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" i yr h, 'Y+i�l ' u"'9 ,t ,t „i , _ _ ._ _ ,,K •�. , , d,° : ...r,d .- "�'� �' -- �+ e `�rtrF,=t1+' ; —Al ff. OFTNE ram, Town of Barnstable o Building Department Services BrianFlorence, CBO • EAMSTABM p MASS. $ Building Commissioner T. p n c €`+ . s639• �0 �� �•t �"k� 4 e 200 Main Street, Hyannis, MA 02601 SIABILE www.town.barnstable.maxs t sC E titi o 2 Office: 508-862-4038 Fax: 508-790-6230. Town of Barnstable Family ApartmenCAffidavit I, being on oath,.depose and state as follows: My name is rl AQy)e� 'fY '1 A I am the owner/resident of the property located at: MA AIL t.,31- The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family,Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this 1 day of j 2019. i Signaffire Phone_Number Print Name q:forms/famaffid.doc rev 11/08/13 Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Town of Bamstable Family Apartment Affidavit I, being on oath, depose and state as follows: i L My name is ,r�P / IY W✓� I am the wne /resident of the property located at: \�- IUD ���,�, 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: m 07 The Family Apartment will be the primary year-round residence for the ve-ident�ed o family members. In the event that the listed relatives vacate said apartment, I wi71 mmediatc�ly am notify the Building Commissioner in writing. I understand that no subletting or su,leasing q(pid z Family Apartment is permitted. CA I understand that I am required to file an Affidavit annually with the Buil 'rag Commissioner listing the names and relationship of occupants in said Family Ap tment. IVko 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 day of Q,.1Mtid 2018. Signature Phone Number Print Name C�I N I w q:forms/famaffid.doc rev 11/22/2017 Town of Barnstable Regulatory Services Richard V. Scali,Director ,Building Division snaxsenaM ' Paul Roma,Building Commissioner ` ass. 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 1n i e d je I am the owner/resident 5 t, e w property located at: .� rp / r. _Lem �en�Lu) The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 0,0 Name&relationship to owner: The Family Apartment will be the primary year=round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately ' notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer-a Family Apartment-at this-location;please explain: - The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pa* and penalties of perjury this day of ayt _ 2017. " U g.� 9. Signature Phone Number &6-aj Print Name V I e-11 (� (1 1Y ,i✓� q:forms/famaffid.do c rev 11/08/12 A _ I Town of Barnstable Regulatory Services of lGf. Richard V. Scali,Director Building Division ` MUMSTABMThomas Perry, CBO,Building Commissioner pl 1639. 1% 200 Main Street, Hyannis, MA 02601 ED MA'l www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623� <_ C) CIO Town of Barnstable FamilyrApartment Affidavit I, being on oath, depose and state as'follows: M. My name is � `.��\-�i��. I"-,V� ✓✓� I am the owner/resident of the property located at: L V�- a 61,�3-Z- The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: >�'l W'W►�� �� S 1SU ` 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. s_ I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also ` understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. .If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this�_ day ofJaAo�jd2016. D -"gip Signature Phone Number Print Name✓ Can-�-> q:forms/famaffid.doc rev 11/08/12 Town of Barnstable oF +E r Regulatory Services Richard V. Scali,Director 1 BAMSTnsLe. % Building Division 63p.�� Thomas Perry, CBO,Building Commissioner Eo i,,ur 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 � 1'� �YV) I am th owne esident of the property located at: The following members of my family will be the sole occupants of the Family Adartment a the aforementioned address: — � :tom Name &relationship to owner: V�'l. 1 ' '1 Y ✓1'� r S 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 penalties of perjury this day of 2015. Signature Phorie Number Print Name CV l ►M q:forms/famaffid.doc rev 11/08/11 P y. { c • , t , a�! f _Ti �I ................. rj �i ,I I 1 i; . , ��� J + y N �� Town of Barnstable Regulatory Services lqy, Richard V. Scali,Interim Director ~� Building DivisioTiVil SJIA V " BAMSTABL& ` Thomas PerryMAM ,CBO,Building Commissioner j 12. 5 Ar039. a 200 Main Street, Hyannis, Na"02601 EO MA'S www.town.barnstable.ma.us Office: 508-862-4038 t V IS10` Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: I, My name is � a �� � � � I am the owner/resident of the property located at: 4 'I YLQ` PL-1-t-u" The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Il Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. if there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pa' and penalties of perjury this day of aiyl 2014. Signature Phone Number Print Name �/�1�� ►�I� 4 �$ Yo I q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services �t rq Thomas F. Geiler,Director'- Building Division AR STABLE v Mnss � Thomas Perry, CBO, Building Commissioner `bAr 1639. A 200 Main Street, Hyannis, MA 0260„1 + ^ ED Mp'l : Z www.town.barnstable.ma.us:. Office: 508-862-4038 Fax: 508-790-6230 '-lt�3` Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: s My nam—isN(A.+( n, �Y1tY`(rv� I am th owner/ esident of the property located at: �1 ()b ,n t, PA P M� J q h U.)A_b7N).1 IL 3-Z The following members of my family will be the sole occupants.of the Family Apartment at the aforementioned address: Name &relationship to owner:- �,Ivi, Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified '. family members.T 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 d penalties of perjury this day of 2013. r g- ` q u �11 Signafure Phone Number ' 'Print Name p IrYl I p � q:forms/famaffid.doc rev11/08/11 Town of Barnstable Regulatory Services ofTME tq,, Thomas F. Geiler, Director Building Division ` MAn&UMSTABLtThomas Perry, CBO,Building Commissioner 019. 6. 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us �A Office: 508-862-4038 F=i 508-790'6230� Town of Barnstable Family Apartment Affidavit �8 I, being on oath, depose and state as follows: � '1��� N My name is r :�'�1 I am th owner resident of the ^� rn property located at: �nl��ILI The following members of my family will be the sole occupants of the Family Apartment at the -aforementioned address: ...--;-_. JName relationship to owner: 4 M L. l ^.,' - l,i�e Name &r`e_i_a n'slu0-6-owner: �` t , - . ._.. + The 1amilyAp'art7nent will'be the primary year-round residence forthe�above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled: The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to der.-the pains and penalties of perjury this day.of L) (,L L)C 6 ` 2012.E '�V ._.._.._ M r.............. ..... ✓U 1�1.C�.I s' , � Signature,..Y °c rwa ., hone Number.. _....._,.... Print Name . . ` 1r ���. t1 TY t ►'✓1 q:forms/famaffid.doc rev 11/08/11 ' Town of Barnstable Regulatory Services F roy�� Thomas F. Geiler, Director - VVII OF "" EST RE- Building Division Thomas, Perry, CBO, Building Commissioner ,) ,3 9 MCI 8 9 059. 200 Main Street Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Office: '508-862-4038 D 'd.-` i`Fax . 508-790-6230 Town of Parnstable` Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �� A-n U:CA� I am the owner/resident of the property1ocated at: �A(DAI 4 RA-k- Cr-1 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner:��)�M11 'vrA '-rl -,Vy\ - 6,10 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 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2011. UIL� or Signalf6e Phone Number Print Name CV lC�;r e-n e, Town of Barnstable Regulatory Services pFTHe toh, Thomas F.Geiler,Di %tort , Buil�diing vision �`iI� anRxsrna , ' Tom Perry, w� ilding Commissioner 9� MASS. ��� 200 Main RN 11 H'y`anriis,MA102601 AlFO .l A www.town.barnstable.ma.us Office: 508-862-4038 D!,VIS t Fax: 508-790-6230 Town of Barnstable Family Apartment.Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: twkvo ��, The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: A 'rill.. Inn'�( A1 Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 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 Swo o under the pains a penalties of perjury this 8 day of 34,4LU4kJ4 2010. Signature Phone Number ChartPrint Name Q/bldg/forms/famaffid Rev:12/08 Tower of Barnstable Regulatory Services THE Thomas F.Geiler,Director Building Division i :1� NSTABl E snRtvsTna Tom Perry, Building Commissioned, �a 200 Main Street,Hyannis, MA 0260"Il � `� 3 Eb A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �i�(` ,Q�(1�-l''�1 (, tY1 I am the owner/resident of the property located at: L�'\�C�(.n o CM �� i_-V—lr\ nkp A O�0 The following members of my family will be the sole occupants of.the Family Apartment at the aforementioned address: Name &relationship to owner: . i_NA Name &relationship to owner:. The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment;.I will immediately notify the Building Commissioner in writing:I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains an penalties of perjury this `2 day of 10-fl 2009. -_ Signarre Phone Number Print Name Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services ` �ti, , , v oF1He Tory Thomas F.Geiler,Director.,�-,, ,� Building Division BARMSTABLE. " Tom Perry, Building CommissioId'erA MASS " 9�6,, i639 �0 200 Main Street,Hyannis,MA 02601 TFD MA'1� 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 ��o ii - L-�_i/�'� I am the owner/resident of the property located at: a 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, 1 will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 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 der the pains and penalties of perjury this ,23 day of ,�,�� 2008. Signature Phone Number Print Name �V t Cl Y/Ve/n Q/b l d g/forms/famaffi d Rev:l/03 n table �/l Town of Bars I� Regulatory Services �rtf1E r Thomas F.Geiler,Director t. ;;` t'j;;415 TABLE . Building Division ��L. Tom Perry, Building Commissioner b t I t .S�J mass. 9 03g6 ��� 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us .._.. 0iftSi1 .; 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 Ci���r L� i/ — r� r 1,"� !^ 1 - I am the owner/resident of the property located at: ` `t h'� i L ' Map and Parcel Number The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address:' - - - } 11 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 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this_j— L day of_ (-6`_� 200` Signature Phone Number Print Name Qfbidg/fonns/f anaffid Rev:1/03 Town of Barnstable 0 K Regulatory Services pFINE rOk� Thomas F.Geiler,Director p, Building Dr s onf*lr' SLE sARvsrnsLe. Tom Perry, Building Commissioner 1639. $ 200 Main Street,Hya;1s 6906 01 P14 1: 0 8 �Ecr www.town.barnstable.ma.us U"WS 10 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 (W(-Q— Vnn,'� I am the owner/resident of the property located at: Ll03� Map and Parcel Number 6�o The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: c�J1r 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 enalties of perjury this day of oin , 2006. ©�--�c —4� Signature Phone Number Print Name ,V \a-c r)e, Q/bldg/forms/famaffid Rev:1/03 Jan 19 05 11 : 54a 5084779072. p. 1 `I,Own of Barnstable LIE Regulatory Services oftNE rp� Thomas F.Geiler,Director Building Diviskq;n; JIA41i 19 u�tvsrestE. : Tom Perry, Building Commissioner Mass • v a639, `0� 200 Main Street,Iiyatinis;MA.02601 fill'� :,._..