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0078 BELDAN LANE
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I ,I, # 1 k a )as ,; Y s' �pl }s r 5 )yy Yy U� i�. i •` r:: :. 1. y.d._._� -- s tit - -_ t - - _� J. __ _.. BAP6TABUZ. _ 1619• DIMrA - Town of Barnstable Zoning Board of Appeals Decision and Notice Appeal Number 1998-83 -Sylvia Special Permit Pursuant to Section 3-1.1(3)(D)-Family Apartment Summary: Granted with Conditions Petitioner: Lori Sylvia Property Address: 78 Beldan Lane;Centerville Assessor's Map/Parcel: Map 189, Parcel 031.009 Area: 0.51 acre Building Area: 1,056 sq.ft. Zoning: RC Residential C Zoning District Groundwater Overlay: AP Aquifer Protection District Background: The applicant is requesting a Special Permit for a family apartment pursuant to Section 3-1.1(3)(D) of the Zoning Ordinance. Family apartments are allowed in RC Residential C Zoning Districts as a conditional use, providing a Special Permit is first obtained from the Zoning Board of Appeals. The property consists of a 0.51 acre lot and is commonly addressed as 78 Beldan Lane, Centerville. The site is improved with a one-story, 1,056 sq. ft. ranch style single-family residence'. The applicant is proposing to construct an addition to the north side of the existing residence, consisting of an attached one car garage and a family apartment over the garage. Currently, there is no garage on the property. The plans submitted show an apartment unit of approximately 416 sq. ft. The application states the family apartment will consist of a bathroom, bedroom, and living room. The applicant is also proposing a separate kitchen.2 The submitted floor plan does not show a separate bedroom, living room or kitchen but only a bathroom with the remainder of the space being open. Access to the apartment unit will be from a staircase at the rear of the addition and from inside the proposed garage. The property is serviced by Town water and a private septic system. The family apartment is to be occupied by Laurie Sylvia, mother-in-law of Lori Sylvia. Procedural Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on June 10, 1998. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened July 15, 1998, at which time the Board granted the request with conditions. Hearing Summary: Board Members hearing this appeal were Gene Burman, Richard Boy, Gail Nightingale, David Rice, and Chairman Emmett Glynn. Laurie Sylvia represented herself before the Board. Also present were Jacques and Lori Sylvia. According to assessor's records dated 07/09/95 2 According to a conversation with the applicant on 07/06/98 -.-- Town of Barnstable-Zoning Board of Appeals-Decision and Notice Appeal Number 1998-83-Sylvia Special Permit-Section 3-1.1(3)(D)-Family Apartment Laurie Sylvia reported she will live in the family apartment when completed. She is currently living in the main house with her son, Jacques, and daughter-in-law, Lori. All family members are year-round residents. The plans for the family apartment were reviewed. The applicant is proposing to construct an addition to the existing residence, consisting of an attached one car garage and a family apartment over the garage. Currently, there is no garage on the property. The family apartment is accessible from both inside the garage and out. There will be a bathroom, galley kitchen and living/sleeping quarters. She does not want bedroom walls but rather has chosen to leave the apartment open and the rooms will be divided by furniture. Ms. Sylvia indicated she understands, and is in compliance with, all the restrictions of Section 3-1.1(3)(D) of the Zoning Ordinance. Public Comments: Robert Stone, an abutter, spoke in support of this appeal. Patrice Johnson, an abutter, stated that as long as they abide by the rules and regulations of the Zoning Ordinance, she has no objection (She also submitted a letter to the file.) Vaughn Avedian asked if the property has Title V. No one else spoke in favor or in opposition to this appeal. It was reported the property has a Title V Septic System. The applicant submitted a 1996 Septic Inspection, showing the septic system was inspected and meets Title V requirements. Findings of Fact: At the Hearing of July 15, 1998, the Board unanimously found the following findings of fact as related to Appeal No. 1998-83: 1. The Petitioner is Lori Sylvia with a property address of 78 Beldan Lane, Centerville, MA as shown on Assessor's Map 189, Parcel 031.009, in an RC Residential C Zoning District. The site is approximately '/2 acre. 2. The applicant is requesting a Special Permit for a family apartment pursuant to Section 3-1.1(3)(D) of the Zoning Ordinance. Family apartments are allowed in RC Residential C Zoning Districts as a conditional use, providing a Special Permit is first obtained from the Zoning Board of Appeals. 3. The site is improved with a one-story, 1,056 sq. ft. ranch style single-family residence. 4. The applicant is proposing to construct an addition to the north side of the existing residence, consisting of an attached one car garage and a family apartment over the garage. Currently, there is no garage on the property. 5. The family apartment will be approximately 415 square feet and contain not more than fifty percent (50%)of the square footage of the existing residential structure, which is in compliance with the requirements of the Zoning Ordinance. 6. The proposal fulfills the spirit and intent of the Zoning Ordinance and may be granted without substantial detriment to the public good or the neighborhood affected. 7. The applicant understands, and complies with, all the requirements of Section 3-1.1(3)(D)of the Zoning Ordinance. Decision: Based upon the findings a motion was duly made and seconded to grant the Applicant the relief being sought with the following terms and conditions: 1. The family apartment shall be developed in accordance with the submitted plans prepared by"Devlin Custom Designs", dated 7/10/98. 2. The family apartment shall comply with all restrictions of Section 3-1.1(3)(D)of the Zoning Ordinance and shall be the primary year-round residence of the family members residing therein. 3. The locus shall comply with all Town of Barnstable Building and Health Divisions Regulations. 2 Town of Barnstable-Zoning Board of Appeals-Decision and Notice Appeal Number 1998-83-Sylvia Special Permit-Section 3-1.1(3)(D)-Family Apartment The Vote was as follows: AYE: Richard Boy, Gene Burman, Gail Nightingale, David Rice, and Chairman Emmett Glynn NAY: None Order: Special Permit Number 1998-83 for a family apartment has been granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made 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. 1998 Emmett Glynn, Chairman Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this day of 1998 under the pains and penalties of perjury. Linda Hutchenrider, Town Clerk 3 Town of Barnstable pTHE Regulatory Services BARNHABLE. # Thomas F.Gei = PERMIT MASS. Building ivision- 1639. 10 ArEpMA'�°i Tom Perry,Building ComrW61640 2002 200 Main Street, Hyannis,MA 02601 TOWN OF BARNSTABLE Office: 508-862-4038 Fax: 508-790-6230 PERMIT# FEE: $ S ur SHED REGISTRATION 120 square feet or less Be- I Agp L_o n e C;ev) ev-U; I It Location of shed(address) Village. Property owner's name Telephone number 7 9.0311oo Aaq Size of Shed Map/Parcel# ^ Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? onservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 >/ K3 IZZ K err r CERTIFIED PLOT PLAN MEW CONSTRUCTION ONLY : TOP OF FOUNDATION IS =.f `FEET _ ON , ABOVE LOIN POINT OF ADJACENT ` ROAD. SCALE: DATE : EERIN; Ci'I�IN !-s"-,:r=ter:` , .f' I CERTIFY THAT THE /� aza CLIENT SHOWN ON THIS PLAN IS. LOCAT90` GISTERE® REGISTERED ' JOB NO. ?��'�" ON THE GROUND AS INDICATED ®, CIVIL LAND CONFORMS TO THE ZONING. LA*8 . -EONGINEER SURVEYOR DR.BY: � ' OF ®ARNST 9 , S ^ 3T 712 MAIN ST. '- ,,. TH MASS. --HYANNIS,_ M�4SS_ .emu«... f _ ro I Z. . . IE, w r I SBBA6.� 0: ._ vk� l C�Asl.n:' -IwA1RaOS�FF —._ 1:�' I FgpNT EIEVAT10ll - 2EM ELEVATION .. ]�Nr�t.O T--� ti: I } 114 3:.' -- •w:�m Svnt[w.