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0097 OLD TOWN ROAD
i 1 I 6 _ Assessor's map and loft'number ./�.,�....v,��.................../...'Z: . ���, •,���1�d7 — .�""� /"" i'/ _ SEPTIC SYSTEM MUST BE Sewage Permit number, ;y.`cc—'..:-............................ INSTAeLED IN COMPLIANCE " " , WITH ARTICLE• II STATE 4, o r3 SANITARY CODE-AND TOWN. r yoFtHEro�� TOWN; OF 'BARN AOLEBARNS - - BUILDING ° INSPECTOR Li APPLICATIO 'M N'FOW1 PERMIT TO v /7..... .`v..... .................................................... TYPE OF CONSTRUCTION ....... .................................. .. ; l �! .. ........ ...........'.................... � ./:................19Z,7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according tothe following information: Location .C2...��/ ......0/ .....�•.v�X—. ..............�`� ........................... ProposedUse .........lA. l....• !. ? ............................................................:................................................................... Zoning District ......(!.1..!:�........................................................Fire District .Y. ............................ Name of Owner/ ry&!�°ol..... 1`�/ /G�(/1����/./.l�ddress / �! C� ..f �✓/. .� 'C .l Nameof Builder .............. 1..1.. .4 .............................Address .................................................................................... r Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...............,c.._.................................................Foundation .............................................................................. Exterior ......(��C�U ./.. .r ..........................Roofing ......�jk/ 4L ........................................ ........ Floors ..................../..............................................................Interior ....................................................:............................... Heating ....................................................Plumbing { Fireplace ............Approximate Cost����� U Definitive Plan Approved by Planning Board ---------------_---------------19________ . Area .......................................... ��7 S1 Diagram of Lot and Building with Dimensions Fee . ...... .. .................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH sy/ O LD ;-,q I hereby-agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam*. 4� ........... ... .. Arthur A. & Marilyn J. Smith No for-A!Wn.......................................... Permit ............................................................................... Location 97 . Old,Town ......... ........... .............................. nis............................. . Owner ....................... ..Frome................ Type of,,C6nstruction .................................................................... ........... Plot .........268.-..;.72.... Lot .................................. r. At Permit Granted .............. 1977 Date of Inspection ....................................19 Date Completed ............. .......19 78 PERMIT'REFUSED ................................................................. 19 r........•...F. .r.................................................... ........... ...................................................... . ............................................................................... ........................:...................................................... Approved .................................................. 19 .......... ........... ...................................................... ............................................................................... aF 114E:Tad +`'BAFtNSTABLEc * + MASS. i6S4. �0 ..._�U.p CD Town of Barnstable en Zoning.Board of Appeals r Decision and Notice v. rn n Comprehensive Permit No. 2014- 046—Foley Chapter 40B Comprehensive Permit ummaryt Comprehensive Permit No.2014-046 is rescinded_ Applicant: John J. and Tracey J. Foley Property Address: 97 Old Town. Road, Hyannis,MA Assessor's Mapil'arcel: Map 268,Parcel 072 Zoning: Residential B Zoning District Deed Reference: Deed: Book 21.897 Page 120 Permit Reference: Book: 28667 Page 1.23 Locus and Background: The applicants applied for a Comprehensive.Permit under Chapter 40B of the General Laws of.: the Commonwealth of Massachusetts, and in accordance with Article I1 of Chapter Nirie of the Code of the town of Barnstable;, more commonly termed the "Accessory Affordable Housing Program." Comprehensive Permit Nuzriber.2014-046 was issued to the applicants on October 8,.2014 and a Regulatory Agreement and Declaration of Restricted Covenants were recorded:at the Barnstable Registry of Deeds on February 6,2015 as Book 28667 Page 123. The Applicants no longer own the property therefore the Comprehensive Permit,No. 2014-046 must be rescinded.. Procedural c& Hearing Summary A.public hearing to rescind Comprehensive Permit.No. 2014-046 was duly advertised and notice sent to abutters and the property owner all in accordance with MGL Chapter 40A. The hearing: was opened on August 21, 2019 at which time the Hearing Officer, Alex Rodolakis, made the following findings and decision: Findings of Fact: 1. The applicants., John J. and Tracey. J. Foley, were granted Comprehensive Permit 201.4-046 for an accessory affordable apartment at 97 Old Town Road, Hyannis, MA. on October 8, 2014,' Town of Barnstable,Zoning Board ol'Appcals Comprehensive Permit No.2014-046•-•Foley is rescinded 2. The applicants, John J. and Tracey J. Foley,:no longer own:the property:. 3.. On Jude 5, 20t9, the.Accessory Apartnient.Piogram Coordinator took acti.on'to rescind. Comprehensive Permit No. 201.4-046. Ordered: Comprehensive Permit number 2014-046 is rescinded. A written copy of this decision shall be forwarded to the Zoning Board of Appeal as required by the Town of Barnstable Administrative Code Chapter 241, section I.I. If after fourteen(14)days from that transmittal the Members of the Zoning Board of Appeals takes no action to reyerse the decision, this decision shall become final and a copy shall be ihe,.filed in the office of the Town Clerk. Appeals of the final. decision, if any, shall.be made to the.Barnstable Superior Court pursuant.to. MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision in the office of the Town Clerk: The applicant has:the right to appeal this decision as outline i MGL Chapter 40B, Section 22. A ex o kakis, Hearing Officer :Date Signed I, Ann Quirk, 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 clay of under the pains and penalties of per uty. Ann Quirk,Town Clerk: �4�41alitfi!� ` RN ,qi °z A Jvi-115�DL�e RARNSTABLE REGISTRY OF DEEDS �_ =``�•0��;.`` John F, Meade Register °.104 o�,•.. , r� '76 fateatae►�ae 2, q.. �1 . �.�'•.• .., k ^ xs�. Y�-.�—...��.--. sr'... ui'2 r.. .... „� - � e.�_..2--� t � 'k , Assessor's map,and lot numbec.r.: tw ......... ... '� 141 Sewage Permit number .. ......�[..1 ' ............ Z BARNSTABLE, e i House number` .......................... ............ ..... ........ so 1639. 9� `s '£0 M d' TOWN OF BARNSTABLE DUILDIH,O IHSPEC:TO 'APPLICATION FOR PERMIT TO .... ... .. ........ .............................. TYPE OF CONSTRUCTION,.... . .... ........................... ......!.... �.c...11:......................19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......1..7.....C.�f /.... ,d............�::v �! `J�� 1........./. z..........:.................. ProposedUse .... ga ff. !....... .. �..............................:.......................f......................... ....:..................................... Zoning District ..... g.:.........................::.............................Fire District ..: /���'��............................................... n�/f ' ) .t .... Name of Owner ......r ? .//. ./-- .. �i.,,�//���1 ....Address l............... .......... Nameof Builder ... ......:.....:...............Address ....... .................................................... ...:. Name of Architect ........-O:.........................................Address ....... :�& ........................................................... Number of Rooms ....... .....::..............................................Foundation ... s n Exterior ..... �.............:.......:...........................Roofing ... ........................................................... Floors v/1 .' ..................................................................Interior .. �.. �/U ..Lek ............ .. Heating L! ......�1/ � /?�� 4 ? .................Plumbing .. ��! .............................. .............. Fireplace . ....................................... ....................:.........Approximate Cost ............ Definitive Plan Approved by Planning Board __? F------------ Area ;....0 ............. Diagram of Lot and Building with Dimensions Fee .... /U .....,/ ..... .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH; [Or r 1 . ENq F:�; - _ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS hereby agree ree to conform to all the Rules and Regulations cf the Town of Barnstable regarding the above 9 9 9 construction. f Name./;/.....1 �1.. � ..�t�l�Ll ... .............. 1 f.. I) Construction Supervisor's .License f. `�f4. i............... --- — | SMITH, MARILYN J. \ � _ { No —r�9.3.4. Permit for ..BARN.... . .. �� | ' ' to FAMILY APT. ' ................................... | ' Location ..9.7_Old.. ..Road'__..____ ................. yAAn1s.P.Qzt_____._ Owner lno.�J._ ,.__,_._.. Type of Construction .��AMQ....... ^ ............................................... Plot Lot -~ ---- ` Perm,_ , . . . Date of Inspection. ` ------------19 . . . . � Date/Comp ' , - ° ' - ' ^ / . . . ' \ ' . . ' y° ^ - 7 z ✓� Assessor's map and lot number .................................. /K, rOc 6T1 r 7 77 :+ Sewage Permit number..........................,................................ ?MEt��� ? TOWN OF BARNSTABLE BARNSTSDLS,NAM i 9 • BUILDING INSPECTOR ' 'a w ar a' o APPLICATION FOR PERMIT TO ......�.f..�.................................r !. ....................................................................... TYPE OF CONSTRUCTION ........ ....:. ' .................................................................................. ............ ...........................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... ...........n.....'f......i r� ...... �..............! ..........:.......... .�;./V/1�i. ..!!'/�..... ............................. Proposed Use ............:�f....../.r �................................................................................................................................ . ZoningDistrict ....Fire District#y�'................................................. .............................................................................. Name of Owners ............................................�' ii�',f�. r1 Y� hr, Address ���✓ 1 i��P}nJri' /......`...... /. v ................................ . ..... . ............. n Nameof Builder /" �1 /...............................Address..................................... .................................................................................... P � Nameof Architect ..................................................................Address .................................................:.................................. Numberof Rooms ..................................................................Foundation .............................................................................. Exierior .( ',','!'i�r� �. 3..�?.� `...........................Roofing �_ i"l. /V.r. �rL `� ................ ................ /.......................... ......................... .................. Floors .Interior ................................................................................................................................................................... ...... - Heating ..................................................................................Plumbing .................................................................................. Fireplace ....................Approximate Cost ..............f' ........................................... ...................