-----"'� Fax: 508-790-0230 Office: 508-862-4038 Town of Barnstable Family Apartment Affidevit I,being on oath, depose and state as follows: My name is I am the owner!resident of the i property located at: ik_ Map and Parcel Number The ZBA granted me a Special PermitNariance on. Date Appcal No. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: 01 • 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 evert that the listed relatives vacate said apartment,I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment.I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above, I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal,No. Other Swo to under the pain and penalties of penury this day of 20OJr Sign a Phone umber Print Name AAA __0 Qlbld eformslfaznaffid Rev:l l03 n i' 'Town of Barnstable id Regulatory Services pFtHE•rgy� Thomas F.Geiler,Director Building Division r • sARvsznaLe. Tom Perry, Building Commissioner H[ W,120 PH 12: MASS. 039. �0 200 Main Street,Hyannis,MA 02601 ArFO MA'1 A Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is �� `j I am the owner/resident of the property located at: _ Map and Parcel Number The ZBA granted me -Special Permit/Variance on ----------- Date Appeal No. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: - - Name&relationship to owner: �. '� Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this. day of ' a 2004. Sign\a6ue - Phone Number Print Name Q/bld g/forms/famaffi d Rev:l/03 Town of Barnstable Regulatory Services �oFIME�gy�o Thomas F.Geiler,Director ® � OF gAOASTABLE Building Division IARNSTABLE, Tom Perry, Building Commissioner 1�3 �AN 22 , t MASS. v� 1639. ,0� 200 Main Street,Hyannis,MA 02601 AlED�r p Office: 508-862-4038 Fax: 508-190-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name i , CL.rl e e_ pm _rk (NI I am the owner esident of the property located at: ICA 1� fl o+k,.i`fine✓ L"P TCR,,le') tl,u,ffv-,% Cf&(,-,3'2- Map and Parcel Number L Lo(go The ZBA granted me a pecial Permi , ariance on "Z'0� ���Z- C�ZG Date Appeal No. The decision of the Zoning Board of Appeals has been recorded Yvith the Registry of Deeds in Barnstable County:.Book Page G._ �G�� ('So The following members of my family will be the sole.occupants.of the Family.Apartment at the aforementioned address: _ \ Name &relationship to owner: PA C �l �y `E'1�1 er CIA ( vt Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. } Other Swo to under the pains d penalties of perjury this �� day of 2003. - Irlc)- Signature` Phone Number Print Name 01,K Q/bldg/forms/famaffid Rev:1/03 j< ro v COMMONWEALTH OF MASSACHUSETTS o� BARNSTABLE AFFIDAVIT I, CkaA-e_,rP__ Pmk, f1� , being on oath, depose and state as follows: Laae 1.) I reside atc4 b Cen.-krolL . 2.) I am the owner of the property located at Sa. 2 e•S a�! shown on Barnstable Assessors.' maps as MAP �G� PARCE 3.) 1 Do - Do not have a Family Apartment at this location. 4.) On ! 7i , 199 Z , the Zoning Board of Appeals, on Appeal No.l qQ Z-6 Zs granted me a Speciai PermiU variance to m--;n*.—;n? 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 04� 1-1"+rt Relationship to owner: - Law 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 Conumssioner 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 Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. a m _ _ - Sworn to under the pains and penalties of perjury this day of, �G2 ZQD Z- Signature " rW__6ent=:= Print ame L COMMONWEALTH OF MASSACHUSETTS 1BARNSTABLE AFFIDAVIT being on oath, depose and state as follows: 1.) I reside at ci l fl�� 1. Cf Ik,_ ���-t� (_;r� (tL ( e 2.lr j T 2.) I am the'owner of the property located at. shown on Barnstable Assessors' maps as MAP_--�--_PARCEL--00 _ 3.) I Do V/ Do not —have a Family Apartment at this location. 4.) On , 199 2. , the Zoning Board of Appeals, on Appeal No.jf(_qL-0?-S granted rre a pecial Permi anance 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 ,',,v Relationship to owner: ', , — '1 ? a'�el" .--•.- �--;- 7; 1,�, 1-. _ �-.4 _e__�J---�-.�-�-F a=_>-�r,� �=�-5 b) NAME q(,, _•;Relationship*tolowner:_—_ 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that.I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 12.) I agree to immediately notify the Building Commissioner in the event of the sale of the above- listed property. Sworn to u er the pains and p of perjury this . ✓ day of_.� -�-rr' � 1, Signature i,, lt.: lt-+ Print Name Town of Barnstable Zoning Board of Appeals Special Permit -. Family Apartment Decision and Notice Summary Appeal No. 1992-25 Applicant: John P. Antrium, Sr. Address: 73 Knotty Pine Lane, Centerville, MA 02632 Property Location: 194 Knotty Pine Lane, Centerville, MA 02632 Assessors Map/Parcel: 191/090 Zoning: RC - Residential C District Property Owner: Richard & Cynthia Johnson Address of Owner: 755 North Street, Windsor, MA 01270 Special Permit Request: section 3-1.1(3) (D) Family Apartment Activity Request: To permit a family apartment unit. Procedural Provisions: Section 5-3.3 Special Permit Background: This decision concerns the petition submitted by John P. Antrium, Sr., requesting that a family apartment unit, which is developed within a single family dwelling at 194 Knotty Pine Lane, Centerville, be allowed for use by himself. This family apartment unit was originally developed by special Permit in 1982 by Stephen & Denise Carlier (Appeal #1982-14) and in accordance with plans submitted to that file at that time and cited as "Proposed Addition to Residence Lot. 21,* Stephen & Denise Carlier, dated 30 March, 1982, Bayside Building Co., Inc., Procedural summary: The application was filed in the office of the Town Clerk and at the Zoning Board of Appeals office on April 07, 1992. A public hearing, duly noticed under MGL Chapter 40-A .was. held at the school Administration Building. The hearing was. opened on May 14, 1992 and was continued to May 28, 1992. At which time the Board closed the hearing and rendered its decision. The petition was .heard by Board Members; Ron Jansson, Luke Lally, Wayne Brown, Gene Burman and Acting Chairman, Gail Nightingale. Attorney Michael stusse represented the petitioner, who has a Purchase and Sale Agreement with the current owner. Mr. Antrim plans to reside in the family apartment with his son and daughter-in-law occupying the main residence. The dwelling and the family apartment are to be the principal year round residence of both Mr. Antrim and his sons family. I Decision and Notice Appeal No. 1992-25 The family apartment is attached to the main structure and has existed by virtue of a prior petition before the Board, #1982-14, Stephen & Denise Carlier. The public was invited to speak, and Ray Ruggles spoke in favor of the petition; however, he wanted to insure that the Special Permit could not be transferred to another party. No one spoke in opposition to the petition. The Board was concerned that the square footage be itemized and that a copy of the Purchase and Sale Agreement be presented to the files prior to the decision on this application. The Hearing was continued to May 28, to provide time for the applicant to present the information. At the meeting of May 28, the materials requested by the Board were submitted and reviewed. The plan indicated that total gross square footage of the home is 1,856 sq.ft., with the Family Apartment occupying 576 sq.ft. ( 320 sq.ft. on the first floor and 256 sq.ft. second floor) and the primary dwelling being 1,280 sq.ft. The percentage of the apartment is 45%. The Purchase and sale Agreement was reviewed and acceptable to the Board. Finding of Fact: Based upon the evidence submitted and testimony given at the meeting of May 28, 1992, the Zoning Board of Appeals unanimously finds as follows: 1. The applicant has met all requirements under the Zoning ordinance, Section 3.1-1(3) (D) for a Family Apartment. 2. Given that the family apartment currently exists, it would not be detrimental to the neighborhood. Conclusion: Accordingly, a motion was duly made and seconded that based upon the findings in Appeal No. 1992-25 a Special Permit for a Family Apartment, be granted in accordance with plans and information submitted and be maintained in accordance with Section 3-1.1(3) (D) of the Zoning ordinance. The vote was as follows: Ayer Ron Jansson, Luke Lally, Wayne Brown, Gene Burman and Acting Chairman, Gail :Nightingale. Nay: None order: The application for a Family Apartment has been granted to John P. Antrim for Appeals of this the .location at 194 Knotty Pine Lane,. Centerville, MA. decisions, if any, shall _be made pursuant to MGL Chapter 40A, Section 17, and .shall be filed within Twenty (20) days after the date of the filing of this decision in the office of the Town Clerk. Any person aggrieved by this decision may appeal to the Barnstable Superior Court, as described in Section 17 of Chapter 40A of the General Laws of the Commonwealth of Massachusetts by bringing:.an action within twenty days after the decision has been filed in the office of the Town Clerk. Chairman I' — t w �!!IGn_n/ Clerk of the Town of Barnstable Barnstable County, Massachusetts, hereby certify that twenty ( have elapsed since the Board of Appeals rendered its decision in)theys above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this DA)IN day of �u L,� 19 pains and penalties of perjury. __under the Distribution: Property Owner Town Clerk Town Clerk Applicant Persons Interested Building Inspector Public Information Board of Appeals May 20 99 10: 37a 15081 477-9072 p. 1 COMMONWEALTH OFMASSA.CHUNETTS I BARNSTABLE AFFIDAVIT ?----------------------- being oil oath, depose and state as follows: 1) I reside at Ott 2.j I am the owner of the property located «t---- --------------------- shown on Barnsahle Assessors' neaps as MAP--- l_'_PARCEL-_-L6j-G ____ --__ 3.) 1 DoL --------Do n()I---------------have a l+arnily Apartment at.this location. 4.) ()n �-_ 199 L-, the Zoning Board o1'Appeals, on Appeal N .. - LC25- g ,uited me a ice to maintain a Family Apartment at the above address. 5.) I !inderstand that.the Family Apartment may only be occupied by members of mry family who are persons related to nee by blood or by marriage. 6.The If61101"2ng members of my family will be the sole occupants of the. Faunily Apartment at the above address: r� ILL------ Relationship --; _ ------ ----- to owner: ---- --------------- L"-------- h} Relationship to owner:-------------------- 7.) The Fwiiily Apartment vill be the Primary year round residence fc=r die above-identified family members. 8.) In the event.dial..the at),Dvc-iisled relative(s)vacate said apartment, I will immediately notify die Building;Commissioner in writing. 9.) 1 understand that no subletting or subleasing of'said Family Apartment is permitted. 10,.i 1 understand that I gun required to annually file an Alrclavit.v ith the Building Commissioner lisrting the mn aes and relationship of zny I'arrlily members r,ccupying said Faunily Apartment. i 1 understand that I aim required to con,pl.y witlr¢ill conditions imposed by (Le Board of Appeals in Appeid No. --------------—--------------------------------------------- 12. 