{ .Y: G:b_M a F.. .. •1 ,� us TO Irn W. I' 1 _ I a 4e 30 ;.4 4' ` ' .. • .ail• r2� I UA {{ r. :. . r ' f dye .e / I -, eon.- a:o• - � � SF[OND F4,.Q t„ . % snrcrrcac.a � _ 77, �vzi•r oa eo�.aG uac _ rQ cower u.,.e+..[- 508-438.6191 'e r••r• r 000; wr•G w...00a :.� .. z.�o�o�n_:��....... ��t k.•'• n.�oao:nr• . c;evlin custom ` s a r N I ^'"TM�•� �:esigns a f m f � sscTiow.n�w y sccnoi•e•e , t i. � y # A 0 p •. ,.:, .p��, r:y o •M r•peor r oe o u•re.re rn•owrrr onry Any arrr own•r••anr preMarr F a t � / `Assessof's map and lot number . Sev age Permit number ...... ,..:..k1JZ off. 61 HIM ' r Z ]DAUSTABLE, i 3� INOD N10311VIS :Hobse number . ................... ....... ........................... • F�4k/1 r "9d 31SA 90 MA86 3� isnw w s�Ild3s `moo y39:�,e� . TORN; OF BARNF.STABLE BVILDIRG -1,' ,PE'CT0R APPLICATION FOR PERMIT TO .:......`,._..Y/ ,J� ...!... . (Cl....... .......................... TYPE`OF. CONSTRUCTION .... ............. .................19. . TO THE INSPECTOR, OF BUILDINGS: The undersigned hereby applies-for a permit accordingg t the following infoorrmatiom Location Sl. .:...e� ....d�� ..... .�........................................................... Proposed Use ...... J�JI, ...... w � (� .... .... Zoning District .....f/��fJ �'l..l..:�:........ ...' ...........Fire District ... ..... ............................. Name of Owner .. o�� �!�✓���L'1 :. .G?�'�:...........Address .f�'��f.... �C�. 4 "/✓ � /../Y.......... /' Name of Builder. .. :.:.. ............. ......... .........Address .........:...........;.................. ..................... Name of Architect ...., ......::..........Address :..................._k .. Number of Rooms ....................................... .......:Foundation ... .... .. Exterior ...........0 ' .......Roofing .................... .�.. . . �/ ...................... t Floors ...... ( ........ .. ..... /.�z....... .........Interior r l./ ........� ........................................... Heating .......� .......... (a'•�. ... Plumbing �L'�.... ......./':�.'y,�oV� ..... .. Fireplace ............................... .... ..... .Approximate Cost .. .�1. ................... Definitive Plan Approved by Planning Board __ _:_ _ ______19�✓__— Area ... �.. .. .`.......... Diagram of Lot .and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1�•a'N I hereby agree to conform to all'the Rules and Regulations of /Tow 'Barnsta regarding the above construction: Name .... .......... ............. .... ....................... � GREENBRIER DEVELOPMENT CORP. No . -?':4 .fi': Permit for One Story . .. ....... ; ,.r •. Siugj.q...F4mi.ly...Dwelln5............. Location Lot. #9 78 Beldan Lane ...... .... .................................. Centerville. .................................... , ....................................... Owner ...Gxeexlklriar...Deve.I.Q.p l.era•.t..... k x + Frame a- Type of Construction ..... ........... ................. ,, ,. 1 YP `� 4 I ............................................ .................................. -. • J`` ' ��` L, ± t r - Plot ........................... Lot ................................ Permit Granted ..... ......19 8 ra '' Date of Inspection .. ' Date Completed .�� l�� ..19 tr a OPERMIT REFUSED t�........................ 19 - y ............ .. ....�.........................................................' .. . ............. ............ r t ... ...%4 ............................... .. Co Approved ...........................................:..... 19 ............................................................................... ..................... ..... ........................................... . I , Assessor's map and lot number .....................' .�'. .9..,- ' .+.?. F T y0 THE 01�L Sewjrge Permit number .......rd��. .....y...- ........................ Z BARNSTABLE, i House number MU& !.. ............................ 90oq�i639. `e0� �E0 MPY a' n TOWN OF BARNSTABLE BUILDING INSPECTOR f APPLICATION FOR PERMIT TO ...............................' ( � r (r��l............ .... ......:....:.... ........................................ TYPE OF CONSTRUCTION /,� 1�1r ��C ✓ ....................... .: .................................. . % c.� ....................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit. according/to the following information: f Location ...../c7..7......�...�.......... ........'`../..... <.L'f....�� i? � ...4....i ..............r /............................................................... l , _s Proposed Use //'+(fit ��" ........;' -2/A Zoning District ......,�l! /'... . `.:'�1`' �l.....:°..... C..........Fire District.. ..,.'.............. .. ......................................... Name of Owner ....i r �"���:'` '.'A......... ...........Address :y..........(;;l �/-n�......i.............................. Name of Builder !>).: �. .. Address .......................................4.2 ��'...: ....................... ........................... Nameof Architect ..................................................................Address .................................................................................... C .� Number of Rooms ..................................................................Foundation c.„ ��?r....f.�t.......... Exlerior ...!::`:'.!'.-'......................... .Roofing /P f................ �..L............................. � .'� 1 r' Ci'�,i . '/ .Interior '�-ft' .. . ✓./.!/!•....Floors '? .................................................. ...... .:.............. `.. Heating f Plumbing _ - Fireplace Approximate Cost ............. ....r ' , J) r'1 r ............. ............I.......................................... i Definitive Plan Approved by Planning Board ______19 2_<_: Area .. ...................... Diagram of Lot and Building with Dimensions Fee :.......� .......... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTHC7 a� x a s I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable, regarding the above construction. i Name . . f '� .�".-�....-'........... o. � A=l89-3l GREENBRIER DEVELOPMENT CORP.. . No Permit for .......S.ing.Le...FaouiIy..DvozJ.ling.----. Location ...Lot-#9-.78-B ..I����.-.. Centerville ` ** . --. ---------.. . . -----. � G.re.eoor.iez Corp. _ ' Type of Construction � "v. "'' Auguit 29, 80 � { � . - PERMIT E SEki ^ _ ................ . lg i y 0 y .... .... .^.......... '---'T'--'�---------'' ' -------'1�---'--'----'--------' .--~.-.--------...-..-...-'~--.-- . ----~-''`^--^^--^'~'---^--'---^~' � . Approved � ....... ........................................ lg ^ .�.�-----.-------.-..--------.- � | ............. ... ............................................................. ( ( � ' TOWN OF BARNSTABLE Permit No. 1 .mn.n Building Inspector cash 7 "Yl • _____________-_______ OCCUPANCY PERMIT Bond ___________ `_L4____ 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 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." Issued to '�'CPP_nbrifmr 1)QVl31CKMt?nT- Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. .....................................................1 ........_ ............................................ ............................ Building Inspector r .1 .l p • -. �. \ . a � .. It , ref k/F a re r i t' tj tq IN cl ,t'♦' ' - .. .. \--...r—_ -t-`—�5., 'P^ ""-_,'- k ra k�q.fJ-."..`f _-q•j CERTIFIED PLOT PLAN NC-V C014STRUCTION ONLY : �;C`✓���'(�/�C,� TOP ,OF FOUNDATION IS LF .`FEET IN _. A®®VV. LOW POINT- OF ADJACENT �oh ROAD. SCALE: �' .:. DATE: d glE ENGINEERING Ca 9�VC I CERTIFY THAT ,THE .e� cirirA.st �y t r ; CLIERIT SHORAN ON THIS PLAN IS LOWED ' ; . Of TER�®( REGISTERED , C'Q90I0� LAN® , JOB NO. �`'��' ON+ THE. GROUND AS INDICATI:G A D ✓ CON'FORMS• TO THE ZONING LA B t3 ~:�PIOIPIE�R SURVEYOR DR- BY: OF ®ARIVST B �, S �+ D IN S`I• _ 712 MAIN ST. CH.BY: x �; ; TH 'MAS S, HYANNIS, MASS. SHEET OF DA E RE®. LAND SURVEYOff - Town of Barnstable *Permit# / �4 OF THE la{. Expires 6 months from issue date ,,�/1B1� : Regulatory Services Fee s 't 0 9� mma $ Thomas F.Geiler,Director 1639• �0 �f0MA�� Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street. Hyannis,MA 02601w Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION Not Valid without Red X-Press Imprint Map/parcel Number Iff 903 10 1 Property Address Value of Work 000 esidential OR ❑Commercial " Owner's Name&Address Q Y 61 I R B e a Lam, C�� yr`�LIE Contrarbr's Name LL,. elephone Number 7'.