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area :.......................:................ 5� Diagram of Lot and Building with Dimensions Fee SUBJECT T.. APPROVAL OF BOARD OF HEALTH — H i • � I I HU7rs I hereby agree to conform to all the Rules and'Regulations of the Town of Barnstable regarding the above construction. Name ................ .............................................................. i . � . , - ` .. Arthur A. & Marilyn J. Smith 97 Old Town Rd. W. t - Type of Construction ....Wood Frame PERMIT REFUSED ` . . . . . � � ` / ' ' � � � . � � ^ ` � --. - - � .—.-.----.—.-.......—.—..~...— ' � ---'---'---'---'--'—'---'—'' � � ^^^^'—'~^^^''—^^'~~''^^'~^'-''—^^^^` Approved - ---------------- lA ~� � -------'-----'^—^—^'^'^—^'''^^^^^—' ----'-----------------^--^^- | Assessor's map Viand lots number. d/fl,.�............ .'....,�.:.::. f '�``// FTNe r f� P �o o� Sewage Permit number .. �< °:�.....(w, ......:.............�.. 1 S Z AR33TAB i B LE, ouse number i / IIA86 00 i639 6� MO MPY a\ TOWN OF�, BARNSTABLE BUILDING 'INSPECTOR sq� APPLICATION FOR PERMIT TO (Y' TYPE OF CONSTRUCTION ........... ... .......................................... ........................... t , ...... c ....��........................19. TO THE INSPECTOR 'OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......F7.....0/f..l��`l�!��....4C�!.............vv.����/��/!!Y/✓��� ................................................... ProposedUse .... 11� -/�.�......�........................................... .......F........................................................................... Zoning District .....................................Fire District .. IY.!Y.!„u,............................................... Name of Owner ....... �/.Vl—. ...Addres"s 17/)V R ...... z ,. Nameof Builder ......... / .......................................Address ....:.. ... . ........4................................................. Nameof Architect ........ ........................................Address .......�-�*wC-•......................................................... Numberof Rooms .......k5.....................................................Foundation ... ..... •.•- .. ..... :.:........... ,. ,.. ...........................Roofing ......... ' .... �/� .................................................:...............Interior . �^� / �/U ..T�4� .. Floors ....... ......... ..................../ ..... Heating . ......,{..�- ...... f ��'/.t C- ....... ....". .`Plumbing'...... .. .(/... ..................'. ......... ...:..... .............. L) Fireplace ............................................:....Approximate. Cost .................. i ....................................... .................................. Definitive Non Approved by Planning Board __?C/ (___D______ __19_ Area C.. ............ Diagram of Lot d................... and{Building with Dimensions Fee ,/ D' 1 i SUBJECT TO APPROVAL OF BOARD OF HEALTHE ICJ( ,y� y ---7V /t/Q,T-1 ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Namel ...................... f�� o�- Construction Supervisor's -License ..... '.��..../........... k i SMITH, MARILYN J. A=268-72 25924 REMODEL BARN , . No ..............!.. Permit for .................................... to Family Apt. c r - 97 Old Town Road 4 Location ................................................................ ................ ................... Owner ....Marilyn..J, Smith Type'-of Construction ....Frame ...............................................:................................ - Plot ............................ Lot :.............................. Permit Granted ,,; December 28, 19 83 .... ........ ..... Date of Inspection ....................................19 . Date Completed .......................................19. S, � t of�He ro .,, „3£ Pnnt2d On�9/,,,{6f2Q79 N ; Com , I'l t CaI1 Repor# yy �x �x Mf s Case#: C-19-727 Address: 97 OLD TOWN ROAD, Date: 9/16/2019 HYANNIS Owner Info: Property Info: FOLEY,JOHN &TRACEY J MBL: 176 CRAIGVILLE BEACH ROAD 268-072 HYANNIS MA 02601 Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Zoning, Medium Priority Walk-in Complaint Summary: Former owner seeking status of Amnesty unit after sale of property. Former owner noted the unit is occupied by more than 2 people. The Amnesty approval limits use to no more than 2 adults. Main house seems to be overcrowded as well and running a daycare business,too. Action History: Action Taken Date Description Fee Inspector Inspector Assigned to Complaint: mckechnr Filed by: andersor Comments: Comment Date Commenter Comment 9/16/2019 andersor Amnesty unit to be rescinded -decision has not yet been recorded but will be by the end of the month. Barnstable y , Town of Barnstable Bui1C1111 g ? a PostThis.Card So That it is Visible From the Street;Approved Plans Must be;Retam.ed on Job�andLLthls Card Must be Kept Posted Until`Final ins ecti Permit . _ p on Has Been'Made w a: ena�° Where a Certificate;of;Occupancy`is Required;_such Building shall No t,be Occupied until a Final Inspection has been made Permit No. B-20-433 Applicant Name: W. Ray Colwell Approvals Date Issued: 02/18/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/18/2020 Foundation: Location: 97 OLD TOWN ROAD,HYANNIS Map/Lot 268-072 Zoning District: RB Sheathing: Owner on Record: BARCELO,JIAN C&PIVA, RENATA ° Contractor Name;`" 5C Energy Framing: 1 Address: 176 CRAIGVILLE BEACH ROAD Contractor License: 194390 2 HYANNIS, MA 02601 Est. Protect Cost: $ 1,212.00 Chimney: �a i Permit Fee: 85.00 Description: insulation ;See Contract $ p Insulation. Fee Paid-'r S 85.00 Pro Review Re CS L TO HAVE WORKER COMPENSATION AS REQUIRED. ... J e 4 Final: , h Date: 2/18/2020 77, Plumbing/Gas Rough Plumbing: m~ 9_ _ Building Official d Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after ssuance. Rough Gas: All work authorized by this permit shall conform to the approved application_and the`approved construction documents for which this permit has been granted. g All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. - �- � This permit shall be displayed in a location clearly visible from access street or road and� shall be maintained open forgpublic inspectio�n for the entire duration of the Final Gas: work until the completion of the same. _ - .. ,. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided onthis permit. Service: Minimum of Five Call Inspections Required for All Construction Work:f , i 1.Foundation or Footing r Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT .?. :..i, 'E"T. A l in i {3ful ....... ........ ............. ...... ....... ... ........ `.........,,.... ^.M:.s,. Y .. a. i. ...w:..a\_.,,..\ �..,........_ ,..`...,.. ....... Line Seas Cate Owner Book/Page Q42 PRCEI�, JIANR� A, REtT 31966/ 31 E 2 03/30/2007 FOLE'Y, JOHN & TRACEY J 21897/ 12C 3 11/16/2€�C S FOLEYj 1 RACY J T ' 20478/ 222 4 04/28/2005 FOLEY,TRACEY &JOHN 19766/ 19e _. f n 3 Town of Barnstable Building Department Services do Brian Florence, CBO ABLE' ` Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 COWLAINVINQUIRY REPORT 0 Date: f�. f Rec'd by: Complaint Name:J , o a 'L C� Map/Parcel Location �- Address: Originator Name:,- Street: Village: State: Zip: Telephone: Complaint Description: C - A let _-)LCk t VPK) /.-4) FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: Additional Info.Attached Q:forms:complaint Revised:08/16/17 ALTERNATIVE WEATHERIZATION • - - -.. .. - - .fit .us Date. f S Town of Barnstable 200 Main S>~ Hyannis,MA 02601 Re!Permit# o- (J 7�lo�i :.Village!'... : �S The insulation/weatherizati6ii.-work at 401 een completed risaE o dance with,7.90CM,k Regards;..: . Timothy Cabral, , President CSL-105454 58 DICKINSON STREET I FALL RIVER,MA 02721. 1 (508) 567-4240 I ALTERNATIVEWEATHER2MON®GMAIL.COM Application number..�dz... s .. Date Issued.............. .......................... sue¢ Building inspectors Initials............ 0 .......... f'OV 2 9 2018 n ... ........ Map/parcel..:;4......... I... ........................ PA./N UJ 8AHNS'l-ABLE TOWN OF BARNSTABLE �5, 06 EXPEDITED-PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: I&JA- ST? M AGE Owner's Name: oh Phone Number Email Address: �D U cdxj, Cell Phone Number J— Project cost$ ��� �' Check one Residential Commercial OWNER'S AUTHORIZATION Wzo r/�.Z.ki-1-o-x- As owner of the above property Y I hereby authorize i7'YYD r P to make application for a building permit in accordance with 780 C / Owner Signature: �P�',�' G�G��.CF' Date: TYPE OF WORK ❑ Siding ❑ Windows(no header change).# Insulation/Weatherization ❑ 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 CONTRACTOR'S INFORMATION Contractor's nam AeY-MLAYC %Z" q C Home Improvement Contractors Registration(if applicable)# l 7JZ (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor , Phone number�.�l -Sid y� ALL PROPERTIES THAT H E STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN. .A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE PERMIT CAN BE ISSUED. i APPLICATION NUMBER ` t_ *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/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: 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,speck inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit app tcationsTarsubject to a building official's approval prior to issuance. O • r Town of Barnstable °. Regulatory Services MRNGUMa MAN �: Richard V.Scab,Director ae3 s� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis.MA 02601 www.town.barnstable.ata.us Office: 508-862-4038 Fax 508-790-6230 Property Owner Must Complete and Sign This Section If Usin ABuilder J �I, o .. � e.y ---•__--,as Owner of the subject pmpc:ny hereby authorize. "kerAC+.I:UL l )P A,'14Wi&24i `/c-F� ace on my behalf, in all tatters relative to work authorized by this building permit application for. (Address of fob) ""Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner N S of p'c Prim Name \ Pnnc Name Date , Q:FORMS:OWNE"FRMISSION?MLS ' r The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 ¢; Boston, MA 02114-2017 ,N www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): ALTERNATIVE WEATHERIZATION, INC. Address: 2 LARK STREET City/State/Zip: FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): 1.M I am a employer with 16 employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.[No workers'comp.insurance required.] 3.a I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 9. El Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance., 6.7 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other INSULATION 152,§1(4),and we have no employees.[No workers'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 sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Li�c..