Loading...
HomeMy WebLinkAbout0102 ELLIOTT ROAD I o t� $,. v q oily Y AY AN CFO to!TOM st AST SWISS IT&S, F ' tr x i 1 ;rl 1 v � t :E i - i - 1 { �. . . . _ _ �fi �` _ �� ' • j r 76 Application number Fee.. .. 7`.5..�.. .. ...... .......... a k ! _ Building Inspectors.Initials..:S� .7.1. WAsa - yy �Q ! Date lssued....k 1 (,,]_ A Date Map/Parcel. ..: ... ... ..... • • fi TO.WN`OE BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHEW-ATION PROPERTY INFORMATION 7 j ti 11 Address of Project: TNM ER - STRE VILLAGE T Owner's Name. eti 1^� / C/C � hone Number Email Address: Cell Phone Number Project cost$ . Q <Check one Residential :g Commercial a OWNER'S AUTHORIZATION As owner of the above property Lhereby,authorize to make application for a building.pem-dt in accordance-with 780 CMR Owner Signature: ...;. h. Date: r TYPE"OF WORK ❑ Siding, ❑ Windows(no header change)#. © Insulation/Weatherization Doors(no header change)# Commercial Doors require an inspector's review oof(not applyingmore than I layer,of shingles ) Construction Debris will.be'going to l Ai � • - CONTRACTOR'S INFORMATION Contractor's naive ' G co( Home Improvement Contractors Registration(if applicable)# A (attach copy) w Construction`Supervisors License# ��`, �7 attach copy) Email of Contractor ' `PU k -G Phone number l) �= S ALL PROPERTIES THAT HAVE STRUCTURES OVER 5 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN ►n�r�n �n�erni+r v^81 MAi seer/1nrAIA# LjicrnDlr ADDDf11/A/ QCCf%DC A DCDAA1T rAA1 DC ICC1►Cn APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected y "Removed on number of tents total Does the tent have sides?Yes "- No (If yes please attach floor planwith exits marked) Dimensions of each Tent X X , r X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event . Check one: Food served Yes No- v • Flame Spread'Sheet of each tent must be attached. Provide d site plan with the location(s)of each tent Fuel source being used LP tan_k 20 lbs. or> Yes No, ;if yes;a gas permit is required. Natural Gas.Yes No if yes,a gas permit is required. _ If food is being served at.your event please obtain a Health RDe partment approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES'* Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back deft side right side. HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name- Telephone Number #,` Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction, Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. - Signature Date APPLICANT'S SIGNATURE Signature •°' . Date L C All permit applic ' ns are subject a building,official's approval prior to issuance. /R; ..�._......�.....�. CA ZEAULT\ ROOFING & REPAIR$ PROPOSAL Proposal No. 19-102219 October 22,2019 To: Eleana Hinckley Work to be performed at , 102 Elliot Rd Centerville MA 02632 We hereby propose to furnish the materials and perform the labor necessary for.the completion of: NEW ROOF 1. Remove existing shingle roof 2. Install drip edge 3. Ice & Water First 3 ft,valleys and penetrations 4. Cover roof with Rhino paper 5. Re-roof with Lifetime architectural shingle 6. Install ridge vent 7. Flash all pipes and penetrations 8. Remove all rubbish from project . Labor and Materials $10,700 All material is guaranteed to be as specified,and the above work to be performed in accordance with the specifications and completed in a substantial workmanlike manner for the sum of Ten Thousand and Seven Hundred Dollars $10,700 with payment as.follows: Five Thousand Three Hundred and Fifty Dollars $5,350 with acceptance of proposal and Five Thousand Three Hundred and Fifty Dollars $5,350 due upon Completion A/ Respectfiilly, submitted'= " Richaid P. Cazeault, Jr. HIC# 168607 CSL#100393 198 Five Corners Road Workmans Comp and Liability with Centerville, MA 02632 Leonard Ins of Ost (508)420-5482 F . Acceptance of Proposal No. 19-102219 The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment is outlined above. ----------- ------- ----- Si afar � Date /'i�y/,A of�-- *Remov of additional layer's of roofm not forseen with result in additional fees of$75 per Sq *All quotes are valid for 30 days i The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lealbly Name(Business/Organization/Individual): r R Address: City/State/Zip: 6rik (;(� Phone#: �Q �-- Are you an employer?Check the appropriate box: Type of project(required): , 1.❑ I am a er w employer with 4. 1 am a general contractor and I P y 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner=;, listed on the attached,sheet. 7. ❑.Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• t _ 9. ❑Building addition [No workers'comp.insurance tromp.insurance. 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.❑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. ;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: �d ( Ja City/State/Zip: ��"1 �� r�° ax C��— Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage w required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.'Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the,pains and penalties of pe 'ury that the information provided above is true and correct Si ature: Date: A"G 0 f Phone#: Official use only. Do not write in ihis 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#: Information and Instructions - Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their, self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to 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 Department of Industrial Accident Offiee of Investigations 600 Washington.Street Boston,MA 0211-1 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia ACORO® DATE(MM/DDNYYY) CERTIFICATE OF' LIABILITY INSURANCE 04/30/19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must.have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement: A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s):. PRODUCER UUNIAUT NAME: JIM.HINDMAN Schlegel 8 Schlegel Ins Broker PHONE Eli: 508471=8381 ' . AAiC'No): 508-771-0663 34 Main Street E-MAILDE West Yarmouth,MA 02673 SS: schlegelinsurance@gmall.cOm. - INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: TRAVELERS PROPERTY AND CAS INSURED INSURER B JINTANA CAHOON INSURER C DBA CAHOON CONSTRUCTION INSURER D 16 WEQUAQUET AVE CENTERVILLE,MA 026323 , INSURER E':._ INSURER F': . COVERAGES. CERTIFICATE NUMBER: REVISION NUMBER: ' 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHEITERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS: INSLTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM LHILSULIK DDT MMIDD/YYYY LIMITS.. _. COMMERCIAL GENERAL LIABILITY EACH(OCCURRENCE $ .. CLAIMS-MADE •OCCUR' i PREMISES Ea occurrence $' - MED EXP(Any oneperson). $ PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ RPOLICY PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: f - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident)_ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED t BODILY INJURY(Par accident) $ .AUTOS ONLY AUTOS .. - HIRED NOWOWNED' PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ . ° 4DED RETENTION _- WORKERS COMPENSATION AND EMPLOYERS°LIABILITY ST TOTE- ERH ANY PR OPRIETORIPARTNER/EXECUTIVEY❑Y/N E.L.EACH ACCIDENT $ 100,000 A OFFICERIMEMBER EXCLUDED9 ;N la ASSIGN1166040 02/13/19 02/13120 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,00,000 If yes,describe under - DESCRIPTION OF OPERATIONS below : +E,L.DISEASE.-,POLICY LIMIT .$ •500,000 DESCRIPTION'OF OPERATIONS/LOCATIONS/VEHICLES.(ACORD 16,Additional Remarks Schedule,may be attached if more space is required) JINTANA CAHOON HAS ELECTED NOT TO BE COVERED UNDER'HER.CURRENT WORKERS COMPENSATION POLICY CERTIFICATE.HOLDER• CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED.POLICIES BE CANCELLED BEFORE THE'EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE.WITH THE POLICY PROVISIONS. R.Cazeault Roofing m 108 Five Corners Rd Centerville,MA 02632 AUTHORIZED REPRESENTATIVE F CAZEAULT77@COIHICAST.NET, ©1988401 ORD CORPORATION. All rights reserved. .ACORD 26 2016/03 The ACORD name and logo are registered marks of ACORD r 3rn, �- s Commonwealth of P:iassachusetts Division of'Professional Licensure Roars;r,f Suilding Regulations'an Sxa.i_rd_ards irixttibti Su rvit5':� -S-100393 E'Pires: 02/03/2020 RICHARD P CAZEAULT,JR. 198 FIVE CORNERS ROAD CENTERVILLE MA 02632 t Commissioner A"`ck�a dt+ „r •i , U S Department oflatior , � faccu�a�ona*SafetY antaldmknkstratkon xa, � $ r let=d a 10 hour Occupata0nal Safety and Health "has sJrxessfully camp x x�knkn�g Course n e g tieattri 4 " � ��-� Office of Consumer Affairs&Business Regulation HOhriE IMPROVEMENT CONTRACTOR TYPE:Individual Reai_ sera I _ Exairation 168607 03/0712021 RICHARD P CAZEAU.LT JR D/B/A R CAZEAULT ROOFING.&REPAIRS RICHARD P.CAZEAULTYJR 198 FIVE CORNERSRD ersecretary Und CENTERVILLE,MA 02632 ' pk Tqy, Application number...�Gl.'. a�„�. ti _ � l DateIssued........�..... ... ...........�........�.. sAMMIN B � Mnss. 1639. �e JUL Building Inspectors Initials.... ....0 102019 .........Map/Parcel.. 12'`i'.... �2.38 T OVA n� �j� �•.�H'� . .... ...................... �� TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INPOPMATION . Address of Project: /o Z El l,-o,Z-f rQ� �� ✓, I NUMBER STREET VILLAGE Owner's Name: ai1Gc ,'nCKIL° Phone Number -7 7 1- Email Address:e6exk°4'r Klee✓ 4",ccw - Cell Phone Number Project cost$ L4 3 8 -7 Check one Residential;y_ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize ; to make application for a building permit in accordance with 780 CMR Owner Signature: S--e- 44rec W Date: TYPE OF WORK ❑ Siding U Windows(no header change)#-3--❑ Insulation/Weatherizatior ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to wg aA r �� G✓v� ,f Nt. CONTRACTOR'S INFORMATION Contractor's name P-� n o r S — A-)pj.,orb D�2ix,J-�-t c L L C Home Improvement Contractors Registration(if applicable)# l 4!0 5 8 91 (attach copy) Construction Supervisor's License# (1 D-7 (o (attach copy) _ Email of Contractor 6 S ! - ,li�. Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVE 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAUPELLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMIt the Massachusetts State Building Code. I understand the construction-inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date . APPLICANT'S SIGNATURE Signature Date 7— /O—/1 All pe It applications are subject to a building official's approval prior to issuance. Page 1 of 13 tv A Reg#146589 CT Reg#0605216 V Federal ID # 20-2625129 Window / Door Contract Customer Information Eleana Hinckley (508) 771-1716 () Date: 06/08/2019 102 Elliott Rd eleanahinckley@yahoo.com Rep: Jason Santos Centerville MA 02632 Office# 800-242-9974 Location Agreement NEWPRO hereby agrees that it will, for the consideration hereinafter mentioned, furnish all labor and material necessary to install the goods purchased by Owner in accordance with the terms described on the following pages of this agreement (collectively, this "Agreement") at the premises located at: 102 Elliott Rd Centerville MA 02632 Windows Being Installed: 3 Doors Being Installed: 0 Window Details Location: Master Bedroom Series: Ecomax Double Hung L Interior Color: White Screen Type: 1/2 Exterior Color: White Grid Pattern: 6/6 Hardware Finish: White Grid Type: Grids Between Glass Additional Labor: None Glass Options: None Location: Master Bedroom _ Series: Ecomax.Double.Hung Interior Color: White Screen Type: 1/2• Exterior Color: White Grid Pattern: 6/6 Hardware Finish: White Grid Type: Grids Between Glass Additional Labor: None Glass Options: None i . t Location: Bedroom 1�SerSeries: ti Ecomax Double HungP ' Interior Color: White Screen Type: 1/2 Exterior Color: White Grid Pattern: 6/6 Hardware Finish: White Grid Type: Grids Between Glass Additional Labor: None Glass Options: None Window Capping Type Standard Capping. Capping Texture PVC Capping Color Aspen White 27243 Additional Details Newpro will remove any demoed or installation debris from the property in relation to this contract. All promotions were applied at the time of purchase and can not be combined with any future offers. Also includes: repair/replacement of two glass packs to existing windows ( bedroom ) ( bathroom) LeapToDigitalxom 1.4.29 s Payment Page 2 of 13 Total Price: $4,387 Deposit $0 Due Upon Completion $4,387 Payment Method Finance Estimated Start &Completion Dates Estimated Start Date 08/03/2019 Estimated Completion Date 088///04 20 9 Customer understands that these are estimated dates and will be contacted to schedule actual date. . I This spade intentionally left blank i i I i LeapToDigitalxom 1.4.29 Lf Terms and Conditions Page 12 of 13 Owner has read and agrees to the terms and conditions of this Agreement. Owner specifically agrees to the (1) Total Cash Price; (2) work being performed; and (3) work not being performed. Owner understands that this Agreement and any attachments contain all of the promises made by NEWPRO. Owner has been orally advised of his right to cancel this transaction at any time prior to midnight of the third business day after the date of this transaction and Owner was provided with two (2) copies of a cancellation form explaining this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. YOU THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY OF THIS TRANSACTION. SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. The undersigned gives NEWPRO permission to debit their checking/savings account, or process a credit card transaction, for the deposit amount indicated on or after the contract date. Subsequent payments, such as start payments, or completion payments will remain in effect until I cancel it in writing, and agree to notify NEWPRO of alternate payment intentions. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that NEWPRO may at its discretion attempt to process the charge again within 30 days. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/bank account and will not dispute the scheduled transactions with my bank or credit card company; provided the transactions correspond to the terms indicated in this authorization form. Eleana Hinckley 06/08/2019 Date f r�L Jason Santos 06/08/2019 Date his space'ntentf ally lefty lank LeapToDigital.com 1.4.29 7 �A. Office -of Consumer Affa'-3 and Siusiness R ag till al'jon 1000 tVashingfon Street - Suite 7101 Bost-cm, Nlas§achuse4s 02113 Home Imoroverrent: ntractor R eg j:S4f 3,tj 0!,l Type: -Supplerner-, Card, Registration: 146589 i',iIE'N PRO OPERATING;!-Lf--- xpiration: 0 CA 2021 E51, 26 CEDAR ST, '- WOBURN, MA 01301 Update Address and Return Card. r/z- Office of Consumer Affairs&Sustness Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE,-,%vvlement Card before the expiration date. If found return to: Realstimition Expiration Of4pe of onsurner Affairs and Business Regulation 05iO4/2021 1000 of Ington Street Suite 710 NEW PRO-OPERA-T-14—d-,rLb Bbst,,n, A 02118 JEFFREY CONN(IRS-i:- 26 CEDAR.3T. WOBURN.NIA 0-1801 1'ridersecUndersecretary �Ii�otvafid without signature J lk.lassnchus�tts Department of Public Safety Soard of Building Regulations and Standards License: CS-110763 S;,,;:.crvlsor JEFFREY CONNORS 64 OLD FIELDS ROAD SOUTH BERWICK ME 03909 1 E.tPiralion. ommis5ioncr 0510512020 L'1' 1 Y _ � _ _ •l YJ't r • it ;i :Lr• .X It t,l 77 .fir z. •� F �'•�`�`t'jfi �'�i.�.a .i,�r_ � �y� ALL -I i tc_7 4.. ',; .�t'��yf•f d .f+S'�y, 'Y._ ? �a� fir �,'! � ��a.�..��;•'vr ,sty tt ?�:F���.�k'.�d t 1, -}'�0.�5 � ff.,�t�,�"L,ri' •j>�.'� � ���7 ry f\n. i^s , J•[rifS" ,e ✓r j��'r`a�j`^1F �'"�r7h��r�r5'������i �`7 i � t ,Ai f'tsl��M1 i"A y,�� i ► • ;, t f ��. f__ -'L p sL J � �,��2 if • _ • .•• r. .�c f s � rr iar��}. �s \ 1. �- 7 �:c.{iY. htl, -t� ti.l ` j:;r. •�.r�. 'T ��j.:.�1 � ���. ryr r,,r €--- .,r• a r M1 •t .'-J �� t a' t �:+�, t 1 -y,-� r ` �tEfr -�•S _'�yr��-. .� •-i- .� _ti F�:�I 7 t _ -�T F ]. �y::� <s`X �S.r >r�� y..(�7,`' +}, -.1° � 1 ��;,�"�sP � r"t'�p -t••• .L- } r I,s'f .-. �1 r r, c fl r, �c�t�r" ,.s'r•.f l ! y K `-"(' �`.b�,S- � -..5t' _' �'�'. 1 . k '. 1. 1 > �'> r + 7(TK 7 1! ,x •[ 1 R Y r .- � z' `�- �$1 ;—f -s�- �a. �rv.'tr—• .i._,s•r�J--.' y. i t�b T�#yt� �+ irY 4 The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 ` Boston,MA 02114-2017 www.mass.gov/dia «-orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): � ctV fi L1--, Address: City/State/Zip: WO I_Q-MA0190 l Phone#:_ /-$0 (-) -3 L.( - Z Z ! Are you n employer?Check the appropriate box: 1. [am a employer with 2-0 -�employees(full and/or part-time).* Type of project(required): 2.❑I am a sole proprietor or partnership and have no employees working'for me in 7. ❑New construction any capacity.[No workers'comp.insurance required.] $- ❑Remodeling 3.[D I am a homeowner doingall work myself 9. ❑Demolition y [No workers'comp.insurance required.] a. I am a homeowner and will be hiring contractors to conduct all work on m 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole I will 11.0 Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.M I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractorss have employees and have workers'camp.insurance. 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other /.Ji nJ 152,§1(4),and we have no employees.[No workers'comp-insurance required.] ree If-e,0'+ei1 1,3 +Any applicant that checks box kl must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the.sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'coi nsation insurance for my employees. Below is the policy and job site information. Insurance Company Name: , Policy#or Self-ins.Lic.#:_/ ) ,02 e__7 Expiration Dater ! Za Job Site Address: /O 2— City/State/Zip: r,< — )"4 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expi atiod,date). Failure to secure coverage as required ugder MGL'c. 152,§25A is a criminal violation punishable by a fine up to$1,300.00 and/or one-year imp�r. ment,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 viol A y of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificatio I do hereby certify nd t pains and penalties ofperjury that the information provided above is true and correct. Sienature: Date: 7- /O— Phone# —8 y— L it 9 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#:. i DATc(YIMIDD/Y`!YY)- 04l30/2019 THIS CERTIFICATE-IS ISSUED AS A b1ATTER OF INFORMATION ONLY AiiND CONFERS NO PiGHTS UPON THE CERT)FICAT E HOLDER.THIS CERTIFICATE DOES NOT,AFFIMIhATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CANT'?ACT BETIMEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this cer.ificate does not confer rights to the certificate holder in lieu of such andorsement(3). PRODUCER NAME CONMcIISsa Pflug Mackintire Insurance Agency Inc acNN Ext: (508)366-6161 IC Ne: (508)366-5202 11 West Main Street E-MAIL melissap@macitintire.com ADDRESS: INSURERS)AFFORDING COVERAGE NAIC II Westborough MA 01581-1931 INSURERA: Sentry Insurance INSURED INSURER B B. Middlesex Insurance Co Newpro Operating LLC INSURER c: Guard Insurance Group 26 Cedar St. INSURER D: Colony Insurance Co INSURER E: Wobum MA 01801 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 REVISION NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. I�SR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIODPOLICY FFF/YYYY MMIDDM(YY LIMITS COMMERCIAL GENERAL LIABILITY. EACH OCCURRENCE s 1,000,000 CLAIMS.MADE ®OCCUR PREMISES I Ea occurrence ; 500,000 MED EXP(Any one person) ; 15,000 A A0092403003 12/31/2018 12/31/2019 PERSONAL 3ADVINJURY $ 1.000.000 rGEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3 3,000,000 CY ❑JEa LOC PRODUCTS-COMP/OPAGG S 2,000.000 ER: s AUTOIMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea accident tAEXCESS BODILY INJURY(Per person) s SCHEDULED A0092403004 12/31/2018 12/31/2019 BODILYINJURY(Peraccident) S Y AUTOS NON-OWNED PROPERTY DAMAGE S Y AUTOS ONLY Per aaidentUninsured motorist BI s 250,000 LIAR OCCUR EACHOCCURRENCE s 5,000,000 R CLAIMS-MADE A0092403006 12/31/2018 12131/2019 AGGREGATE S 5.000.000 RETENTION S 0 s WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY TATIITE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.LEACHACCIDENT S 500,000 OFFICERIMEMBEREXCLUDED? NIA NEWCO28778 05/01/2019 05/01/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s 500.000 It yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S Limit $1,000,000 Pollution Liability D CSP304242 12/31l2018 12/31/2019 Aggregate $2,000,000 DED $5,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Addltlonal Remarks Schedule,may be attached H more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE MA 01504 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD t � c TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 00 4' Map— Parcel. ;, Application # Health'Division Date Issued l Q � ( U Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ! 01271f Historic - OKH _ Preservation /Hyannis Project Street Address O b 2 i t 1r I Village CcYi Owner GLEWA 1-'rIIJCLn Address `S^VKt_ as u.re Telephone Permit Request I b I 4k celI u Lag ouay 9%011 SM 2-V, tt1A osx i n Square feet: 1 st floor: existing proposed 2nd floor: existing . proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 91000 Construction Type 1 irCA Lo't Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) ((r,Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No �VJV Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) - 0 Number of Baths: Full: existing new Half: existing n a Number of Bedrooms: existing _new '"4 �+� Total Room Count (not including baths): existing new First Floor Room Count N y Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other 3 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 07Yes7D No CD rn Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ n6? size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: �Zonin Board of Appeals Authorization ❑ Appeal # Recorded ❑ 9 PP Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name fi2ft I M S OLU-1)UkIft, Telephone Number 174- 4 Q - S l5_7 Address S 5 S License# I DZ 1-79 Home Improvement Contractor# 16 0 ASS L/ l ft' A LAunZ&L Worker's Compensation # 01ZA 5-tiol ?� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 10 (I] 14 s FOR OFFICIAL USE ONLY 4APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS - VILLAGE OWNER t P DATE OF INSPECTION: FOUNDATION FRAME INSULATION174 4 FIREPLACE Y _ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS ROUGH .<. a4 F= FINAL t } F . .'FINAL BUJ L_"DING$> DATE CLOSED OUT b c ASSOCIATION PLAN NO.. r r The Commonwealth of Massachusetts `.6 Y Department of Industrial Accidents Office of Investigations 600 Washington Street .' t� - Boston, MA 02111 ' jy www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _Applicant Information Please Print Lelzibly Name (Business/Organization/Individual): N ' ` G IyMU '1 SDZU 1 ' DO S Address: 135 S} 4. City/State/Zip: Phone #: 3?J� ' ��Z 7i�Z3 ' AVreouhe an employer?-Cck the appropriate box: Type of project(required): 1. 4. ❑( I am a general contractor and I I am a employer with 7— - have'hired the sub-contractors. 6. ❑ New construe ion eiziployees-(full and/or pait-time). - -= - --- --- - • -- - 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 an ca aci employees and have workers' Y P h, 9. ❑ Building addition' [No workers' comp. insurance comp. insurance.1 required.] 1. 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a bomeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions myself: [No workers' comp. right of exemption per 12:❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 1.3.❑ Other comp,insuiaricc required.] *Any applicant that checks box fll must also fill out the section below showing their workers'compensation policy information. 1 t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContraetors that chock 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. A, Insurance Company Name: I M tM �U �JV1�-NN' = - Policy# or Self-ins.Lic, #: fool � 01 � VV Expiration Date: ZO I If W, Job.�Site Address: (�. D�1.� �� City%State/Zip; uc'f - Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A-of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil,penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator, Be advised that a copy of this statement may be'forwarded to the Office of Investigations of the DIA for insurance coverage verification. I'do hereby certify under the pains'andpenalties ofperjury that the,,information provided above is true and correct. S i ature: ��y a Phone#' 7 3Gl D G S2 2' Z� Official use only. Do not write in this area, to,be completed by city or town offciaL City or Town: Permit/Llcense#' ' 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#: hformatzon and fnstructzons s if employees, Massachuseti:s General Laws.chapter 152 requires all employers to provide workers' compensation for the Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, parinership,.4associaliob or other legal entity, employing employees. However the owner of a dwelling house'heving not more Than thiee'apartrdenls and.who resides therein, or the,occupant of the house dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling or on Lbe grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.' MGL chaplerY152, §25C(6).also states that "every state or local licensing agency shall )rithhold the issuance or h for any renewal of a license or permit to operate a business or'to construct buildings in the commonwealt applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,lvlGL chapter'1521 §25C(7) states "Neither the conirnonwealth nor any,of ifs political subdivisions shall enter into any contract for Lheperfonnance ofpublic•-vtork until acceptable evidence ofcompliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please :611 out•the workers' compensation affidavit completely, by checking the boxes Lbat apply to your situation and, if necessary,supply sub-conlraeLor(s) name(s), addresses)and phone numbers)along with their certificate(s) of imited Liability Partnerships(LLP) with no employees other than the insurance, Limited Liability Companies (LLC)or L 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 IodustriaJ Accidents for confirmation of insurance coverage. Also be sure to sign and date th-e 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, Shouldyou bave any questions regarding the law or if you.are required to obtain a,workers' compensation policy,please call the Department at the number listed below,.Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly, The Department has provided a space al the bottom of the affidavit for you to fill out in Lhe event the Office of Investigations has to contact you regarding the applicant. Please be'sure to fill in the permitllicense number which will be used•as a,refercnce number. Inaddition,an applicant Thai muss submit multiple permitllicense applications in any given yea ,�need only submit one aff davit indicating current policy information(if necessary)and'under"Job Sitc Address" the applicant should write"all ].cations in _(city or Lown).`A copy of the affidavit that has been officially stamped or marked by the city or town may be provid e d to the lure permits or licenses. A new affidavitlnust be filled out each a bcant as roof that a valid affidavit is on file forfu FP p li cerise or ermit not related to any busines commereia s„orl venture e year. Where a home owner or citizen is obtaining a p (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affi'davtl. The Office of Investigations wou i e o hen pu��rr✓adv� r +�r 'DP"ration and shou➢d youhave any questions, please do not hesitate to give us a call. t The Deparlmeni's'address, telephone and fax number: i y zV, The.Commonwealth of Massachusetts Department of Industrial Accidents Office of In-yestigations 600 Washington Street, Boston, MA 02111 Tel. # 617-727-4900 ext 406'or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia Town of Barnstable Regulatory Services • BAR7(sI'esl.� v ' MAC- Thomas F. Geiler,Director ` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town-barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623.0 Property Owner Must Cqmplete and Sign This Section If Using ABuilder ./x)�/ L C as Owner of the sub�ect property hereby authorize -NeAkm M R� SDuLM13Kk> to act on my behalf, in all matters relative to work authorized by this building permit application for. 1 a kb ercazu)w c /lu�- .(Address of Job) Sig atuxe of Owner Date Pnnt Name If Property Owner is applying for permit please complete the 4 Homeowners License Exemption Form on the reverse side, I Q:FORMS:0"ERFERA ISSION CERTIFICATE OF LIABILITY INSURANCE{ z,a,EY :. RM2010 SIRS CWrrlCm s Is,Issm As'&,MTM OF Motmarlos'QNlX ARM,aorosao NO aisEWs uQ011 YRIi CZR7XW Ci'S aatasa, M8,cus"l-ml . DOfB DD2.A1731i0LTIVgil.OR:=SLTTSIif.Y`f1RID,. •OB:aLSR tBQ CO!giAiR]►tPOA=PY SRi YoLICI66$LiaM. !!QB lSICLR2:0), >a)ounwa Dm Nm catsnrium A cuO�CTziTmm m,issulm ixamm(s), aVl'It0lttt C6A .ID 7ALSs8l,!!9II GA D$iDDUC1eA,, 1BD Z61 CMIMICR2'R sum: the tli iE the o6stiEio>Lt�bolds;i'a as)YDDITIom1L 7A8YB»;'ttie P�1 aYtieq meat bo .udos�ed. :iE.gpI RYLOg,Ia-1D11ViD, subjeat to tba evv s ana ooffiitloas of tbe.PclloY. C*lain vo"I"e7 , molre an.em osossol.,A statewnt.an tLts oart"Latte do",not =W"r migbt6fto'tba, cote bolder,ii lien o1 4uob aodosaseatial., — Rogers A Stay Insurance. Agency. gA=. Inc tirc.'■o.■R�: tak.,s;. BO Box 1601 a ralr $quth Dmmis r 21A, r02660 same■xo. m� �■ca�■uraarsom:nTa■■iaa ...__. .Hmal Insuranm Co _. Hroattr EA�rgy 3olutYoaa LLC 39. siascoaset Drva 9agamoro Beach 2�A, 02562 n■tue o: :_ :emn_e:. OOVffitAG'BS CBRTIFICATB.N� BF R8VF8Z08 NO}ID8&: ':This 78.TO COMET TlW.TW-'DOLIGp[9 Of nUVM it- ATW BMW HAW;BM-I48"D: `. T.m iH9Ue�.. ... - Fa4.-9�;➢01ICT BLSIOEI MOTIiiTN■TltID>kG�1/P:�Sov uism':.Tim Oa-00Emrrm,07 AAT a01Thum Cir dl DOL�fl'oft s A T To.11ffiCa TSI6-�..CpATrv.r..e.u BE..t88t1� 17F�.Z�II�LeU1 :A77CADtti,sT.Tim soS.IC1Ei.mtomnBW.�'17.809.7Ua To a13.':lta.ffiOss�ffiCI.OSI44�ND EAIIDRTI066 GR<BOCZt SOZIC C .40T.ICY:lTI 701ICTtA@ . ,�' .-...TOE,off:laSOAANfY 7OLICif 6{l®lla OWeVnnn.. air/oeiiRq _ ,1.ffiT9 ("1 - SAM Gcommt �. asmar+ rya aunu.irt Ge.'L'JOVAii.R■..Lnd?Amain-.dl.. .11■Waiff - .� ,T _._ ST' - ....:. - -.... _.. @a77®Qt■OG{.Liial._ _..- __.. ate'^o, Oft1:a WtHG tan.nz 0007Lt::maV�pi'pie�, -;'1, w _ - D AMA a4C1aC9L8L+AlfYe: - ■auuT;��uaT1n..!m!�aa ,t ... Q6Lt■BB 1fA6., ,,Q 'tAIIe'ffALE '' _' f.- -_ _. _ AID DOLO1ls8 LIAaILITT 7I1j:9B)Ypa 70r.JFaRrunsi: L.tK1171000em A EFPP_tlT1V,6 090WI es AM l;000,000 ta.. ines._..ry,aprprs< 5012954012010 07/25/2010; 07/25/2011 al i i;o00ooD . s.a.c:la�-'■i.00rioim ;A 3,OOA,�000 ,cae�t■-pint.. a•.a-vsivcoeaee:racataarn .... .:-..-.. _. - . ..;_. - ALL 9 A88;;8XC{NDND•'880li:THB OFQRD �cmdit788TION po1.ICY. CERT' inCA= HOLDER,_._ _ .,=r. 'CWC67LATIox CONSffijMXON'9=VICEg OWUD - - - . 8HOO1D'AFT 07,Ta6,ABOM_WSMUND!PO ICZE9•at CAe■CELLM-B -.T9B,. e7Ip=UlgN aATL Tf�07;..•Ip4I�tiCLL:�i:Bc";L�1:IVID®II1:AODt3�tai�,N3fl Tim. 4o NA3HINOT6N ST. VMTCV VAMIBIQO9. 1��TS4ROUCiA,'!4A 01581 -� •mi�isio:■tvuoeei�sm Board of Buildin;; Re(yulations and Standards. Construction Supervisor Specialty License License: CS SL 102778 Restricted to: IC CONOR MCINERNEY" 39 SIASCONSET DRIVE SAGAMORE BEACH, MA 02562 Expiration: 8/19/2012 ('ummi.ssioner Tr#: 102778 ✓fze -Varnirrwouueo,`� o��u�.ecde� Office of Consumer Affairs&Bd " HOME IMPROVEMENT CONTRACTOR Regulation License or registration valid for individul use only R = Registration RACTOR before the.expiration date. If found return to: 160854 ,= Expiration 9/8/2012 Type' Office of Consumer Affairs and Business Regulation w LLC: 10 Park Plaza-Suite 5170 FR TIER ENERGY SOLUTIONS r Boston,MA 02116 MCINERNEY CO[V,OR3r I 135 STATE RD SUI,T,E#4fi SAGAMORE BEACH MA 4 G 1 02562' — — lll///���►►►"'lll���tltltl"'lll Undersecretary alid without signatu i rr; Town of Barnstable �a..THE Regulatory Services �OF 1�� P Thomas F.Geiler,Director Building Division f - • BAR-STABLE, � v s639. �SS. g Tom Perry,Building Commissioner iOrEo a` 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: �` d Name: (AQ W Phone#: 9a -7 L, 1-11 6 Address I �i l ��'� Village 6"+�1J(' ` Y,Q Q ZCO�Z I c Name of Business: ( r— --��L_�� S�_� JeVVI �LQ I R '� Type of Business: 5 ,f y- Map/Lot: �—t () — a3 Pp411 ' INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. 6 If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling uni I;the undersigned e ao ani agree with the a ve restrictions for my home occupation I am registering. Applicant Date: Jo Homeoc.doc Rev.5130103 7 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1 u FL., 367 Main Street, Hyannis, MA 02801 (Town Hall) DATE: � Fill in please: f !_ k } , � APPLICANT'S YOUR NAME: 074N(i coo ! e o(4e:n w BUSINESS YOUR HOME ADDRESS: /0'Z E1 0 FY CeotewI%I-C, ••!ha 04� 9- r" TELEPHONE # Home Telephone Number Ot VIf f/ be cc o. NAME OF NEW BUSINESS CApe 5 Ati J U45Se*-v ce a dj- YPITA O.F BUSINESS a n IS THIS A HOME OCCUPATIO ,7 YES NO f r Have you •.. Y ADDRESS OF BUSINESSE t a MAP/PARCEL NUMBER • Ce y ew%/ e.1 AAa 42 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 20-aAdain St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ONER'S OFFICE This individ al h engnf e any permit requirements that pertain to this type of business. Aut prize .S' ture* COMMENT : t A S% 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: . 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: .,�. _ b, �� `� � I _ �. i `� 1 � . —r����� �- IT'S D � . e ,� ._ Y [ ] [R248 238 . ] LOC] 0102 ELLIOTT ROAD CTY] 07 TDS] 300 CO KEY] 156235 ----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 HINCKLEY, C STEVEN&ELEANA M MAP] AREA149DC JV] MTG13004 102 ELLIOTT RD SPl] SP21 SP31 UT11 UT21 . 37 SQ FT] 2268 CENTERVILLE MA 02632 AYB11970 EYB11975 OBS] CONST] 0000 LAND 27500 IMP 110900 OTHER 1000 ----LEGAL DESCRIPTION---- TRUE MKT 139400 REA CLASSIFIED #LAND 1 27, 500 ASD LND 27500 ASD IMP 110900 ASD OTH 1000 #BLDG (S) -CARD-1 1 110, 900 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 1, 000 TAX EXEMPT #PL 102 ELLIOTT RD RESIDENT'L 139400 139400 139400 #RR 0492 0104 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE100/00 PRICE] ORB11471/810 AFD] LAST ACTIVITY] 05/09/96 PCR] Y C 1 R248 238 . A P P R A I S A L D A T A KEY 156235 HINCKLEY, C STEVEN&ELEANA M LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 27, 500 1, 000 110, 900 1 A-COST 139, 400 B-MKT 98, 800 BY 00/ BY JG 3/87 C-INCOME PCA=1011 PCS=00 SIZE= 2268 JUST-VAL 139, 400 LEV=300 CONST-C 0 ----COMPARISON TO CONTROL AREA 49DC -- TREND EXCEEDS STANDARD NEIGHBORHOOD 49DC CENTERVILLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 275001 LAND-MEAN +Oo 1394001 80282 IMPROVED-MEAN +380 2506 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1000-. LOCATION-ADJ A - - ] PPLY VAL STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] { R248 238 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 156235 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR .CMP NEW/DEMO COMMENT [B29984] [09] [86] [AD] A 500001 [GB] [01] [88] [100] [NEW ] [CE ADD'N ] [ ] [ ] [ ] [ ] ] [ ] [ ] [ J [ ] [ ] [ ] [?] BARNSTABLE COUNTY REGISTRY OF DEEDS JOHN F . MEADE , REGISTER REGISTER RECEIPT # : 1998 29620 RG17OR PRINTED: WED 9/30/98 12 : 37 : 12 BATCH : 4941 CUSTOMER: N/A PAGE : 1 BOOK-PAGE : 11733 324 RECORDING FEE : 12 . 00 INSTRUMENT # : 73623 POSTAGE : . 32 RECORDING_DATE,: WED 1998-09-30 12 : 35 MARGINAL REF FEE : . 00 ADDRESS :02iE_LLIOT ROAD COPY FEE : . 00 STATE EXCISE: . 00 TOTAL AMOUNT DUE : 12 . 32 COUNTY EXCISE : . 00 PAID BY : CHECK 7421 -------------------------------------------------------------------------------- GTOR/GTEE GROUP : 001 TOWN : BARN BARNSTABLE INSTRUMENT: N NOTICE OR CAVEAT CONSIDERATION : . 00 STATE EXC CONSID : . 00 COUNTY CONSID: . 00 GRANTOR: GRANTEE : DESCRIPTION: SEE INSTRUMENT MARGINAL REF BOOK-PAGE : GRANTORS : BARNSTABLE TOWN OF (APPEALS &0) HINCKLEY ELEANA M (&0) GRANTEES: NONE RECORDED -------------------------------------------------------------------------------- RETURN ADDRESS : ELEANA HINCKLEY 102 ELLIOT RD CENTERVILLE MA 02632 -------------------------------------------------------------------------------- 2 1 --- - ___ _________ _ 2 84 12 O 2 91 ----- r t 5 I lu 10' ------ - - 07-10 4D 3 57-5 -.. 0 - -------------- Eleana M. Hinckley H Map 248 Parcel 238 102 Elliot Road "' E Centerville S Scale V = 120' 14216' <'': ...... LD :.:............ ' ' �f�.:> :. � :: k.:::<�......:.::.:.. . . IBUILDING ............................- •`: ........<•'•v+<::. :::" ;.M1'ti.,y...1%:•`"`•,':???M1: ;`.M1:2': `M1v `<`%:::i` ::M1 :;: :`:?:2:::M1M1 t r •`.%+?? ? t �:�:r:` loin ELLIT:: <: ><<: TE V :> ..:n. •::..'•.•:v•ry;:.}vxyv:;v.vv}.:::..:;:.xx.v}.xvvv...v:•.::.vvxxxv;vu;.yn}}}:;.v v.w:::.w::.xxvy: .. PON NIX ...... ,::,:..,:.:::::•:::::::::::..::::::.:.., :S•iiY{nvv . .::...,•::::.,<,•.,•:.:t:•:.;i..:•.:.:i.:;iti•:t•:iS.ti22iti;.;y;;:;;tai ::::::::::x is ::.�.w::.�•:v:i;4:^:iii4:•i:•ii:•i:•i:•iiw::::vi•:itti:•i:L::�::::::n...:.:::.v::�:.w:.vvw::::: ILLEGAL PT�. .....,..... •:vSi•:iL:•iiiY •` •:::.;".: :,::WILL CHECK x < >:: RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET 102 Elliott Road _ Centerville LAND 248 238 C-0 BLDGS. OWNER TOTAL LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. Hinckley, C. Steven & Eleana M. 5 12 70 1471 810 B TOTAL LAND , r C 6 BLDGS. I . TOTAL LAND 11 t BLDGS. !! �.Y r s ` •� TOTAL /; / 0 8 0 fv LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND INTERIOR INSPECTED: m BLDGS. j TOTAL DATE: LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT ��,f, �? 0 y 0 LAND CLEARED FRONT - 0) BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. rn WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH % FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ,9 v ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND FOUNDATION BSMT. & ATTIC PLUMBING PRICING . LAND COST USIab Fin. Bsmt.Area Bath Room Base �, BLDG. COST Bsmt. Rec.Room St. Shower Bath Bsmt. PORCH. DATE/q%v Bsmt.Garage St. Shower Ext. Walls PURCH..PRICE•nQ,O Odv 'h - ---._._ .:. � Attic Fl.&Stairs Toilet Room Roof RENT / Fin.Attic Two Fixt. Bath Floors 1 INTERIOR FINISH Lavatory Extra1 2 3 Sink I -- — -- - r/2 r/ Plaster Water Cie.Extra Attie .)`— " EXTERIOR WALLS Knotty Pine Water Only %Z`d able Siding Plywood No Plumbing Bsmt. Fin. ogle Siding Plasterboard 4 Int.Fin. 'Ve'yLshingles TILING ze-M mc.Blk. G F P Bath Fl. Heat 3(p . ice Brk.On Int.layout Bath#r&Wains. 0 `� Auto Ht.Unit 'I .)rj —`— Veneer Int.Cond. Bath Fl.&Walls Fireplace am.Brk.On HEATING Toilet Rm. Fl. Plumbing IAid Com.Brk. Hot Air Toilet Rm.Fl. &Wains. Tiling Steam Toilet Rm.Fl. &Walls Ilanket Ins. Hot Water %rl/ St. Shower )of Ins. Air Cond. Tub Area Total , Floor Furn. ROOFING A COMPUTATIONS sph. Shingle v1 Pipeless Furn. S.F. 7Q food Shingle No Heat S.F. sbs.Shingle Oil Burner S.F. late Coal Stoker S.F. ile Gas 7 S F OUTBUILDINGS ROOY TYPE Electric S. F. 1 2 3 4 5 6 7 8 9 30 1 2131415 6 7 8 9110 MEASURED able Flat ip Mansard FIREPLACES S.F. Pier Found. Floor /.� iambrel Fireplace Stack Wall Found. 0.H.Door LISTED FLO RS Fireplace / Sgle. Sdg. Roll Roofing onc. LIGHTING Dble.Sdg. Shingle Roof n arth No Elect. DATE Shingle Walls Plumbing 'ine lardwood ROOMS Cement Blk. Electric l r Isph.Tile Bsmt. 1st TOTAL ^) U i7 !.. Brick Int. Finish PRICED Tingle 2nd 3rd FACTOR REPLACEMENT \. V OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. )WLG. )f`kIO2 JJ9 :/A .S&- -a zo-1�2. 1 2 3 4 5 6 7 6 i 9 10 TOTAL w M Assessor's offioe (1st floor): �j �; o 0 and lot n p ed�ov�(v l..?f ...ol, X........Assessor's map ` e�Qy F tNF T �♦� Board of Health (3rd floor). Sewage Permit number ..................... . ?�....