�0 L15-6 Home�,.Tmprovement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: )(.PRESS PERMIT ❑ 1 am a sole proprietor � P R I` G ❑ I the Homeowner Cave Worker's Compensation Insurance MAY 1 3 2�02 Insurance Company Name Leh opt ' o Bp�RNSTABLE � tF �, N °F Workman's Comp.Policy# l lJ (D Permit Request(chec x) ing old shingles) iT 7-d C'o /= y al �Z r3rt! s l7es P e-roof(stripp _kN- -r,, CpD�=�!iF,JGB3.G,S.I ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Valde _ (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations.i.e.Historic.Conservation.etc. . Sisnature expmtrg P`�F HE ftp T_be Town of Barnstable : BARNSTABLE, ' Department of Health Safety and Environmental Services Y MASS. 1639. �0 prEOMA+p� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location T C LD A(-j Permit Number 4' Owner Builder 0 One notice to remain on job site, one notice on file in Building Department. The following items need correcting: KC-, V 0 A-L/%-, \-7�use- 4AIT. C�?' e P-t JZ� Ls Please call: 508-862-40r38 for re-inspection. Inspected by 01 Y Date Engineering Dept. (3rd floor) Map /c? r Parcel-Dv/ C)0 Permit# House# X Date Issued ,, ard of Health'(3rd floor)(8:15 -9:30/1:00= ) rr 811 r G Xnservation Office(4th floor)(00- 9:30/1:00-2:00) - l/ > ]/a Tic YSTE BE.'Ptam►ing�pt.(1st floor/School Admin. Bldg.) 1� STALLE®IN CE Duffl4 i m ive lan Approved by Planning Board 19 WiTH T ABLE. ; VIRON ENT Yet TOWN OF BARNSTABLNREGUND Building Permit ApplicationProjecress 1 3 9 0A Village CEn ff,V-L, l YnLl Owner �_Or l S641 U i CI Address 7 O QQ da LY) Telephone 7 9 5" 1 q(05 Permit Request rC r �af.Z 'A First Floor square feet Second Floor square feet a, -Construction Type Estimated Project C st $ Alrdoo 3 071D I Zoning District Flood Plain Water Protection Lot Size CA, C -.L Grandfathered ❑Yes UWo Dwelling Type: Single Family Z Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes M/N0 On Old King's Highway ❑Yes f1(No Basement Type: N�Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 9 4,(� Number of Baths: Full: Existing New .3 Half: Existing New No.of Bedrooms: Existing A New Total Room Count(noY(G cluding baths): Existing ,S New First Floor Room Count !j Heat Type and Fuel: s El Oil ❑Electric ❑Other Central Air ❑Yes No Fireplaces: Existing New (7 Existing wood/coal stove ❑Yes Irio Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded Commercial ❑Yes �No If yes, site plan review# Current Use 'Proposed Use Builder Information Name 51) 7 Telephone Number 5 d , 7 7,5--- 17 (�S Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRU ION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r LV SIGNATU DATFI z%41v S� BUILDING PERMIT DENIED F014 HE FO OWING REASON(SS) FOR OFFICIAL USE ONLY PERMIT NO. 53 DATE ISSUED - ; 7. MAP/PARCEL NO: ADDRESS - ,VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME r ti INSULATION 00 - ` FIREPLACE ELECTRICAL: ROUGH FINAL' ' PLUMBING- ROUGW ' ( FINAL'. GAS: c.) LROUGH' FINAL FINAL BUILDING". t=h .• y.. 10,E „ Gi DATE CLOSED OUT4 r ASSOCIATION PLAN-NO. G 0 �Fno cv TOWN OF BARNSTABLE, MASSAC'KU! SETTS A SSE SORZ M APS - i,%O= Moir ►i 'JsAgC a h '24,� p � is �.'pQ,,,., �•»2 -�-� ' ♦yam• Jy� tit a. af. 23 • 4 `�`~, w s a 1tl� —_— f _ i c$•�f � " �r.t r6°� �� � -_ A.T. '�� S�o t The Commonwealth of Massachusetts Department of Industrial Accidents OlficeVUffYestlgatians - - 600 Washington Street 0V Boston,Mass. 02111 — Workers' Compensation Insurance Affidavit name l Jr •' " `✓1` �. '✓ N I location: G ��+ ,'A ci ( �L v''` f hone# 7 57- I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capamy city ❑ I am an emplover providing workers' compensation for my employees working on this job. 1 company name: address: city phone#• 1 1 insurance co. ! olicv# ❑ I am a sole proprietor,general contractor, homeowner circle one)and have hired the contractors listed below who have the following workers' compensation polices: com anv name: address: city phone#: insurnnce co olicv# ....::..,..,.... . camnanv name: address- city phone#: Insurance Co. :: .. olio Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a One up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Oitice of Investigations of the DIA for coverage verification. 1 do hereby certify ,der the pains d fenaltiet of perjury that the information provided above is true and correct Signature Date Print name Phone# official use only _ do not write in this area to be completed by city or town official dty or town: permitilicense# OBuilding Department QLicensing Board Ofllce ❑checkif Immediate response b required ❑S eWth cepn's rune—n ❑Health Department contact person: phone H• ❑Other (tevaca 9/95 P1A) ` Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers compensation for their from the "law", an employee is defined as every person in the service of another under any contra: employees. As quoted of hire, express or implied, oral or written. f" 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 . trustee of an individual, p artnership association or other legal entity, employing employees`. However the owner of a dwelling house having not moie than three apartments and who resides therein, or"the occupant of the dwelling house of -,L cr--I-- e.....1--.,A.c,,.,�to do maintenance , construction or repair work on such dwelling house or on the grounds o: 6LLULL1G1 Wl1U w��rw�.. rr..•...... -- .. 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 renew of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who ha 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 sitnation and be supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may submitted to the Department of Industrial Accidents for confirmation of fimir+nce 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 ou are required to obtain a workers' compensation policy, please call the Department at the number listed below. 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 b r which wile Office of l be used as a reference estigations has to Inumberct u affidavits regarding the applicant. ay be s Pry to be sure to fill is the permit/license rum arrangements have been made. the Department by mail or FAX unless other 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. ��MINE! The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 0Mce of Imlestlgadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 eat. 406, 409 or 375 CF THE t . The Town of Barnstable RAMWALBM T�$ ib¢ `0$ Department of Health Safety and Environmental Services '' Building Division ' 367 Main Street,Hyannis MA 02601 , Office: 508-862-4038 Ralph Cressen Fax: 508-790-6230 Building Commissioner 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. r0i LAW "PT. Type of Work:A±[A:CftO fQAn.AA g, Estimated Cost 0 o v Address of Work: Owner's Name: ( C Date of Application: �1 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law C]Job Under$1,000 Building not owner-occupied 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 Contractor Name Registration No. Q_ OR Date Owner's Name q:fbnns:Affidav L i7WCl4RAVpuwkj TAkJL7.ib(toadaaed) Freeripdve Paelcago for One sad Two-Family Reaidendal Baildlap geared with Fad Fuels MAXIMUM MINIMUM GLaag Glazing Ccilli,g wall Hoar Basm m Slab EIe WnWCwft Ama'(K) U value, R value' R vduel &valuer wall Fbinow Emir' page Rrvalue' it-value 5"1 to 6500 Headag Degree Daw Q 12% 0.46 38 13 19 l0 6 Nonni R 12% 032 30 19 19 10 6 Nomml S 129A 0.30 38 13 19 10 6 83 AFUE T 15% 036 38 13 23 WA WA Normal U 15% 0.46 38 19 19 10 6 Namml V 15% 0.44 38 13 25 WA WA 83 AM w 13% 032 m 30 19 19 10 6 85 AF1IE X 19% 032 38 13 93 WA WA Nomml Y 19% M42 38 19 23 WA WA Nonni Z 13% 0.42 38 13 19 to 1 6 90 AFEJE AA 18:'. 