1 agree to immediately notify the L'uilding:CG:m:rrissiorter in the event of the. sale of the above- hstcd property. Sworn to a er dl-.e pains and pc . toes of ixriury this (_✓ day of 199 Sigma.tur Prmt Nance. COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT John P Antrim, Jr. and Charlene iyIFBAANSTAWE h - - _ — ,. ,r ? being on oath, depose and state as follows: 194 Knott Pine L �JAN 13 1998 1.) I reside at Y n _Lane, Center e _ 1 2.) 1 am the owner of the property located U at194 Knottj Pine Lane, Centerville___________________________ shown on Barnstable Assessors' maps as MAP_ 19_1 PARCEL---90\_ 3.) I Do-_X ----Do not_ -_have a Family 4.) On May 28._17......... 199_2 the Zoning Board of granted me a Special Permit/Variance to maintain a Family Ap 5.) 1 understand that the Family Apartment may only be occupied are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Famil above address: a) NAME John P. Antrim, Sr. -------------------------------------------------------- Relationship to owner: Father --------------------------------------- �r b) NAME-------------=------------------------------------------------- __. Relationship to owner:* __—_ `G• 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. - 1 9.) Lunderstand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying-said'Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. __j 992-2 -------------------------------------=---------- 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. `'` Sworn to under-the p ' d p s of erjury this_-9 day of_January 1998 Signatee y Print O John P. Antrim, Jr. Charlene Antri QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 01/07/98 PARCEL ID 191 090 GEO ID 11487 LOT/BLOCK 21 DBA PROPERTY ADDRESS OWNER ANTRIM 194 KNOTTY PINE LANE JOHN P JR & ANTRIM CHARLENE M CENTERVILLE 194 KNOTTY PINE LN CENTRVILLE MA 02632 PHONE DISTRICT CO DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY(NOTES) ZONING DIST/ZOC RC SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? ## BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 16988 .4 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST (N) EXT / (P) REVIOUS / NO (T) ES / PER(M) ITS / (V) IOLATIONS , / (G) EOBASE / (E) XIT 1. Town of Barnstable Zoning Board of Appeals Special Permit - Family Apartment Decision and Notice Summary Appeal No. 1992-25 Applicant: John P. Antrium, sr. Address: . 73 Knotty Pine Lane, Centerville, MA 02632 Property Location: 19.4 Knotty Pine Lane, Centerville, MA 02632 Assessor's Map/Parcel: 191/090 Zoning: RC - Residential C District Property owner: Richard & Cynthia Johnson Address of owner: 755 North Street, Windsor, MA 01270 Special Permit Requests section 3-1.1(3) (D) Family Apartment Activity Request: To permit a family apartment unit. Procedural Provisions: Section 5-3.3 Special Permit Background: z This decision concerns the petition submitted by John P. Antrium, sr., requesting that a family apartment unit, which is developed within a single family dwelling at 194 Knotty Pine Lane, Centerville, be allowed forluse by himself. This family apartment unit was originally developed by special Permit in 1982 by Stephen & Denise Carlier (Appeal #1982-14) and in accordance with plans submitted to that file at that time and cited as "Proposed Addition to Residence Lot 21, Stephen & Denise Carlier, dated 30 March, 1982, Bayside Building Co., Inc., Procedural Summary: The application was filed in the office of the Town Clerk and at the Zoning Board of Appeals office. on April 07, 1992. A public hearing, duly noticed under MGL Chapter 40-A was held at the school Administration Building. The hearing was opened on May 14, 1992 and was continued to May 28, 1992. At which time the Board closed the hearing and rendered its decision. The petition was heard by Board Members; Ron Jansson, Luke Lally, Wayne Brown, Gene Burman and Acting Chairman, Gail Nightingale. Attorney Michael Stusse represented the petitioner, who has a Purchase and Sale Agreement with the current owner. Mr. Antrim plans to reside in the family apartment with his son. and daughter-in-law occupying the main residence. The dwelling and the family apartment are to be the principal year round residence of both Mr. Antrim and his son's family. • 1 �- Decision and Notice Appeal No. 1992-25 The family apartment is attached to the main structure and has existed by virtue of a prior petition before the Board, #1982-14, Stephen & Denise Carlier. The public was invited to speak, and Ray Ruggles spoke in favor of the petition; however, he wanted to insure that the Special Permit could not be transferred to another party. No one spoke in opposition to the petition. The Board was concerned that the square footage be itemized and that a copy of the Purchase and sale Agreement be presented to the files prior to the decision.on this application. The Hearing was continued to May 28, to provide time for the applicant to present the information. At the meeting of May 28, the materials requested by the Board were submitted and reviewed. The plan indicated that total gross square footage of the home is 1,856 sq.ft., with the Family Apartment occupying 576 sq.ft. ( 320 sq.ft. on the first floor and 256 sq.ft. second floor) and the primary dwelling being 1,280 sq.ft. The percentage of the apartment is 45%. The Purchase and sale Agreement was reviewed and acceptable to the Board. Finding of Fact: Based upon the evidence submitted and testimony given at the meeting of May 28, 1992, the zoning Board of Appeals unanimously finds as follows: 1. The applicant has met all requirements under the zoning ordinance, Section 3.1-1(3) (D) for a Family Apartment. 2. Given that the family apartment currently exists, it would not be detrimental to the neighborhood. Conclusion: Accordingly, a motion was duly made and seconded that based upon the findings in Appeal No. 1992-25 a special Permit for a Family Apartment, be granted in accordance with plans and information submitted and be maintained in accordance with Section 3-1.1(3) (D) of the zoning ordinance. The vote was as follows: Aye: Ron Jansson, Luke Lally, Wayne Brown, Gene Burman and Acting Chairman, Gail Nightingale. Nay: None Order: The application for a Family Apartment has been granted to John P. Antrim for the location at 194 Knotty Pine Lane, Centerville, MA. Appeals of this decisions, if any, shall be made pursuant to MGL Chapter 40A, Section 17, and shall be filed within Twenty (20) days after the date of the filing of this decision in the office of the Town Clerk. .y Any person aggrieved by this decision may appeal to the Barnstable Superior Court, as described in Section 17 of Chapter 40A of the General Laws of the Commonwealth of Massachusetts by brin in action within twenty days after the decision has been filed i a nthe office of the Town Clerk. Chairman �,v f L Cn Ufa^^� , Clerk of the Town of Barnstable Barnstable County, Massachusetts, hereby certify that twenty ( have elapsed since the Board of Appeals rendered its decision in)theys above entitled petition and that no appeal of said decision has been filed in the office of the Town. Clerk. Signed and Sealed this pains and penalties of perjury. day of Zvi P J 19 under the Distribution: Property Owner Town Clerk To Clerk Applicant Persons Interested Building Inspector Public Information Board of Appeals -- �4 1Qlll;r GLEN +iARNSTABLE. 11 S IN OF BARNSTABLE '82 - APR 22 PHI 12 Zoning Board of Appeals Stephen_,&._,Denise Carl ier Deed duly recorded in the .... _._._...a................._. Property Owner County Registry of Deeds in Book Same as above _ _ _..._._ ....._..__ ...._..................... Page _.__._..._.. , --_...-------Registry Petitioner District of the Land Court Certificate No. Book __. Page Appeal No. ............. __w... ....._. ....Apr...i_]_.2.L...._____._.__._..._ 1982 FACTS and DECISION r Petitioner .51.ephe[1....&....O.en.i.s.e...Car...l:ier._ .._.._.__ ._ filed petition on _ _.CGb..9..................._. 19-82 requesting a variance-permit for premises at J3.4...KnQt.ty._..P..1.t).e....Lan.e........___...._.... ...__ ., in the. village (Street) of Centerville _ _ adjoining remises of see attached list) Locus under ,consideration: Barnstable Assessor's Map no. _...__1.9.1_.. lot no. 90. Petition for Special Permit: . Application for Variance Q made under Sec. of the Town of Barnstable Zoning by-laws and Sec. 9..4f__ _. �_ Chapter 40A., Mass. Gen. Laws dd1tion exi s in dwell_ing--for family for the purpose of _.G.AC4lS .tQ1LR � _.t.4 ._Q�_ X Locus is presently zoned Notice of this hearing was given by mail, postage prepaid, to all persons deemed affected and by publishing in Barnstable Patriot newspaper published in Town of Barnstable a copy of which is attached to the record of-these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town of Barnstable was held at the Town Office Building, Hyannis, Mass., at .._._:......._�..�1�._._.XXi1�. P.M. _...........Al?.C!L...$..,._._.._........_.... 1982 , upon said petition under zoning by'-laws'. Present at the hearing were the following members: Luke - P. Lally ..__ . Frank P. Congdon Gai 1...._......._.Ni Bht.i ngale _......._._...._.._._._...... Chairman .'"""...._._....._...__...._... ._ k.c the conclusion of the hearing, the Board took said petition under advisement. A view of the i was made by the Board. Appeal No.__.....1982m11L_._ _ _ Page of 2 _ On __-.AP...r i 1 8 _ 19 82 , The Board of Appeals found Brian Dacey represented the petitioners before the Board and introduced Mr. Carlier, owner. of the locus at 194 Knotty Pine Lane, Centerville in a residence C zoning district. Mr. Carlier would like to construct an addition to his residence as shown on the plan submitted with his filing and this addition would have use as a family apartment for Mrs. Carlier's parents. This dwelling would retain its cape-style appearance and the apartment addition would measure 16 ft. x 20 ft. without the breezeway as shown on the first plan submitted with the filing. The petitioners will comply with all of the requirements of Sec. V. of the zoning by-laws and none of the abutters have objected to the petition. No one present at the hearing spoke in favor of or in objection to the petition and the Board took the matter under advisement. _ The Board voted unanimously to grant the petitioner a special permit under Sec. V Family Apartments and found that this use would not be detrimental to the neighbor- hood nor in derogation of the spirit and intent of the zoning by-laws inasmuch as all of the regulations imposed under Sec. V. will be fully met. Construction shall be in accordance with the plan submitted with the filing and cited as follows: "Proposed Addition to Residence Lot 21 , Stephen & Denise Carlier, Knotty Pine Lane, Centerville - Drawing 1 and 2, Date: 30 Mar 82, Bayside Building Co. , Inc. , Centerville, MA." Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decision in the above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this .............._.- day of 19 _ _ . __ under the pains and penalties of perjury. Distribution:— Property Owner. _...........____._........_____.__._..._.... Town Clerk Board of Appeals Applicant Town of Barnstable Persons interested Building Inspector Public Information 'By__ - Board of Appeals Qsir in 6 A t hJ55) er i Qom' July 16, 1991 RECMEO ' Mr . Joseph D. DaLuz VU, 2 3 �991 Building Inspector ` Town Of Barnstable tr, r SCwNrr ?5'P&_ Town Office Building Hyannis Ma . 