�0. `..., Engineering Department (3rd floor): / (� oBb a�0 • g 1 pv ,x House number �( o YAK APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 PA. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..C3yi�D...ADOiT�U�1 A � O�� .................................................................. TYPE OF CONSTRUCTION ...�&)...1 .()...... ��....P.i� ... ................................................................. ............ .5 ....._..19..A3(o TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....�OZ.... - �. .��►�.; _ -- 'cJ/CC ............................................................................................ Proposed Use ...... .....OaO.(.`.^........(..��...�G..O..._*.., .;..... elf l(Zt�tC ? ....c....................................................... ZoningDistrict ........................................................................Fire District .......... l........................................................... Name of Owner .�1..-��. 1. K— Nn...1 �.Pk + Address ...{.n. -. :<! .. � 1�:1 Vl,C M f;z iLQ Name of Builder .A.&'J..H..Address ...(.. "A ...,.-n�—�`�1 Name of Architect ....../(� ��...............................................Address .....AIIA......... ... ..... ...... .................................. �l-ton) � 3 �AOt�i-t'ipf.1 �..4,w�YLS Number of Rooms ' .-.�..... ..=... ................Foundation ... t=�--U� s K/G CC.19PSor�205 Exterior ....r r't-1, E., w/c.<.. t�` �. ,�. ..................Roofin S�/�4�% "r�'° g A:.... .....:...... A019 _T ()AJ — l/Z OAKr �z tJ!ivcG AOl>/-(ic�N " o�`.Irgc-c. Floors (,.A:) '.. ?n(l .., ..:.........../......................I4nterior .. 0 =.. �C,.:.n+C� r1 CC ..L�� Heating ..7 d ..( J..ln ?` ....'"./`fr .. ...,.P.lumbing .... n ............. ...... .,. J? / ?� � r� ..... { , Fireplace ....A !Approximate Cost .. .�� (�' � Definitive Plan Approved by Planning Board ______________________ ________19________ . Area .....� j/..L..(�?��' �Diagram of Lot and Building with Dimensions Fee .............�-,>0... ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH 430 sF w,-r r- we=494 t5F 2noD fCfn =4so5f 19 7TIS' o N OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS G I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... .. ...c ....... Construction Supervisor's License . z ............ ' 29984 ADDITION/GARAGE Np ................. Permit for .................................... ' Siogle Fomily DWeIlin8 - . -- ...... --......—.... —......— .... ------'' \ \ � 102 Elliot Road \° Locohon ---------------------. Centerville --------------------------� ' �leou Biouhley ^� \ {Jvvm�r ---------------------- ' Frame ~ Typo of Construction -------------- -------------------------- ~^ - . / . P|co ---------. Lot ----------. - . . Permit G,onoe6 --��D���b���'29^.....l9 86 ' ~ ; . Dote of Inspection ------------l0 . . ~ . ' . � ` Dote Completed ------------'l9 i ` -- ----- -~ , . ^ zz- ts . ' ' . . � - . ' . - ' � Assessor's off ioe-(1st floor): ":. ,: r Assessor's maps and lot7numbei. .�. .�r:. � Y �_ y�F THE tO`` wUt"� r ��• v + 4rP o Board of Health (3rd floor): 'a ., w1 J3�� d 6—: O O-S EP` I SYSTEM MUS . Sewage Permit number .'................•............... ..•................ y . Engineering Department (3rd floor) 9 IN C I�{I� M snL House number .::...........•... ,[ INSTALLED 9 !'r. l,. p? .v`i ; + "TITLE 5 MAI,Ord! �..,APPLICATIONS PROCESSED '8:30"9:30 A.M. and',1:00-2 00 P.M.= �only+ ENVIRONMENTAL C*C* AND TOWN rnONS TOWN {OF ARN-'TA :B • IUI•LDING I,HSPECTOR � ^ APPLICATION `FOR PERMIT TO urc.D faD01Ti01�1 (p....irL'A.•. ......j.• .••. ..•...,,......•••....I' G1"1elJ ' TYPE OF. CONSTRUCTION ...4•l)(!fDOU....... :.. .....: t ..............................................:... TO THE INSPECTOR OF BUILDINGS: ti The undersigned hereby applies fora permit according to the following information: + '3 Location _...:(OZ EC�G� .�� ,:�.. �wl -sC. ................................. ........ ......... .. Proposed Use 1. .�a....t .. .`...I}.. 4�O..i��CX?1i .,�.•.:.�0! 21�kw�� ...................................................... Zoning- District ....... ......... ................................Fire District .... .....( /) Name of Owner. lJ. :..1- .N3..GK<JE� ......................Address ..LO M. sw Name of Builder ��g2....� 1`�4C?.( J.&J.E:...Address ..(..C�...(a..: `t! 5�..�—.�C�.,..��? tJ/•f : lV� .. ..A Name of Architect ddress ..... .. . • '�v'JAiT►tx�1 � 3 .. Ao�nrlp�.3 - . Number of Rooms �i" �C�.�-..1....:....... ....... Foundation ..�2F.�P.-!��..�...�:�.Sti?pxx'-��...Wf..�G.�.�,�... Exterior :°..0 1 -� w�<.... •►�cJ.Cry -a.........•....:'....Roofiing .. ��A5fL.e �(••....—eV. !�i ?>Y. ..... - % 77!� F/OAJ J�� ©AK;#�� tJ�N4G ,40�iT7�N m p°2�C�Y3ct, ; Floors (pA7A,' ::................Interior ...C� ` 1-91 _ .......PlumbingHeatin :�!J' 9 � ;.� OGJ G/7L3' Fog �i9 !r,. Fireplace :...,/V`/� Approximate Cost •. ,,,••„• '.j...... ................. i' _ .. •v Definitive Plan Approved by Planning Board ____________________"_-- �(p - 19 Area ,Diagram of Lot and Building"with Dimensions r' Fee ............C).(,►.3. .��.. ............. SUBJECT TO APPROVAL OF' BOARD OF HEALTH s k r i - 432 51:- ^ s Am i--r �o Fccn2=45�sF . •ti • soy- ' - -•. � _ ;� ' • f . J -OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS:. I hereby agree to conform to all the Rules and Regulation`s"of the Town of instable regal ding the obov construction. ,•' Name ... ...... ' Construction Supervisor's License .0Z4'?40............ . . HINCKLEY', ELENA ~ :29984 . ADDITION/GARAGE 4 t , No ...... . Permit for .... r J •Single-FamilY.. Dwelling .... .1•D2 Ellio.. R................. ...........� - _ - � •• ,• . . � � � a. Location .. .......................oad...... .... i , Centerville ...'............ ............. ... ..`�-.......... ` Owner2 .....Elena' Hinckley ' i • Type of, Construction ......Frame...... ... ....... Plot ............................ Lot'.................. ....... t••. � �'°� - �� I ? It � �`' �' L•- `� Permit Granted ......:..September 29� :19 86 are Date of Inspection' .. ... ........... .. ... '.19 , Date Completed .............. ................ .19 t , i' , TATE PROPERTY ADDRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHD KEY NO- 0102 ELLIOTT . ROAD 07 RB 30C 07CO 07/09/95 1011 00 4'9DC R248 238 5 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS TY UNIT ADJ•D. UNIT N I N C.K L E Y. C S T E V E N - MAP- Land Destription By/Date SizeDimension res LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE CARDS IN ACCOUNT - CD. FF-De thlAcres E B L A N D 1 27,500 L 10 18LDG.SIT 1 X .3.. =10 186 39999.9 74399.99 .37 2751J 43LDS (S)-CARD-1 1 110,900 01 OF 01 #OTHER FEATURE 1 1 ,000 T A BATHS 2 .0 U X C= 100 7000.0 7000.00 1 .00 7JJG B 1?L 102 ELLIOTT Rfl MARKET 98800 N FIREPLACE U X C= 100 3100.0 3100.00 1 .0E 3100 3 4RR 9492 0104 INCOME D SHED S 8 x 14 198 C= 90 10.3 9.27 112 1 JOU F USE A PPRAISED VALUE D 139,400 ' D J ARCEL SUMMARY A U AND 27500 T S LDGS 11090E A T -IMPS 100E M OTAL 139400 E CNST F N DEED REFERENC Typa DATE Raco.tl.tl R I O R YEAR VALUE C t E T Book Page Inst. MO. Yr.D Sales Prior AND 2 7 5 0 C A 1471 /813 00/00 LDGS 11190C T S I l OTAL 139400 U I I I R 1 I E BUILDING PERMIT R E M E A S U R E D 8 7_ Number Date Type Amount ADDN .& GAR 5 0% S LAND LAND-ADJ INCOME Sc SP-SLDS FEATURES BLD-ADJS UAITS /87 FWD Stiff. 2750±1 1000 10100 29984 9/36 AD 50000 Const. Total Vear Built Norm. Obsv. Class Units Units Base Rate Adj.Rate Atqd Age Depr. Con,- CND Loc 4b R G Rept Cost New Atll Repl Value Stories Height Rooms Rma Bathe Ifix. Partywatl Fac. 01C 000 110 110 57. 50 63.25 70 75 19 80 100 8G 138569 1179JJ 1 . 5 7 4 2.0 7.0 . Description Rate Square Feet Repl.Cost MKT. INDEX: 1 -0 0 IMP. BY/DATE: J G S/ 8 7 SCALE: 1 /O U.5 9 ELEMENTS CODE CONSTRUCTION DETAIL 8AS 100 63.25 936 59202 GROSS AREA62S SINGLE FAMILY DWELLING CAST J-P : JL S 15S 132 83.49 396 33062 *-------30-------* STYLE 04 APE COD 0.0 T FFG 30 13.98 352 6681 ! FWD j ESI ':iN ArjJi-IT d2- ESIG_ N ADJUST 10.0 R FWD 35 8..50 360 3060 It 12 "XT A.WALLS 31 .400D FRAME ------ 0.0 C FOP 35 22.14 72 1594 ! ! �F/A[ TYPE J2 "'AS 0.0 B15 42 26.57 . 936 24370 *-------- 3b--*------*30--1b---*-----22-----* INTtR. FI f.7jA UO 0.0 --- ---------------------- T ! 815 ! 15S ! FFG ! �1T <3.L.AYIJIJT 01 0.0 - - - -- -------- -.-- ---------------------- U i ! 16 16 INTER. aUA1 TY J4" :A E AS EXTER. 0.0 R i ! + ------------- --- ---------------------- LJO: STRJCT JG 0.- --------------- --- ---------------------- A W26 BASE 22 22 ! E LO-Ci- CJV'E t Ju 0.0 L D 784 1332 ! ! *-----22-----* -JDF TYPE JG 0.0 Total, teas Auz Base E BUILDING DIMENSIONS fiAe T W3o NL6 E36 15S E1$ FFG £2_ ! ! ! 0D-4-5 I�ti T --- UG -----------------99,9 2 -------------- - --- ---------------------- S16 W22 1"416 .. FWD '412 W30 S12 I - - ------- ------- E30 . . 15S S22 FOP SO4 W18 N04 *---------3V---------X---FOP---* -----�T1=Z t�31Ri�t)i�5 4�iD� CENTERVILLE L E18 15S W16 N22 . . BAS S26 LAND TOTAL MARKET 1315 N?S W36 S26 E36 . . PA2CE.L 27500 139400 ;AR A 3920 4ARIANCE +0 +1463 iTA"40A"' D 25 ` ; Town of Barnstable �oF tKE rqy, Regulatory Services 1% Thomas F.Geiler,Director Building Division EAMSTABIA +� v� sMAM 1� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: , lea Permit#• rl/ (p q HOME OCCUPATION REGISTRATION Date: EL - 1 Name: r(`1 n C I`t e MA eC / Phone#: S0Op 77 1 — �� f b�'�' Ne�o(GI � Address: a ` illage: r� cR1 n2-6-3 Name of Business: �/1 pYu�ecr vi V Type of Business: v `t 'k e < kot Map/Lot.o� Z� d Zoning District Zoning Districts RF Ld RC-1 require Special Permit from Zoning Board of Appeals. INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. ,r • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. 0. There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. •, Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. , There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. No sign shall be displayed indicating the Customary Home Occupation. If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. No person shall be'employed`in the Customary Home Occupation who is not a permanent resident of the - dwelling unit. I,the'under_igned,have read and agree with the above re ctio for y hom cc ation I am registering. Applicant:- Date: Homeoc.doc Rev.5/30/03, ,�,.,,.. .r r , � '` . _ �. ..... �r .._. f 2 . _ � iy �- 4 ,. J TO ALL NEW BUSINESS OWNERS DATE: Fill in please: ,Mt , 1 '-* nn APPLICANT'S 1 YOUR NAME: V2 w v1 I r T+ c�(� f I v is fits ec.0 N am( (,,a", BUSINESS w YOU R HOME ADDRESS t� : �io �i'71-1"7l6 � `d�- P o AA-) OZ(p32 y TELEPHONE Telephone Number Home NAME OF NEW BUSINESS 1v1 v-es wl , TYPE OF BUSINESS V i e IS THIS A HOME OCCUPATION? YES LZLN Have you been given approval from the building division?tYES O ` ta ADDRESS OF BUSINESS o a 1�11 e VV( �2MAP/PARCEL NUMBER O When starting a new business there are several things you,must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need: Once you have obtained the required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall)or if you get the business certificate first you MUST go to . the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - (corner of Yarmouth Rd.&Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OF This individual has a 'n med of Oy pbrmit requirements that pertain to this type of business. ut orize Signature(* COMMENTS: —r--m �:-—tt BOARD OF H This individual a e i of t permit requirements that pertain to this type of business. thorized Signa re* COMMENTS: 3. CONSUMER AFFAIRS (LICENSIN UTHORITY) This individual h en inf rtaed of Vi requirements that pertain to this type of business. , Authorized Signature* COMMENTS: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. it does not give you permission to operate-you must get that through completion of the processes from the various departments involved.. **SIGNIFIES APPRO VAL FORA BUSINESS CERTIFICATE ONLY, E�' f To whom it may concern, September 10, 2003 My husband, Matt Needham, and I are opening up a new business called"MJ Property Investments". We will be going to public auctions and buying foreclosed properties which we will then turn around and sell for a profit(hopefully). We will enlist the services of a handyman to help with any big projects that our property might need and we will be doing the small jobs A� 0 ourselves. We will be using our personal cars to go to the auctions, so no business type vehicles will be parked in our yard. We have rented a storage unit at Camelot Self Storage in Plymouth, l so any business related items will be kept there. We will have a home office with the usual things- a computer,phone, fax, etc.,but there will be no reason for any business traffic because of the nature of our business..All the real estate transactions will be done at the bank, lawyer's office or Registry of Deeds. Hopefully, I have answered any questions you might have about our new business, and if you have any other questions please do not hesitate to call. My home phone number is 771-1716. Thank you, Jennifer Hinckley and Matthew Needham �_ Town of Barnstable LL Growth Management Department `tj0 0 i 25 PH 2- -9' �. 