TYPE OF ON TR C S UCTION 19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: S 3 3 ,C�.�c o.C,� �(�(. iC';t T �/yiq,,,i•�t ASS- Location p 6d Proposed Use IAA4, )0a),e Zoning District !k Fire District yi4>vN lS Name of Owner 4V4,,,Az 40�,e I-A A) Address Name of Builder 4'W 1po r/ , /Uy Address Name of Architect Address Number of Rooms Foundation N/1q Exterior GcJ as ��>V S Roofing v Floors. Interior `-7 c, Heating 71 Plumbing L' & 7 7 y� Fireplace Approximate Cost O Area llt� Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name a Construction Supervisor's License JOS-6 0<--J WHALEN, EDWARD (AN. _ a� to No 34675 Permit For BUILDr DORMER Single Family,, Mell 'Rilcl Location 533 Lincolun €Road iExt. .t i Hyannis G' ± Owner^^ Edward Whalen Typ i,of'Constructiori- Framdl 'Li r. :.Lot Permit Granted November l , - 19 91 Date of Inspection 19 Date Completed 197. - `* t V. cr too 1 # f 7 t ! 1��'�'ivNJ S �i0 5 S• �o-�d� la� P2�No3�,d Da2�te2 �c�2rue2, is P;roh �� ;vd ,� lacy ay� �k•s�i� �,�b .a l ser�R�Iz � ayx/6 '��fi c- 1 p co 2L4� 5 s e ��c �.ti i y ,� ��o6d ,e y,-1�e 5!���,re� /�3 ho/z-/-t-e,/L �.T./t e✓ 13�T 2c>a T�i ��/�,d a 6-"c 0 ,/)G/z,l/L t. eP-R eGti - dC`X%, Z"-2 d /.v i S h �cb 4,w Tfa! I-ATe2 /tCS�JF �� TIql G�oue/z�� /v�T� Fide, ,(�s5 6/�se Sl,.terlas. 7-16 •v� �a v e�2 u� 7'!6 /o� f, S Li e e-!/2a c�k STlz��oeo�Q( 71V s JJ S%2�oo�i� 16 " o_ w Ti`d �'� Fi -e/e 9.. 71-o ti COMMONWEALTH 'DEPARTMENT OF PUBUC SAFETY a OF 1010 COMMONWEALTH AVE. . z MASSACHUSETTS BOSTON,MASS.02215. LICENSE ENCLOSE CHECK OR MONEY ORDER i EXPIRATION DATE o 19,;_.3 '' CONSTR.. SUPERVISOR FOR REQUIRED FEE, EFFECTIVE DATE LIC-NO. MADE PAYABLE TO RESTRICTIONS . j i_.i_ _;t")/y -r_i y ��j C;,: "COMMISSIONER OF PUBLIC SAFETY" (DO NOT SEND CASH). r-i—,ii-_;,ti f.ii(? t-ri.Lf":j`��.Y'= I�t1I ! PHOTO(BLASTING OPR ONLY) FEE: .I (Jui. i-t i.) . HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY SIGN NAME IN FULL-ABOVE SIGNATURE LINE I STAMPED-OR -SIGNATURE OF THE COMMISSIONER Does THIS DOCUMENT MUST BE CARRIED SIGNATURE OF AI ENSEE .p« SIGN NAME IN FULL-ABOVE SIGNATURE LINE THE HOLDER WHEN - G. P THE PERSON ' OTHERS-RIGHT THUMB PRINT- ED IN THIS OCCUPATION COMMISSIONER j r Regulatory Services �t Thomas F. Geiler,Director Building Division TOWN, Q AR ST f `• Thomas Perry, CBO, Building Commissioner ABLE 1639.1 9 2 Main Street, Hyannis, MA 0260 1 x k, 00 S 7• '0l � �, y � t.��.�i � I www.town.barnstable.maxs Office: 5.08-862-4038 Fax:. 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: ow an e��►A�+,1- My name is I am the owner/resident of the .. property located at: S 6 Q%�V coc LsX�r The following members of my family will be the sole occupants of the Family Apartment at the . aforementioned address: Name &relationship to owner: SPeV e Ge a,iiS 6fdt-ev� 14'.) L-1 V✓ 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 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA 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 l U 1'K day of �j 4Nvwe- 2013. 710 3y56 Signature Phone Number Print Name ebw v!gin- e I' q:forms/famaffid.do c rev 11/08/11 Town of Barnstable Regulatory Services oFt"E Thomas F. Geiler,Director. Building Division To J ' OF BAR; S 1 A F1 E ' Thomas Perry, CBO,Building Commissioner 1639. 200 Main Street,. Hyannis, MA 02601 I' P ifs I www.town.ba rnsta ble.m a.us 1 Office: 508-862-4038 Fax: 508-790-6230 DIVISION 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: S3 3 L t w co ij.J it�4 u-5 - The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: k?v �•I �✓ 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 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 fai, day of 5004avl 2012. C �^dt-1Su 3`l5 a Signature Phone Number Print Name L w�n° `"�tr,e t 4 aJ q:forms/famaffi d.do c rev 11/08/11 Town of Barnstable Regulatory Services oFTMEbk, Thomas F. Geiler;Director {{ OF R Building Division IARNSrABLE, + MAss Thomas Perry, CBO, Building Commissionervaa , � 1639. •Ar � 200 Main Street, Hyannis, MA 02601 fp MA'S www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax' 508-790-6230 Town of Barnstable- Family Apartment Affidavit I, being on oath, depose and state as follows: My name is P_ I am the owner/resident of the property located at: 2 3 l-C o 1 w R o Cox M A-S f 016 y l The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: S-rc U e^' G Cs o 0 I'd 71~r vi .j 14K/ Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn.to under the pains and penalties of perjury this !