02601 Dear Mr . DaLuz , This is in reference to my telephone call to your office on July 16 , 1991 in response to your letter dated June 28, 1991 . I understand that you will allow me to leave the in-law apartment at 194 Knotty Pine Lane, Centerville , intact for the time being . The condition for this will be that , since the property is currently vacant and for sale, our realtor , B. Joan Bussiere of Walsh Realty, will advise any prospective buyers of the need to obtain a permit in order to maintain the legality of the apartment . Should the buyer not wish to keep the apartment , your office must also be notified . Ms . Bussiere is to confirm the above , in writing, to you . If there are any changes , I will be in touch with you at once . Thank you again for your patience and understanding in this matter . Sincerely, Richard C . Johnson 755 North St . Windsor , Ma . Tel . 1-413-684-9711 cc: B. Joan Bussiere , G .R. I . Walsh Realty l� 7�,�XFJ WALSH REALTY ���® 610 West Main Street AL HYANNIS, MASSACHUSETTS 02601 LETTER (508) 775.7330 Date ............ To Subject ................................................................... ......................... o ........ �- ............ ......... . .... ....................- ........................... ........... ........... ........... 17 a, ......................................-............ ..........- ..........................- ............................ ....................- ...................... ..................... ............ .......................... ... . ........... ............. ............ ........... El Please reply El No reply necessary SIGNED f P 650 798 S06 Certified Mail Receipt No Insurance Coverage Provided o Do not use for International Mail UNITED STATES (See Reverse) POSTAL SERVICE Sent to Richard Johnson Street&No. 755 North Street P.O.,State&ZIP Code Windsor , MA 02170 Postage Certified Fee Special Delivery Fee Restricted Delivery Fee O Return Receipt Showing p) to Whom&Date Delivered Return Receipt Showing to Whom, Date,&Address of Delivery 7 TOTAL Postage &Fees co Postmark or Date - M E 0 rn a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). rl 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return a'> address of the article,date,detach and retain the receipt,and mail the article. E ^ o/ 3 If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed m ends if space permits.Otherwise,affix to the back of article.Endorse front of article RETURN � RECEIPT REQUESTED adjacent to the number. -� 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, p endorse RESTRICTED DELIVERY on the front of the article. t0 M 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If E return receipt is requested,check the applicable blocks in item 1 of Form 3811. ri U) 6.Save this receipt and present it if you make inquiry. *u.S.G.P.o.1990-270-153 a SfNDtRt Complete items 1 and 2 when additional services are desired, and complete items 3 and 4. Put your address in the"RETURN TO"Space on the reverse side. Failure to do this will prevent this card from being returned to you.The return recei t fee will Provide you the name of the erson delivered to and the date of deliver . For additional ees the oilowing services are available. Cons postmaster for fees and check oxlesl Tor additional service(s) requested. 1. ❑ Show to whom delivered, date, and addressee's address. 2. ❑ Restricted Delivery (Extra charge) (Extra charge) 3. Article Addressed to: 4. Article Number P 650 798 506 Mr. Richard Johnson Type of Service: 7 5 5 .N O r t h. S t r e 2 t- ❑ Registered ❑ Insured Windsor , MA 02170 U Certified ❑ COD ❑ Express Mail ❑ Return Receipt for Merchandise Always obtain signature of addressee or agent and DATE DELIVERED. 8. Sig re — ddre ee 8. Addressee's Address (ONLY if X P requested and fee paid) fi. ature — Agent 7. Dat of Delivery PS Fdrm 3811, Apr. 1989 *U.S.GAO.1989-238-815 DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS Q so ' Print your name,address and ZIP Code in the space below. • Complete items 1,2,3,and 4 on the me reverse. u U.S.MAIL • Attach to•front of article if space "� O permits, otherwise affix to back of +�1 article. �9J1 E1QA`LTY FOR PRIVATE • Endorse article "Return Receipt 1'1 FUSE, $300 Requested"adjacent to number. RETURN Print Sender's name, address, � �2r� in the space below. TO TOWN OF BARNSTA�B` BUTLDTNG INSPECTOR' S OFFICE 367 MAIN STREET N 11YAN PIS MA 02601 ' I j I' LN SALES-RENTALS 4777. < NOTARY PUBLIC + e ' ® equal xo USING ///�� / UPPOg7UNIiY Joan 12u99tere� REALTOR WAtSH REALTY i 610 WEST MAIN STREET' HYANNIS,MA 02601 HOME 771-0376 OFFICE:(508)775-7330 FA (508)771-1282 r JOSEPH D. DALUZ 73 � t�t7CY�Y3(�C7� �XX Building Conimiffiontr - XXXY7lDOSCX=7 TELEPHONE 508-790-6227 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 June 28, 1991 Mr. Richard Johnson 755 North Street Windsor, MA 02170 Re: 194 Knotty Pine Lane, Centerville, MA A= 191.090 Dear Mr. Johnson: As of the above date, you have not filed an appeal with the Board of Appeals to authorize the apartment in the above referenced dwelling. I Please contact this office within fourteen days of your receipt of this letter to discuss this matter. (My office hours are 8:30 - 9:30 A.M. and 1:00 - 2 :00 P.M. , Monday through Friday) . Should you fail to contact me, I will assume that a zoning violation exists and appropriate action will be taken. Peace, oseph D. Da Building Commissioner JDD/km cc Town Attorney Certified Mail PD 650 798 506 RRR II ___�,.. _.,_�.... .__�.� �_� - - r i I � ��v t � t I � � 1��� � ���� _� - v N _ - E October 24, 1990 ' J Mr. Joseph D. DaLuz Building Commissioner Town of Barnstable Town Office Building Hyannis , Ma . 02601 Dear Mr. DaLuz, This is in reference to your letter dated October 19, 1990 and my telephone call to you on October 24, 1990. Your letter indicated that the kitchen facilities located in the apartment at 194 Knotty Pine Lane, Centerville, Ma . must be removed . After explaining my situation and the reason for the delay in conforming to your request , you allowed that I would be able to leave the property as is until the Spring of 1991 . At that time another review of the property would be made. I would like .to thank you very much for your help in this matter . If circumstances. regarding this residence change in any way, I will contact you at once . Sincerely, Richard C.` nson Richard C. Johnson 755 North St . Windsor, Ma . Telephone 413-684-9711 I Joseph D. UaLuz Telephone: 790-6227, Building Commissioner TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING HYANNIS , MASS. 02601 October 19 , 1990 Mr. and Mrs. Richard Johnson North Street. Windsor.-, MA 02170 Re: Family apartment located at: 194 Knotty Nine bane, Centerville, MA Deer Mr. and Mrs . Johnson: It was the understanding of -this office in November ," 1989 , that you intended to apply for a' Special Permit for the above referenced illegal apartment.' Our- records indicate that , as of this date , you have not yet done so. Therefore, the kitchen facilities must be removed from this unit , .Please contact this . of. fice immediately to schedule an inspection of this property. Should you fail to do so , I Will assume that a zoning violation exists and appropriate action will be taken. Please be advised that this office shall strictly enforce the provisions of. the Zoning By-law. Conviction of a violation of this by-law is subject to a fine of $100 per day for each day from the established date of offense and , also, subject to a criminal complaint to issue from the First Lristrict. Court of Barnstable. 'Peace , ph D. a uz o Building Commissioner- JDD:km cc Zoning Board of. Appeals Town Attorney � s kL,� � I 7141 c (, eo�t . �c S � 4 C + r u , �� � ���� i v�.2 "/ ' �� t � ; �a} /l t � � Gl. 4 . o .iy,y�axrs�.+wv✓+Wu�Mmn, r e J� ��� ✓ ®/7 7 26�j yam - jOSePM 0 . UaLUZ Telephone: 775- 02-0 Building Commissioner Ext. 107 TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE 131-I &DING HYANNIS , MASS. 02601 NoVermner 1 . 1989 *, chard ana Cyntnia Johnson Nortn Street Windsor, MA 02110 Re : A= 19i 091) Aparrment located at 194 Knotty Pine Lane, Centerville, Dear Mr. ancl mrs . jonnson : it was the understanding of this office, in July, 1989, that you intended to apply for a Special Permit for the above referenced illegal apartment . Our records indicate that, as of October 27 , 1989, you Mad not yet applied to the Zoning Board of Appeals for this permit . Please contact this office immediately regarding this matter . Peace , obselon D . DaLuz Builaing Commissioner JOD/l,rm josepn C). DaLuz Telephone: 775-1120 bui ) cling Commissioner Ext. 107 TOWN OF BARNSTABLE BUILDING DEPARTMENT MOWN OFFICE BUILDING HYANN I S, MASS . 02601 April 26, 1989 Richard and Cynthia Johnson North Street. Windsor, MA 02170 Re: Appeals No. 1982- 14 Dear Mr. and• Mrs. Johnson: On April 8, 1982, the Board of Appeals granted a special permit to Stephen and Denise Carlier for a family apartment under Section V, "Family Apartments" in the Town of Barnstable Zoning By-law. The by-law permits accommodations for a kitchen and bath to supply a year-round residence for a member or members of the property owner ' s family for whom the special permit was granted. Said permit is non-transferrable and any and all sales negate the special permit . Any similar use can only be granted by the Board of Appeals 'if conditions so warrant. Our records indicate that you are the owner ( s) of sa i d Property to wrrich a family apartment was authorized by the Board of Appeals. Shnuld this be the ease, you would be in violation and Saia unit must be removed. It should also be noted that said authorization was required to have been filed with the Registry of Creeds in order to prevent any violation of the special permit . Therefore, this office will require that an affidavit be filed in the Building Department , Monday - Friday from 9: 30 A. M. through 1 ::30 N. M. Please be advised that this office shall strictly enforce the provisions of this by-'law. Conviction of a violation of this by- law is subject to a fine of $ 100 per day for each day from the established date of offense and, also, subject to a criminal complaint toissue from the First. District Court. of Barnstable. Peace, c},? i Joseph D. DaLuz Building Commissioner JDDjkm cc Board of Appeals Town ( OLAI-ISe) TOWN CLERK HARNSTABLE. NAT .OV6TN OF BARNSTABLE '82 APR 22 PM 1 11 Zoning Board of Appeals Stephen & Demise Carl ier. _,_,_ Deed duly recorded in the Property Owner County Registry of Deeds in Book Same as above Page Petitioner District of the Land Court Certificate No. r Book ..-.-- Page Appeal No. ....._.....Apr...i..l....21_......__...._....__..M..... 1982 FACTS and DECISION Petitioner filed petition on 19 82 , requesting a variance-permit for premises at J-9-4..._KnQ .Xx....P-1ne....i..an.e ___ _.__.. , in the village (Street) of _ ._.:_Centervi l le _ , adjoining premises of --- (see attached list) Locus under consideration: Barnstable Assessor's Map no. _..._19.1...— lot no. q0 Petition for Special Permit: {� Application for Variance: ❑ made under See. of the Town of Barnstable Zoning by-laws and See. _ _ Pf w_ __ _ __..__ . __-_ __ Chapter 40A., Mass. Gen. Laws for the purpose of G_QM.1n C4r l QIL.�f di`t t i prL ,g e�i i ng dwelling for family Locus is presently zoned in RaS..A.dcaro C.