367 Main Street,Hyannis,MA 02601 -Ruth J.Weil,Director Zoning Board of Appeals 200 Main-Street HyanrnsgaMA 0260't-- Gail Nightingale,Chairman Phone(508)862-4785 Fax(508)862-4725 October 25, 2005 Jennifer Hinckley-Needham&Matthew Needham 102 Elliott Road Centerville MA 2 0 632. Reference: October 11, 2005,request for a 6-month extension of Variances Number 2005-005 &006-B Dear Mr. &Mrs. Needham: At a October 19, 2005,regular scheduled hearing of the Zoning Board of Appeals,your October 11, 20015 request for a 6-month extension of Variances Number 2005-005 and 2005-006-B was discussed. At that hearing,the Board reviewed the fact that: ' • Variance 2005-006-B,that adjusted the lot line between`lrl'6& 102 Elliott Road>was recorded at the Registry of Deeds on February 8, 2005, in Book 19514 page 112, and the plan recorded February 10,2005,in Plan Book 597 page 28. • Variance 2005-005, that divided 116 Elliott Road was recorded at the Registry of Deeds on February 8, 2005,in Book 19514 page 105, and the plan was recorded March 14, 2005,in Plan Book 597 page 86. • And, on June 3, 2005,Lot 2,the newly created undersized vacant lot authorized by Variance 2005-065 was transferred to Matthew Needham and Jennifer Hinckley by deed recorded in the Barnstable Registry of Deeds in Book 19901,page 299. Based on those facts, a motion was made, seconded and voted unanimously to find that an extension of the variances was not necessary as the relief authorized in Variances Number 2005-005 and 2005-006-B had been executed and the vacant developable lot transferred into separate ownership. The Board also noted that at the time of development of the vacant lot,it will remain restricted to all applicable conditions contained with the.Variances. - Respectfully,'. _ (0 /off G , airman File:letters-2005 1,102005 Needham on Hinckley Extension.doc Copy: File_Hinckley 2005-005r&006-B Tom Perry,Building Commissioner , Town Clerk ti Regulatory Services..: ti Thomas F: Geiler,Director Building Division Thomas Per CBO Building Commissi�ile�D • saxivsrna g Mass rye 03y ArEp 200 Main`Street, .Hyannis;MA 0260,] y 13 r www.town.barnstable.ma.us tE ,? Office: 508-862-4038 : Fax:: 508-790-6230 D. iVIS Town of Barnstable Family Apartment Affidavit A I,being on oath,depose and.state as follows: CL�R�JR l7 ,yc�LL 'My name is t I am th owner/resident of the property located at: /O,;t ROAD eE,�TFg OIL L r MASS The following-members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationshi to owner: E� Tl�L2 L IT/GKL(: l/ UC�HTL P Name &relationship to owner-: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no,subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Aff davit 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 Fanuly 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 of5; 2013. Signature Phone Number Print.Name': L-"LfAodA /ytNGIGG e q:forms/famaffid.doc rev t 1/08/11 Town of Barnstable Regulatory.Services of Thomas F. Geiler, er ,for pp yp e ' F �u � E..'§� e� 4t�^.��1cdi#;'s'�ivt�. # 7A# Building Division H"x''',', Thomas Perry, CBO,Building1Com:missioner �.. a�.3s , i4' 15 A0���m� 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 L IV Svl,04 Fax,: '508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: Lc13N� M. N�N�x�� My name is y I am the owner/resident of the . property located at: I _. g'LLior7- )?.j.A The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to.owner: AeAi-j-ic- //1Nc/CL-i�/ Name &relationship to owner: ad d 1-e 2, 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. 1 also, understand that I am required to comply with all conditions imposed by the ZBA Special Permit andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 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. i The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to.,under the pains and penalties of perjury this day of 6 VAR 2012. SignatGre Phone Number Print Name L� q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services o*'THE roy, Thomas F. Geiler, Directoriw Building Division 9 TA LE, Thomas Perry, CBO,Building Commissioner ! JlAill 'r �Al i639. Aim 200 Main Street, Hyannis, MA 02601 FD MA'S www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax 508-790-6230 Town of Barnstable, Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: 1- 01 a� f.rJ�f2y�LLF. /y►i3S;S The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: #6AL/!C2, H 14161(G 4 ZI 1),V61-17-E%�. Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that 1 am required'to file an Affidavit annually with the Building Commissioner listing the names.and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of U 2011. Signat e Phone Number Print Name ��LC" Town of Barnstable Regulatory Services pF1ME top, Thomas F.Geiler,DirectorOF Building Division BARNSTABLE, Tom Perry, Building Commissioner -� i ;, h 1 v MASS. g r,4 at Q3 039. 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is L /1�/i /�/NG [ � I am the owner/resident of the property located at: /0 G GGia (_ 4 i7 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 Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.I Family Apartments. 1 agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this /16 day of�wt3R 2010. Sgna ure '' Phone Number Print Name. . ft�✓� �7/NG�L C= Q/bldg/forms/famaftid Rev:12/08 Town of Barnstable Regulatory Services pFTHE rqy Thomas F.Geiler,Director Building Division Uf BA l' ,t3L BARNSTABLE, Tom Perry, Building Commissioner 9 g pgJ��! 21 I: 13 �A 1639. �0 200 Main Street,Hyannis,MA 02601 L �En MA+" 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 t:- e4- �. �///��/<LL'/ I am the owner/resident of the property located at: `LL C,5Al f lZ v/LL S. �S S The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &.relationship to owner: z,,-7 f / lllc-Ie'L6` Name_& relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,.I.will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the Building_ Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-4.7.1 Family Apartments. I agree to 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 a. 3 day of J,rldAlz 2009. Signature Phone Number Print Name, G 6 1(111 11VCIC6 Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services Ftae t° Thomas F.Geiler,Director Building Division BARNSTABLE, " Tom Perry, Building Commissioner 9�b 1639. ,0� 200 Main Street,Hyannis,MA 02601 ATfD�,�p www.town.barnstable.ma.us Office: 508-862-4038 Fax: 50&790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is JEL.EA.+/!j 9IN0K 1-9 I am the owner/resident of the property located at: y `:a/n1 p�,y The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: 1-1L�,t AVIN�(CF�sG 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 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 per this day of v/}(Z 2008. Sign ture Phone.Number;~ Print Name C �it1l1 ^yC/C t' E ca Q/b ldg/formsdamaffid Rev:1/03 Town of Barnstable Regulatory Services pFIHE TOy� Thomas F.Geiler,Director °•� Building Division ,OWN V 8ARHISD 8LE BARNSTABLE, Tom Perry, Building Commissioner .,MASS. 200 Main Street,Hyannis,MA 02601 2607 JAN 24 PH 2: 26 Fo ' a www.town.barnstable.ma.us Office: 508-862-4038 t1E' , 'F x: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �£11y I am the owner/resident of the property located at: /D)--- CGG/6 77—l6/1 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: - Name &.relationship to owner: /� T F�( Z I-11,v / G D q u&,,1� Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above=identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 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 a d penalties of perjury this day of .2007.Ql� Sign tore _ _ _ Phone Number. _........ Print Name L N4. Q/bldg/forms/famaffid Rev:l/03 Town of Barnstable O A-1 Regulatory Services �� oF1HE t � Thomas F.Geiler,Director Building Division 'fUlI l 10F',8A H3'rA5LE sne►asTnBM i Tom Perry, Building Commissioner MA & 200 Main'Street,Hyannis,MA 02601 2 � � _�- PM, I AlF p �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 z4&�,u g /d CkL I am the owner/resident of the property Ylocated at: fN�f�?T/�LGf- - � Map and Parcel Number , 3 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Ls /�� G/G� ' Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of, said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalt'es of perjury this ACL- day of /?,&v4jZj, 2006. Signature Phone Number Print Name Q/bldg/forms/famaffid Rev:1/03 Town of Barnstable Regulatory Services pF1ME lO�y Thomas F.Geiler,Director Lilk- Building Division * entuvsrna[e. Tom Perry, Building''Commissionerj-• {{n !4.6 9 MASS. u i H R v J ! I r) f E 039. ��� 200 Main Street,Hyannis,MA 02601 ATFn +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 Z-71EM# I am the owner/resident of the property located at: Id21 IQL vTX6,q/� C, iiJ i 90eL(,� Map and Parcel Number Mil P A', _ 49Cf4-1 23 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: ., . �• - Name & relationship to owner: f BAN !�!/1/V £ Name &relationship to owneri�ylo�{T��'—"' T The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 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 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 pe alties of perjury this �2.3 -day of- /�;vU/IR 2005. Signature Phone Number Print Name G- Q/bldg/forms/famaffid Rev:1/03 0A Town of Barnstable nor- Regulatory Services °FtNE•T°�� Thomas F.Geiler,Director Ta 0 'V!Ii 's R�� S iA0LE Building Division _ BARNSPABLE, + Tom Perry Building Commissioner '� _ , MASS v 039. 10� 200 Main Street,Hyannis,MA 02601 ��ED 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 � ��� C�C��7 I am the owner/resident of the property located at: /a 2, �Gd� 40'f p Y Map and Parcel Number IMP YYl /ACC 3 The ZBA granted me a Special Permit/Variance on Dat Appeal No. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: LlName &relationship to owner: 1,2 � - Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. ' I understand that I am required to file an Aff davit 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 0 2004. Signature µ Phone Number Print Name 6—/Iq/t✓/I' #//ti C;/C L';j Q/bidg/forms/famaffid Rev:l/03 Town of Barnstable U Regulatory Services °F1HE Tok, Thomas F.Geiler,Director , r, ti TOE �F OAR+STABLE Building Division BARNSTABLE, = Tom Perry, Building Commissioner M3 FEB 10 AM 8. S3 9q, 639. � 200 Main Street,Hyannis,MA 02601 AlEO�r a . IV f 510N Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is L I am the owner/resident of the property located at: Tf%. v/vt, it ss Map and Parcel Number 4 4,2 2V RA,a a U a 3 The ZBA granted me a Special Permit/Variance on Date Appeal No. The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book :2 . Page 2 2 i�=. The following members of my family will be the sole occupants of the Family.Apartment at the aforementioned address: Name &relationship to owner: j�to 1'1-I Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred.to the Amnesty Program (Appeal,No. ) Other Sworn to under the pains and.penalties of perjury this Lj day of 2003. Signature Phone Number Print Name ZF4�� N I U Q/bldg/forms/famaffid Rev:1/03 Y Town of Barnstable -� Regulatory Services °Fig roy� Thomas F.Geiler,Director Building Di hid p S ABBE • snxxs1ns Peter F.DiMatteo, Building��Cgqo neA� 8-. 33 9 039. ,0$ 200 Main Street,Hyanct�st}il`�11 �ArED MA'S Office: 508-862-4038 S14N Fax: 508-790-6230 a� Town of Barnstable. Family Apartment Affidavit I, being on oath, depose and state as follows: My name is ��racf /' I am the owner/resident of the r property located at: /Q Map and Parcel Number 'Z _2 The ZBA granted me a 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 Lr 2002. Signature - . - Phone Number Print Name Q/bldWfonnVfamaffid Rev:010702 COMMONWEALTH OF MASSACHUSETTS , d- J AFFIDAVIT '�- BARNSTABLE I, LAG��i✓/3 �/NC KL being on oath, ��- depose and state as follows: j 1.) I reside at 2.) I am the owner of the property located shown on Barnstable Assessors' maps as MAP ,1 y Y PARCEL ;2- 3 9- 3.) I Do t/"^ Do not have a Family Apartment at this location. 4.) On 99,K, the Zoning Board of Appeals, on Appeal No.j�my granted me a Special Permit/Variance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the above address- a) NAME Relationship to owner: C" S iolJ b) NAME ---, Relationship to owner: ' 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. -r Sworn to-under the pains and penalties„of perjury this /__day-of Signa Print Name COMMONWEALTH OF MASSACHUSETTS BARNSTABLE beinj o oath, depose and state as follows: FEB 2 3 1999 1.) I reside at__�C __L'��/C11C'r .c'7£ �JL�t—fJ/./ASS_=--------- 01D� NNSTABLH BUILDING DIV. 2.) I am the owner of the,property located Irlo ---------- — shown on Barnstable Assessors maps as MAP-_,12�b�-----PARCEL__ ___________ 3.) I Do-------- ---__Do not _____________have a Family Apartment at this location. 4.) On_'z&�.L�-1 �•__ 199_ the Zoning Board of Appeals, on Appeal No.1 y9 _Yr granted me a Speckd Permit/Variance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME---� ;�L%SS11 _ . ��I//CiCG -------------------------------------- Relationship to owner:__ 19UG%f ---------- ---------------------------- b) NAME_------ _ -----=== -- ---------=--=----------=------------------ Relationship to owner:------------------------------f----------------------- 7.) The,Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 9.) 