#: XWO(19)58867158 �/ Expiration Date:6/8/19 �j/ Job Site Address: ! �� AL! City/State/Zip: ��Lt.I. /'G,4 Attach a copy of the workers'compensation policy declaration page(showing the policy nu, er and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify�udjpain a p lti s f perjury that the information provided a/boov is tr a and correct. Si ature: Date: Phone#:508-567-4240 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#: ACORO® DATE(MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE F06/11/18 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 UUNIAGI NAME: Anthony F.Cordeiro Insurance Agency PHONE FAX Ext: 508-677-0407 ac,No): 508-677-0409 171 Pleasant Street DE Fall River,MA 02721 ADDRESS: HSouza@Cordeirolnsurance.com Fall INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual INSURED INSURER B: Ohio Security Alternative Weatherization INSURER C: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS:AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR OWUL bUbK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE Fx_1 OCCUR PREMISES Ea occurrence S 300,000 MED EXP(Any one person) S 15,000 A Y Y BKS58867158 06/08/18 06/08/19 PERSONAL aADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY 0 PRO- JECT 7 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO BODILY INJURY(Per person) S B OWNED rx SCHEDULED AUTOS ONLY AUTOS Y BAS58867158 06/08/18 06/08/19 BODILY INJURY(Per accident) $ XHIRED NON-OWNED - PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/08/18 06/08/19 AGGREGATE $ 1,000,000 DED RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 500,000 C OFFICER/MEMBER EXCLUDED? � N/A XW058867158 06/08/18 06/08/19 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary&Noncontributory basis per the terms and conditions of form CG2001 (04/13),for Ongoing Operations per the terms and conditions of form CG2010(04/13),for Completed Operations per the terms and conditions of form CG2037(04/13)and Waiver of Subrogation applies per the terms and conditions of form MEGL0241-01 (04-11) Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02/16) Excess Liability is a following form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT l! ©198f8-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Ub*Softy, i . I fB I i cIl t aw awwwo '��nstruc��trn Strt�is�r 7`tNb�lf I+A .fttt10 MA" y w � y Y �arrrtlptff�lst�i O� tZti'19- u Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, M=,a etts 02116, Horne Improvem �C�ntractor Registration W Type: Corporation l Registration: 175683 ALTERNATIVE WEATHERIZATION, INC Expiration: 05128/2019 2 LARK ST FALL RIVER,MA 02721 ry a Y Update Address and return card. Mark reason for change, 17..Addmss..r R�rEz"�2-1ti!i mplaymprlt 1:3 Ls3sf. a ..... J) J) 1� J�. .. _......_..._. .... .._. .. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Comoration before the expiration date. If found return to: s Rectistraftion �r ig0 Office of Consumer Affairs and Business Regulation 17ww 05/28/201g 10 Park Plaza-Suite 5170 ALTERNATIVE WEATHER17ATION,INC. n,MA 02116 TIMOTHY CABRAL 2 LARK ST FALL RIVER,MA 02721 Undersecretary ti V Out 3i 8tuf iW 1 of �w Town Of Barnstable Permit 4 OExpires 6 nronilrs from issue date Regulatory Services Fee d'&mwsTABLS. 3 -7 `�9eb jL619. �0`a Richard V.Scali,Director b Building Division �J�J Tom Perry,CBO, Building Commissioner � .! � . 200 Main Street,Hyannis, tvfA 02601 '+.lr*A, www.town.bamstable.ma.us Office: 508-862-4038 `790-6230 EXPRESS PERINIIT APPLICATION - RESIDENTIAL ONI.Y�/I��S'/� Not valid without Red X-Press Imprvtt iivfap/parcel Number Z6g 07 Z-- Property Address dO (Residential Value of Work S_1-3/lk613 Minimum fee oft$35.00 for work under$6000.00 Owner's Name&Address s W Q 7 014 iIwn 7t 44 ouzo I Contractor's Name E 'nJ&.I 2�/i ( //r spl( Telephone Number t!L{O( ' IIotne Improvement Contractor License it(if applicable) �-'.32 44 Email: Construction Supervisor's License#(if applicable) 7 Q 7 12<orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ �m the Homeowner I have Worker's Compensation Insurance Insurance Company Name F- r Pete_ n L� Z1 rint-1 a e �f4, Workman's Comp.Policy# \(/C A 3 1-,�7 a 7 2-19 — 2—L Copy of insurance Compliance Certificate must accompany each permit. J Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side O Replacement Windows/doors/sliders.0--Value ,, Z (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property caner must sign Property Owner Letter of Permission. A copy the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Luca!\4licrosoft\Windows\Temporary Internet Fi1es\Content.0ut1ook\2P101 DHR\EXPRESS.doc Revised 040215 renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England John Foley MR11A..W.M Legal Name:Southern New England Windows,LLC RI#36079, MA#173245,CT#0634555,Lead Firm#1237 . 10 Reservoir Rd I Smithfield,RI 02917 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com Buyer(s)Name: John Foley Contract Date: 11/24/17 Buyer(s)Street Address: .. Primary Telephone Number: Secondary Telephone Number: Primary Email: Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document;the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement'). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $13,863 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $6,931 Balance Due: $6,932 Estimated Start: Estimated Completion: Amount Financed: 7-9 weeks 7-9 weeks $13,863 Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 50% deposit by bank,balance on completion by bank Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal- understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do,not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 11/28/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba-Re: And rsen of Southern New England Buyer(s) _ Signature of Sales Person : Signature Signature Paul Sandrey John Foley Print Name of Sales Person Print Name Print Name UPDATED: 11/24/17 Page 2 / 12 Massachusetts Department of Public Safety t Board of Building Regulations and Standards License: CS-095707 Construction Supervisor r` r BRIAN D DENNISON 7 LAMBS POND CIRCLE CHARLTON MA 01607� _51 Expiration: Commissioner 09/08/2018 Office of Consumer Affairs nd Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home improvement Contractor Registration Registration: 173245 "�--�- Type: Supplement Card =.1 r Expiration: 9/19/2018 SOUTHERN'NEW'ENGLAND WINDOWSIL =i BRIAN DENNISON 26 ALBION RD fi =' LINCOLN,RI 02865 =- Update Address and return card.Mark reason for rlta e. sra, c zoewsrn ❑Address ❑Renewal j I Employment 1.ostC3rd -iTce ofCoasvmer Aft nirs&:Basiaes-Regulation Registration valid for individual use only before the OME IMPR0VEMENT CONTRACTOR expiration date If found return to: Office of Consumer Affairs and Business Regulation Registration_M 45. ?YPe: 10 Park plaia-Suite 5170 ExpuatlWn 9/19720,1.67 -Supplement Card Boston.MA 02116 SOUTHERN NEW ENGLAND-.W_i_NDOWS LLC. RENEWAL BY AN6EEi50N===BRIAN DENNISON DENNISON �' 26 ALBION RD � LINCOLN,RI 02865 -l_g'ydersecre rr l Not valid without signature E The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractorsillectricians/Plumbers. TO BE FILED NVITH THE PEP-WTIT''G AUTHORITY'. Applicant Information Please Print Le "biv Warne. (Business!Organization/Irtdividual): e Address: .2 -. r Ci-v State/Zip: 1J Phone 1: �,f�t - 2�g' FEW Are you an employer?Check the appropriate box: Type of project(required): ll am a employer with �0 templovees(full and/or par-time".'time".' New construction 2.71 am a sole proprietor or parutershir and have no employees working for me it S. Remodeling any capacir}•.[No worker'comp.insurance required.j o 0 Demolition ;.O I.am a homeowner doing ah work mvself LrNo workers'comp.insurance required._ 10 Building addition c:.❑1 am a homeowner and wil be hiring contractors to conduct all work or:my propern•. I will 11 Electrical repairs or additions that all contractors either have workers'compensation insurance or are sole proprietors with nc employees. 12.a Plumbing repairs or additions z __❑1 am a genet contractor and;have hired the sub-contactor listed or:the attached sheet 13.E]RoOf repairs These sub-contractors have emplovees and have worker'comp.insurance. N��GC, E.❑we are a cornoratior and.its o 5cer have exercised thei7 right of exemption.per MG-L c. i;L.F 1(4),and we have ne emplovem.rNo workers'comp.insurance required.: f 'Any applican that checks box;=?must also fill out the section below showing then,worker compensattoc police information,. they are do all work and ther.hire outside contactors must submit a new affidavit indicating such. Homeowners who submit this of idavit indicating doing +Contractors that check this box trust attached an addition sheet shoving the name of the sub contractors and state whether or no=.those entities have emplovees. Lithe sub-contractors have employees,they must Drovide their workers'comp.Dolicy number. ng workers'compensation insurance for my employees. Below is the policy and job site I am an employer that is providi information. Insurance Company Dame: Ire !tie � 2� Policy or Self-ins.Lic. 87 Z — Z- Expiration Date: B i -7 Job Site Address: l (i(�� City/state./Zip: �l s Attach a cop)'of the workers compensation policy declaration page(showing the policy num r and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$I-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.A coFy ofthis statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verification. c hereby certify under th ains and penalties of perjun°that the information provided;bo e,is ue and correct Date: Si ature: Phone;u: Df- 2� official use only. Do not write in this area,to be completed by city or town off dial City or Town: Perffiit/License 4 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City;ToRnClerk 4.Electrical Inspector 5.Plumbing Inspector 6.Gather Phonei Contact Person: r ESLERCO-01 SANDERSO l DATE(MMMDn-" ,ACORO' CERTIFICATE OF LIABILITY INSURANCE F06/0712017� F1401 0ERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS TIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES OW. THIS CERTIFICATE.OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED RESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT- If the certificate holder is an ADDITIONAL INSURED,the policy(iss)must have ADDITIONAL INSURED provisions or be endorsed. UBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT CER ME Insurance Inc.-CO PHONE 303 988-0446 FAX ,No):(303)988-0804 Lawrence St,Ste.1200 lac,IL Ext):( ) E-MAIL COMail@cobizinsurance.com Denver,CO 80202 ADDRESS: INSURERS AFFORDING COVERAGE NAIC 9 INSURER A:Acadia Insurance Company I31325 ___JINSURED �INSURERB:Firemens Insurance Com an of WA D.C. 21784 Southern New England Windows,LLC.dba Renewal by suRER c:LibeSu lus Insurance 110725Andersen of Southern New EnglandsuRER D 26 Albion Road,Suite 1 Lincoln,RI 02865 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFF POLICY EXP LIMITS INSR ADDL SUER POLICY NUMBER MM1DD MM/DD L TYPE OF INSURANCE INSD WVD 1,000,000 A X I COMMERCIAL GENERAL uABILJTY EACH OCCURRENCE S �X 1 DAMAGE 70 RENTED 300,000 I I CU41M5-MADE ❑X OCCUR CPA3158728 01/0112017 01101/2018 PREMISE Ea occurrence 5,000 MED EXF An,one erson 5 ` 1,000,OOD 111 i I - PERSONALS ADV INJURY S GENERAL AGGREGATE s 2,000,OOOI l GEN'L AGGREGATE LIMIT APPLIES PER: I 2,000,0001 j X POLICY jECT ❑LOC PRODUCTS-COMP/OF AGG S EBL AGGREGATE s 2.W0,000 OTHER: COMBINED SINGLE LIMIT S 11000;0001 A AUTOMOBILE LIABILITY Es accident) i�ANY AUTO CPA3158728 01/01/2017 01/0112018 BODILY INJURY Per person) S --OWNED SCHEDULED BODILY INJURY Per accident S AUTOS ONLY AUTOS PROPERTY DAMAGE r—1 HIRED NON-OWNED i Per accident S —I AUTOS ONLY AUTOS ONLY I I 5 A 1 X UMBRELLA LIAB I OCCUR EACH OCCURRENCE S ,,000,OOO X CPA3158728 0110112017I0110112018 AGGREGATE 5 EXCESS LIAR CLAIMS MADE Aggregate s 1,000,0001 DED X RETENTIONS X TA UTE I ERH S g WORxERscOMPENSATION 1,000,000 AND EMPLOYERS'LIABILITY YIN N WCA3158729-20 01101/2017 01101/2018 E.L EA ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE I N NIA I 1,000,000' (MandemryEn BE EXCLUDED? _ E.L DSEASE-EA EMPLO S 1,000,000 If yes.describe under :1, SEASE-POLICY LIMIT SDESCRIPTION OF OPERATIONS below• 1,000,000g Worker's Compensatio WCA3158730-20 01101/2017 01/0112018 101/0112017 01/01/201111,000,000,D7SC W ro krOF s ComATIONS LO ATION I VEHI States OR 01,pt Add OH,WA,aYW�WeYule,may be amached'rf more space is requn • I CERTIFICATE HOLDER CANCELLATIONSHO ( ELLED BEF THEULD ANY OF IXPIRATiONH DATE�THEREOFBED N OTICEIES BE WILLCBECDELIVERED IN I ACCORDANCE WITH THE PO1J6'Y PROVISIONS. AUTHORED REPRESENTATIVE iI I I IF OR 113fgrrnationalP TION. All rights reserved. ACORD 25(2016/03) ©1988-2015 ACORD CORPORA The ACORD name and loge are registered marks of ACORD i 4.. mot ' . Town of Barnstable o� Building_Department - 200 Main Street , STAB . * Hyannis, MA 02601 9 MASS. se.9 . (508) 862-4038 Certificate of Occupancy Application Number: 201502891 CO Number: 20150110 Parcel ID: 268072 CO Issue Date: 06108/15 Location: 97 OLD TOWN ROAD Zoning Classification: RESIDENCE B DISTRICT Proposed Use: MULTIPLE HOUSES ONE PARCEL Village: HYANNIS Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: ACCESSORY AFFORDABLE APARTMENT DETACHED 1 BEDROOM Building Department Signature Date Signed TOWN OF BARNSTABL•E - -J, Building, _ � 201502891 , * BAMUrnBLE, * Issue Date: 05/21/15 Permit MASS. 039. A� Applicant: FOLEY,JOHN&TRACEY J Permit Number: B 20151231 Proposed Use: MULTIPLE HOUSES ONE PARCEL Expiration Date: 11/18/15 Location 97 OLD TOWN ROAD Zoning District RB Permit Type: AMNESTY APT NO CONSTRUCT RES Map Parcel 268072 Permit Fee$ 35.00 Contractor • PROPERTY OWNER Village HYANNIS App Fee$ License Num OWNER Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TO ESTABLISH A ACCESSORY AFFORDABLE APARTMENT NO CO ST1jWdQRD MUST BE KEPT POSTED UNTIL FINAL DETACHED 1 BEDROOM INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: FOLEY,JOHN&TRACEY J BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: PO BOX 354 INSPECTION HAS BEEN MADE. WEST HYANNISPORT,MA 02672 Application Entered by: SS Building Permit Issued By: THIS PERMIT CONVEYS'NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART`THEREOF,EITHER TEMPORARILY OR PERMANENTLY ENCROACHMENTS ON LIC PROPERTY,'NOI SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT.FROM THE CONDITIONS OF ANY.APPLICABLE Sur DIVISION. RESTRICTIONS MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). a r BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS FF F 2 . 