0.30 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: ' 44 tw4--• 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): / S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPRO L: YES: NO: q-forms-t980303a 780 CMR Appendix J Footnotes to Table J5.2.1b: ' 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 ft of glazing area. =After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accdrdance 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 irsulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R-19'requirement could be met ETIMR by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame 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 crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included.with the other glazing. Basement doors must meet the door U-value requirement described 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 eff ciency required by the selected package. 'For Heating Degree Day requirements ofthe closest city or town see Table J5.2.1 a ROTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. 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 JI.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(i.e.,may have a U-value greater than 0.35). 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 V ad,1 ' 1. :%` 4.Xti'[�' As I)%.XK : i: 'Jn; 1 ' h :.;F } °ki�y�T�•NUJ,& n.: h :+ ytf�''4�,t,''1 ''w. .:u }' l�,`a'• '`}Cf y r ��'.�: ,_'� :?•T"r "K �'fil?!t"���' �':� �' J':.' �1 .a+.� -yce 1 < �.+•'K R,. �' '�`•t',; @�T" Jr . � I} •;"' �'�`i:.�j bdy '4e'�J'`t'1'" t r,. �'1y J(,:, * +. 1f ' t � �}�'Ys,J." 1' .Y 1'':t yr�,i?�'"•Ct�4♦ •S4' �§t'""a.��°tv`"'n 1� F r -,�•vt h,T_.. 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"t 1 ,�. § .;, carol rq.� .yam' kr tia �r -Y: N�' 'K- .q TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print::'' DATE JOB LOCATION c Number Street address Section of town "HOMEOWNER" �,.,(`� ( SLi lV Name Home phone Work phone PRESENT MAILING ADDRESS dan L "'... City town State' Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one 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 Officia. on a form acceptable to the Building Official, that he/she shall be resnonsibl� for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Sta- Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will compl with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER' S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Owre. shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix 01 Rules and Regulations for licensing Construction Supervisors, Section 2. 15) .. This lack of awarene:often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner act_.as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/fier responsibilities, ma communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. �pFtHE Tp� . Town of Barnstable do Building Department Services Brian Florence, CBO + BAPNSTABL,E, * Ms3q. `�� Building Commissioner - � Arfonw+° 200 Main Street, Hyannis, MA 02601 .. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Midavit . I,being on oath, depose and state as follows: r t My name is L—Q R-� -LIO-1 cl , I am the owner/resident of the property located at: �, The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: C U i q 1\40+he/ ( n�-o 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 ofperjury this day of an 2019. tA I- S Signature Phone Number Print Name q:forms/famaffid.doc rev 11/08/13 Town of Barnstable Building Department ` Brian Florence,CBO • snaxseMIX • Mnss. Building Commissioner 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: y My name is l I am the owner/resident of the property located at: 7iL '� �Y V C. L)I The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: LU Name &relationship-to owner: I�ar1� A� 1 Cr !LhQ 4+V_ l r�`Ix(/ Name &relationship to owner: The Family Apartment will be the primary year-round residence for t q above-ideVified.-I family members. In the event that the listed relatives vacate said apartment, J wt'1 immed0ely note the Building Commissioner in writing. I understand that no subletting o bleasing�saz4 Family Apartment is permitted. j o I understand that I am required to file an Affidavit annually with the ding _ co Commissioner listing the names and relationship of occupants in said Family A artment. I also;aunderstand that I am required to comply with all conditions imposed by the ZB Special Armitcc and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Ap tments.�iagr W to note the Building Commissioner immediately in the event of the sale of this roperty.w � _ w 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 �f 1 2018. Signature Phone Number ,..F, Lo� -T Sytu !�- Sod- 5-- 1 q%yPrint Namea. I � 7�1 S^ y q:forms/ha naffid.doc` rev 11/22/2017 Town of Barnstable = -- -- _R_ egulatory Services Richard V.Scali,Director ° Building Division Paul Roma,Building Commissioner` T 0,19. � 200 Main Street, Hyannis,MA 02601 " www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family-Apartment Affidavit I,being on oath, depose and state as follows:' My name is .I am the owner/resident of the roe lo.,at:,d at: Ce&--efu L(,e� Oab,:5 cm The followingmembers of m family will be the sole occupants of the Family A ment aPthe y Y p Y ,P aforementioned address: Name &relationship to owner: V l V t G 1 .T Name &relationship to owner: tm 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 andUor 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 apartmenthas been dismantled. The apartment has been transferred to the Amnesty"Program(Appeal No. ) Other f Sworn to under the pains and penalties"of perjury this'_ day"of Cc t/1 2017. 5 o7-- 77 S'- N'G Signature Phone Number Print Name O v- L � l U I .G, q:forms/famaffid.do c rev 11/08/12 Town of Barnstable Regulatory Services oF1HE Richard V. Scali,Director Building Division STABM a s ' Thomas Perry, CBO,Building Commissioner SAT 1639. A��� 200 Main Street Hyannis,MA 02601 Fn tra+ wwwaown.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 LOP-1 �i.� �i� ( I am the owner/resident of the Cie - property located at: 7 �`e G(.CQ f 7 t-.6') � �(J% The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Lour 1 Q, G ju, 4 ivi Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-ident f ed family members.-In the event that the listed relatives vacate said apartment, I willmediately notes the Building Commissioner in writing.I understand that no subletting or subleasing of said Ui Famil A artmen t is permitte d Y P P °--b� I understand that I am required to file an Affidavit annually with the Butng Commissioner listing the names and relationship of occupants in said Family Apa�tment. 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 a''gree4 to note the Building Commissioner immediately in the event of the sale of this 1operty. *, c Co 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 lh day of / 2016. �2 07' 775- l q(o Signature Phone Number Print Name q:forms/famaffid.doc . rev 11/08/12 Town of Barnstable of T Regulatory Services .r i4,s Richard V. Scali,Director �� OF PARNSTABLE 9RAMSTABLE. Building Division ,�; ^ (� l 1639. p�m Thomas Perry, CBO,Building Commissioner �fD MA'S 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us . j O 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 IR 1 , �-( ��S 1 I am the owner/resident of the property located at: �. �`eil G�C�,� `...,del The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: LaL)r-(--"O- J C-P 6 V s a 7- I () IQUJ 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 anctpenalties of perjury this day of lmuqry2015. Signature Phone Number Print Name q:forms/famaffid.doc - rev 11/08/11 pi f a a • � A s a F 1 i . j: r Town of Barnstable Regulatory Services Richard V. Scali,Interim Director Building Division * 8A MASS. Thomas Per CBO Building Commissioner v ,aass, �, Perry, > g �p 1639. 