1 understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. � - ---------------------------------------------- 12.) I agree to immediately.notify the Building Commissioner in the event of the sale of the above, listed property. Sworn to,under the-gams-and penalties of penury this / =_day of _ f/�� ' 1.99 Signa _ _ __--------_____________ Print ame/_�- J - f6J9. Fp Mld A Town of Barnstable Zoning Board of Appeals Decision and Notice Appeal Number 1998-88-Hinckley Special Permit Pursuant to Section 3-1.1(3)(D) -Family Apartment Summary: Granted with Conditions Petitioner: Eleana M. Hinckley Property Address: 102 Elliott Road, Centerville f Assessor's Map/Parcel: Map 248, Parcel 238 Area: 0.40 acre Building Area: 2,264 sq.ft. Zoning: RB Residential B Zoning District Groundwater Overlay: GP Groundwater Protection District Background: The property that is the subject of this appeal consists of a 0.40 acre lot commonly addressed as 102 Elliott Road, Centerville. The site is improved with a one and a half story, 2,264 sq. ft. wood frame single- family residence'. The applicant recently (within the last 6 months) converted a portion of this residence to a family apartment unit, consisting of a bedroom, bathroom, living room, storage space, and a kitchenette. A review of Zoning Board of Appeal's records indicates that no prior approval was granted for a family apartment on this property, making the existing apartment unit, and its use, questionable. The applicant is now seeking a Special Permit for a family apartment pursuant to Section 3-1.1(3)(D)of the Zoning Ordinance. Family apartments are allowed in RB Residential B Zoning Districts as a conditional use, providing a Special Permit is first obtained from the Zoning Board of Appeals. The application indicates the family apartment is 572 sq. ft. in area and is to be occupied by Melissa M. Hinckley, daughter of Eleana M. Hinckley. Procedural Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on June 25, 1998. An extension of time to file the decision was executed by the applicant and Board Chairman. A copy of that extension is contained within the file. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened July 29, 1998, at which time the Board granted the request with conditions. Hearing Summary: Board Members hearing this appeal were Richard Boy, Gail Nightingale, David Rice, Elizabeth Nilsson, and Acting Chairman Gene Burman. Attorney Kevin Kirrane represented Eleana Hinckley, who was present along with her daughter, Melissa Hinckley. Attorney Kirrane submitted a memorandum in support of this appeal and submitted some photographs of the property. He explained that Ms. Hinckley has lived in the main house for some twenty-five years. The family apartment will be occupied by her daughter, Melissa. The property has four bedrooms (a fifth bedroom has been converted to a computer room). The family apartment is on the second floor and is accessible from both the main house and an outside stairway. According to assessor's records dated 06/17/98 Town of Barnstable-Zoning Board of Appeals-Decision and Notice Appeal Number 1998-88-Hinckley Special Permit-Section 3-1.1(3)(D)-Family Apartment Attorney Kirrane reviewed the requirements for a family apartment and indicated that the applicant understands, and complies with, all the regulations of Section 3-1.1(3)(D)of the Zoning Ordinance. The family apartment was built earlier this year and the applicant is seeking to legalize the use. The Building Commissioner reported the property was part of an enforcement action. On June 5 1998, the Building Division received a call about an illegal apartment. On June 8th, a letter was sent to the applicant and they came forward immediately to correct the situation. They have no problem with the granting of this Special Permit. Public Comment: No one spoke in favor or in opposition to this appeal. Findings of Fact: At the Hearing of July 29, 1998, the Board unanimously found the following findings of fact as related to Appeal No. 1998-88: 1. The petitioner is Eleana M. Hinckley. The property address is 102 Elliott Road, Centerville, MA, as shown on Assessor's Map 248, Parcel 238. The site is approximately .40 acres. The,subject is located in an RB Residential B Zoning District. 2. The site is improved with a one and a half story, 2,264 sq. ft. wood frame single-family residence. 3. The applicant recently (within the last 6 months)converted a portion of this residence to a family , apartment unit, consisting of a bedroom, bathroom, living room, storage space, and a kitchenette. The application indicates the family apartment is 572 sq. ft. in area. The floor plan has been submitted to the file. 4. A review of Zoning Board of Appeal's records indicates that no prior approval was granted for a family apartment on this property, which is why they are before the Board tonight. The applicant is now seeking a Special Permit for a family apartment pursuant to Section 3-1.1(3)(D)of the Zoning Ordinance. Family apartments are allowed in RB Residential B Zoning Districts as a conditional use, providing a Special Permit is first obtained from the Zoning Board of Appeals. 5. The family apartment is to be occupied by Melissa M. Hinckley, daughter of Eleana M. Hinckley. 6. The proposal fulfills the spirit and intent of the Zoning Ordinance and may be granted without substantial detriment to the public good or the neighborhood affected. 7. The applicant understands, and complies with, all the requirements of Section 3-1.1(3)(D)of the Zoning Ordinance. Decision: Based upon the findings a motion was duly made and seconded to grant the Applicant the relief being sought with the following terms and conditions: 1. The family apartment shall be developed in accordance with the submitted plans, copies of which are in the file. 2. The family apartment shall comply with all restrictions of Section 3-1.1(3)(D) and shall be the primary year-round residence of the family member residing therein. 3. The locus shall comply with all Town of Barnstable Building and Health Divisions Regulations. The Vote was as follows: AYE: Richard Boy, Gail Nightingale, David Rice, Elizabeth Nilsson, and Acting Chairman Gene Burman NAY: None 2 Town of Barnstable-Zoning Board of Appeals-Decision and Notice Appeal Number 1998-88-Hinckley Special Permit-Section 3-1.1(3)(D)-Family Apartment Order: Special Permit Number 1998-88 for a family apartment has been granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision. A copy of which must be filed in the office of the Town Clerk. 1998 Emmett Glynn, Chairman Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this day of 1998 under the pains and penalties of perjury. Linda Hutchenrider, Town Clerk . 3 i Town of Barnstable Planning Department Staff Report Appeal Number 1998-88-Hinckley Special Permit Pursuant to Section 3-1.1(3)(D)-Family Apartment Date: July 15, 1998 To: Zoning d of Appeals From: Approved By: Robert P71chernig, Director Reviewed By: Art Traczyk, Principal Planner Drafted By: Alan Twarog,Associate Planner Petitioner: Eleana M. Hinckley Property Address: 102 Elliott Road,Centerville Assessor's Map/Parcel: Map 248,Parcel 238 Area: 0.40 acre Building Area: 2,264 sq.ft. Zoning: RB Residential B Zoning District Groundwater Overlay: GP Groundwater Protection District Filed:June 25, 1998 Hearing:July 29, 1998 Decision Due:December 2, 1998(this includes a 60-day extension signed by the applicant) Background: The property that is the subject of this appeal consists of a 0.40 acre lot commonly addressed as 102 Elliott Road, Centerville. The site is improved with a one and a half story, 2,264 sq. ft. wood frame single- family residence'. The applicant recently (within the last 6 months)converted a portion of this residence to a family apartment unit, consisting of a bedroom, bathroom, living room, storage space, and a kitchenette. A review of Zoning Board of Appeal's records indicates that no prior approval was granted for a family apartment on this property, making the existing apartment unit, and its use, questionable. The applicant is now seeking a Special Permit for a family apartment pursuant to Section 3-1.1(3)(D)of the Zoning Ordinance. Family apartments are allowed in RB Residential B Zoning Districts as a conditional use, providing a Special Permit is first obtained from the Zoning Board of Appeals. The application indicates the family apartment is 572 sq. ft. in area(see the submitted floor plan for details). The family apartment is to be occupied by Melissa M. Hinckley, daughter of Eleana M. Hinckley. Staff Comments: From information submitted, it appears the family apartment meets the following requirements of Section 3-1.1(3)(D) of the Zoning Ordinance: • the apartment unit is under the 50%size limitation, • all zoning setback requirements are met, • the unit has been developed in a manner which retains the residential character of the area and • the property owners and family member will be primary year round residents. The property is serviced by Town water and a private septic system. The applicant has submitted a copy of the Disposal Works Construction Permit(Permit No. 86-1005)and Certificate of Compliance issued by According to assessor's records dated 06/17/98 r Town of Barnstable-Planning Department-Staff Report Appeal Number 1998-88-Hinckley Section 3-1.1(3)(D)Special Permit-Family Apartment the Board of Health in September and October of 1986 respectively. The up-graded system meets Title V requirements. Groundwater Protection The property is located in a GP Groundwater Protection District. The Town Ordinance and Title V of the State Environmental Code (310 CMR 15.00) limit the amount of wastewater discharge and the amount of nitrogen loading allowed within zones of contribution to public water supply wells. Nitrogen loading is based upon the number of bedrooms on the property and the size of the lot. The site, being approximately 17,400 sq. ft., is only allowed a total of two bedrooms without a variance from the Board of Health. No more than three bedrooms could be approved on this lot if an alternative septic system,which reduces the amount of nitrogen loading, is approved by the Board of Health. The Town of Barnstable Wastewater Discharge Ordinance limits flows to 330 gallons per acre per day. There is no variance procedure available under the Wastewater Discharge Section of the Town of Barnstable General Ordinances. According to assessor's records, dated 06/17/98, there are currently 4 bedrooms in this residence. Special Permit Findings: In addition to meeting all of the provisions of Section 3-1.1(3)(D), the granting of a Special Permit requires the following finding of facts to be made by the Board (as required under Section 5-3.3(2)): • that the application falls within a category specifically excepted in the ordinance for a grant of a Special Permit, (Special Permits pursuant to Section 3-1.1(3)(D)-Family Apartment-are permitted in all residential Zoning Districts provided all criteria are met.), and, • that after evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the Zoning Ordinance and would not represent a substantial detriment to the public good or the neighborhood affected. Suggested Conditions: If the Board should find to grant the relief requested, it may wish to consider the following conditions: 1. The family apartment shall be developed in accordance with the submitted plans, copies of which are in the file. 2. The family apartment shall comply with all restrictions of Section 3-1.1(3)(D) and shall be the primary year-round residence of the family member(s) residing therein. 3. The locus shall comply with all Town of Barnstable Building and Health Divisions Regulations. Attachments; Assessor's Card Copies: Petitioner/Applicant Application Forms Floor Plans Application for Disposal Works Construction Permit& Certificate of Compliance 2 Y Town of Barnstable-Planning Department-Staff Report Appeal Number 1998-88-Hinckley 1 Section 3-1.1(3)(D)Special Permit-Family Apartment Copy of: Section 3.1.1(3)(D)-Family Apartments D) Family Apartment subject to the following: a) Not more than one(1)family apartment is provided. b) The family apartment is within or attached to an existing residential structure or within an existing building located on the same lot as said residential structure. c) The residential character of the area is retained as nearly as possible. d) The family apartment contains not more than fifty percent(50%)of the square footage of the existing residential structure if being proposed as an addition thereto. e) All setback requirements of the zoning district within which the family apartment is being located are complied with. f) The property owner resides on the same lot as the family apartment. g) The family apartment is occupied by members of the property owner's family only. h) The occupancy of the family apartment does not exceed two(2)family members at any one time. i) The family apartment is the primary year-round residence of the family member(s) residing therein. j) The family apartment will not be sublet or subleased by either the owner or family member(s) at any time. k) Scaled plans of any proposed remodeling or addition to accommodate the family apartment have been submitted by the property owner or his or her agent to the Building Commissioner and the Zoning Board of Appeals. 