- _----•-- -----_-_--- Notice of this hearing was given by mail, postage prepaid, to all persons deemed affected and by publishing in Barnstable Patriot newspaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town of Barnstable was held at the Town Office Building, Hyannis, Mass., at _ Z:_4 __.X?4Vt. P.M. --A-P.r-iJ.J-...___._._......._ 1982 , upon said petition under zoning by-laws. Present at the hearing were the following-members: Luke P. Lally___.__ Frank P. Congdon Gail Night.ingal.e ......__._._._............_......... Chairman ..._._._._.... C At the conclusion of the hearing, the Board took said petition under advisement. A view of the as was made by the Board. , Appeal No.- -l�$2 1 _ _ Page ._ ? of 2 On - -_-An r i 1 8 _ 19 82 , The Board of Appeals found Brian Dacey represented the petitioners before the Board. and introduced Mr. Cartier, owner. of the locus at 194 Knotty Pine Lane, Centerville in a residence C zoning district. Mr. Carlier would like to construct an addition to his residence as shown on the plan submitted with his filing and this addition would have use as a family apartment for Mrs. Carlier's parents. This dwelling would retain Its cape-style appearance and the apartment addition would measure 16 ft. x 20 ft. without the breezeway as shown on the first plan submitted with the filing. The petitioners will comply with all of the requirements of Sec. V. of the zoning by-laws and none of the abutters have objected to the petition. No one present at the hearing spoke in favor of or in objection to the petition and the Board took the matter under advisement. The Board voted unanimous) to the Y grant petitioner a special permit under Sec. V. Family Apartments and found that this use would not be detrimental to the neighbor- hood nor in derogation of the spirit and intent of the zoning by-laws inasmuch as all of the regulations imposed under Sec. V. .will be fully met. Construction shall be in accordance with the plan submitted with the filing and cited as follows: "Proposed Addition to Res.idence Lot 21 , Stephen & Denise Carlier, Knotty Pine Lane, Centerville - Drawing 1 and 2, Date: 30 Mar 82, Bayside Building Co. , Inc. , Centerville, MA." I --- Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decision in the above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this _._. day of _.._. _ _ __ 19 _ under the pains and penalties of perjury. Distribution.— Property Owner Town Clerk Board of Appeals r Applicant Town of Barnstable Persons interested Building Inspector Public Information rB y- _ - - Board of Appeals Chai an _777_701 R191 09o. A P P R A I S A L D A T A' KEY 114879 JOHNSON, RICHARD & CYNTHIA LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RC 48, 900 1og, 900 I A-COST 158,800 B-MKT 106,700 BY 00/ BY /oo C-INCOME PCA=1011 PCS=00 SIZE= 1856 JUST-VAL 158,800 LEV=300 CONST-C 0 ----COMPARISON TO CONTROL AREA 41BC -- TREND EXCEEDS STANDARD NEIGHBORHOOD 41BC CENTERVILLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 489o0l LAND-MEAN +0% 1588003 90503 IMPROVED-MEAN +21% 20% 1 FRONT-FT 3 100 DEPTH/ACRES TABLE 02 100%3 LOCATION-ADJ APPLY-VAL-STAT I LNRILAND LFT/IMPIADJS/SB/FEAT STRISTRUCTURE ARR3AREA--MEASUREMENTS NOR INOTES, COMIMARKET INCIINCOME PMR3PERlylITS ORR3 GRAPH IC FUNCTION-[ 3 STRUCTURE-CARD NO-10001 DATA-[ 3 XMTE?3 kC l C R 191 090. l LOC 10194 KNOTTY FINE LANE C:TY l 10 TDS 7 _00 CO KEY] 1 14879 i ---MA I L I NC, ADDRESS--- ___ PCA l 101 1 PC S l 00 YR l00 PARENT l 0 EWINDSOR I�IS N, R I`'; ��HARD & �:YNTH I A MAP] AREA l 41 B : ,_IV l 3751'2 3 MTG l��t�00 TH T sp1 _l :_,P'2l wP33 IIT'1l UT :l . 39 SO FT7 1:;56 MA 02170 AYB 3 1981 I EYB l 1981 C BS 3 C ONST I _00oo LAND 48900 IMF' 109900 0 OTHER ----LEA SAL DESCRIPTION---- TRUE MKT 158800 REA CLASSIFIED #LAND 1 4S, 9c:0 ASD LND 48900 ASD IMF' 109900 ASD OT'H #BLDG(S)-CARD-1 1 109, 900 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 194 KNOTTY FINE LANE TAX EXEMPT #DL LOT 21 RES I DENT L 106700 158800 158800 #Sl 06/81. 14 $ u0C'21'2 0 1 OPEN SPACE #S2 10/81 21 $0 05450 0 I COMMERCIAL #RR 0847 0100 INDUSTRIAL EXEMPTIONS SALE309/86 PRICE] 154900 ORBIC108008 AFDI I A LAST ACTIVITY311/07/88 PCR3Y Sc -� 18411 M7,4 i l oFTME The Town of Barnstable Department of Health Safety and Environmental Services , ,a,ABM $ Building Division MA059. SS. 367 Main Street, Hyannis MA 02601 ArEO MA'S� � Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissione January 7, 1998 The Antrim Residence 194 Knotty Pine Lane Centerville, MA 02632 Re: Family Apartment located at the above address Dear Mr./Ms. Antrim, Our records indicate you have not filed an affidavit regarding the above referenced family apartment in quite some time. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable Zoning Ordinance that an affidavit be submitted annually for the duration of such occupancy. Please indicate the status of the family apartment on the enclosed affidavit return to this office by January 30, 1998. Enclosed is an affidavit for your convenience. Thank you in advance, Ralph Crossen Building Commissioner CCARTHY va a e s � � art= rem ® RUCTION w sac! Wand"Commercial S - - EA "TION,SP CIAI IST e T 'QUALII ' CO�(I _�, 0 .£ March 15, 2014 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main Street Hyannis, MA 02601 RE: Insulation Permits Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#201203250;Status A; Parcel 191090 at 1"Knotty Pine Lane, Centerville, MA; Permit Type RADD and issued on 12:00:00 AM has been inspected by a certified Building Performance Institute(BPI) inspector.All work performed meets or exceed Federal and State requirements Sincerely, Michael McCarthy McCarthy Construction ti a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION qr6 � Map t Parcel ()9 0 App'cafi tion# Health Division Date Issued Z-- Conservation Division 'Application Fee4VU Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board r (o/7//LJ,1'—'0' Historic - OKH _ Preservation/Hyannis Project Street Address ICYr�t . �►4.� L� Village Owner Address Telephone 7 7 f'd q5) Permit Request (` Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) izz Age of Existing Structure Historic House: ❑Yes ❑ No On Old King sH'i hway: qYe s ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new CD Number of Bedrooms: existing _new - ' ' Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Mike Mee 16-oe1M1ktrU tj0 Telephone Number PO Boa SZ Address W"t r0.._a_ M� #� License # CseU•(508) 28"%4 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE dY L t , FOR OFFICIAL USE ONLY R A 4 APPLICATION# DATE ISSUED MAP/PARCEL NO. .ss ADDRESS VILLAGE » ; OWNER " `b '.� kv 164 464 DATE OF INSPECTION: , `., FOUNDATION .} FRAME INSULATION Y FIREPLACE t ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL k FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): __Mike McCarthy Constructionmil 1loY 52 Address: West Dennis,'MA 02670 City/State/Zip: CSL-5p# #:HIC-169393 Are you an employer?Check the appropriate box: Type of project(required): I.VI a employer with 4. ❑ I am a general contractor and I loyees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition: working for me in any capacity. employees and have workers' [No workers' comp: insurance comp. insurance. $ 9. ❑Building addition required.] 5. ❑ We area corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their ,11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL .12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no /- employees. [No workers' 13.VOtherr,���►� u comp. insurance required.] *Any applicant that checks box#1 must also fill.out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: Policy#or Self-ins. Lie.#: Expiration Date: Job Site Address: City/State/Zip: OaC312- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under a ns and Penalties of perjury that the information provided abov is true and correct. Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supery isur License: CS-058633 r MICHAEL J 11 eCAR PHY ��� f Y •1 PO BOX 52 W DENNIS 1f[A 02670 h I ,� Commissioner Expiration04/10/2014 . ✓/� l%O�IY7/IIGO7GC(/GCIN./G �a/�LCLQdCLCJI.L[l1fiU.0 —�---- '.._.--1—_•. - Office of Consumer Affairs&B siness Regulation License or registration valid for individul use only j HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration •1,69393 Type: Office of Consumer Affairs and Business Regulation Expiration 6/16/2013 Individual 10 Park Plaza-Suite 5170' ` Boston,MA 02116 MI AEL MCCARTHY k MICHAEL MCCARTHYF +` 6 RANGLEY LN SOUTH DENNIS,MA 02, 60' ;` Undersecretary t valid without signature i j I x OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at ` (Property Address) (Property Address) L- hereby authorize � 1 ' 'k (n rrt f' I Y �'(4 �-tf t� •' fOILS�'�C�[�'l _ t � l (Subcontractor) l: f an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature r Date F , OvIE • ' ;Y$ l .,. r. _ cirri if cl4�Is G sk4„ ., �A Cape Cod Court Reports Page 1 of 1 BARNSTABLE DISTRICT COURT February 7,2012 In court February 6,2012 ARRAIGNMENTS ANTR_IM- do .. -Knot`�'P_ine_.L_ff,-Centerville•kidnapping;assault&battery with a dangerous weapon,not specified;assault&battery;intimidating a witness;threatening to commit a crime;vandalizing property,February 2 in Barnstable. Co-defendant with LONG. Pretrial conference scheduled for February 17. BONFIGLIO,Anthony E,25,5 Alicia Rd,Hyannis;Class B drug possession with intent to distribute,oxycodone; conspiracy to violate drug laws;disorderly conduct,January 24 in Barnstable. Co-defendant with LITCHMAN and THOMSON. Pretrial conference scheduled for April 9. According to police reports,a Massachusetts state trooper and a Barnstable officer were on undercover patrol with the Barnstable Street Crime Unit. From an unmarked cruiser parked off Route 28,they watched Bonfigho enter,then exit cars arriving at a Hess station. They followed Bonfiglio as he left in a green Ford Explorer. Police saw the SW had an expired sticker,then effected a traffic stop. One passenger's lap held a plastic bag holding three pills: one dark blue,marked V/4812,the others light blue and marked M/3o. No one would admit to owning the bag. Police arrested all three men. http://www.capecodtoday.com/news/Court 2/7/2012 co � � 9� Town of Barnstable, *Permit# Expires 6 its fJ E isysuo e date JQL 10 Regulatory,Services Fe 10• Thomas F.Geiler,Director TOWN OF BARNSTABLE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PET IT APPLICATION. RESIDENTIAL ONLY Not Valid without Red X-Press imprint Map/parcel Number l �(, J Property Address �` ��10 ly� � GIZi 817 �(Residential Value of Work ram ( Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address rt1 V�,Y V J+ d� Contractor's Name pA." cjlrt.j Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable)--a [Workman's Compensation Insurance Checl one: ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance n Insurance Company Name Glo , // '� � 03 � t ryrnSS/ Workman's Comp.Policy# l.� Copy of Insurance Compliance Certificate must be on file. f Permit Request(check box) 0—Re-roof(stripping old shingles) All,construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: QTorms:expmtrg Revise061306 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 4' s 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _F/(, L LC, .r,p Address: 90)( City/State/Zip:_ MA- OX 3_'� Phone #: 56 c9- 7 0� Are you an employer?Check the appropriate box: Type of project(required): 1;,�i am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance. 9. ❑ Building addition comp.