200 Main Street' Hyannis, MA 02601 rE0 MA'S A www.town.b a rn sta b le,m a,us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state asfollows: �My name is o 1 J� I U I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Low r I .Q- Name &relationship to owner: The Family Apartment will be the primary year-round residence for tlt� ove-iden�ed family members. In the event that the listed relatives vacate said apartment, I$W" immediat ly z, notes the Building Commissioner in writing. I understand that no subletting o psubleasing of said-' Family Apartment is permitted. zz I I understand that I am required to file an Affidavit annually with the B #lding C') Zo Commissioner listing the names and relationship of occupants in said FamilJAartments. artment_,,,I�>also understand that I am required to comply with all conditions imposed by the Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family -- agree, to note the Building Commissioner immediately in the event of the sale of this property If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of a n0 2014. (3 veu),� S b?--7?5-1 Signature UPhone Number Print Name L oiz f q:forms/famaffid.do c rev 11/08/11 Regulatory Services Thomas E Geiler,Director Building Division Thomas Per 7CBO)Building Commissioi e 1' t ..MAS& RNSTASLE . 639. �� 200 Main Street, Hyannis,MA 02601 www town.barnstable ma.us E' f ' .I Liiw 41. Office: 508-862' 038 Fax 508 790=6230 Town. of Barnstable Family Apartrnel ti'Affidavit I,being on oath,:depose and state as follows. My name is. 2 l U b°�1 l�l' i am the owner/resident of the dw property located at e. 60:n 4=. �. 1 v si— The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: - relationshi to owner: Name & p 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 f le an Affidavit annually with the Building Commissioner listing the names and relationship of occupants.in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree_ to 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 I a. day of JQ n 2013. Signature - Phone Number . Print Name q:forms/famaffid doc aw rev:11/08/11 ,. Town of Barnstable Regulatory Services of Thomas F. Geiler,Director � N iy Building Division' s '" i U grASM ` Thomas Perry, CBO Building Commissioner , Mass. � r3'> > g f % t {_ € � �ti`� 1 i �A . �� 200 Main Street, Hyannis, MA 02601 www.town.ba rn stable.ma.us Office: 508-862-4038 `I V s Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is L o 12„i ';c4 tj I q I am the owner/resident of the property located at: -7 ��.� �.an L n I ry d1. `q- o,�& The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: n n I A Name &relationship to owner: Q uv, 17 `-i l L>f G M o oL lx - ),A/qv Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event thai 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 frle 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 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 ID day of Tan 2012. - off -77A9_- Signature Phone Number Print Name q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services �TME Thomas F. Geiler,Director ] ,;., IFF _rMG)'' Building Division _UMST"BM ' Thomas Per CBO Building Commissioner"`ex 12 P lil 1: 9 M"S& $ rY� g Ar i639' 200 Main Street, Hyannis, MA 02601 ED MA'S www.town.barnsta ble.ma.us Office: 508-862-4038 V�.�I 1C!Fax: 508-790-6230 �: x Town of Barnstable, Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �47r I - Sal�U C q I am the owner/resident of the- property located af: � {� C?e,L-ru v i I I Vn o g,63r,), The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner. I._.au r i 19_6D+Ler [n I Q ltl 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. 1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment)-I also understand that 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. 1 agree to note the Building Commissioner immediately in the event of the sale of this property. w 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 2011. n �44_� Signature J Phone Number , Print Name Town of Barnstable Regulatory Services pFTHe roy, Thomas F.Geiler,Director �j ... Building Division I 'a'+F,0 OF anxrrsTna . ► Tom Perry, Building Commission er�l �� y mass. j jF f 1 1639. �0� 200 Main Street,Hyannis,MA 02601 ArEn l„�pl s 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 _ U'l I am the owner/resident of the property located at: �� �r�� o Uatecu'i 1 Im a , 0 a'�' 3a The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: L lJ v- -1 ,e_ A- U 1 ( MOA-e-r (V)law) 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 1 day of 2010. Signature Phone Number �l Print Name O / Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services pFINE t0�'1' Thomas F. Geiler,Director 1 p tip Building Division BAR S TABLE 9snarrsrAsLE.�" Tom Perry, Building Commissioner zQQQ 2 MASS. J � �A 1639• �� 200 Main Street,Hyannis, MA 02601 M 1 1. rEn �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 L- I L4 UJ I am the owner/resident of the property located at: ��e I r in Ln CPA. lm A The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: L AUr I S )U Icl (Mo4v- I Ll�� Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that.the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed.by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale.of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of an 2009. Signature Phone Number Print Name l,, 0 p I S4 luf Q/b ldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services oFTME t0/y� Thomas F.Geiler,,Director Building Division BARNSPABLE. ` `' '` Tom Perry,.Building Commissioner MASS. 059. `0� 200;Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is ( �� I U t C1 I am the owner/resident of the property located at: Rd dan La,,-ne Untero 1 f /q- 0 C9&S Q- The following members of my family will be the sole occupants of the Family Apartment at.the aforementioned address: Name & relationship to owner: if f n C1W Name & relationship to owner: The Family Apartment will be the primary year-round residence for the ab ve-identi ied family members. In the event that the listed relatives vacate said apartment, 1 will media�y notify the Building Commissioner in writing. 1 understand that no subletting or surb asing said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Buildi-R, N ' Commissioner listing the names and relationship of occupants in said Family Apart ant. I al o understand that I am required to comply with all conditions imposed by the ZBA Splal Perm and/or the Town of Barnstable Zoning Ordinances Section 240-47..1 Family ApartmF 1 agrq, to notify the Building Commissioner immediately in the event of the sale of this proper, cn 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 day of Jan 2008. S EDT `?5- 1q'b Signature. U. Phone Number Print Name I--o t— ; a o S . 1 Q/bldg/forms/famaffd Rev:1/03 Town of Barnstable Regulatory Services �oFWE rOy. Thomas F.Geiler,Director ti Building.-Div sion;�,i� , �B!E BARNSTABLE, ' ---Tom Perry, Building Commissioner 9 MASS. i639• �0 200 Main Street H an is AMA 02601E� 1 pp ' yJ' .. l+ c�'6�3Y €.. . _ __ _. . _. ..... .. ._._ A •; www.town.barnstable.ma.us ��4��ISfll� 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 �oR1- ���oi I am the owner/resident of the property located at: n Uoff-roi I(e VW © A03(D- The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: L Q I �e_ SWIM 0 ''ir i n low 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 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of JQ I)a 2007. o r7r?-s Signature U Phone Number Print Name (7`r I Q/bldg/forms/famaffid Rev:1/03 Town of Barnstable Regulatory Services THE ta,,_ Thomas F.Geiler,Director Building Division a�rtsr�at.� Tom Perry, Building Commissioner 30 P� z pe1. 06 MAS& g 200 Main Street,Hyannis,MA 02601 ?006 ,1AN www.town.barnstable.ma.us �r 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 S `j V I Of I am the owner/resident of the property located at: Q-1 �y n " L� �`��`e '�'�/ j l "Q Map and Parcel Number VAA ( � R rC J d -31 . O 6rc( The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: �( Name &relationship to owner: ` -e /, 1 Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2006. S s04 .r7"7 s_ C1�- Signature 6P— Phone Number Print Name I S`i L y i q Q/bidg/forms/famaffid Rev:1/03 Town of Barnstable Regulatory Services �OFTHE Tp Thomas F. Geiler,Director , (F &A R LE P Building Division 5 r3 r7. v' n BARNSfABLE, Tom Perry, ,Building Commissioner t o f �}• j p MASS. 200 Main Street;Hyannis,MA 02601'prec r��a www.town.barnstable.ma.us .........- .....w.....