2 2, t 3' 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health -�, Am nest. ':P�rog ram _ r v Helping to make affordable-'*ho.u.sing -'po sible.". 'own amsldbl' v a Alficate of Co Banp„ This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building:Code rrj and Town of Barnstable-i6nmg ordinances in accordance with the Amnesty program i Owners Tracy and John Foley, - .-Location 97.01d Town`-Road; 'Hyannis Unit'Capacity One B oom .rip o exceed 2rP,eo le _ Inspector ..` a- t 1VUP=No..268/072. �; 6/8/2015 _ -o w a'n rL ................ ..................... ...................... ........................ r� .............................................. T'iY 1-E3r fidst'. v, ............ r .. .. _ .............. ... L , (!�E ram- _.: = (� may} }.e, �Y, ,N ae 1_� yh CkY ri `v MPGcatton k .,x (�'� .✓ a `- Oetad AppBcation 26L50289L '� E_ s � i'. r F`t``.`" s F pvaner 1 34D9 to J {�'��- Cokled Status� ACT3E V PO JOHN&TRACEY 3 D a b3o0 BUILDING DEPAMENT CIaSe/Oeny rtmaat c-r. c RT Contras PROPERTY 4VJNERI� i hrojectjActivxy,55[ 5 APf NO CONSTftttCT RES E v€ACdve #a ' € ; _ ..... %. Jq�' OeSU{pUon 1 TO ESTABLISH A ACCESSORY AFFORDABLEA OTPARTME NO CpNSTRUCTIO �,� StatuS CO ACN ACTNE APPLLCATIOtd °+, €E `Ftoparry E Dascnpfmn 2 t DETACHED1 BEDROOM Business Applrrznf OWN PROPERTY O1hRdER. ^'. u - r -xRT sME �i �� s ki'�. ' "' .�� Estimated cyst ,�.,� 0 Fees effechue D5...... ReaCrmte -- d -R-a"g7 PEmtit tYtULTIPLE ,x;,,,.-..r `'' I; 8 AdluSt Fees'. i. - - I n r S `".e" Escrow E TYPe ,r„_StaWsTssued tuberRestrtn E'`ECuntia ou'" d Fee,TotBt t)npdd,Atnt� � � � E' MEst ChgS:. ] RESIiEaDIALT„f.SSpp ,,,,,ObR RO1S,,6 Of5Y23S ;PROPEfi?'l,OWNER .. ;COO:RESO... REVI EW .... .. «a PROPERTY OWNER 25AD oo. F;`Paymt"Hrstory :. r E !':Audit Hlgary E _ € et f-Permit Alerts t Totak fear b0 Bo Totaf an aEd �`" 0o xuY �' Unk L15pS: E _ rs IIN '� r NY xa n IN ,: f3 Pr�requtsiees �fx`3 Hazard/Restr P�(dames : �Bonds x is"`i Sub Addrs- f�7eM� f�;Plan Review: l�Find'by PaeLef Q � : .� �, � +: : E �'dE its . a 'Y •i'--'c. : E x "� aan L Ei BafFermg G3 ParKhng o�_SaptEc , t3 Well: s ^'A. �Find Raiatedp t, '� t >`Yr ti �- - t .. ! Frldr Hrs[ory F3 7nspecuons, VEofadons'' ra3 BaartC RevEews d Open Sens Attachments a a'UIE T,� OT cx - .. Custanvm `, OI'{ .� ..a._' r r . r '>n as Arn Start Ir�r-Y§w'd � � rrt F� s ... .- 0,MUDO k. t j J • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map-- G Parcels Application R9 Health Division Date Issued Conservation Division Application Fee 26 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning BoardLJ` Historic - OKH _Preservation/ Hyannis /► ��` �� (�y�� Project Street Address Village vAItC. S (Y\ 0;L Owner c L A Address `�1 ®1c1 1�` , Telephone Eo R -11 1 Z CoS L 8`t Gs L 3 Permit Request 10 CC,�SSuc'� P �li facli� A P�r�w.tA We:. ac C-A)i ' 5 1 Qc.c A:.v�c. $guare feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new . Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s_upporting docub- ntation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) 'a Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kin Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other - Basement Finished Area (sq.ft.) Basement Unfinished Area (sq. t) ' r Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other sa Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage.❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER)_ Name 734\ �- 01 Telephone Number `'2 �.� S 0 vv\ Address License # y c;nr; 5 '� Home Improvement Contractor# U a Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE J—Q) �.� DATE ,` ` 5 J FOR OFFICIAL USE ONLY APPLICATION# a - DATE ISSUED a -f t MAP/PARCEL NO. ADDRESS VILLAGE Y OWNER' a '. DATE OF INSPECTION: �. x FOUNDATION,,' t. FRAME INSULATION 7 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL H GAS: 4 ROUGH '.s.. FINAL i:`IIFINAL-BUILDING %.,DATE CLOSED OUT ASSOCIATION PLAN NO. Bk 28667 PS 123 4930 U2-06-2015 a`1 09 : 25a limp MR� Town of Barnstable -'1T !o►?',!,� t.j•j' Zoning Board of Appeals �._ . Comprehensive Permit Decision and Notice Accessory Affordable Apartment Comprehensive Permit No.2014-046 Foley jL! ` F1;'tl,"-r t'1 cT f L Applicant: John J.Foley and Tracy J.Foley Property Address: 97 Old Town Road,Hyannis,MA Map/Parcel: 268/072 Zoning: RB-Residence B Zoning District Summary: Allows an existing apartment unit,located in a detached accessory structure and formerly used as an accessory family apartment,to be maintained and used as a studio accessory affordable apartment pursuant to the Code of the Town of Barnstable,Chapter 9,Article II. Deed Reference: Book 21897 Page 120 Applicant-Site Control: The Applicant is John J. Foley&Tracy J. Foley,owners and occupants of property addressed 97 Old Town Road, Hyannis, MA. The Applicant has a mailing address of P.O. Box 354,West Hyannisport, MA 02672. The Applicant has owned the property for 9 yeas as evidenced by a deed recorded at the Barnstable County Registry of Deeds on March 30, 2007 in Book 21897,page 120. A signed Affidavit dated September 3, 2014, declaring that 97 Old Town Road is the primary residence of Tracy J. Foley has been submitted to the file. Locus: The property is a 0.35-acre lot created by a 1949 land division plan entitled"Hemeon Development- Hyannisport-Cape Cod,Mass"recorded at the Registry of Deeds in Plan Book 85, page 105. The property is developed with a 1.5-story,four-bedroom,2,664 sq.ft.,single-family dwelling and an accessory detach one- story,1,030 sq.ft.,structure. The lot is served by public water and an on-site private wastewater disposal system. The principal dwelling's on-site disposal system appears to be sized for 3 bedrooms. Installation of this system pre-dates Title 5 and its age is unknown. A June 20 2014 inspection report found that system in satisfactory operating condition.The accessory building had a 3-bedroom Title 5 system installed in zoos. Background: In 1983,the accessory structure was converted to a one-bedroom accessory family apartment as provided for in Special,Permit No.1983-94 issued by the Zoning Board of Appeals to the then owner,Marilyn J.Smith. That Permit,was recorded at the Registry of Deeds in Book 16595, page 18. In 2005,Tracey Foley,heir to the Estate of Marilyn Jean Smith,deeded the property to the Foleys. The deed is recorded in the Registry of Deeds in Book 19766,page 199. Following that deed the property was co-owned with a trust and then to the Applicant in 2007. During that period of time and up to 2014 the Foleys continued to use the accessory apartment as a family-apartment per a 2oo6 Family Apartment Agreement with the Building Division recorded at the Registry of Deeds in Book 20827,page 313. This Agreement was made Town of Barnstable, Zoning Board of Appeals Decision Notice,Comprehensive Permit No.2014-046—Foley pursuant to revised zoning regulations that permitted family-apartments as an as-of-right accessory use to an owner-occupied,single-family dwelling. At this point in time,the family member has vacated the apartment and the Foleys now seek to convert the units to an Accessory Affordable Apartment Unit by a Comprehensive Permit pursuant to Chapter 4oB of the General Laws of the Commonwealth of Massachusetts,and in accordance with§9-15 of the Code of the Town of Barnstable,more commonly termed the"Accessory Affordable Apartment Program". Procedural&Hearing Summary: On May 5,2014,John J. Foley and Tracy Foley submitted an application for a Site Approval Letter as prescribed in the Code of Massachusetts Regulations 76o Section 56.00 and provided for within the Accessory Affordable Apartment Program of the Town of Barnstable. The application was submitted as a local initiated Chapter 40B. Notification of the application was submitted to the Departmentlof Housing and Community Development on May 21,2014. A Site Approval Letter was issued to the Applicant for the subject property by Town Manager,Thomas K. Lynch on August 20,2014. Notice of the Site Approval Letter was sent to the Department of Housing and Community Development in accordance with the requirements of CMR 760 56.00. An application for a Comprehensive Permit was filed at the Town Clerk's Office on September 16,2014. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on September 19 &26, 2014 and notices were sent to all abutters in accordance with Section 11 of MGL Chapter 4oA. The Hearing Officer,Craig G. Larson opened the Public Hearing on October 8,2014 at 6:oo p.m. Present at the Hearing were;the Applicant,John J. Foley and Tracy J. Foley,the Housing Coordinator and Monitoring Agent, Arden R.Cadrin, Regulatory Review/Design Planner,Arthur P.Traczyk,and Principal Assistant, Karen A. Herrand,recording secretary. Mr. Larson asked the Applicant if they have read the proposed 18 conditions and if they had any questions or concerns for the proposed conditions. Mr. Foley stated that they have read the conditions and understand them. He stated that they have no issues with any of the conditions to be imposed. The Hearing Officer invited the public to speak and no one came forward to speak. Mr. Larson noted that there were no letters entered into the file in favor or opposed to the grant of the permit. Findings of Fact: At the hearing on October 8, 2014,the Hearing Officer made the following findings of fact: Concerning"Standing",that is the right of the applicant to seek a comprehensive permit,Mr. Larson found; 1. The Applicant,John J. Foley and Tracy J. Foley,are the owners and occupants of the property located at 97 Old Town Road, Hyannis, MA as evident by a deed recorded at the Barnstable County Registry of Deeds in Book 21897,page 120. A September 3,2014,signed Affidavit from Tracy J. Foley declares that 97 Old Town Road is the primary residence of the Applicant. 2. ,The application for a comprehensive permit is being made in accordance with the Town of Barnstable's Accessory Affordable Apartment Program,Chapter 9 Article II of the Code of the Town of Barnstable. That program is structured as a self-regulating income-limiting local initiated housing program. A qualified funding program accepted under the Code of Massachusetts Regulations 76o Section 56.00 that govems grant of comprehensive permits. 