[No workers' comp. insurance p• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.El Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. Insurance Company Name: �1�¢ 2 h Policy#or Self-ins. Lie.04 6 -® 1 rl✓xpiratiorl Datee-+ . C�"'a ? - Job Site Address: 1 �/ � 7 City/State/Zip: 69-- ­'t l/mot �Ii/v� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi a nd�d�es of perjury that the information provided above is true and correct Si ature: CC a Date: Phone#: CJQ�' Y� 0 ' Offtcial use only. Do not write in this area,to be completed by city or town offtciad City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: •.,a baa vs w., va. a. v♦ •.+v• ---- . Vv , •-,— •••• a a•V•.. ..,• vva.. • w•f uvr �vs ACORD. CERTIFICATE OF INSURANCE DATE(MM\DD\YY) 09-29-09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WISE&QUINN IRIS AGCY IN HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 449 PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BROCKTON,MA 02301 COMPANIES AFFORDING COVERAGE COMPANY 24WCB A HARTFORD GROUP INSURED COMPANY B FRASER CONSTRUCTION LLC COMPANY P.O.BOX 1845 C COTUIT,MA 02635 COMPANY D COVERAGE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMOMYY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OP AGG. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ AUTOMOBILE LIABILITY MED.EXPENSE(Any one person) $ ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-034IM556-09 09-26-09 09-26-10 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 500,000 PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CER73FICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FRASER CONSTRUCTION LLC EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS.WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT PO BOX 1845 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NOOBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. COTUIT,MA 02635 AUTHORIZED REPRESENTATIVE ACORD 25-5(3/93) Ramani Ayer SLIIN $oard of$ullding ReguIn tions and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR kv befhro the expiration date. 7f found return to.. ReBist lt• 112638 Board ofEuildingRegulations and Standards n WK 3/2011 T1* 281021 One Ashburton Place Rm 1301 lypel Boston,1%".02108 FRASER CONSTRI;"I NCO. DEAN FRASER 104 TWINN VIEW ANg E FAL MOUTH,MA 02G9B Administrator Not re Cil-I&V an a` S One Ashbwton Place m Room 1301 Boston. Massaghusetts 02108 ®one Improve ent Cb tractor Re stratj®n Registration: 19258E Type: SBA FRASER CONSTRUCTION CO. Expiration: 3/23/2Q71 n* 281021 DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 'Update Address and return card.Marlt reason for change, Ai d3 40M Oe/pB�88LIFORMC�A1U881E008 ❑ L4.ddr 89S ❑ Rene l ❑ li mployment ❑ Lost Card � � Li ,U+u}IQI$�$Ilt�g (BII `81,�p H;.. 7as.. F �..-NO MONEY DOWN'- NO Payment at the start or part way thru Payments accepted are: r° CASH- CHECK-MASTERCARD -'VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged l,%%for every 30 da s the Payment is late. y Any deviation or alteration from"above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, r control.accidents or delays are beyond ou Owner should carry fire, tornado and other necessary insurance u on p the above work. We, if not accepted within thirty days may withdraw,this'proposal: ° ERASER CONSTRUCTION: Carnes WVorkman!s`°Coazpensation and Liability Insurance on the above work.- . u Public DATE OF ACCEPTANCE' i J E' .v a R Home Owner, r Fraser C ° onstruction , *Permit# o2 00 9ol Town of Barnstable Y '4 Expires 6 months from issue date Regulatory Services Fee. _ RAMSrnBLM : Thomas F.Geiler,Director �b1639. .��'�Fo N,a+. Building Division r' l� oy Tom Perry,CBO, Building Commissioner ik 200 Main Street,Hyannis,MA 02601 www.towri.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TEXP IT CATION - RESIDENTIAL ONLY OeU06Yot Valid without Red X-Press Imprint Map/parcel Number �� �l�Srge Property Address `l & \ C� �1 - �. A Q � t Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address��(��n rn) 1� t'�Iy1�l�<' t 0A Contractor's Name SP Telephone Number Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ Iarn a sole proprietor Cal,am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑-Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximumy381 • *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign.Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: iA Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ADplicant Information Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zino Phone.#: ® Lk LIR Are you an employer? Check the appropriate bog: Type of project(required): 4. I am a general contractor and I 1.El I am a employer with 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a•sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling • ship and have no employees These sub-contractors have g, (]Demolition ' working for me in any capacity. employees and have workers 9 Building addition [No workers'.comp.•lnsurance comp.insurance.$ �] 5. ❑We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp,insurance required] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomration. t Homeowners who submit this affidavit indicating they are doing aA work and then hire outside contractors must submit anew affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead th the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. _ I do her ceritfy nd e n s of perj that the information provided abav is_ a and correct 6 Simafore _...o_._ Date: — Phone# Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): Department tment 3.City/Town/Town Cl erk 4.Electrical Inspector 5 Pl umbing Inspector 1.Board of Health 2.Braking p ty P g P 6.Other Contact Person: Phone#: ` 'J f1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hue, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall,withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for'any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LIP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Tows►Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office.of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in {city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (Le. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number. The Commonwealth of Massachusetts Dgmttnent of Industrial Accidents Office of Investigations ' 600 WashinPn Street Boston, MA 02111 TO. #617-727-490.0 ext 4-06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable VE t ti y� o� Regulatory Services " Thomas F. Geiler,Director w BARNSTABLE. f, 9 MASS. Building Division Tf0 �A Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 K nv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: Q c I JOB LOCA ION: number .,street village "HOMEOWNER": L NAA name home phone# work phone# CURRENT MAILING ADDRESS: city/town state 6 zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license;provided that the owner acts as supervisor. t " DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to xeside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minim nsp ction pro dures and requir ments and that he/she will comply with said procedures and requir men Si ature of Homeowner Approval of Building Official 1 Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. i oFjKEr�:, Town of Barnstable Regulatory Services RAIMSTABLE' Thomas F. Geiler,Director 'OlFn�u►ta Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner MuItction Complete and Sign This Si . If Usirig A Builder Owner f the subjectproperty T as Ow r o e l authorize m bhlf, I� to act on hereby autho yea . in all matters relative to work authorized by this b/ding -"e'rfki1t application for: (A essof Job) ,r f` ignature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel 0(0 Permit# j' B Health Division �-L(?S- ` 6� ` '� `��`'S ABLE Date Issued s ? 2— i!-� Conservation Division Z 7€711 V, -23 A 8: 49, Application Fee Tax Collector Permit Fee J. Treasurer - �--- ollnflU SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANC Date Definitive Plan Approved by Planning Board VM TITLE 5 ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULR:TIaNS Project Street Address 04 IKO0 a ` Village 's t'XUti yCP� Owner 1&0P 1` Ck"l- Coe- tV�AvnnAddress b PL&' .0; Telephone P C)r oz (0 2— Permit Request 24 Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District C Flood Plain _ Groundwater Overlay Project Valuation Construction Type iAJa�--� Lot Size D� �( C �f� Grandfathered: ❑Yes �No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes XNo On Old King's Highway: ❑Yes WNo Basement Type: ' LFull O Crawl O Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) - Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial O Yes ❑ No If yes,site plan review# Current Use Proposed Use t. BUILDER INFORMATION Name Af AU_ bA�� Telephone Number Address hl.0mkot—� License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _�23�(� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED d MAP/PARCEL NO. ADDRESS VILLAGE OWNER - DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGHS `- FINAL GAS: ROUGH" C• FINAIA FINAL BUILDING C t e ' G, roc) = DATE CLOSED OUT ASSOCIATION PLAN NO. P' i pt THE.fp� The Town of Barnstable mRvrrABLL Department of Health Safety and Environmental Services M"� Building Division rfD M 367 Main Street,Hyannis,MA 02601 508-862-4038 508-790-6230 PLAN REVIEW �Y'A Map/Parcel: Owner: �n + L.v1 Builder: l��.t.)ytQ-y Project Address:� . The following items were noted on reviewing: S (2- , Clo 2 l 2 "v- ' i Reviewed by: Date: The Commonwealth of Massachusetts Department of Industrial Accidents . _- — Office ofl01VOSON&JIS _ t 600 Washington Street Boston,Mass. 02111 Workers' C4mpensation Insurance Affidavit name: location. city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole p pnetor and have no one woridn in ca acltp em to rovidin workers' compensation for my employees working on this job.:;:.::::::..:;? I am an p 3'�P g.....................:::::.:::::::::.::.:.:::::.:::::.:.:........ ::::..:: :cow anv n ..... ...... .;. t.{:}4: r:4tn:^i:?L:^ C.... iiti�iY:iii:i::j:�::}}iiiY:ii:ii':<};J::i}iii:>::i:;`:!;:$;{:i;ii:'riiii:;:v:yji�ii::?:Yi$+:'iiii::::y;i:;iT:ii{?i?i::ii:i<:i:::ii::::;:{::iF:i':?:::{L: :::i<:i:jii}iiit'iJiiiiii?::?}::j•:�:!j??;t?•:r:ii<ii�:::'i:?:?i' ???;•i:4i:i:%ail:: NEW0 :`•`'•e��cO ```?? <>isiS� i>i' %?i >ii i`:isi;5 ;i .i� �it :i;:;?i°i%'i `'": ;y;iy; i: ii2''% ?5; bh �3risuranc ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have workers' co ensation olices; :.:::::::::::::.::::::::.:::;::.:::::::.::::::::::::.:._:.:::::::::::::::.::::::::::::::.».:::...,::...x•:,:nx.:.,;;:•:. the followm mP ...............P.......................:.::::::::::..:............:.::,::,.:...............:.:.: g....................:.::.:::::::::.:........:.....:.:::::::.:.::.::::._:.:... ..................... arc;::»:.:::.<:.;:�;.:::;'?.,:.::;::.:.;'.;'.;.; .. :.: .cow .... .. ? x:::;;�:i'•:y::�:�?i:{x;sjl:$i:;i:;: ':::is!;:t?$:::i::::ii:;i::i:;`:j;:yi i�:$::j::??: '•:'iii�:$ii::}::;::;`•ii:;:i ...:.tiv::::•::':'?iiiii?iii:v:•iii:::�i iii:•:}Yi X:iiil:}i::J: , v.�:::w::::.�:::.i:?•i:v:Oi:L!•:i:.�.ii:t??•:iiiii'r:6:4.,...... vn}•.