1) Prior to occupancy of the family apartment, affidavits reciting the names and family relationship among the parties seeking approval have been signed and shall be signed annually thereafter for the duration of such occupancy. m) Prior to occupancy of the family apartment, an occupancy permit shall be obtained from the Building Commissioner. n) No such occupancy permit shall be issued until the Building Commissioner has made a final inspection of the proposed family apartment. o) Within sixty (60) days from the date authorized family members vacate the family apartment, the owner or his or her agent shall remove any kitchen facilities in such unit and notify the Building Commissioner to inspect the premises. p) In addition to the provisions of Section 3-1.1(3)(D)(o) above, upon vacation of any family apartment, the premises shall be restored as nearly as possible to their state prior to the creation of such family apartment. q) The Building Commissioner shall have the right to further inspect the premises upon which a family apartment has been vacated at least three(3)times per year for three(3)years consecutive from the time of such vacation. 3 TOWN OF BARNSTABLE Zatr n , 6oar& of Appeals 1 A_VOl_ication forF Family Aba rtmaat Special PermitIN 2 g'?Nltd� R 8d - For- office use onl : ow r Office Appeal # TT� �NING RELI ;' �_,.:?G 30V(iHTBAa Z BEEN DETERMINED BY-F iE ZOM NQ .Hearing Date 1 EMRCEMENT OFFh' R TO � Decision -Due BE APPROPRIATE RELIEF GIVMTMSE The u�gned hereby applies to the Zoning Board of Appeals fora special ' Permit for the development and maintaining of a Family Apartment in accordance with section 3-1.1(3) (D) of the Zoning ordinance, in the manner and for the reasons hereinafter set forth: Applicant Name: 'ELzrA,11; Al/I/CKL Fy ' Phone y 7 712 21 Applicant Address: _/VA 1_:,1_L10rr ' 04D Property Location: C£�I/T�/Zy/CL � 1I'JitS , Property owner: �L�/�il/ft /y1- /�//SfG�G�� , Phone Address of owner: /D,� L=LL�o7T' %�a/tl� CCNTL-)?111u /'I7rl S c Zf applicant differs from owner, state nature of interest: Number of Years Owned: al 7 Assessor's !lap/Parcel Number: tj )L'Ite Pmael- �3P' Zoning District: RB , RB-1 [], RC [], RC-1 [j, RC-2 [], RID Il. RD-1 []. RF [ ]. RF-1 [], RF-2 []. RG I]i RAH []r PR [ ] . Groundwater overlay District: AP [j, GP [j, WP H . �'l�tP � ayY {emu-N�D /�ROTEcT/oN A�S'TR�cT Name(s) and relationship of the family members to occupy the Family Apartment: Name: . AC•'L6W M. A1'HCxLSZ Relationship to owners: Name: ,Relationship to owners: The Family Apartment is to be developed: within the existing single family structure. (] as an addition to the existing single family structure. [ ] in an existing accessory building. [ ] other - Please Explain: Y Application for Pamily Apartment Special Permit Description 'of Construction Activity: Proposed Gross Floor Area of the Family Apartment Unit: .... ...... sq.ft The Gross Floor Area of the Existing Single Family Dwelling Unit: ft Do all structures, existing and proposed, comply with all setback requirements for the zoning District in•which it is located? Yes(' ! . No[ Will this be the permanent address of the occupant(s) of the Family Apartment: .................. ...0...... ... ............... .. .. Yes. No[ Zf no, Please Explain: is the property located in an Historic District? Yes[] No�k Sf yes OKH Use Only: No Exterior Changes. .... .. . . ...[ Plan Review Number Date Approved is the building a designated Historic Landmark? Yes[] NOX. If yes Historic Department Use Only: �!�\ Date Approved is the property served by public water supply? Yese No[] is the property on private septic? Yes No[J If yes Health Department Use Only: Title V System Yes(][] No( ] Date Approved _ Signature: Date: Applicant or Agents Signature Agent's Address: EZ410r /(Si it1%f Phone': a Town of Barnstabll Family Apartment Affidavit I, L�LFf1NA y/NG/CG�� , being on oath, depose and state as. follows:. 1. I reside at /D�l FLL/OTl /�Ug cglvmRVW ,K45 that I have owned since L , and which is my domicile and principal residence. The. property is shown on Barnstable Assessors Ha and Parcel Numbs . P rp�',,�/ 2. on , 19 ,the Zoning Board of Appeals, in Appeal No. '* granted to me a Special Permit to develop and maintain a Family Apartment accordance with Section .3-1.1(3) (D) of the Zoning ordinance and in agreement wi condition of that Special Permit at the premises above. 3 The following members of my family will be the sole occupant(s) of the Famil Apartment Unit Name: N1NC�L fY Relationship to owner: �i9OGNf�/�_ Name: , Relationship to owner: I understand that the Family Apartment: * shall only be occupied by members of my family who are persons related to m by blood or by marriage, * shall be the primary year-round residence for the identified family members * shall not be sublet or subleased to any other person(s), and . * shall, at all times, be in compliance with all conditions of the special Permit issued by the Zoning Board of Appeals,. including plans and commitmer made in the application and approved by the Board. This affidavit shall 'be filed annually with the Building Inspectors Office and 1 the unit shall be vacated by the above identified family members, I shall withir 30 days notify the Building Inspectors office of that and shall immediately proceed with the removal of the .family apartment unit. In the event of the sale or transfer of ownership of the above property, I shall notify the building inspectors office and shall surrender the .Special Permit for this Family Apartment. Sworn to under the pains and penalties of perjury this day of 19B. Signature: /x (Please Print) Name: G / GKL� Phone: 77/--`�L�o Hailing Address: /C�?/�l��df ICD �L- MASSACHU9ETTs �hrtr ►arm of . (INDIVIDUAL) TO .............................................................. 19........ at................o'clock and...............minutes........m. Received and entered with................................... .................................................................Deeds Book ......................Page........................ N Attest o M Register... > o FROM THE OFFiCS OF 94 41 x 43 ai a.. 4J ., • O .a > � w � m � W U RETURN TO HOBBS at WARREN, INC. PYBWMZ" MANDARD LEGAL FORM/ VV^VVq 0CWrCM . MASS. FORM 881 REVIBED CHAPTER 49761080-717-1080 i G' MAOOACMU0LTT0 OUITCWY Dial"ORT RORY (INDIVIDUAL) 001 a BP�10150-0236 96-04-16 10:24 #020691 I, Aurelia D. Hinckley, Of 116 Elliott Road, Centerville, Barnstable Gaunty�Massachuset% being nnma►Tied,for a4LcJc) 19t,�1P1�714c �19P11�E947P:� love and affection s grant to Eleana M. Hinckley. Of 102 Elliott Road with qMb tt 0101U023 Centerville (Barnstable) Massachusetts, 02632 thelatld in Barnstable (Centerville), Barnstable County, Massachusetts, ipewapdw and eecvmbnlwa,if awl A certain parcel of land containing 1,433 square feet, more 1 or less, in Barnstable (Centerville) , Barnstable County, = Massachusetts, off Elliott Road, shover: as "PARCEL C" on a plan of lard entitled "Plan. of Land at #102 Elliott Road, Centerville, Mass. for Eleana M. Hinckley, Scale 11, = 301 , Date: November 6, 1995, Baxter & Nye, Inc., 812 Main Street, Osterville, Mass. , 02655, (508)-428-913111, said plan is to be recorded herewith in Barnstable County Registry of Deeds in Barnstable. Boo JG 3 })a-8- S) Being a portion .of the premises shown on Barnstable Assessors Map 248 as Parcel 056, conveyed to me by deed of Richard B. Hinckley, December 6, 1967, recorded in the Barnstable County Registry of Deeds, Book 1385, Page 1160. 0 venom ..............hand and seal this......✓...?r 59 .......day of... .................19.9 .......................................................................... ....! [l ........ ..... :....1�„t„�....... ................................................ ..................... ........................................................................... .......................................................................... ........................................................................... �e �imnnttltaataltq of !R� Barnstable ss. to /Z_ /Jr 19 Then personally appeared the above named R kE f-J A D, N W C8 LE 1 and admowledged the foregoing instrument to be HM free act and deed before me 1 Notaq "40t, llff commw►on expires « Alf) (*In&vidud—Joint Teunts—Tenutfs in Common.) �F d CKAFM 183 SEC 6 AS AMMED BY CHAFM 497 OF 1969 ` Every deed presented for record shall contain or have endorsed upon it the full name,namenon and post ofrm addow of;�i'fl_�g•�mbee and a recital of the amount of the full consideration thereof in dollars or the omm of tlu other consideration dmdor,If-not deliaaed for a aaedfic monetaq sm.The full consideration shill men the total trice for the rrsmw".. -»�--__ �- goy liens 0r enwm6ronas assumed trf the Seamans or remaining Wen If the deed. Pailuee to aemplr wild Wis seetioa shell not efiat We � m 2 MOMW A!wpa.wwiding°Oim ti V .i. 46 - We, C. STEVEN HINCKLEY and ELEANA M. HINCKLEY, of Barnstable, Centerville, Barnstable County, Massachusetts pursuant to a division of marital assets incident to a divorce in Barnstable Probate & Family Court, Docket No. 94D-0595-D1 grant to ELEANA M. HINCKLEY of 102 Elliott Road, Centerville, Barnstable County, Massachusetts with quitclaim covenants the land in Barnstable, Centerville, Barnstable County, Massachusetts, more particularly bounded and described as follows: PARCEL. 1 Beginning at the sideline of Elliott Road, an undefined town way, thence going in a SOUTHEASTERLY direction, a distance of-140.00 feet to a cement bound; thence 0i 1THWESTERLY a distance of 20.00 fcai; i;aricks NORTHWESTERLY a distance of 149.92 feet; thence NORTHEASTERLY a distance of 20.73 feet to the point of beginning. Said premises are shown as Parcel B on plan of land entitled, "Plan of Land in Centerville, Mass: to be conveyed to C. Steven Hinckley & Eleana M. Hinckley, Scale I' _ 40' Date: April 20, 1970, Lloyd C. Latimer, Falmouth, Mass.", which said plan is to be recorded herewith in Barnstable County Registry of Deeds. Being a portion of the premises conveyed to Phobe E. Rhames and Albert T. Rhames as joint tenants, by deed of Hannah A. Austin dated April 26, 1945, recorded in Barnstable County Registry of Deeds in Book 627, Page 260. Said Albert T. Rhames having since deceased. For our title see Deed from Phobe E. Rhames to grantors dated April 27, 1970 and recorded in the Barnstable County Registry of Deeds in Book 1471, Page 809. PARCEL 2 Beginning at the sideline of Elliott Road, an undefined town way, thence going in a SOUTHEASTERLY direction a distrance of 149.92 feet to a cement bound, thence SOUTHWESTERLY a distance of 80.00 feet, thence NORTHWESTERLY a distance of 176.20 feet, thence NORTHEASTERLY a distance of 84.18 feet to the point of beginning. Said premises are shown as "Parcel A" on plan of land entitled, "Plan of Land in Centerville, Mass. to be conveyed to C. Steven Hinckley & Eleana M. Hinckley, Scale 1 40' Date: April 20, 1970 Lloyd C. Latimer, Faimouth, Mass.", which said plan is to be recorded herewith in Barnstable County Registry of Deeds in Barnstable. °roperty Location. 102 ELLIOTT RD MAP ID: 248/ 238/// y Other ID: Bldg#: 1 Card 1 of 1 Print Date:06/17/1998 Description (;ode ,APPralSea Value ASsessea Va ue %HINCKLEY,ELEANA M 102 ELLIOTT RD SIDNTL 1010 109,901 109,901 801 CENTERVILLE,MA 02632 IESEDNTL 1010 40 40 BARNSTABLE,MA ccoun tm ' ax Dist 300 Land Ct# er.Prop. #SR VISION Life Estate DL 1 PAR A Notes: DL2 &B oa 143, , �' r. o e ssess ,a ue r." o.e ssesse value r. o.e ,As'sessea value HINCKLEY,ELEANA M 11029/145 10/28/91 U I 1H o o1^44fq TOW14 , re a now ages a visit y a.Dard C.011e=r or Assessor earlypelvescription AMOUnt Code Description number Amotuint mm.Mr. Appraised Bldg.Value(Card) 107,400 Appraised XF(B)Value(Bldg) 2,500 Appraised OB(L)Value(Bldg) 400 ° Appraised Land Value(Bldg) 38,500 Special Land Value 0 ADDN&GAR 50% 1/87 FWD SQD. Total Appraised Card Value Total Appraised Parcel Value 148,800 Valuation Method: Cost/Market Valuation Net o a I Appraftedar ue ermt'1V issue Date lype Description AnWUnt insp.Dare ro Comp. Dare nip. Comments Futposelicestar gum use a Description ne ron age ep nt s nt ce j.ractor ac or /. o es- pecta Lana value a e Fam 10tal Land LInMoa roperty Location: 102 ELLIOTT RD MAP ID: 248/ 238/// Other ID: Bldg#. 1 Card 1 of 1 Print Date.06/17/1998 , a r ,r x• S4'n»t a •., .. ...' .