3. In accordance with MGL Chapter 4oB and 76o CMR 56.04(4),a Site Approval Letter was issued to the Applicant for the subject property by Town Manager,Thomas K. Lynch on August 20,2014. Notice of the Site Approval Letter was sent to the Department of Housing and Community Development, in 2 Town of Barnstable,Zoning Board of Appeals Decision Notice,Comprehensive Permit No.2014-046—Foley accordance with the requirements of 76o CMR 56.04(z),and no issues were communicated from the Department on this application. Based upon the finds,Mr. Larson ruled that the application of John J. Foley and Tracy J. Foley has met the requirements for Standing and he can now consider the merits of the application for consistency with local needs. Regarding the"consistency with local needs"Mr. Larson found; 1. The use of the detached building as an apartment has existed for 31 years. First as a family-apartment by special permit and then as an as-of-right accessory family-apartment use. No expansion of the accessory structure is being proposed. It is to remain as it has existed. To now permit the apartment as an accessory affordable unit under Chapter 9 Article II of the Code would represent no perceivable change in the neighborhood. . 2. On May 12,2014,the Building Commissioner,Tom Perry, preformed an on-site initial inspection of the unit and has determined that it can conform to applicable state building codes. He is requiring smoke and carbon monoxide detectors be installed to current code,assurances that two means of egress are provided and final floor plans be submitted at the time a building permit is sought. 3. The Health Director,Thomas A McKean, has reviewed the Health Division's file regarding the on-site wastewater disposal system for the property and health division staff conducted an on-site inspection of the apartment unit on August 20,2014. The property is approved for a total of 4 bedrooms with 3 bedrooms being in the principal dwelling and one bedroom in the accessory building. The second floor loft area was found to not have sufficient height to meet code as habitable area and therefore not usable as a bedroom. The sleeping area will have to be incorporated into the first floor that will make the unit a studio apartment. Appropriate plans depicting this will have to be submitted at the time a building permit is sought. 4' The Applicant has been informed that the program still requires a building permit be applied for and an occupancy permit be obtained prior to occupancy of the accessory apartment. This step is required to assure final approval that the apartment unit conforms fully to all applicable building,fire,and health codes and this decision. 5. The applicant has been informed that upon certification of this Comprehensive Permit by the Town Clerk, a Regulatory Agreement and Declaration of Restrictive Covenants, restricting the accessory apartment unit in perpetuity as an affordable rental unit shall be executed. Thereafter both the Comprehensive Permit and the Agreement shall be recoded at the Registry of Deeds as binding covenants on the property. The documents limit the apartment to that of an affordable unit rented to a person or family whose income is 80%or less of the Area Median Income(AMI)of the Barnstable Metropolitan Statistical Area(MSA)and cap the monthly rental income(including utilities)to not exceed 30%of the monthly household income of a household earning 80%of the median income, adjusted by household size. In the event that utilities are separately metered,the utility allowance established by the Town of Barnstable shall be deducted from rent level so calculated. 6. According to the Massachusetts Department of Housing and Community Development,Subsidized. Housing Inventory,the Town of Barnstable has 6.6%'of its year round housing stock qualify as affordable housing units. The town has not reached the 10%statutory minimum affordable housing required in MGL Chapter 4oB. Nor has the Town met any of the Statutory Minima provided for in 76o CMR 56.03(3) 'April 30,2013 information 3 ' - r i Town of Barnstable, Zoning Board of Appeals Decision Notice,Comprehensive Permit No.2014-046—Foley 7. The Town of Barnstable's Comprehensive Plan encourages the.adaptive use of existing housing stock to create affordable units and the dispersal of these units throughout Barnstable. This application and the location of the unit conform to that objective. Based upon the finds, Mr. Larson ruled that the application of John J. Foley and Tracy J. Foley is deemed consistent with local needs because it adequately promotes the objective of providing affordable housing for the Town of Barnstable without jeopardizing the health and safety of the occupants provided certain conditions are imposed. J Decision&Conditions: Thereafter the Hearing Officer, Mr. Larson ruled to grant Comprehensive Permit No.2014-046 to John J. Foley and Tracy J. Foley for 97 Old Town Road, Hyannis MA to allow for an existing detached apartment to be used as an accessory affordable studio apartment unit as provided for in Chapter 9,Article II of the Code of the Town of Barnstable and in conformity to the following conditions and restrictions: 1. Occupancy of the affordable unit shall not exceed two(2)people. 2. The total number of bedrooms on the property shall not exceed four. The accessory unit is limited to that of a studio accessory apartment unit. This detached accessory building shall not be expanded in gross area or footprint unless pre-approved by the Hearing Officer after a hearing call to review any expansion. 3. Family member of the applicant/owner shall not at any time occupy the accessory unit. 4. All leases shall have a minimum term of one year and have provisions that require the tenant to provide any and all information necessary to verify eligibility with the Accessory Affordable Apartment Program including income information of the tenant and rent and utility payments. 5. All parking for the accessory apartment and the principal dwelling shall be on-site. Overnight on-street . parking is expressly prohibited. 6.E Accessory lodging or renting of rooms is prohibited for the duration of this Comprehensive Permit. 7. The applicant shall,within 6 months of the certification of this Comprehensive Permit by the Town Clerk; ■ . execute a Regulatory Agreement and Declaration of Restrictive Covenants,as approved by the Town Attorney's Office, and ■ make application for a building permit with the Building Division for the accessory apartment, including revised plans reflective of this decision specifically Constancy Finding No.2. 8. It is the explicit intent that the applicant secure an occupancy permit and the unit be occupied by qualified tenant(s)as restricted by this comprehensive permit within one-year of the certification of t the permit. The Building Commissioner and/or monitoring agent may extend this time for good cause. 9. To meet affordability requirements,the rent charged(including utilities)shall not exceed 30%of 80% of the median income for a household for the Barnstable MSA(adjusted for family size). In the event that utilities are separately metered,the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated. 10. The applicant shall engage in open and fair marketing of the unit and provide documentation of the activity to the Housing Coordinator,and information regarding the income level of any prospective tenant shall first be submitted and approved by the Housing Coordinator before any lease is signed. 4 Town of Barnstable, Zoning Board of Appeals , Decision Notice,Comprehensive Permit No.2014-046—Foley 11. Annually,the applicant shall work with the Housing Coordinator/Monitoring Agent to provide necessary information and documentation of tenant income eligibility and conformance with the Accessory Affordable Apartment Program on an annual basis. 12. Whenever a vacancy occurs, notice shall be given to the Housing Coordinator/Monitoring Agent before reengaging the selection process previously cited. 13. The Housing Coordinator of the Growth Management Department shall be the monitoring agent for the accessory apartment. Annual monitoring shall include verification of tenancy, affordability,and compliance with Comprehensive Permit.The homeowner shallcover the cost for annually monitoring for Housing Quality Standards(HQS). The fee for.the initial monitoring of affordability and annual certification inspection of the accessory unit shall be the same as the Health Department HQS fee for the rental registration program. Currently that fee is$9o.00. 14. -Every twelve months the applicant shall review the income eligibility of the tenant of the Accessory Affordable Apartment unit. No later than a year from the date;of issuance of this Comprehensive Permit,the applicant shall file with the Housing Coordinator/Monitoring Agent,an annual affidavit istating the rent charged and income of the unit tenant along with supporting documentation. The property owners and/or tenant shall provide any additional information deemed necessary to verify the information provided in the affidavit and annual monitoring documents. 15. Upon any report from the Housing Coordinator/Monitoring Agent that the terms and conditions of this permit are not being upheld,the Hearing Officer of the Zoning Board of Appeals may hold a hearing to revoke this permit or cause enforcement action to be taken for compliance. 16. This Decision,the Regulatory Agreement and Declaration of Restrictive Covenants and all'other necessary documents shall be recorded at the Barnstable County Registry of Deeds 17. Should ownership of the subject property transfer the permit holder identified herein shall notify the Housing Coordinator/Monitoring Agent and provide,within 60 days of the date of transfer,the name and current contact information for the new owner of the subject property. 18. This Comprehensive Permit shall be exercised as conditioned herein or it shall expire. Ordered: Comprehensive Permit Number 2014-046 is granted with conditions to John J. Foley and Tracy J. Foley for property addressed 97 Old Town Road, Hyannis MA.This permit is not transferable without prior permission of the Hearing Officer.The zoning relief issued in this Comprehensive Permit is that of a variance to Section 240-11 (A)Principal permitted uses in a RB Zoning District to permit an accessory affordable studio apartment unit within a detached accessory building. A written copy of this decision will be forwarded to the Zoning Board of Appeals as required by the Town of Barnstable Administrative Code Chapter 241,Section 11 (date transferred—October ,2014). If after fourteen(14)days from that transmittal and provided that the members of the Zoning Board of Appeals take no action to reverse the decision,this decision shall be filed with the Town Clerk's Office. It shall then become final only after zo days has expired and certified by the Town Clerk that no appeal was filed on the decision. Appeals of this decision, if any,shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A, Section 17,within twenty(zo)days after the date of the filing of this decision in the office of the Town Clerk. The applicant has the right to appeal this decision as outlined in MGL Chapter 4oB,Section 22. 5 Town of Barnstable, Zoning Board of Appeals Decision Notice,Comprehensive Permit No.2014-046—Foley 6 �L Craig G. Larson, Hearing Officer Date Signed I Ann Quirk,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 mt) ��jL/,3t � under the pains and penalties of perjury. Ann Quirk,Town Clerk . R IL1 l*dam Z; H LF' • �_d r ., q: .0 • 4'>.