�:ntv'•v..:u................. 0. �:::'is':.i:::::v:•.::......... :.:....... .. .... ........�. ..... ....................... ...............................:::.........................:::::.�::::•:::::....... ::::ii:i'.;.:x•i:?•::•:iiY+:i:•:{.:•ii:>:ji:::}j::;.vix::;•:!!:i'•>Y}:'�tts. one; n:..:'•xi:+}xy'{?:{,4>ii;?v} ... np' ............. ............ ...,........... ....................... ....................... :. •i;•;};};:•ist•:�::::?.�v\ii':vi:.iisii:ii:^i'•i::.::::.::::::.::::::::::••.�:::......ii::4::v;':.:ri is ...........:..... ...:::::..:::.}•4:;??w:•i:::4:?!�:?:'>:::i�:$iii is?:::::;`.�::}:::::::i:':'::41i:�iisi�iiii:::+isisisiii'?;}:::;:y:::i:;ii::�i:i?i; 'r:yi;:;#:;isi'tv:::::j::}:i;isy:.i:{:f•:i:;:;:yj:yj;:�::; :;}:2L;:!:;:;ii:{?•iii l:;::?:,'ii:ivl•..:: aril.n :.:.;;..:..::::::•::::::::.::::::.�:: . ... .............. :................................:... i:i>:;�:':ti.:��;'?;:,��,(:�:isi;:;`.�ii'?:::•i%�i?'?`.�:�:ii::ti:vi::�:i'rii';'r::. ::.:;.:::.::::«....:........::...... off,:.:• �`CO3•'�±'�<�'�"{�<>"�`k? >``�tSciri5}> 'ii"ii ' }ii%i? :'::.`::: ; i �i:',•:;:.:; :;iiuurauce �. Baibae to secure coverage as required wider Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine to$1,500.00 and/or one year,,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and p alties of perjury that the information provided above is tnto and correct. Signature oLxu Date Print name y � �-(le Phone# official use only do not write in this area to be completed by city or town official city or town:-- petadt/IIcense# ❑Building Department ❑Licensing Board che&ifimmediate response is required ❑sdiectmeres Office ❑Health Department contact person: phone#; - ❑Other K Ocmai 9/95 VA)_ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants N Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retumed`tn the Department by mail or FAX unless other arrangements have been made. - The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Deparbaieat's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727.-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 �oFt1ETti Town of Barnstable Regulatory Services Director srwsrs, F.Geiler, s�xrr Thomas F , nsass. 9� 019. A g Buildin Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Work: Estimated Cost ' Vy lC1—® � Address of Work: Cm- �a 6 vyt4 ���— owner's Name: so�_(? Pf tb�.V_"' y-- Date of Application: I`Z��67 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME UYUROVEMENT 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. O , A 2)L3 Date wner's Name I�Q The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Dffice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: L U L� Lv� U UAMber street village .�► l�n e_ �b1�� _y wv� '2i0MEW 0NER": �•lVt ✓"� � 5O"I"?7-7 2�7Z name home phone# •work phone# CUMENTMA=0ADDRESS: '5GNti_9L city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more.than one home in a two-year period shall not be considered a homeowner. Such"homeowner"'shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work-performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable.codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said p ce ores and requiremen . Signature of Homeowner Approval of Building_Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the iespbnsibilities of a Supervisor: On the last page of this issue is a f c / I j noor l I i I i t i .I cap- aX�a Newer I I I I � I SpNATJ�eS Grace = i S l w s .0 7 tie ouc���et I I Tro n;T U k e.w i i i { _. ay S 78'28'20"E 100.00 LOT 21 17, 022 SF. F-T W —v Q) cY tiN � NQ p •, i 12.00 77 o to S _{o •00 e garage EXISTINS $7.00 , DlVELLINS 115 B7 12.00 /O a � 2 D'` 12.00 ?f.s7 100.00 N 78'28'2001V KNOTTY PINE LANE PL O T PL A N OF LAND 'TO THE BEST OF kY KNOWLEDG& THE LOCA TED IN DWELLING SHOWN ON THIS PLAN IS AS BA RNS TA BL E — MASS , 17 AMIALL Y EXISTS ON THE GROUN ,DATE' NOMMER 2, 1995 � �iti'..� PREPARED FOR /a JOHN P. A N%RIM DAVID CNA C;K I DATE. a R.E+�3.CK ��.,,.� ��i• ,..�� l? � ; ' NOV. 2, 19'35 SLSCALE: 1 ' 30 FT. — — —• --- — — — t�, �s FLOOD ZONE C (NON—HAZARD 1` „ A26085 ,K CAPE 6 ISLANDS ENGINEERING D-30 �fGYs14q� MASHPEE - MASS. °FTHE►�ti The Town of Barnstable BARNSTABLE. * Department of Health Safety and Environmental Services 7 MASS. 0a t67q. �0 prEUMPye., Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location I q A K,n., (�+n L Y) Permit Number 9 Q S 4- Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: � � J f JQ k Cc r+,� r Ou n n t c ci o A Ct u\ Please call: 508-86}2-4038 for re-inspection. Inspected by -1 A .'� Date /Z - U v Assessor's Office 1st floor MaD Q A Lot 0" S,e. �., Permit#_ � fJ � ^ "Conservation Office 4th floor).. : — —Fj Date Issued Board of Health 3rd floor En ineerin Dept. 3rd floor House# SEPTIC S INSTi�LL�ODDE T BE PlanningDept. 1st floor/School Admin.Bldg.): l�NCE wl Definitive Plan Approved by PlanningBoard EIVsI�®�� (Applications processed 8:30-9:30 a.m. & 1:00-2:00 p m) % ® AND WN REGULATIONS �H '1 TOWN OF BARNSTABLE-? Building Permit Application Project Street Address4AdZ22� if /l/ 64; Villa e d Fire District Owner Address / :. Telcnh e •� Permit Request: Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Anneals Authorization Recorded Current Use Proposed Use Construction Tyne Existing Information Dwelling T e: CngF a:�Iv Two family Multi-family Age of structure Basement type Historic House Finished Old Kind s'Highway Unfinished Number of Baths No.of Bedrooms Total Room Count(not including baths) / First Floor Heat Tyne and Fuel �,AI s�/ /T/�t//.Ri'�.�, Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name 2. Telephone number --r0e5 7 Ad re /1J License# O® � Home Improvement Contractor# r d E- Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Al Proiect Cost r3 O Cl-10 Fee ! SIGNA 1 DATE BUILD PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T 2/2 8/9 5 37+73"-" FOR OFFICE USE ONLY f 191.090 ADDRESS 194 Knotty Pine Lane VILLAGE Centerville John P. Antrim ' OWNER i DATE OF INSPECTION: FOUNDATION ' } INSULATION , FIREPLACE . ) F ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUII,I3ING- DATE CLOSED OUT: ASSOCIATE NO: I 11%02•'94 1 :02 V617 i2i i122 DEPT IND ACCID Z001 Jr_ C�01izano12.1tipalili. o{ "l'�a��aclzu�et 2apartrrtent o��ndu�triaC.�lcctdenL9 600 !/Vaal nyton St.t - James J.Campbell &Ion., Vaj6ac" 02 f f 1 , Commissioner __- Workers' Compensation Insurance Affidavit I, (Oaeasec/pr3mitree) with a principal place of business at: (ctyistAWz V) do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company . Policy Humber I am a sole proprietor and have no one working for me in any capacity.. () I am a sole proprietor general contr�ic, r homeowner (circle one) and have hired the contrauors lined belo ve I owing workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number LonuacLor Insurance Company/Policy dumber (�I am a homeowner performing all the work myself. und!:!-_Uric; ;t 3 Copy of&:S s=tement will be forv:arded ie t x Office of Invesos,72tions of&,e DIA for coverage verification and that failure to sEtere cc-;e-;ge as ree.;;.-Ed under Section 25A of MGL 152 can iead to dl�c imposition of criminal penalties consisting of a fine of up to s 1,5oo.00 and/or cr.= ' imGr< w inomofa$TOP WORK ORDER andaGneofSi00.00adayagainstme-yeas 7 sv . h Signed this day of 19 o a o /I Licensee/Permiitee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT # --9 7 4'�`j' B,P.,sr" : The Town of Barnstable MASS. �0� Department of Health Safety and Environmental Services ►+ ' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crosser Fax:. :508-775-3344. ;Building Commissioner �..._ For office use only Permit no. Date AFFIDAVIT y 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 ping owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work. Est. Cost Address of Work: Owner Name: Date of Permit liption: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S 1,000 Building not owner-oo upied. . : -_Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OAT'PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANIY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: b D Contractor name Registration No. R ate Owner's name X, ft� cs (3 r k ry ,Q�nn ro No sCA�► t �* • �0 %epkvws I I cev,te ° LLL •f r � S 78*28,20"E 100.00 LOT 21 17, 022 SF. =u 3 N N Q h h h h h h _ 12.00 h r——-•� � �' Ip i t0 Im OECK �^16." .00 0� :o EXIST pl 35.75 ^ N FOVAC WI EXXSTXN6 $7.00 �O OMEUMS 15.67 L 12.00 N � b 12.00 pi ! 24.33 100.00 N 78'28'20"W KNOTTY PINE LANE • PLOT PLAN OF LAND "TO THE BEST OF MY KNOWLEDGE, THE L OCA TED IN FOUNDATION SHOWN ON THIS PLAN IS AS BA PNS TA BL E - MASS. I7"ACIVALL Y EXISTS ON THE GROUN47,," PREPARED FOR DA TE.• OCT.23, 1992 `� x., i`r� ,�, �`1 :�`° JOHN P. ANTPIM DATE. OCT.23, 1992 SCALE. 1"a30 FT. FLOOD ZONE C (NON-HAZARD ' CAPE 6 ISLANDS ENGINEERING D-30 ._. MA SHPEE MASS. Assessor's office(tst Floor): w Q - ., � INSTPALLED 6N &. Asses sor's map and lot nu er / Q C �� WITH'��CON NCE q C ONME Conservation Board of Health(3rd floor): i TOWN REG Sewage'Permit number �� • �o riva Engineering Department(3rd fl or): 1039 r House number 1 .7 Fjj Definitive Plan Approved by Planning Board 19, APPLICATIONS PROCESSED 8:30-9:30 A.M.'and,1100-2:00 P.M.only TOWN ' OF ;, BARNSTABLE BUILDING SPECTOR APPLICATION FOR PERMIT TO 101, TYPE OF CONSTRUCTION 19 . r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informal' Location Proposed Use. , Zoning District Fire District Name of Own Address Z-12Z V� �— Name of ui er Address Name of Architect Address f Number of Rooms Gaed�IF Foundation &mac/A Exterior Roofing , Floors Interior Heating Plumbing /' ge_ Fireplace �/ L Approximate Cost Area •e Diagram of Lot and Building with Dimensions Fee �� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar ing the above construction. Name /fir Co struction Supervisor's License ��� ANTRIM, JOHN P. SR. 35411 ADD GARAGE & BREEZEWAY ' ..- No Permit For - Single Family Dwelling = ' Location Lot #21 , 194 Knotty Pine Lane Centerville Owner John P. Antrim, Sr.. Type of Construction Frame �- Plot r Lot Permit Granted September 30 ; 19'-' 92 t Date of Inspection `, 19;; Date Completed 19 .fir $>•� {. ; _ .f�'�!` . ,t i t •t ,r, 13 IL ------ F --'�.-�R��G1E�oevL�b�1►d d�iC.►"ZX�.�. w . . < /���� . ,. _4 -�' t j -- r __$�,. W♦�.►�OvJ 1�-�QOv�t Y4LM��X3 2�9LL -` _ _ . .._:�:.'�-b r�.�._ Apr s.F44.lr+.+s� ��.��•ati.�-� -Yta o�= -- - , .. C�o.��i.Vh ����O.r o� °�.: ��v1 tM+�s -+e-'Go•�N s.�o.r� '��`�Ce�Der. - {' 'EtJ GC.oSe�O �+� CTa.ev,'atir O `Oeo� o�% '[1 e S 78'28'20"E 100.00 LOT 21 17. 022 SF. W 3 � N NQ o � = r---� OEdC , 2/ r to DECK I fe.Pd El 8 19 1" 35.75 EXISTING OMELLIN6 fa.es a 12.00 24.33 b �i ti 100.00 N 78*28'20'W KNOTTY PINE LANE "TO THE BEST OF MY KNOWLEDGE. THE PLOT PLAN OF LAND BUILDING SHOWN ON THIS PLAN IS AS L OCA TED IN IT ACTUALLY EXISTS AND IT CONF M TO BA PVS TA BL E - MASS. THE ZONING REGULATIONS IN BARNSTABLE, REGARDING YAR ; �,' PREPARED FOP o I DA TE.'MA Y 27. 1992 C A I S `^, JOHN P. A N TPIM I SAMCKI v �2RO8 DATE.'MAY 27. 1992 SCALE.' 1"a30 FT. CAPE 6 ISLANDS ENGINEERING FLOOD ZONE C (NON-HAZARDI ` ��'k41. LA147`'i' MA SHPEE - MASS. D-30 { DEPA�MENT OF 11010 COMMON PVgUC 8AFETy P C19sroN ALiNVE,�MASS.02215 A �.�•' a, ,' colys- SCR' EFFECrIV *n E pgrE 06'/30/1 99 LIC-Np..- n j0 01a01, � KA�TA NTRIM C.