( day of 5A-a,*-y 2011. Signature Phone Number Print Name L5 D UJ A _o (A e 4 P' r Town of Barnstable Regulatory Services pptHe rok, Thomas F.Geiler,Director Building Divisiou nki' BARNSTABLE, Tom Perry, Building Commissioner r 9 �. ,0� 200 Main Street,Hyannis,MA 0260'1 .. l i -) �ATEG Mp'�A www.town.barnstable.ma.us Office: 508-862-4038 ' ' ' a Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is tEbW'A R+d �k tk A-N I am the owner/resident of the property located at: S3 o_�o C5 x� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Sj e J Ce�Cpe a I S / .K"Osve."4� lww 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 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 /sT day of A a6441Ly 2010. d g..�I, 3 Signature Phone Number Print Name 6D w 0�t 1� e t o" Q/bldg/forms/famaffid Rev:12/08 i i I III l'oo i Town of Barnstable Regulatory.Services OFIHE Toy, Thomas F.Geiler,Director Building Division Y`'�r l )f: BARNSiA�iI.E iARNSTABLE, ' Tom Perry, Building Commissioner p MASS. �+i639• �� 200 Main Street, Hyannis, MA 0ID09 BAN 1 4. PM 025 'Alen nay 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 LDWAA-0 9 tJtt!f 14AJ I am the owner/resident of the property located at: - L�P"r°°11+rD o XT The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: �C Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that-I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediaiely 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 13 k day of j 4ovg z y 2009. Signature Phone Number Print Name fs_QcV4n,a Q/b l d g/fo rm s/fa m a ffi d Rev:12/08 Town of Barnstable Regulatory Services �'THE toy, Thomas F.Geiler,Director 7� Building Division FUVV r, sAuvsTAat$, " Tom Perry, Building Commission1poe J4�J 9 MASS. Y f �A 1639• Aim 200 Main Street,Hyannis,MA 02601 1 411 rFn � www.town.barnstable.ma.41__1 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 ����.�� � l�� I am th caner esident of the property located at: 3 3 -r'b<.c 6-or The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationshipto owner: S?e 0 e� �4S-n01 6/07-4"r"x (. w Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this t _day of SAPvAot J 2008. l .Q Sar- 7fu- 3 q Signature Phone Number Print Name_ C-OW A&d A t. 4-c t 4,J Q/bldg/forms/famaffid Rev:1/03 i i Lai* (3 4 Lf Town of Barnstable o Regulatory Services �pFTHe rqy� Thomas F.Geiler,Director Building Division r:r^itt ' "LE a r �k3 i��r-��%� * snxrvsTnst e, * Tom Perry, Building Commissioner v MASS. g �A 039. 200 Main Street,Hyannis,MA 02601 2011 JAH G 2 {{ U www.town.barnstable.ma.us Dt"E "FtJ( 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 �O U�2� ti � �'`� I am the owner/resident of the property located at: Q<-3 3 .`,vc�jtJ 40 CS�L7— ✓�� 0-2 J C/14ry f'✓1 G 1 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: &C 0 fo Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that 1 am required to comply with all conditions imposed by the ZBA 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 I (P Ck day of '::�A,-104/L�_2007. ::�L 0&( K 268- IT 0 -3 V�J Signature Phone Number Print Name b(,Y►q et n YZ U �,e (,4 w Q/b(dg/forms/famaffid Rev:1/03 Town of Barnstable �G Regulatory Services THE t°k, Thomas F.Geiler,Director Building Division fUIRSI � E aaxxsraste, + Tom Perry, Building Commissioner MASS,9q, 2006 JAId 18 Pik 1 4 I 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 0�0 w 14(ZQ RL I am the owner/resident of the property located at: wC6 L) g-0 T f-�c�14''u'w i5 rv1 ASS Map and Parcel Number r1A a-7 c)� PO &f , t 3 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: S��J e.v - G e��✓�S e�e��e c i N �dLcv Name & relationship to owner: r 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 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 S"gauq._Y 2006. L�A o 7�6 -3((S a,. Signature Phone Number Print Name J-2(A/J Q/bldg/forms/famaffid Rev:1/03 a I� Town of Barnstable Regulatory Services IHE rOk� Thomas F.Geiler,Director k ;ns � G is zW °� Building Division snxivsrna Tom Perry, Building Commissioner 95, ( ' { : E,t Lt �° 1 . ��� 200 Main Street,Hyannis,MA 02601 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: 9/©s My name is OD LU AU I -e ht J (2L I am t o�esidenof the property located at: 1`-N Colx/ lea 6�t rt rf - Map and Parcel Number e� 7 D- 1 S 3 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: IsTed.