- i`4f Q S tiF . Office: 508-862-4038 �; Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit r I, being on oath, depose and state as follows: My name is Loz l S 41C) Q I am the owner/resident of the property located at: a to 16 ,vim 41 1 IL/v �P Ma and Parcel Number p The following members of my family will be the-sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name &relationship to,owner: - The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that 1 am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains andpenalties of..perjury this_,_day.of_� 2005. Signature Phone Number Print Name l2?J S �U a f: Q/bldg/forms/famaffid Rev:1/03 b6 �' � '1 \ Town of Barnstable /6 Regulatory Services g Y pFIKE, Thomas F.Geiler,Director Building Division r r « sexxsrwaM Tom Perry, Building Commissioner 1b� ��� 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 LI am the owner/ esident f the property located at: ! `Z �ta a ta tt 2 4 Map and Parcel Number rh �a 4 1 O cr c The ZBA granted me a Special Permit/Variance on J Li Date Appeal No. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: f , Name &relationship to owner: d nJ li►C-c cz-) �Q l)"j n ..P� Name &relationship to owner: 6✓� �� 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 bee n dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2004, Q� 7 S G �7-3 Signature Phone Number Print Name t Q J Q/bldg/forms/famaffid Rev:1/03 © X Town of Barnstable Regulatory Services °FT►+E royti Thomas F.Geiler,Director TOWN OF BARNSTABLE Building Division • saaxsraste, Tom Perry, Building Commission03 JAN 22 AM 11 15 Mass. 9� 1639. � 200 Main Street,Hyannis,MA 02601 DIVISION Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: Logi -' S I�ig My name is `'t I am the owner/resident of the property located at: -, $ 6_eA rya V, LY) Ct nte'r o l I f f_ M it t-,§> Map and Parcel Number M(W L U pa{ce 03 r , 0 Q 6 to The ZBA granted me a Special Permit/Variance on 4WA 4 7 11 19 q?-33 G%u l A ate Appeal No. ,The decision.of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: 'took 16 S 1 ,Page 3 OCT The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: ( h Name &relationship to owner: 4 A V e 1 e S u I u t q \ t `aW* VA 0+VI ,e 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 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 acid penalties'of perjury this a'JD day of '-S4;f) 2003. m . S g • 7 - Iq -S Signature Phone Number Print Name 01_J c( Lilt t# Town of Barnstable Regulatory Services IME rqy� Thomas F.Geiler,Director TOWN OF BARNS`IABLE Building Division * RAFwsTnaiE Tom Perry, Building CommissionW93 JAN 22 AM 11 15 9� 1 q. �m� 200 Main Street,Hyannis,MA 02601 AlFD��p 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 L'o 9l S Si, `y i q I am the owner/resident of the property located at: -7 $ 6-eA G a n 6 i C-cn of V i l l e (M a c-S' Map and Parcel Number'. 17g . Pay C e 1 0 ` 0 The ZBA granted me a Special Permit/Variance on L ate 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-myfamilywill be the sole occupants of the-Family Apartment at the aforementioned address: Name &relationship to owner: L 4 V v t 2. Su�y t G " \ t lac-�� I ©*2 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. f 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 o1'f>>" ' " day of SOLn 2003. . Signature `L , " Phone Number, , Print Name o?t 4 t!i Q/bldg/forms/famaffid Rev:1/03 COMMONWEALTH OF MASSACHUSETTS , BARNSTABLE AFFIDAVIT �\ I, Log ' �• �`�+ U , being on oath, i A depose and state as follows: 1.) I reside at ��'��• ��� 2.) I am the owner of the property located 3 shown on Barnstable Assessors' maps as MAP _PARCEL 3.) I Do y� Do not have a Family Apartment at this location. 4.) On , 199 , the Zoning Board of Appeals, on Appeal No.*,;? 3 r granted me a Special Permit/Variance to maintain a Family Apartment at the above address. 5.) 1 understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. r 6. The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME �,,�'; w . B/i a Relationship to owner:n a AKS4 b) NAME GI� Relationship to owner: - 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) 1 understand that no subletting or subleasing of said Family Apartment is permitted... . 10.) I understand that I am required to annually file an Affidavit with the Building Gommissiulic -- listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. �79 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. Sworn to under the pains and penalties of perjury this _-Lday of _, 199 Signature ILA Print Name TinQ �-P4i n- efit s ; I( i� ��ess oP PU', ldA n, yw� corplk`��er� COMMONWEALTH OF MASSACHUSETTS BARNSTABLE A F MAVIT I `1� � D , --- `— ` 111 I� - --------------- -----, being on oatf depose and,state as follows. MAR 1 1999 1.) I reside at= — — — _ -._. ._ 1` -----.BUILDING DIV. 2.) I am the owner of the property located shown on Barnstable Assessors' maps as MAP__IcPARCEL_� �i� ________ n.g 3.) I Do_______________ _Do not _jL --have a Family Apartment at this location. 4.) On---2�7A 5_____------_, 199`3 the Zoning Board of Appeals, on Appeal No.L�_gJ7%3 granted me a Special PermitNariance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME---L au r_I --- (A g------- ------------ — Relationship to owner:__yYV� b) NAME-------------------- ----------------------Relationship -------------- to"owner:---------------___--- ---_—__-- 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) i understand that I ain required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. _ha qj'-- --------------------------------- 12.) I agree to immediately notify the Building Commissioner in the event of the sale of the above- listed property. Sworn to under the pains and penalties of perjury this—_ I __day of_1M ar C�1 Signature t ' ----------------- — --------- Print Name , ------------n��--- a� ------------------------- --------- 'f .I c rr �,sln ot qq COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT I, L.o(-% J gAt► SU�(�lA , being on oath, depose and state as follows: { ` 1.) I reside at ri S6&(� l ) C�n� qv o\k, a.L 3a- 2.) I am the owner of the property located at rt Q e.1C�a�1 Lfl U Pl42(-U shown on Barnstable Assessors' maps as MAP I$ck PARCEL 0 31 .06 cl 3.) I Do Do no have a Family Apartment at this location. 4.) On 3 V ItA _, 199O_, the Zoning Board of Appeals, on Appeal No. 1 9113 granted me a Special Permit/Variance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME L 0.V 1- t 2. 54 01 q Relationship to owner: IM o+h Q(' I n IQ Ui b) NAME— -- Relationship to owner: 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals ' Appeal No. 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. ,1 Sworn to under the pains and penalties of perjury this day of_� 199q— Signature Aj-A,��L Print Name , Lc?r"k Sw a a 6 Town of Barnstable Planning Department Staff Report Appeal Number 1998-83-Sylvia Special Permit Pursuant to Section 3-1.1(3)(D) -Family Apartment Date: July 07, 1998 To: Zoning Board of Appeals From: Approved By: Robert P. Schernig, Director Reviewed By: Art Traczyk, Principal Planner Drafted By: Alan Twarog,Associate Planner Petitioner: Lori Sylvia Property Address: 78 Beldan Lane,Centerville Assessor's Map/Parcel: Map 189, Parcel 031.009 Area: 0.51 acre Building Area: 1,056 sq.ft. Zoning: RC Residential C Zoning District Groundwater Overlay: AP Aquifer Protection District Filed:June 10, 1998 Hearing:July 15, 1998 Decision Due:September 18,1998 Background: The applicant is requesting a Special Permit for a family apartment pursuant to Section 3-1.1(3)(D)of the Zoning Ordinance. Family apartments are allowed in RC Residential C Zoning Districts as a conditional use, providing a Special Permit is first obtained from the Zoning Board of Appeals. The property consists of a 0.51 acre lot and is commonly addressed as 78 Beldan Lane, Centerville. The site is improved with a one-story, 1,056 sq. ft. ranch style single-family residence'. The applicant is proposing to construct an addition to the north side of the existing residence, consisting of an attached one car garage and a family apartment over the