•. • BARNSTABLE REGISTRY OF DEEDS John F. Meade, Register 6 Bk 28667 P9129 -0-44931 02--06-2015. al 09 0 25ci REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS THIS REGULATORY AGREEMENT aryd DECLARATION OF RESTRICTIVE COVENANTS,is made this Z-15 day of v LAA 20 1 ,by and between John J. Foley and Tracy J. Foley of 97 Old Town Road,Hyannis,MA and its successors and assigns (hereinafter the"Owner"),and the TOWN OF BARNSTABLE(the"Municipality',a political subdivision of the Commonwealth; WHEREAS the Owner has been granted a Comprehensive Permit under Massachusetts General Law Chapter 40B and local regulations by the Zoning Board of Appeals to permit the creation of an accessory apartment in an owner occupied dwelling which will be rented to a Low or Moderate Income Person/Family(hereinafter "Designated Affordable Unit';and NOW THEREFORE,in mutual consideration of the agreements and covenants contained herein,and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged,the parties agree as follows: I. PROJECT SCOPE AND DESIGN:__ A. The terms of this Agreement and Covenant regulate the property located at 97 Old Town Road, Hyannis, MA, as further described in a deed recorded herewith as Barnstable County Registry of Deeds Book 21897 Page 120. B: The Project located at 97 Old Town Road,Hyannis,MA will consist of one accessory apartment unit which will be rented to an eligible low or moderate income individual or family(the"Designated Affordable Unit"or the"Unit'. C. The Owner agrees to construct the Project in accordance with the terms of comprehensive permit Appeal No. 2014-046 and any plans submitted.therewith and all applicable state, federal and municipal laws and regulations. Said permit is recorded herewith as Barnstable County Registry of Deeds Book Page D. The Owner agrees to occupy the principal dwelling unit located on the property as their principal residence in accordance with the terms of the comprehensive permit. IL THE OWNER'S COVENANTS AND RESPONSIBILITIES: A. THE OWNER HEREBY REPRESENTS, COVENANTS AND WARRANTS AS FOLLOW: 1 In receiving the comprehensive permit to create the Designated Affordable unit, the Owner agreed that the Designated Affordable Unit shill be set aside in perpetuity for+he public purpose of providing safe and decent housing to persons earning at or below 80%of the area median income of Barnstable Metropolitan Statistical Area (MSA) and that the Designated Affordable Unit shall be deemed to be impressed with a public trust 2. The Designated Affordable Unit shall be rented in perpetuity to a household with a maximum income, of 80% of the Area Median Income (AMI) of Barnstable MSA and that rent(including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent level. 3. The Designated Affordable Unit will be retained as a permanent,year round rental dwelling unit with at least a one-year lease. 4. . The Owner has the full legal right,power and authority to execute and deliver this Agreement. 5. The execution and performance of this Agreement by the Owner will not violate or, as applicable,has not violated any provision of law,rule or regulation,or any order of any court or other agency or governmental body,and will not violate or,as applicable,has not violated any provision of any indenture, agreement,mortgage, mortgage note,or other instrument to which the Owner is a party or by which it or the Owner is bound,will not result in the creation or imposition of any prohibited encumbrance of any nature. 6. The Owner,at the time of execution and delivery of this Agreement,has good,,clear marketable title to the premises. 7. There is no action, suit or proceeding at law or in equity or by or before any governmental instrumentality or other agency now pending, or, to the knowledge of the Owner, threatened against or affecting it,or any of its properties or rights,which,if adversely determined,would materially impair its right to carry on business substantially as now conducted(and as now contemplated by this Agreement) or would materially adversely affect its financial condition. B. COMPLIANCE The Owner hereby agrees that any and all requirements of the laws of the Commonwealth of Massachusetts to be satisfied in order for the provisions of this Agreement to constitute restrictions and covenants running with the land shall be deemed to be satisfied in full and that any requirements of privileges of estate are also deemed to be satisfied in full. C. LIMITATION ON PROFITS a 1. The Owner agrees to limit his/her profit by renting the Designated Affordable Unit in perpetuity to a household with a maximum income of 80% or less of the Area Median Income(AMI) of Barnstable Metropolitan Statistical Area(MSA) and that rent(including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. 2. The Owner shall annually deliver to the Municipality and to the Monitoring Agent,as designated by the Town Manager,proof that the Designated Affordable Unit is rented, the tenant's income verification,a copy of the lease agreement and the rent charged for the unit or units. Such information shall also be forwarded to the Monitoring Agent within 30 days of the occupation of the dwelling unit or units by a new tenant. The Owner shall notify the Monitoring Agent, as designated by the Town Manager,within thirty(30) days of the date that a tenant has vacated the Designated Affordable Unit. III. MUNICIPALITY COVENANTS AND RESPONSIBILITIES 1. The MUNICIPALITY,through the monitoring agent designated by the Town Manager agrees to perform the duties of verifying that the Designated Affordable Unit is being rented in perpetuity to a household with a maximum income of 80% or less of the Area Median Income (AMI) of Barnstable MSA and that rent (including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. IV. RECORDING OF AGREEMENT: Upon execution, the OWNER shall immediately cause this Agreement and any amendments hereto to be recorded with the Registry of Deeds for Barnstable County or,if the Project consists in whole or in part of. registered land, file this Agreement and any amendments hereto with the Registry District of the Barnstable Land Court(collectively hereinafter the"Registry of Deeds"),and the Owner shall pay all fees and charges incurred in connection therewith. Upon recording or filling,as applicable,the Owner shall immediately transmit to the Municipality evidence of such recording or filing including the date and instrument,book and page or registration number of the Agreement. 2 V. GOVERNING OF AGREEMENT: This Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any amendments to this Agreement must be in writing and executed by all of the parties hereto. The invalidity of an7 clause,part or provision of this Agreement shall not affect the validity of the remaining portions hereof. VI. NOTICE: All notices to be given pursuant to this Agreement shall be in writing and shall be deemed given when delivered by hand or when mailed by certified or registered mail,postage prepaid,return receipt requested,to the parties hereto at the addresses set forth below, or to such other place as a party may from time to time designate by written notice. VII. HOLD HARMLESS: The Owner hereby agrees to indemnify and hold harmless the Municipality and/or its delegate from any and all actions or inactions by the Owner,its agents,servants or employees which result in claims made against Municipality and/or its delegate,including but not limited to awards,judgments,out-of-pocket expenses and attorney's fees necessitated by such actions. VIII. ENTIRE UNDERSTANDING: A. This Agreement shall constitute the entire understanding between the parties and any amendments or changes hereto must be in writing, executed by the parties,and appended to this document B. This Agreement and all of the covenants, agreements and restrictions contained herein shall be deemed to be for the public purpose of providing safe affordable housing and shall be deemed to be, and by these Presents are,granted by the Owner to run in perpetuity in favor of and be held by the Municipality as any other permanent restriction held by a governmental body as that term is used in MGL Ch. 184, Section 26 which shall run with the land described in a deed recorded herewith as Barnstable County Registry of Deeds Book 21897 Page 120 and shall be binding upon the Owner and all successors in title. This Agreement is made for the benefit of the Municipality and.the Municipality shall be deemed to be the holder of the restriction created by this Agreement. The Municipality has determined that the acquiring of such a restriction is in the public interest. The Municipality shall not be subject to the defense of lack of privity of estate. The covenants and restrictions contained in this Agreement shall be deemed to affect the title to the property described in a deed recorded herewith as Barnstable County Registry of Deeds Book 21897 Page 120. IX. TERM OF AGREEMENT: The term of this Agreement shall be perpetual,provided,however,that the Owner of a Designated Affordable Unit or Units may voluntarily cancel the granted Comprehensive Permit and the terms and restrictions imposed herein. Such cancellation shall only take effect after: 1) expiration of the lease terms entered into between the Owner and Tenant occupying said unit and 2)notification by the Owner of said dwelling to the Zoning Board of Appeals of his/her desire to cancel the Comprehensive permit upon a date certain and the recording of said notice at the Barnstable County Registry of Deeds or Barnstable County Registry of the Land Court as the case maybe,.thus rendering said Comprehensive Permit void. Upon the cancellation of the comprehensive permit,the property which is the subject matter of this restrictive covenant shall revert to the use permitted under,zoning and the restrictive covenant shall be rendered void. X. SUCCESSORS AND ASSIGNS: A. The Parties to this Agreement intend,declare,and covenant on behalf of themselves and any successors and assigns their rights and duties as defined in this Regulatory Agreement and the attached comprehensive permit. 3 B. The Owner intends,declares,and covenants on behalf of itself and its successors and assigns (i) that this Agreement and the covenants,agreements and restrictions contained herein shall be and are covenants running with the land,encumbering the Project for the term of this Agreement, and are binding upon the Owner's successors in title, (ii) are not merely personal covenants of the Owner, and(iii) shall bind the Owner,its successors and assigns and inure to the benefit of the Municipality and its successors and assigns for the term of the Agreement. XI. DEFAULT: If any default,violation or breach by the Owner of this Agreement is not cured to the satisfaction of the Monitoring Agent within thirty(30) days after notice to the Owner thereof,then the Monitoring Agent may send notification to the Municipality that the Owner is in violation of the terms and conditions hereof. The Municipality may exercise any remedy available to it. The Owner will pay all costs and expenses,including legal fees,incurred by the Monitoring Agent in enforcing this Agreement and the Owner hereby agrees that the Municipality and the Monitoring Agent will have a lien on the Project to secure payment of such costs and expenses. The Monitoring Agent may perfect such alien on the Project by recording a certificate setting forth the amount of the costs and expense due and owing in the Registry of Deeds or the Registry of the District Land Court for Barnstable County. A purchaser of the Project or any portion thereof will be liable for the payment of any unpaid costs and expenses that were the subject of a perfected lien prior to the purchaser's acquisition of the Project or portion thereof. XII. MORTGAGEE CONSENT: The Owner represents and warrants that it has obtained the consent of all existing mortgagees of the Project to the execution and recording of this Agreement and to the terms and conditions hereof and that all such mortgagees have executed consent to this Agreement. IN WITNESS WHEREOF,we hereunto set our hands and seals this a day of 20�. OWNER BY: Signature Printed Name: off,,. , • 0\, e COMMONWEALTH OF MASSACHUSETTS County of Barnstable, ss: this aiday of 201 S before me, the undersigned notary public,personally appeared u.0't ��- /- the Owner(s),proved to me through satisfactory evidence identi cation,w ' were / ,to be the person(s)whose name(s)is signed on the preceding or attached document and acknowledged to be that he/she signed it voluntarily for the stated purposes. z 91 SKYE L. GREEN _ Printed: VEM NOTARY PUBLIC Tv y Commission Expires: MR, Q�S Commonwealth of Massachusetts J,.My Commission Expires :�'•r ='r ? , .July 2, 2016 4 �' r • hu "_.'oll. Y P U �' OWNER BY: '/fad Signature Printed Name: COMMONWEALTH OF MASSACHUSETTS County of Barnstable, ss: On this O�,) day of Ti -r\l. 201.5-before me,the undersigned notary public,personally appeared the Owner(s),proved to me through satisfactory evidence of identification,which were , to be the person(s)whose name(s)is signed on the preceding or attached document and acknowledged to be that he/she signed it voluntarily for the stated purposes.