•eti/. Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identif ed family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this r y day of S Avu a t 2005. u- Signature- 4— Phone Number Print Name C-5 ✓t"h 2 (A) Jd-e Q/bldg/fonns/famaffid Rev:1/03 l Town of Barnstable 04 - rY, Regulatory Services Thomas F.Geiler,Directory, Building Division r 2 BARMNSTABI a Tom Perry, Building Commissioner, ? f F � 0i�s. ,0$ 200 Main Street,Hyannis,MA 02601 iOrFn►�+a Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is -e l 4t I am the owner/resident of the property located at: 33 1`' n' ca("' �`o ;cr !�`�Jl.✓n `S Map and Parcel Number The ZBA granted me a Special PermitNariance on Ci— Date Appeal No. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: JTeJ e_A.� C-e-OO 5 /J1-flier ifs Q.r},,j 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 3 rra day of S4,1 v*,#_ 2004. Signature Phone Number Print Name �-.0 ty 4/L 0 � - tJ Q/bldg/fomis/famaffid Rev:1/03 O/C Town of Barnstable Regulatory Services °FINE T°� Thomas F.Geiler,Director ��,��,+� Building Division �}il vs LE,g» Tom Perry, Building Commissionel�� �� 1639. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is �QWA� Uf� (AW � I am the owner/resident of the property located at: Map and Parcel Number m 4p a 2� The ZBA granted me a Special Permit/Variance on --7' 0 2' Cb 7 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: a Ll,C Nt Phl e w Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. 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 -5 day of ro 4/z ch 2003. ��A , � a ,08 -75 6-3 416 Signature Phone Number Print Name w 1)14 to Q/bldg/forms/famaffid Rev:1/03 h Dvc:915� 692 04-09-2003 12:34 ? PM 1;: 03 BARNSTABLE LAND COURT REGISTRY AR S ABLE TOWN CLERK CF THE► � BAAN6TABLy r ' � MABB. a ' t6Jy. `ee pTEO Mpy+ � Town of Barnstable ' i Zoning Board of Appeals Decision and Notice ` Appeal 2002-97 - Whalen Section 3 1.1(3)(D), - Family Apartment Special Permit' '� n'• v • k,°fr�� 1,6 Summary: Granted with Conditions Ed `'_ s Petitioner: "' ward Whelan "� '• $ '+ .�-� .,; � , Property Address: 533 Lincoln Road Ext,Hyannis,MA ', '' fig' Assessor's Ma /Parcel: P Map 272,Parcel.183 Zoning: - 86g- Residential B and Groundwater Protection Overlay Districts c Relief Requested &Background: .Appeal 2002-97 is for a Special Permit to allow a family apartment in accordance with Section 3-1.1 (3) (D)'of the Zoning Ordinance. The locus is a 0.40-acre lot."The existing dwelling is a one-story, thre em bedroom single-family dwelling constructed in 1981. It is serviced by public water and a private.septic system. The applicant isseeking a family apartment special permit to allow the development of a studio apartment above the proposed garage and a new kitchen/breezeway. The applicant has identified that the apartment is to be occupied by his nephew, Douglas Williams,Jr. Procedural &Hearing Summary: . This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on July 03,2002. A public hearing before the Zoning Board of Appeals was duly advertised and notice sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened August 07, 2002 at which time the Board found to grant the family apartment special permit. ' Board members deciding this appeal were Daniel M. Creedon, Gail Nightingale, Richard L. Boy, Ral h —opeland and Chairman, Ron S.Jansson. The applicant, Edward Whelan represented himself before the 3oard. He explained the apartment unit and proposed construction noting his nephew would occupy the partment. Chairman Jansson asked Mr. Whelan if he understood all of the requirements and restrictions Dr a family apartment as itemized in the Zoning Ordinance. Mr. Whelan responded that he did and the e would abide by all of those restrictions including removal of the apartment unit when it is vacated. he issue of family member was discussed. The Board noted that Douglas Williams,Jr. was