garage. Currently,there is no garage on the property. The plans submitted show an apartment unit of approximately 416 sq. ft. The application states the family apartment will consist of a bathroom, bedroom, and living room. The applicant is also proposing a separate kitchen.Z The submitted floor plan does not show a separate bedroom, living room or kitchen but only a bathroom with the remainder of the space being open. Staff suggests the applicant provide the Board with a more detailed floor plan of the family apartment unit showing the layout of the bedroom, living room and kitchen. Access to the apartment unit will be from a staircase at the rear of the addition and from inside the proposed garage. The family apartment is to be occupied by Laurie Sylvia, mother-in-law of Lori Sylvia. Staff Comments: The subject property is located on a cul-de-sac. Single-family residences are located on the adjacent lots to the northeast and south. The residence to the northeast is screened from the subject property by a strip of trees and shrubs. Fuller Mill Pond is located to the rear of the property. Subsection c) of the Family Apartment provisions of the Zoning Ordinance requires that the residential character of the area be retained as nearly as possible in the development of a family apartment. The applicant has submitted floor plans and elevations of the proposed addition for the Board's review. 1 According to assessor's records dated 07/09/95 2 According to a conversation with the applicant on 07/06/98 s 1 r Town of Barnstable-Planning Department-Staff Report Appeal Number 1998-83-Sylvia Section 3-1.1(3)(D)Special Permit-Family Apartment The property is serviced by Town water and a private septic system. The applicant should be prepared to show the septic system has been inspected and that it meets Title V requirements. From the materials submitted it appears: • The apartment unit will be under the 50%size limitation. • All zoning setback requirements will be met. • The unit will be developed in a manner which retains the residential character of the area. • The property owners and family member will be primary year round residents. • Scaled plans of the proposed addition have been supplied to the file. The petitioner's application states the proposed family apartment will be 540 sq. ft. in area. However, it appears from the architectural plans that the apartment unit itself will be approximately 416 sq. ft. This figure does not include the stairwell or garage floor space. Special Permit Findings: In addition to meeting all of the provisions of Section 3-1.1(3)(D), the granting of a Special Permit requires the following finding of facts to be made by the Board (as required under Section 5-3.3(2)): • that the application falls within a category specifically excepted in the ordinance for a grant of a Special Permit, (Special Permit pursuant to Section 3-1.1(3)(D) -Family Apartment-is permitted in all residential Zoning Districts provided all criteria are met.), and, • that after evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the Zoning Ordinance and would not represent a substantial detriment to.the public good or the neighborhood affected. Suggested Conditions: If the Board should find to grant the relief requested, it may wish to consider the following conditions: 1. The family apartment shall be developed in accordance with the submitted plans prepared by"devlin custom designs", dated 6/10/98, copies of which are in the files. 2. The family apartment shall comply with all restrictions of Section 3-1.1(3)(D) and shall be the primary year-round residence of the family member(s) residing therein. 3. The locus shall comply with all Town of Barnstable Building and Health Divisions Regulations. Attachments; Assessor's Map/Card Copies: Petitioner/Applicant Application Form Plan Reductions 2 Town of Barnstable-Planning Department-Staff Report Appeal Number 1998-83-Sylvia Section 3-1.1(3)(D)Special Permit-Family Apartment Copy of: Section 3.1.1(3)(D)-Family Apartments D) Family Apartment subject to the following: a) Not more than one(1)family apartment is provided. b) The family apartment is within or attached to an existing residential structure or within an existing building located on the same lot as said residential structure. c) The residential character of the area is retained as nearly as possible. d) The family apartment contains not more than fifty percent(50%)of the square footage of the existing residential structure if being proposed as an addition thereto. e) All setback requirements of the zoning district within which the family apartment is being located are complied with. f) The property owner resides on the same lot as the family apartment. g) The family apartment is occupied by members of the property owner's family only. h) The occupancy of the family apartment does not exceed two(2)family members at any one time. i) The family apartment is the.primary year-round residence of the family member(s) residing therein. j) The family apartment will not be sublet or subleased by either the owner or family member(s) at any time. k) Scaled plans of any proposed remodeling or addition to accommodate the family apartment have been submitted by the property owner or his or her agent to the Building Commissioner and the Zoning Board of Appeals. 1) Prior to occupancy of the family apartment, affidavits reciting the names and family relationship among the parties seeking approval have been signed and shall be signed annually thereafter for the duration of such occupancy. m) Prior to occupancy of the family apartment, an occupancy permit shall be obtained from the Building Commissioner. n) No such occupancy permit shall be issued until the Building Commissioner has made a final inspection of the proposed family apartment. o) Within sixty (60)days from the date authorized family members vacate the family apartment, the owner or his or her agent shall remove any kitchen facilities in such unit and notify the Building Commissioner to inspect the premises. p) In addition to the provisions of Section 3-1.1(3)(D)(o)above, upon vacation of any family apartment, the premises shall be restored as nearly as possible to their state prior to the creation of such family apartment. q) The Building Commissioner shall have the right to further inspect the premises upon which a . family apartment has been vacated at least three(3)times per year for three (3)years consecutive from the time of such vacation. 3 Tl�ZONIN('�RELIEF BEING SOII(3RT NA9 TOVIN OF BARNSTABLE BEEN DETERKNED BY THE ZONE v ENFORCEMENT OFFICER TO Zoning Board of AppealsBEAPPROPRLazBET Application for Family Apartment s-C-19- it r '_�_ ''A Date Received T„ • c For office use onlv: Town Clerk off i # Appeal INS i ` �� Hearing Date i Decision Due The undersigned a he 1 W ' p the Zoning Hoard of Appeals for a Special Permit for the develcpmenf °an mai taining of a Family Apartment in accordance with Section 3-1.1(3) (D) of the Zoning Ordinance, in the manner and for the . reasons hereinafter set forth: Applicant Name: Phone - G S Applicant Address: Property Location: Property owner: O R I U It) l a Phone Address of Owner: 78 �21d4n Ln . C n4" ru; k I/Yl ' oa(o3a If applicant differs from owner, state nature of interest: Number of Years owned: 3 Assessors Mao/Parcel Number: G �,�t ( Zoning District: RB [], RB-1 [ ] , RC [y} RC-1 ( ] , RC-2 ( ] , RD [J• RD-1 [J. RF [J . RF-1 [ ] , RF-2 [ ] , RG [Ji RAH [Ji PR [ ] . Groundwater overlay District: Ap [ ], Gp [], WP [ ) , Names) and relationship of the family members to occupy the Family Apartment: Name: ct u r 1 e- �TI1 q � Relationship to Owners: o Er b Name: Relationship to Owners: The Family Apartment is to be developed: [ ) within the existing single family structure. as an addition to the. existing single family structure. [ � in an existing accessary building. [ J other - please Explain: Application for Family Apartment special Permit w Description of Construction Activity: Proposed Gross Floor Area of the Family Apartment unit: Sq.ft The Gross Floor Area of the Existing Single Family Dwelling Unit: sq.ft Do all structures, existing and proposed, comply with all setback requirements for the zoning District in which it is located? 