� ...... __,... r4A' :..1 r. emen Description ommercia o Elements ype4 e od Elementescrtp on 1odel 1 esidential ea 'Trade C ram Type 30- ton aths/Plumbinges 5 1/2 Stories WDK Iccupancy 0 eiling/Wall 12 12 oms/Prtns ,xterior Wall 1 14 ood Shingle /o Common Wall 2 all Height .00f Structure 3 GableMp zof Cover 3 sph/F Gls/Cmp tterior MM Wall 8 Typical memenCode: : escnp on , ac or BAS 16 FGR 6 rt BAS FHS erior Floor 1 0 Typical omp ex 2 2 oor Adj 6 UBM 6 nit Location (eating Fuel 3 as FHS 22 (eating Type 9 Typical umber of Units .0 Type 1 one umber of Levels /o Ownership FOPB �edrooms 4 Bedrooms .athrooms Bathrooms ,fJo 0 Fail nab ase mate UU otal Rooms Rooms ize Adj.Factor .95960 ath Type de(Q)Index 01 itchen Style dj.Base Rate 6.52 ldg.Value New 22,068 ear Built 970 Year Built 975 rml Physcl Dep 2 uncnl Obslnc on Obslnc n pecl.Cond.Code da eDescription Perceniq e pecl Cond% 10 tng a am JLUU l%Cond. 88 c.Bldg Value 107,400 rR Code escription u units unit MEW Yr. Lip A t Yound I Apr. a ue > SHED Shei y L 11 4.0 80 100 �4 .. ` Mrs JFGR A escnp on ving rea Toss rea rea nitCost. n eprec. ue rs Moor 133 tached Garage �35 112 16.2 5,72lf Story,Finished 93 1,33 93 32.5 43,35rch,Open,Finished 7 1965sement,Unfinished 93 18 9.2 8,69ood Deck 36 3 4.6 1,67 M Gr-a—ss LfvlLease Area .. �r � -� Na. Fss_e 4 THE COMMONWEALTH OF MASSACHUSEWt _ BOARD 9F HEA T . _-..... V..........OF..... Appliratian for Disposal V arlw Iff attshw Wn flrrmit Application is hereby made for a Permit to Construct ( ) or Repair (Ay"m Individual Sewai System at. ,.�AIG.ie.._ _p or Lot No. Address Iostalkr_ �lr ._......._— Addreas.._.�_...._.� Type of Building Size Lot.__-_._-_.___ Dwelling:W,. of Bedrooms_._-__.__—_.-_-_.---._.-. Ex nsion Attic Garbage G ply Other—Type of Building ______....—.-....— No. of persons..._-... _ Showers ( ) — Cal Other fixtures Design Flow_--_-__.._-____-_._._..___-gallons per person per day. Total daily flow_....._ Septic Tank—Liquid capacity_....._...gallons Length.............._Width............._.Diameter....._........DeE Disposal Trench—No._.__.. .Width...—...._._.-.Total Length..__.__-__-__Total leaching area..__ Seepage Pit Na__........._ Diameter.:___-_.....__ Depth below inlet..._....____.Total leaching area—.-.-Other Distribution box( ) Dosing tank( ) Percolation Test Results Performed by__._.....__...__. Date._--.__... ._. Test Pit No. I......_____minutes per inch Depth of Test Pit_..... ..__.Depth to ground water... Test Pit No.2- ___.minutes per inch Depth of Test Pit__.__„.___. Depth to ground water.... O Description of Sort--_._ 1 — Nature of Repairs or Alterations—Answer when applicable� i l ........._..._........... The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in acco the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place it operation until a Certificate of Compliance has be7issued by th ar of Application Approved By-- Application Disapproved for the f ollon ing reasons:_.......... Permit No neL�r ._—__........_.....—.issued_.._._._._._........_ ... Dam THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEAL H/ (drrWirab at (anmVitatm TIES TRT�fFY,Xt>Individual Sewage Disposal System constructed ( ) or Re has been installed in accordance with the provisions of I'I�1Fy 5 of The State Sanitary Code as esc application for Disposal Works Construction Permit No -�--:p-.__LC.X.7�L. dated...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA NTEE SYSTEM WILL FUNCTION ATL$EACTORY. DATE.... _ Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARDDF: HE�A�LTAH /�!% �1.......OF_...5/. 4 ........ Fes... Otopasii 10arlIn Tatishmainn Permit Permission Is hereby granted. _._.._.. _:::�``" ' • �" to Constrnct��) i' .'j as I dyai Sewage Disposal System at No.-_--2 tip` _...._..... _. Serest as shown on the application'for Di Works Construction Permit Nb::-'__.ALM&91ted� DATE Board of Health ASSESSOR'S MAP NO. q PARCEL LOCATION SWAGE PERMIT NO. 10 2 � - I o05 YI.LLAGE iRILL INSTALLER'S NAME i ADDIII SS e UILDER OR OWNER _ 11 DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED cl r I\ _.T -j j I - r ( x w i f ! i ��RS'1' �Loo � . � � i Z_ � - ► I �✓_ .tom, z __ � ----�ARA(o.�� �E� .._- ,-- � � --�. � -- _ - T __.._____._.___..__. _.... ---- _. _. r---- �.:�-_ _. .___._� --- -...__ _ �. i ct OII I � I ' u►` � i i H IZ U.1 i ' I � I n u JI 9 � O Icc v �] �y CLOSET 13 v't i CF THE tiO + BARNSTABIA gyp,39. The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner June 8, 1998 Mr. Steven Hinckley 102 Elliot Road Centerville MA 02632 RE: 102 Elliott Road,Centerville.Mass.(Map#248 Parcel#238) Dear Property Owner: Our records indicate that your house at 102 Elliott Road,Centerville is currently being used as a two- family home contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to either: 1) apply for a building permit to restore the property to a single-family home 2) apply to the Zoning Board of Appeals for a variance 3) prove that these are legal two-family. You must contact this office immediately to tell us what direction you wish to take. Sin , Gloria M.Urenas Zoning Enforcement Officer GMUlkI f97031Ia x f �� 3 . f D i 1 s' €tY Town of Barnstable CF THE fps o Building Department Services Brian Florence, CBO • BARNMBLE. v MASS. Building Commissioner To" Q -B�R� . i639• �0 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us 019 ,1AN 24 T-1`a 29 Officer 508-862-4038 Fax: 508-.790-6230 Town of Barnstable Family Apart r>t e�riAffidavit I;being on oath, depose and.state as follows: My name is e�Z e`a^t A NjN Ciu-cy I am the owner/resident of the property located at: l o a, ECLio1i Rd1U ^ 2--InASS W O a63 r N 2vi The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: >/11IP 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 tofile.an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also... understand that I am required to comply with all conditions imposed by the ZBA Special Permit andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the airs.and penalties of perjury this day of 4,v t)/¢rz V 2019. Signature Phone Number Print Name V6&6e q:forms/famaffid.doc - rev 11/08/13 Town of Barnstable Building Department Brian Florence, CBO SCA N MUMSTABMAW`'E$ Building Commissioner l 14 - 1 y.sG3 �� 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: ' fon1 wing mbers of my family will be the sole occupants of the Family Apartment at the a remeC tioned ddress: c» � z o- I lXne 4jelation lip to owner: /VE,frN92 D-4 o 6rfrr_eP l the elation lgp to owner: 0 o IhF;�-amily Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment,I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of An/OAR 2018. 7;'i-i�i� Signature Phone Number Print Name �� L'��� / 1//NG/K4 E1 q:form s/famaffi d.do c rev 11/22/2017 Town of Barnstable ` Regulatory Services ..Richard V. Scali,Director TOWN OF BARNSTABtE Building Division Paul Roma,Building Commissioner ,r M,►ss g U!I7. .A 25 P 12= 4�l ArEo 200 Main Street, Hyannis,MA 02601 www.town.ba rnstable.maxs Office: 508-862-4038 �-M jtqX, : 508-790-6230 Town of,,Barnstable Family Apartment Affidavit I,being on oath, deposer and state as follows: My name is 6LF11th9 dwG&L g y I am the owner/resident of the property located.at: j 6-a•- rr" - L - The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: - ` relationship to owner: T /� � Name & _ 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.tofile 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-Farily_Apartment at this location,please explain: The.apartment has been dismantled. The apartment has been transferred to the AmnestyProgram(Appeal No. ) Other Sworn to under the painsand penalties of perjury this R y day of ! /u u R' 2017. Q ao f Signature Phone Number Print Name 6/-) 1V q gl4)G&L y q:forms/famaffid.doc rev 11/08/12 Town of Barnstable Regulatory Services of�"E rW�ti Richard V. Scali,Director °* Building DivisionBAMSTABM - • s vMAM Thomas Perry, CBO,Building Commissioner ? F%,A 200 Main Street, Hyannis,MA 02601 wwwaown.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is 9/,A)CK&E y I am the owner/resident of the property located at:' /y 9 4 4L le,- j,oti10 y f J%cLt /h,q s5- . The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: I WTii-in L. /f irycKL e I /5i u&,-1 Name &relationship to owner: The Family Apartment will be the primary year-round residence for_the above-identified ` family members. In the event that the listed relatives vacate said apartment, I will immediately 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 Deen dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury,this 5�'��' day of"1AV,�+/9 P/ 2016. Signature t Phone Number Print Name Z:Z,e4N/f /yI-- ,.�. „ �,R .. • : ti ,.tic q:forms/famaffU doc rev 11/08/12 Town of Barnstable oFSHE rqy, Regulatory Services Richard V. Scali,Director &UMSTABLE. i Building Division 1639. p.0� Thomas Perry, CBO,Building Commissioner lED MA'S 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 r Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is 25L,'-Xx//-� /�I- f 1ryG<<G L-7 7/ I am the owner/resident of the property located at: %O A G=L.L/o-77—';5o q 1) 061.1 9_/1UlGL E. Mh-5- S; 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 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 ZBArSpecial Permit, and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family tsprtments. :I_=agree to note the Building Commissioner immediately in the event of the sale of th prcperty. ';, If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. _ Other Sworn to under the pains and penalties of perjury this 13 day of .0 1V A2) 2015. c z_/� Signature Phone Number Print Name If"�--t-l-iAVA" 1-4 f7/yC%GL'/ q:forms/famaffid.doe rev'l 1/08/1.1 Town of Barnstable Regulatory Services Richard V. Scali,Interim Director Building Division TOWN OF L�'�,-,�RNST S B"�", Thomas PerrASS. y,CBO,Building Com�'s i n,gP"Jr Atz629 3 vp�0� 200 Main Street, Hyannis, MA 0260�1 9 ED MA www.town.barnstable.maxs Office: 508-862-4038 Y -. --MM: 508-790-6230 DVli�= 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: I-O A �LGi �i f oil►.� 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 notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: T e.a . has 1 x apartment ieii d2STTlu'ltwd. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of J1AA1U tM, 2014. Signature Phone Number Print Name EL1611m 141 NCKL L= q:forms/famaffid.doc rev,11/08/11 b�Py�FTHET��yn TOWN OF BARNSTABLE Z SAHHST/IDLS, i CEO Of a• BUILDING INSPECTOR APPLICATIONFOR PERMIT TO .... ..... .................................................... ........�.........................�................ 000D rP4"if TYPEOF CONSTRUCTION ..................................................................................................................................... ...........�� ..�.....��.........19. 7� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies form permit according to the following information: Location 4.. . O Tf /CU�I. Proposed Use �%£ ..�/� ��'L/� Zoning District ......I.�.... ....................................................Fire District .�...�"�/�!dV//L� ... �(JI�.G. . .... ....... ......................... 77 Name of Owner . ........... ........................................ ............ ddress ... !�..........�%.. <.....C; il� (/.L.�... Name of Builder /t1�/S �iUS"J lj/'/. S�14r'......(kddress Name of Architect ....... ........................................................Address 73..J£.3'AC7 t..WleS%OC� ................. ? �7 � Number of Rooms ..... .�� ...........................Foundation .l..�h.... ..�0 0OkoE r�.k)ekl' l I 6�/wi�� C��� 5����Es /qs T Ship%urLFS Exterior .:......... ...........� Roofing ......... L Floors .. . e �tiC. r�l�L/� sro& .... i�S` s/e ....................Interior ............ ................................................................... Heating ...1/� 4�........................................Plumbing ....r�A � .......................... ..... .................. . Fireplace .........�/ r .'...�`Q�..�p.......................... /... �?....: ...................................................Approximate Cost ................. ................ Difinitive Plan Approved by Planning Board ------------------------- Diagram of Lot and Building with Dimensions to© A �. O j 0 C) ..rl tV Z ;_. z L.L ei O >a_ M \O ® }— x Zf 9-' die � LJJ � LU - J a. V7 < w1_- 0 z' U -- /C'7o,� r a ,o hereby. agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name �',/!/ .!f!� ... �! . ........... Hinckley, Mr. & Mrs. C. Steven I DEC 31 1910 13..3.?6 Permit for .......1 1lz stor�r,,,, i sin.le famil dUrelll ..................................... ..................y............... ,V. Elliott Road y Location ................................................................ Centerville ............................................................................... Owner ........Mr. & Mrs• C. Steven Hinckley ........................... .......................... i Type of Construction frame........... .1 ............................................................................... t v Plot ............................ Lot ................................ II F f, Permit Granted ......September 19 70 , P� Date of Inspection ..Ocl ..........Q9.a.......19rf a Date Completed 19 n f PERMIT REFUSED i ................................................................ 19 t} ............................................................................... i ............................................................................... { ............................................................................... Approved .._.............................................. 19 ............................................................................... ...............................................................................