�NTERVILYL pMA E02 yy t; .632 P } Not AMPEDOR UNTIL :SIGNED BY S LICENSEE AND SIGNATURE LICENSEE THE C OFlICA OMMISSIONER LY E. l ID SIGNATURE OF ENS EE �_..a,.,.V_ COMMISSpNER J it f 4 Assessor's m'? and lot numb r ................ ............................ ` FT Ero xFH Sewage Permit number ... .. ...... ....4F,�-,.............• �� , . + t S� : BARNSTADLE, i House number ................ .............................. : g� 'it`J�i 9 PLJAt4CEo MAea ....................... p► SEP-ti TOWN OF R . - ALMAmo vIRON BUILDING S TOR�IN 9 eI0 APPLICATION FOR PERMIT .TO :. l J d ......(� .................... TYPE OF CONSTRUCTION _ i ........................... . .. ..............19..: . . .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby pplies f a per according to the follo inf rmati Location // .... ....... J .... ....................... f " '' Proposed Use ..... K. . ........ .. ZoningDistrict ....... .. ..................................................Fire District4�!�� !�/ ..... .... ............. Name of Owner . ..:.... . .... i /.. ..:Address ...`..��. ... c'v. .. .. . .... ...... Name of Build r✓... . ............ ..................Address ... ...... .�... ... .... ... .............. k 1 Name of Architect .... ... . . .. .. ........ ...........................Address ..... Number of Rooms ..... �.�.............. .............. ................Foundation .. . .. . . ..... ..... . ../�4kofin ....... ... .. ". .a.-A Exterior /...l�.` ... � .......... ...� .:.............:.... :........ Floors ll..l ........4�/ d.'::� ...Interior .�/1!� ~��J. G�✓f.?.Y.l� ........ Heating .....................Plumbing>... ........ r....... .:TIT....................... Fireplace ........ ....................................... pproximate Cost ................ .......... .................................... V ................................ � Definitive Plan Approved by Planning Board ___________ _____ __________19__ Area ......................................./. Diagram of Lot and Building with Dimensions Fee �..`-��............................. . ..... SUBJE Toi, APPROVAL OF BOARD OF HE TH `i• i 1 LIV !6 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS hereby agree to conform to all the Rules and Regulations of the own of Barnstable. a ardin, t above construction. Name ............... ......... . ... ........... ........... CARLIER, S6VE & DENISE No 24099.... Permit for ...ADD...FAMILY API-,;SIT. . .......... . ........ ... ................. notation ...19.4...K.not.tv....Pi.ne.'.Lan.e............ .. .. ....... ... .... ..... ......... .. Centerville ................................................................................ .. .... ..... .. .. ....... .... ....... .... .. ..Owner ..S.te.ve...&...D.eni.se....Car.li.e.r...... Type of Construction .Frame............................ It ....... .... .......... ..................................................................... A� Plot ............................. Lot ................................ Y L /- f, ' r ~--- '� 1 Permit'Granted. ....June.. .........2-............n.........eig 82 Da.t,e,of Inspect* ............. .. 9L3 Date mpleted ....i .. A..04-3 19 /7 /* �. Sewage Permit number House number ....................../V MAO& TOWN OF - BARNSTABLE BUILDING INSPECTOR TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies-for a permit accord to the following information: LocationW....... ......... 19....... ............................................ X ......................................................................... Zoning District ........ Fire Districtimr .......... ........................ . Name of Builder- ................Address .... ......6�1...................... _4................................................................. 04, SUBJEcyT,6APPROVAL OF BOARD OF HEAYTH Ln HEA OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS | hereby agree to conform to all the Rules and Regulations of the-Town of Barnstable regarding,theabove construction. Nome ---- ���—�,... = ---. CARLIER, STEVE & DENISE No ..24.0.9.9.. Permit for ..AcLd...Mamily. ..Apt. ........Single...Fami-ly. ..Dwe'll-ing............ Location KnJQ.t;.t;�...,P;Lr1.e..1Ar1e.......... .................Qexltexmille.................................. Owner Steve & Denise Carlier. .................................................................. Type of Construction .........Frame..................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ........................................June 2, 82 19 Date of Inspection ....................................19 Date Completed ......................................19 C> /00<� /,200 > ASSbSSOf S map and lot number ........................................... y0f THE TOE Sewage Permit number SEPTIC SY5 .... ..�..3�,�.... .................... .INSTALLED IN COMPLIANCE e Z BA"STADLE, i ......._.. �' WITH TITLE 5 Maea House number =.... ..•................................. 9 ENVIRONMENTAL CODE AND i°�Ft639- oMpya�e� TOWN -OF BAI. STAgE w 1 f BUILDING INSPECTOR 11 APPLICATION FOR PERMIT TO .r�C �tl � � . TYPE OF CONSTRUCTION .. '[l,Q ... 1.1.�/'` ... ............................................................. . .............1949../ TO THE INSPECTOR OF BUILDINGS: The undersi nedheeby�r applies /for a permit acccc ding to the following information: Location��........ ...........lt�.�! ., A.. ••./ ' .'.. ,. ... ! .: ................................... Proposed Use � .+ /9/2 2.. .. J-... .. "" .e. ...... of— Zoning District � ,t. ...............:...Fire District � 4/�........................................... Name of Owner/ .. ....... ......'.�. ..Address �.. Name of Build .... ... .�. ,, ... Address��., Name of Architect d!5... .......... .19P..G5ze, f4a....Address .. e.��� . ...................................... Number of Rooms ..........1.0.................................................Foundation 1 .�n! .................. ................... Floors .'1. ..( ...................................Interior ...... .. ..... Heating ........................ ...........................Plumbing 4��` L:.�...�� .. .j.�.". , ...... Fireplace .............. ( Approximate Co t ..... .............................. Definitive Plan Approved by Planning Board __________ ------------194__. Area .: ./... ........... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 6 . I hereby agree to conform to all the Rules and Regulati8ns of the Town of Barnstable egardi pg t119above construction. Name .......... ............ 0~ CARLIER, STEPBE0 ' N,p _3.�3O9.. Permit 2_for ..0��_..1/ S ��� Y � ^ j_..Single..I7 i .. ' _____. _` -----.. ^ . ~ ^ Locotion —.Lot— � �2IB—l94— .. irze I,ane_/ ` ` Centerville --. .--...---~ .---------.. .--.. — � � Owner �]� C��li��. ---~'' ----- ----'---' - ''— ��—� " � Type of Construction .....�r.40e........................ � —~...--------------------.--- Plot ............................ Lot ----''r''*........... ' ' ' ~ � Parmh Gronuyd --July-3.3��—__..]g 81 —�����.�� Do^a of Inspection --------/.�--]A ' Date / . ~ ! -PERMIT REFUSED __.~_~_,_.,^,._,,__,---...._.. lV � ----..--.^..—.--.------ —~--.--�. ' ' . .�~'-~'--~^^'-^^----~---'''!—_—'~'_—/ . � '--'—'—''~''--'----^--^'—'—'r—^----' / . ____,--...—.—.—..�. ..................... � - —.—.. . 'r --..�—.. lg ', ~`~~� ----------- .....................................................:�. —..---.. .. .. . ..................................... Assessor's map and lot number ......... ......... `�!... '........ y�F THE 3�� Q Sewage Permit number ....... .............. ........................... Z BJSBSTABLE, i House number 1(1.(4...............:..'��.�...................................., � MABL 00,0�t639, 'Ea No tr TOWN OF BARNSTABLE 0 J BUILDING INSPECTOR APPLICATION FOR PERMIT TO .(, � r"R�.,-sf' .... ...... 5::c �.� ra^.................. ...,.......... TYPE OF CONSTRUCTION ..: f % ... `'/.. ./�i �a-:,.....................................: ... F.. TO THE INSPECTOR OF BUILDINGS: 6 � 1 The undersigned hereby applies for a)permit according to the following information: -17 Location l.' ! -:!.... ..... Y?�s?f �` .�....::'"�' '...1 ' �E/� ... �? � r �� ` ProposedUse '',.:/tr o_ 1.;...... , L..-......,1:....` ... ?!.t..... 3.................................... .................................................. Zoning District .:.s.......:::.....:7:�...................................................Fire District ...��i...�............................ Name of Owner' illrlr.................X'.Address 4�`/i"ry�' t"/� !...;a:J�- .................... Name of Builder Y � F. ��- ! -r'�-..../.. !�". - ..Address�.%7� ! i , ..,f r�� +. :���'":- : 7 iI� %%jr! f Name of Architect _ /i �a � % :r/C Address �.: c l f..................................... Number of Rooms ........... .................................................Foundation % . � r Exterior(.::...............,..�.:..... .........� ............:... :..,Roofing ......... ... .. Floors G!- --r n.:r�:a...r`,,.A�•!�,,, . ..................................Interior : �1� %:. :. 'a... ��r�'�';...ii.. Heating Z:::. ............... Plumbing ......�.. ,..:..................... ..........................?t-L Fireplace f `= ." /r' -r; �f n i r ��� ' r �.,!`sgPProximate Cost ....................................icef..................... . . ;..� _ _ J Definitive Plan Approved by Planning✓Board _ Area ......................... :.. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1"�' �•- �� / J � f � I i max 1 c t=' I hereby agree to conform to all the Rules and Regulations`of the Town of Barnstable,regarding the above construction. Name ............( ......................................... ' CARLIEIl,-`43TEPBEN ` No —. Permit for .....Pg!P...l /Z..StQXY � ..I}��lIi�.9.......... Location ..L.Qt...#.2][15...[,9.4...K.rlDt;.t;Y..]Riae Lane � . ................. .................................. /_- ' —/ .................... ^ Type of Construction --Fra.mxe....................... . � '--^—''---------------------' ' ' Plot un . ^ � . ` . Permit^ Granted J.u.j,...,,...Z.............19 81 Date of Inspection ' un,e Completed PERMIT REFUSED � / � � ,____.,___, ___------.. lA � --..--_--.. ----.---------.--.. . ' � / . / --~~—^~^^—^^^—^^^--'---------~—' � � '' --'-- —^------'---~~' ' ' x J�~~ ..m~w --':a��'.p' ............................. � Approved � ................................................ lg ' � ^ � r � --------..-------....—...--.----. � ----------'--------^--~'~'^^^^' | � ` TOWN OF BARNSTABLE ___--_- `��°33_.•e Permit No. -- Building Inspector l ZA"3TAn Cash ----------------------- � qua �O ,670. P MR,( OCCUPANCY PERMIT Bond 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 ^*. !.P-� "- •y i Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department '- , _� ,� �� � 1_ _ x 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 19...... ................................................................................................................_ Building Inspector 141 L i F 1 "7ol ��2 �. r a e _ ri F M F v, fit 30 CERTIFIED PLOT . PLAA! NEW/ CONSTRUCTION ONLY :; � `a/ e11*A TOP OF FOUNDATION IS FEET IN ABOVE .LOW POINT OF ADJACENT M L -A A",.,� `3 ROAD. ' SCALE, / "='Y /. DATE tl- -Txj-l.q L® ;E E 1 /A! live CLIENT s��� 1 CERTIFY THAT THE MO. BHQ�N ON „ THIS PLAN' IS LOCATtoi, Ef$ISTERED REtiI�STERED ��g . CIVIL LAND JOSL. ._.� ON= THE 8R4UI�O Ai IlCATE , ENGINEERSURVEYQR ; DR.i�Ti `X P% CONFORMS TO. :TK ZONIX.G;3 9F -BARN-ST . ` $. OH.13Y� ►, , 712' MAIN STr ------ oz h : iYAI+INJ ,'MSS."SHEET'QF` D ® : AOU