a nephew of ie applicant. It was determined that the requirements for a family member were met. Public testimony , as requested and no one spoke in opposition to the granting of the family apartment permit. indings of Fact: t the hearing of July 24, 2002, the Board unanimously made the following findings of fact: Appeal 2002-97 is that of Edward Whalen seeking a family apartment special permit in accordance with Section 3-1.1(3)(D) of the Zoning Ordinance. The applicant seeks to add a family apartment of 480 sq. ft, to an existing dwelling. The property is shown on Assessor's Map 272, Parcel 183, addressed as 533 Lincoln Road Ext., Hyannis, MA in a Residential B Zoning District. y 2. The locus is a 0.40-acre lot. The existing dwelling is a single-story, Cape Cod style home constructed in 1981 and consisting of three-bedrooms and two-baths,serviced by public water and a private septic System. 3. The applicant is seeking a family apartment special permit to allow the development_of a stu- apartment above a proposed garage: The applicant has identified that the apartn.,.R't�3` .ctpied by.his nephew, Douglas Williams,Jr. , 4. The applicant has testified before the Board that he understands all of the requ' 'meritsestr> tioi' for a family apartment and that he will abide by all of those restrictions includ: gem.. of they ; apartment unit when it is vacated. 5. The applicant and the proposed family apartment unit complywith the re wir <�� t� �"'�e�:�• - .1 . �,: , (3) (D) of the Zoning Ordinance. 6. The application falls within a category specifically accepted in the ordinance for a grant`.«a Special Permit, and after evaluation of all the evidence presented, the proposal fulfills the spirit the Zoning Ordinance and would not represent a substantial detriment to the public good ' neighborhood affected. Decision: Based on the.findings of fact, a motion was duly made and seconded to grant the appeal with the following conditions: 1. The family apartment shall be developed as presented in plans submitted to the Building Division, a copy of which was entered into the Zoning Board's file, entitled; "Whelan Residence", and consisting of 7 sheets. 2. The applicant will have prepared a certified plot plan of the existing and of the proposed addition to assure that the addition will comply with all applicable setbacks. A copy of that plot plan is to be delivered-to the Zoning Board of Appeals Office and to the Building Division to be entered into the files. 3. The apartment unit shall be maintained in accordance with all requirements of Section 3-1.1(3)(D). 4. The family apartment is limited to one-bedroom and shall not exceed 480 sq.ft. 5. The on-site septic system shall meet the requirements of Title V. 6. The property shall be maintained in compliance with all applicable building, health and conservation regulations. 7. Before the Building Commissioner issues an occupancy permit.for the family apartment, he shall confirm,that the required plot plan in condition 2 is on file. The vote was as follows: AYE: Daniel M. Creedon, Gail Nightingale, Richard L. Boy, Ralph Copeland and Ron S.Janson NAY: None . Ordered: Special Permit 2002-97 is granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of.this decision, if any, shall be made pursuant to MGL, Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision: A copy of which must be filed in the office of the Town Clerk. 2 it . s Ron S.Janss �, Chairman Date Signe I,Linda Hutchenrider, Clerk of the Town of Barnstable,Barnstable.County, Massachi"ses, certify that twenty(20) days have elapsed since the ZoningBoard of Appeals filed thi'�decisf�' no appeal of the decision ha PP PPeen filed in he office of the Town Clerk. = Signed and sealed this f day o . ) i' er n er he peria s A u Linda Hutchenrider, To Clerk. F i t ' 4 BARNSTABLE COUNTY REGISTRY OF DEEDS A TRUE COPY,ATTEST s MEADE,REGISTER BARNSTABLE REGISTRY OF IJEEDS nTM-r--77" °S hk � .:y ., .. 4.yE � ` _ 4� •rv=»^L4`3,Yr3*._� �4� / Y__. _ +_....a-+.._....._ .._.._.... :rho......: a.•y.. '.� '. 5 �8et �• �3�z• tlo- R.. i � �r '. i . 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Fkt � �.'` d - B` Y.y. � v"�".,._ �` 't' �,�'". � _:.^S `.•�,.��• �r,w..