0. 0 . . 0. Yesu"o( will this be the permanent _address of the- occupant(e) of the - Family Apartment: ..... ... ...... . . .. . .... ... . . . ... . . .. .......0. . . . .. Yes No( If no, Please Explain: Is the property located in an Historic District? Yes(] No�� If yes ORH Use Only: No Exterior Changes. .. . . . . . . . . ( Plan Review Number Date Approved Is the building a designated Historic Landmark? Yee[] No[V If yes Historic Department Use Only: Date Approved Is the property served by public water supply? Yes NO[ ] No[ ] Is the property on private septic? YesW100'No( ] If yes Health Department Use Only: Title V System Yes(] No( ] Date Approved Signature: Qu Date: Applicant or Agent's signature Agent's Address: Phone: Town of Barnstabal • r Family Apartment Affidavit I'11)►Ls 1 SA N 5H LV�1� being on oath, depose and state ae i P follows: 1. 1 reside at 1 6E-LVeAJ Wilt t LL9�_ that I have owned since (11(p , and which is my domicile and principal residence. The property shown on Barnstable Assessors Hap and Parcel NumbeAM/ 0 34 pd 2. on , 19--;the Zoning Board of Appeals, in Appeal No. granted to me a Special Permit to develop and maintain a Family Apartment in accordance with Section 3-1.1(3) (D) of the Zoning ordinance and in agreement w condition of that special permit at the premises above. 3 The following members of my family will be the sole occupant(s) of the Fami. Apartment Unit Name: 1AdaI "Sqt a Relationship to owner: $toTH-grt. r;1 4,i, Name: I Relationship to owner: I understand that the Family Apartment: * shall only be occupied b members of family who are y my Y persons related to a by blood or by marriage, * shall be the primary year-round residence for the identified family members * shall not be sublet or subleased to any other person(s), and * shall, at all times, be in compliance with all conditions of the special Permit issued by the Zoning Board of Appeals, including plans and commitmer made in the application and approved by the Board. This affidavit shall be filed annually with the Building Inspectors office and i the unit shall be vacated by the above identified family members, I shall withir. 30 days notify the Building inspectors office of that and shall immediately proceed with the removal of the family apartment unit. in the event of the sale or transfer of ownership of the above property, I shall notify the building Inspectors office and shall surrender the special Permit for this Family Apartment. sworn to under the pains and penalties of perjury this day of v �. signature: A I (Please Print) Name: DR VI Q Phone:, 77 5 19 65 Hailing Address: 7 8 Q _ Ln Q r-I+ Mp, � 1 4 s� I Lo a s oJo • 47o s 'Noo -� ~ QD F N a •0 a 0 � � . a Go . r O cr IV I s II�� y �N a '• � :. i n N+ © • tr 7 �� 'Ia r Q • r _ tl c<. 41 It it F - 4 F - O '�• � � . � n� o o'� or �� Q O yi o ■��11 ••c ers , S, A� I +l �� Q r • ft' ?� �j � , al s ^< �w.� � i�•o kin ® C � ° � � ";� ` �� ~ � `� .L� a s- ' wOtop y ^ ► •.•� .n n 1.. 'c n Q lk< tr ��• / i, '� M� ab 9 I EY[illOr ,/,... .....s1 .... 3 R �//\\\ � � - A• n Uw'glle•w 1• BP:1003.5-0325 96-01-30 0:5 #OOS41 DE® ' I, GRACE K. GUIOD, of Needham, Massachusetts in consideration of NDU f(THOUSAND AND 00/100 ($90,000.00) DOLLARS paid grant to LORI SYLVIA of 78 Beldan Lane, Centerville, MA 02632 with QUITCLAIM COVENANTS The land, together with the buildings thereon, situated in Barnstable (Centerville), Barnstable County, Massachusetts, described as follows: SOUIVAESTERLY by Lot 8, as shown on plan hereinafter mentioned, a distance of one hundred seventy-two and 50/100 (172.50) feet; NOSY by land of owners unknown, as shown on said plan, a distance of one hundred ninety-seven and 09/100 (197.09) feet; NORTHEASTERLY by Lot 10, as shown on said plan, a distance of two hundred twenty-two and 83/100 (222.83) feet; and SOUTHEASTERLY by Beldan Lane, .as shown on . said plan, � an arc distance..of fifty-three and 55/100 (53.55) feet. Being LOT 9, containing 22,100 square feet, more or less, as shown on plan of land entitled: "Plan of Land in Centerville, Barnstable, for Greenbrier Development Corporation dated December 26, 1979, Scale 1" = 40', Eldredge Engineering Co., Inc., Registered Civil Engineers & Surveyors", which said plan is duly filed in the Barnstable County Registry of Deeds in Plan Book 340, Page 46. The above-described . premises are conveyed subject to and/or together with the benefit of: Easement to New Bedford Gas & Edison Light Company et al dated March 13, 1980, recorded in Barnstable County Registry of Deeds in Book 3068, Page 267; Water Easement to Centerville-0sterville Fire District recorded May 21, 1980 in Book 3100, Page 166 and Road Taking by the the Town of Barnstable of Beldan Lane ; dated June 2, 1982, recorded in Book 3493, Page 31. For Grantor's title, see Deed from Greenbrier Development Corporation dated November 18, 1980, recorded in Book 3197, Page 257. Executed as a sealed instrument this 30th day of January, 1996. Gr . �rotriv r OOMMCWEAL.TH C SSF MUSE , Barnstable ss. January 30, 1996 Then personally appeared the above-named Grace R. Guiod and acknowledged the foregoing instrument-to be..her free.act and deed, bef. _ My Commission Expires: >f �- Notary Public DONALD F.HENDERSON MY COMMISSION EXPIRES Property address: APRIL 19,1996 78 Beldan Lane Centerville, MA 02632 Ctr IF L3CA C-1 J LU 7 u W +" L 1 C"1 \C L CT .7 I W N K La i !C !3 1. t l -" C7 1 'R [i PROPERTY ADDRESS J rr �� t I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHD —STATE PARR 1 MEB1JF KEY N< iiult3 3ELJAN LANE 10 RC 300 loco 07/09/95 loll �JJ 41AC i{la's :JJ1 .Di.`9 1103' LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS Land OWDale Sae Dlmena on V UNIT ADJ'D.UNIT ACRES/UNITS VALUE Descdphon u U I li D r GRACE K MAP- - / CD. FF.De mlAc•as LOC./VR.SPEC.CLASS ADJ. COND. P PRICE PRICE Z 2 i S O0 L AN i) 1 CARDS IN ACCOUNT L 10 IEJLDG.SIT 1 X .51 =10 148 29999.9 44399.9 .51 22!5u'J 73LDu(S)-CARD-1 1 60.70.0 01 OF 01 A, !P L '7 8 8 c L D A N L N CENT �--_T30-(3 N SAT4S 1 .1 U X C= 100 6000.0 6000.00 1.00 I 6JJL: J `r'OL LOT 9 hMVAJRKET 7150( D RR 0113 UJ53 -iNCOM F A I 1CL 41C iJSE D I kPPRAISED VALUE AJ IA 3.3.3CC T U � VARC_L SUMMARY A S ANO 2260( T z1LDGS 607C( M -IMPS F E TOTAL 3330C CNST E T DEED REFERENCE Type DATE geGbrded R I O R YEAR V A L U A Book Page Ins1' MO. vr.p Sales Price AND 2 2 6 0 C T S 3197/257, 01)/00 LDGS 607CC I OTAL 33300 E S BUILDING PERMIT LAND LAND-ADJ INCCPI't � SE SP-BEDS FEATURES SLD-A DJSI U:VITS Number Date TyPe Amount _ 22600 ti0DID Class Cpnsl. Total Base Rala Atl.Rale r B Il Norm. Obsv Units Units I A ! I Aga Oepr. Cond. I CND I Loc %R G Repl Cost New Adl RBPI Value Slone^-I Height Rooms Rma BOtns I Fia. i Pulyw.11 FOG. 0 1 C UJO 1i0 100 59.40 59.40 80 80 14 87 100 67 69746 6J7wJ 1 .t} 5 3 1.1 6.0 j D. ipllnn Rale I SOVd1 Feel Repl C sl MKT.INDEX: 1 0 U IMP.BY/DATE: / SCALE: 1 /00.3 ELEMENTS CODEI CONSTRUCTION DETAIL -- S AS 1Jo 59.40 1u5o 62726 FWD 35 8.50 120 1020 T I N. rt----12---* STYL ANCH 0 of R ! FWD ! _` _ oF4-_'_JJ'1T- -J0 ------------------ ..SI U 1 i 1 =XTe-;.-j-A".LS-- -JT 0�d7J3 -f}2-AN � `------- j C �iEAT".4C-TY�E -JL�: y 1- --------------- .01 +_ -44------------*-4-*--J- T 4 } .0 i r; Ir:0 fNTc:iT:LAYJ0T- -JT --------.-_-- ------ R ! '. iF�T_�! J:+t iY -i7�' 4KE-AS-EXTYFF_--�-.0 L'JU":T 37JCT- -Ju ---- A W I - --, - - -• -- - - ------ - Jr E TolatAreas A..= 120 Baae= 1056 ! ! Zuil�-TY?c---- -Ju ------------------TT 0 BUILDING DIMENSIONS 24 BASE - - - ---�- ------------------ C4 -trt I RTI: L-- JO Lf.(1 T tiAS W44 N24 E44 FWD E08 N10 W12 q ! =CirC7fiTZi*/V- - JC ----- --- -------9�.-'- Sl0 Eti4 _. 8AS S24 .. � ,VE 1-.-`rrJOR�i ;I6 4-I-AC-TrENTERVf ELr -- L ! ! LAND TOTAL MARKET *-----------------44----------------' PA;, ,".L 2260i 33300 X ; ?,.A 6020 VARIANCE +0 +1284 ;T;SDARD 20 < � i -++a�^.%W:+w":?Nm.w�,a��:.rw'ww.+..wd.:w.,+;w...w++µu�raw.:w.....,...,..•' .e.._.::....,..... ...�_. ,y' .