- y ota y Public ,. Pt ted: Lz My Commission Expires: C'4,r+. • .......cv c�� �, KJIAEN A.HEM 'Coo .4 x. NdwyPLd* =m. rr.""x�. w _ COWXWNApH OF W3&CH<1WM MY:2 : Colton TOWN OF BARNSTABLE 2:k 2 s ......'�•. BY: 1 ' TOWN MAN R COMMONWEALTH OF MASSACHUSETTS County of Barnstable,ss: �/ On th+s6r 'day of�/al?t 2046�before me,the undcrsigned notary public,personally appeascd IUTYIOt IL "11 A , the Town Manager for the Town of Barnstable,proved to me through satisfactory evidence of identification,which were & 1?Vi2 ACz7. , to be the person whose name is signed on the'preceding or attached document and acknowledged to be that he/she signed it voluntarily for the stated purposes. /4U Notary P lic a Printed: M Commission E fires: -�A §y SHIRLEE MAY OAKLEY ;.. �'. ' Nota, Public ' 't COIAIYtOMNEALTM OF MAS4ACNllSETTS M My oe Merd11® 2613 BARNSTABLE REGISTRY OF DEEDS John F. Meade, Register \A a oI ZIT I 3 `vim I� _ 1 p 7 9r.Diu,au.y77; :.'N.���rremus:y.- i 13x1� 1 7e f gX g: 1 i WO I .. � rt1�5x •� _ h I� I -77 y U-1 rn A,Cr . f i s r.';?.s r�r��sr p�c vo 'Sn DPW j / �l � -I—�c 6�• I I I x O f J®SIN � 1 C1os����iolc�L `J ! —VP � 6kQ i i o � O i I 1 V i 11 r. c \. s I, V � I RNISTABLE i �I lax /3 IJ l` 7S 1 k) r,;i.�.t z ,g f I 5 ,i� . �. 11 X J S li • . 1Js. - t IAyr_r� >t r. • �-.... �o=stiff ra A a., C1r L� To o y� (,> n n is (.� S;A sr 1 0 � �bL u, l�v.• I _ J• x 8 .. r,.1 5Tf9LZ 1 • lz ► S z I ` i � � � �L-C �'LYC•I I I J x �C St O C•Gs �� �.+.,,so�l I StoCa ¢.. ! l C1 o s c i�Si orc•�C 5777 I D 5.-, �ry._ I 2 ( /G x l O loy I j 4•Xla U Sl:d�r i� �f I� I t :5iotvq � I i 6 r r� i 1 C� *P i E •j � i. i t � I 1 �3 s7AI&s A .Mck, vct,^ 67p w.�leds vi— f'O)( )Y To m W 00 LoiT v 0 I f l� ®s�„k� 3 Co vvT<< -V `- lox av /tix 1 S i— i 3 ` 4x�a 0 Ac47 EnT�Gr�c� / r 3 �v e Rya tl R v i q R \ a °I� O►��'To�JSV R�, 1 i-� xlo IIxlB i y5iii�;ti i f,yX /a i . 13k16 gar$ f � � ',' t q iai (' r 'd1 s �l i r � r �` ��•n a J Vr ).� E t l � J Town of Barnstable Regulatory Services oFt"E rogti Richard V. Scali,Interim Director, Building Division TO WN OF Rr rn,1 E, ssB Thomas Perry, CBO, Building Commiss' - r 9�Ari639 A�`� 200 Main Street, Hyannis, MA 02601 �1 `9 P�`x 423 fD MA'S www.town.barnstable.ma.us Office: 508-862-4038 �-�_,7,�Fax�.508 7790-6230 � R° == Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I " \ S r �� C �� , �� e`11 am the owner/resident of the property located at: 3,71 d 7o'(JV 11 'z 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 note the Building Commissioner immediately in the event of the sale of this property. If there is no longer•a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of_a G c) . 2014. 4 C)5- Signat&e Phone Number Print Name j q:forms/famaffid.do c rev 11/08/11 Regulatory Services Thomas K Geiler,Director Building Division t BUAMsTAsLF ' Thomas Perry, CBO,Building Commissioner 16.39. ��� 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 °�� \ `t - I am the owner/resident of the property e located at: �►1 . u \ o, > Z . The`following members of my family will be the,sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: �� r v� \J 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 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. IIso 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 2013. Sub - '1'� Signature. Phone Number Print Name ��. , 7 rc VX e. q:forms/famaffid.do c rev 14/08/11_ Town of Barnstable Regulatory Services of � Thomas F. Geiler, Director T0�kjq or Building Division ' ELMMs''"B14 ' Thomas Per CBO Building Commissioner_'," mass �'� g _ r.r 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 1°Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is mac \e I am the owner/resident of the property located at: ��_7 oP The following members of my family will be the sole occupants of the Family Apartment at the .aforementioned address: Name &relationship to owner: ' V h e,'7-) Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or,subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 21 2012. CP 5_08- -7 75 = 0 5- Signature Phone Number Print Name i cRCS J C� q:forms/famaffid.do c rev 11/08/11 Town of Barnstable Regulatory Services pFIKE r 4n Thomas F. Geiler,Director f i, t ", t Building Division 9 .g Thomas Perry, CBO, Building Commissioner;{j *`' 1 ;1 { 1639' 200 Main Street, Hyannis, MA 02601 FD MA'S www.town.barnstable.ma.us Office: 508-862-4038 0a.+d_Fax:="508-790-6230 Town of Barnstable- Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �� J � I am the owner/resident of the property located at: G dw R The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: D` Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this _ day of LiPqv,_-r4 2011. Signature U V Phone Number Print Name J 1 -, Q• T'8� I Town of Barnstable Regulatory 'Services kIME roh Thomas F. Geiler, Director .( ti Building Division (9sw MASS. Thomas Perry, CBO, Building.Commissioner �Al i039. A 200 Main Street, Hyannis, MA 02601 FD MAC www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is \« -�� L I am the owner/resident of the property located at: 1 a The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: XX'_�- ol 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. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled: The apartment has been transferred to the Amnesty Program (Appeal No. . ) Other Sworn to under the pains and penalties of perjury this day of Zi�f, �201 Signature U 0 Phone Number b Print Name OFTHE t Town of Barnstable Regulatory Services &"MASS.`� ' Thomas F. Geiler, Director y Huss. � � �'Arfo�:,A�` Building Division Thomas Perry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: Tom FROM: Lois DATE: 12/7/10 RE: 97 Old Town Road, W.. Hyannisport Attached is the family apartment affidavit completed by Tracy Jean Foley after your meeting this morning. Are you approving the family apartment with this affidavit? y Or do you want a family apartment building permit application and a CO? They had a permit to restore to a single family, which I'll close out. } Town of Barnstable Regulatory Services oFtt Thomas F.Geiler, Director Building Divitsiot WtiS '(BARNgrABLMK ' Tom Perry, Building Cep �s ner MASS. d f 1639. n 39. 200 Main Street, Hyannis, I�tA I2 PM 3: 3 www.town.barnstable.ma.us Gt�1lSf9P� Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: ivly name is GC �d�e F, I am the owner/resident of the property located at: - �1 --�` CW n - C---------- - -- The following members ofmy family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner:__D.1�_ V4AtA,0K _Q_ Name & relationship to owner: The l'unrily Apartment will be file prinrun') .1'ccrr-rnnnd residence./or tilt' clbove-identified JUnlily members. In file event that the 1i.1'ted I-el0lil'c15 V41C(71c' A(lid crp(11-OPUnt, I Will inrlllediatc'ly nolifj,the Building C'ommissiom'r in writino. / lrl7del'.1(crnd that no.1'rrbletiill or sllblc osill,i'of .chic/Fcrinill'Apartment is permitted. I understand that I air required to lilt, cln Affidavit alnrr(allY Irilh the 131(ildilig Commissioner mlissioner living the narnes and relcltiowhip of occupants ill said 1�'annilt Apurtme'nt I ul.w undervond that 1 am required to compll- with all conditiclns imposed by the 113.4 .S%vec i(rl Pernnit and/or the Town of Bcrrnstoble Zoning Ordinunc•e.c Section 2404.7 1 1.'(rinil y Apul-tmelu.� / (NII et, to notify the Building Commissioner inlmediutelY in the event of the .rule of this prapel-t,y Ifthere is no longer a Family Apartment at this location, please explain: _ The apartment has been dismantled. -- ']'he apartment has been transferred to the Amnesty Program (Appeal No. _ ) ------------....---- Other Sworn to under the pains and penalties of perjury this J day of �--eb . 2009. Signature ":.,)ne Number Print Name �e Q/bldg/forms/famaf tid Rev.12/08 Town of Barnstable Regulatory Services pFTHEr Thomas F.Geiler,Director t �sl�r Pl 1 Building Division HAM STABLE, ` Tom Perry, Building Commissionelt MASS �3 P( 136 y 039• ,0� 200 Main Street,Hyannis,MA 02601 �AlFv Mp'�s www.town.barnstable.ma.us if S I ON Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is _ �'�^�^ S -o�Qy 1 am the owner/resident of the property located at: �1 C)1� A�l�hr�5��c� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: S • ���bo�a� 1 a-t�or C,ous�..� Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town ol"Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify.the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this a,�—day of 7v.noa,- 2008. Signature Phone Number t Print Name ox e. Qibldg/forms/famaffid Rev:1/03 Town of Barnstable n �c Regulatory Services J1 THE T° Thomas F.Geiler,Director Building Division '* saxrvsTAsc e, Tom Perry, Building Commissioner MASS. g A 1639• 200 Main Street,Hyannis,MA 02601 rEn �a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: �� �,C�3 � Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. .1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 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: Q' The apartment has been dismantled. , The apartment has been transferred to the Amnesty Program (Appeal No. <i )= s t co "-. Other ,.., Sworn to under the pains and penalties of perjury this day of 2007. i Signature Phone Number Print Name l c� sC Q/bldg&rms/famaffid Rev:1/03 j, Bk " 20827 1` :313 a-$ THE Town of Barnstable �p Tp� Regulatory Services s,►xxsznsre. ; Thomas F.Geiler,Director MASS.: ,0� Building Division jfD MA'S A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 97 OLD TOWN ROAD, HYANNISPORT, MA, holding title under a deed recorded with the Barnstable County Registry" of Deeds or Barnstable County District Registry of the Land Court in Book, Page -z 2 1 , or as Document No. being shown on Assessors' Map 268 as Parcel 072, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended for use as a family apartment,for year-round occupancy. The intended and authorized use is for DEB TAYLOR, COUSIN OF OWNERS JOHN AND TRACY FOLEY associated with the residential use on the same premises. This unit shall be used for a"Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single room,or in any fashion,,which rental would be a_violation of the Town of Barnstable's rules,regulations,and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. . WITNESS our hands and seals this_Lr�day of MCl r 200 to. TOWN OF BARNSTABLE OWNER(S) By: Building Commissione THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date D w Then personally appeared the above-named (owner),Jah/) -f /'�l �` /ac`f /"� and made oath as to the truth of the foregoing instrument,before me. Notary Public My Commission ExpiresPIANE M.ININALSON y -NOTARYPUDau" MY COMMSS ON Eli IRES OCT.4,2007 Q01dtownrd97 i Town of Barnstable �h Regulatory Services �t►te•r Thomas aY F.Geiler,Director �;, ,tk` ,'•„ !ik -�-,r 1 � Building Division * syszna Tom Perry, Building Commissioner,? " 1, 2 Mass. � 039. 