�' n� �",W..5: 4s #%� „� :�f+� t,.., ,C@'" .�Y �g�. a ) ��rb;.} 4 FtK�E r� Town of Barnstable do Building Department Services sTnB Brian Florence, CBO BARNv MASS. $ Buildin Commission I.jm = t 1639. �0 g d�¢t 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma us, �,? `I Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is e:D wAvQ.Ii I am thag3eresident of the property located at: 4� 51 L,ww Ce,,w (-a tJAA d I b y The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: S-A eve t.i 6 e no" Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. .. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,-please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this /U ��. day of t4Nv;Ap4 2019. Signature Phone Number Print Name G^n 1<„A urn a� lL 1A 4 w q:forms/famaffid.doc rev 11/08/13 Town of Barnstable WE Building Department a Brian Florence, CBO Mass. �, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit o I,being on oath, depose and state as follows: v cA My name is tEtDtj jik4_c W�A2`ti4 U I am the owner/resident of the property located at: Sf 33 L ,-wco�,o e o ex-r NO O-z , The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Co e,o 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 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 l -AL, day of 'SAN)Av_. 2018. i 0g . '34,4- oo'a v Signature Phone Number Print Name L?(3,v ri_n f"- W�^e 1ug-Q q:forms/famaffid.doc rev 11/22/2017 Town of Barnstable Regulatory Services Richard V. Scali,Director ' Building Division ELI M ` Paul Roma,Building Commissioner 1639. 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 WrA L LLJ tAt t R O I am the owner/resident of the property located at-' N Nj OA 4 C�Zc..eD The following members of my family will be the sole occupants of the Family A:pament of the ; aforementioned address: Name &relationship to owner: S-t,e V p F o n Name&relationship to owner: RR LtD r ` w The Family Apartment will be the primary year-round residence for the above-id�tifieg; 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 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 longcr 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 lh r%- day of S kw,;4AAq 2O17. S-ag -75u --;4 G Signature Phone Number Print Name ►3u,,Ana q:forms/famaffid.doc rev 11/08/12 Town of Barnstable Regulatory Services of rAy, Richard V. Scali,Director Building Division s ' B"x AS& Thomas Perry, CBO,Building Commissioner Ar i639' s`e� 200 Main Street, Hyannis, MA 02601 Ec Mpl 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 CS-0 LU A 2 o fit✓�e-l ArV I am the owner/resident of the property located at: '5_3 3Jive-019.r. (er, 0x t ^4 0O-4a The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: S �e✓e 6-e p rn i t�1,9 tie,_ 1W L4 Name&relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified -:family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this 2 day of j,q N, 2016. 75u - 3Y5 o Signature Ca o�4h ne Number Print Name w✓ J10 K: ,�.L e 14 N1. ✓q '9 5 N NSTge _. q:forms/famaffid.doc rev 11/08/12 i Town of Barnstable Regulatory Services Richard V. Scali,Director OF f6i1gp4STABLE 9BARMABLE .g Building Division `6pr 1639• A.� Thomas Perry, CBO, Building Commissioner ° ED MA'S 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.usslot 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 LY3a14 Q I am the owner/resident of the property located at: 4-C_.?i u LS x.�r an A- J �_4. i . 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 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 IS y,l day of 2015. o� 4 5-dr- 75u - 3v96 Signature Phone Number Print Name e I L4, q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services of roti, Richard V. Scali,Interim Director Building DivisioaOWN 'OF BARN.STABL E "B Thomas Per CBO Building i i er , y 1Mass ,eg Perry, > C ?1 05 �ArFo �A 6390. 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 a 1 508-790-6230 D1VIFS _N 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: 0x-- The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: `!S-te e (tee iS f�✓urt� Sj,., (ww 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 19KC day of J;gxyq c!l 2014. :i�4Ar ✓L b---- 5bt- 776 -3q5 Signature . 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