200 Main Street,Hyannis,MA 02601 �FO MA'S A LU Office: 508-862-4038 Fax: 508-790-6230�, c t Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: t� My name is AM14 Yr '►r 'S��r/� I am the owner/resident of the property located at: �� QZ� loci✓ �4� ��Sr A- �Ir3 oat 7Z Map and Parcel Number 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: 6711AV 4 f PL 46�}' 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 c�O day of 2004. �o - 77S 3 o fJ igna 4e Phone Number Print Name/;/A4, S�017- Q/bldg/fomis/famaffid Rev:1/03 Bk 16594 Ps 1 u "Ir34 42 Town of Barnstable Regulatory Services °FTME Kok, Thomas F.Geiler,Directo , -or BPIR�51NB E Building Diyision� 5 • aaxxsrAsM Tom Perry, Building Comm, Mass 9 1639. ,0�' 200 Main Street,Hyannis,MA 6101. llcaR Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I.being on oath. deDose and state as follows: My name is � ���Y1V - I am the owner/resident of the �' r property located at: �� OL� r`'Oly/✓ '� — �"ST" �tY/9-.c/i✓sls/�e•� � o-2G -� Map and Parcel Number 74 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 ll_ Page The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name &relationship to owner: . The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, Twill 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�ains and penalties of perjury this / day of `�",� 2003: Sign ture Phone Number Print am /4/P% 1_� o � Town of Barnstable Regulatory Services r �ppTHE tqy� Thomas F.Geiler,Director BuildiftyD fVJJiW9TABLE EnRNSTAai E Peter F.DiMatteo, Building Compm`i`s''s,io er 1639. �� 200 Main St 1 nis,�Mt�M2C� 9 • Office: 508-862-4038 Fax:.508-790-6230 01V Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is /9iP/G. YV -7 S/�/ !�� I am the owner/resident of the property located at: &v °`J&"v Map and Parcel Number 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: 1 /�/�/✓ -� FoL�`y 42 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. 1 also understand that 1 am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. /1Y 1`3e04 E ssThe apartment has been transferred to the Amnesty Program (Appeal No. ) ,q./so Other Sworn to under the pains and penalties of perjury this T/�j�o�day of /Yj9/;c 2002. Signature G v_ Phone Number S'o /L Print Nan.::; Q/bldg/forms/famaffid Rev:010702 1 COMMONWEALTH OF MASSACHUSETTS . BARNSTABLE AFFIDAVIT I, 14A.04/�20/ 17— .-SW/%� , being on oath, depose and state as follows: i 1. I reside at Gq' /owlyl n y 11 l SeM r f 2.) I am the owner of the property located at shown on Barnstable Assessors' maps as MAP c2C PARCEL Q 7A 3.)`I Do Do not have a Farqy Apartment at this location. 'PS -0 942 4.) On , 199 , the Zoning Board of Appeals, on Appeal No. granted me a Special Permit/Variance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME 40A, Relationship to owner: SOS✓ 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. Sworn to under:the pains and penalties of perjury this _day of Signature Print N e ���/� CIA✓ REC COMMONWEALTH OF MASSACHUSETTS BARNSTABLE FA `FIA�"1 TOWN OF 8A NSTA8LE I, --- — --- --------------------------- DIV. depose ands e as Allows:/ 1.) I reside at_�/ --- -- --------- 2.) I am the owner of the property located at ----------------------------------- ----- ------------- ------------- shown on Barnstable Assessors' maps as MAP_ __PARCEL_69 3.) I Do___ _______Do not___________ have a Family Apartment at this location. 4.) On__/�O_�-3------- 199____, the Zoning Board of Appeals, on Appeal No. granted me a Sp cial Permit/Variance to maintain a Family Apartment at the above address. 5.) 1 understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will bethe sole occupants of the Family Apartment at the above address: ����- 0� `7 a) NAME----------------------- ----------------------------------------------- Relationship to owner:__-- -------------------------- 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. _/9 -9 y_ --------------------- ------------ 12.) I agree to immediately notify the Building Commissioner in the event of the sale of the above- listed property,. Sworn to,under,the,pains and penalties of perjury this_ ?9__day of-_ ____� 199 _=__ Signature ---------- -------------------- Pii t N e //7 -------------------- ------------ -- - i ' COMMONWEALTH OF MASSACHUSETTS B.�RNSTABLE AFFIDAVIT -------------- being on(iath„< depose and state as follows: �4S4� 1 ✓qN. 1.) I reside at�7aL Ql _���/�-'�°�----GUST _�� �/✓ 44 T_ 3�'/ 67., 2.) I am the owner of the property located Q j/ at _SnM shown on Barnstable Assessors' maps as MAP__a/�--_--PARCEL_ O 3.) I Do__ v__-----Do not __have a Family Apartment at this location. 4.) On--- LL Lb 19993 , the Zoning Board of Appeals, on Appeal No. granted me a ecial 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. --_XI /12/11 /e� -- ------------------------------------------- Relationship to owner:____ski`✓ 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. le—=9G —----- 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. :Sworn`to.under the pains and penalties of perJury this _ ___day of__I.- ----- 199 ---- Signature : . _ P t Name-Zl' ------------------------------------ oFt"E'+� The Town of Barnstable Department of.Health Safety and Environmental Services Building Division MAM �m� 367 Main Street, Hyannis MA 02601 ArEp MA'S A Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commission January 21, 1998 The Smith Residence 97 Old Town Road PO Box 354 West Hyannis Port, MA 02672 Re: Family Apartment located at the above address Dear Mr./Ms. Smith, Our records indicate you have not filed an affidavit regarding the above referenced family apartment in quite some time. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable Zoning Ordinance that an affidavit be submitted annually for the duration of such occupancy. Please indicate the status of the family apartment on the enclosed affidavit return to this office by February 15, 1998. Enclosed is an affidavit for your convenience. Thank you in advance, C�- Ralph Crossen Building Commissioner QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 01/21/98 PARCEL ID 268 072 GEO ID 17067 LOT/BLOCK 17 DBA PROPERTY ADDRESS OWNER SMITH 97 OLD TOWN ROAD MARILYN J HYANNIS P 0 BOX 354 W HYANNISPORT MA 02672 PHONE DISTRICT HY DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY(NOTES) ZONING DIST/ZOC RB SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? ## BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 15246 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST WP (N) EXT / (P) REVIOUS / NO (T) ES / PER (M) ITS / (V) IOLATIONS / (G) EOBASE / (E) XIT COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss: AFFIDAVIT it �2g&� being on oath, depose and state s +fjj40 _::_ ' 1 . ) I reside at 9,7 • 2. ) I am the owner of he Pr per y located at shown on Barnstable Assessors ' Maps as: Map _ 2w'Q , Lot D Z2. 3 . ) On + , the Zoning Board of Appeals, on Appeal No. .3 - .r -.� granted me a special Permit to maintain a family apartment at- the above address. 4. ) 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. 5. ) The following members of my family will be the sole occupa of the f y _apartment at the above address: (1) Name: RelatioPship to ner: (2) Name: v`�j.�, • Relationship to Owner: 6. ) The family apartment ill be the primary year- round residence for the above-identified family members. 7. ) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 8. ) I understand that no subletting or subleasing of said family apartment is permitted. 9. ) 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. 10. ) I understand that I am required to•.comply with all con itions mposed by the Board of Appeals in Appeal No. 10. ) I agree to immediately notify the Building Commissioner in the event of the sale of the above-listed Property. Sworn to un er the pains d day of FPenalties of perjury this 19 ...... -_ . -- gnature WERMREV1EW (Please Print Name) : � JUN 17 1994 �-- E0EIVI ti COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss : AFFIDAVIT I ► RAe/L //rl ,7 and state as follows : being on oath, depose —'" res id at� O nawl✓ ly am the S owns of the �S D� property located at ° shown on rnstable Assessors ' Maps as : Map o?� Lo /o2 Appeals, on A ° 19 ° the Zoning Board of jpp�eal_ No."" -' - gr,,z:nt.ed me a --eCia1 Perm" to maintain a family apartment at the above address. 9 • ) I understand that the family apartment. may only be ` occupied by .members of my family who are persons me by blood or by marriage . on� related to 5 . ) The following members of my family will be the sole occupy s, of th fa ily rtment at the above address (1) Name: / Relationship to Owner: � y - ► (2) Name: L Relationship to Owner: _L o ° 6: ) The family apartment will be the 'PrimarY round residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment , I will immediately notify the Building Commissioner in writing. 8 . ) I understand that no subletting or subleasing of said family apartment is permitted. 9• ) 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 . 10 . ) I _ understand that I am required all co d tio to .comply with n imposed by the e0a-, „ :_ _ _ , .,+ .,�F, •uis in Appeal No. 10 . ) I agree to : immediately notify the Building Commissioner in the event. of the sale of tiie above-listed Property. Sworn day to ul/�.� Le pains and da of 199 Penalties° of Perjury this ° TOWN OF BARNSTggLE BUILDING DEPT i gnat u r e) n JUN (P ease Print Name) : .' 41 2 2 1993� /l�tie/� Yif ,i T�/ IN . COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss ; AFFIDAVIT I ' / .��tY�l T S�lr� and state as follows ; being on oath, depose reside at 49------------ �rj, 2 . ) I am t e owner of the property located at 5�14Ah,r_ shown on Barnstable Assessors ' • Maps as : Map Lot .. a �� 3 ' ) on 19Y.3 , the Zoning Board of Appeals, on Appeal No._ Arm{ , granted me a special Permit to maintain a family apartment at the above address. 9 . ) � I understand that the family apartment may only. be . occupied by ,members (,f my family who are persons related to me by blood or by marriage . 5 • ) The following members of my family will be the sole occupants, of the family Apartment at the above address; (1) Name f3___f/�9 (/R 1-71 Relationship to Owner , (2) Name ; ��if° ,T" S --- -- Relationship to Owner; 6 . ) The Family ape j1-tment will be the ` round ry year-* residence for the above-identified family Primumembers . 7 . ) In t:.he event that the above-listed relative(s) vacate said apartment. , I will immediately notify the Building Commissioner in writing . S. ) I understand that no subletting or subleasing of said family apartment is permitted. 9• ) I understand tt-,�:jt. I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members oc family apartment . cupying said 10 , ) I understand that I am required tO'-comply with all conditions imposed by the Board of Appeals in Appeal No. 10 . ) I agree to immediately notify the Buildin Commissioner in the event, of the sale of the above-listed property. orn to u de the Pains 19 0-nd ' day of penalties of perjury this � 2. .� (Signature) XUC ra (P ase Print Name) n!1G DEPr, — :lSi„BLF i i 7 `JUN 01991 COMMONWEALTH OF MASSACHUSETTS UNWE N BARN BLE, ss: AFFIDAVIT a �' I ► being on oath, depose state as f 11 s : 1 . ) D r s i at a a. 2 . ) I (C\^a�m ' Qe owne of he property located at �7'3Y , shown on Barnstable Assessors ' Maps as : Map v269 Lot /,0`7.A. K 3 . ) On *//G , 19,1?'3 , the Zoning Board of Appeals, on Appeal No. J9-1;- 3 - 15t y , granted me a special permit to maintain a family apartment at the above address . 4 . ) 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 . ° 5 . ) The following members of my family will be the sole occupants of tie famil apartment at the above address: (1) Name: Relat o ship t 0 (2) Name: Relationsh ' to Owner: ° 6 . ) The family apartment vAll be the primary year- round residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing . 8 . ) I understand that no subletting or subleasing of said family apartment is permitted. 9. ) 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 . 10 . ) I understand that I am required to•.comply with ail conditions imposed by the Board of Appeals in Appeal No. /-1-fr3-9 f� 10 . ) I agree to immediately notify the Building Commissioner in the event of the sale of the above-listed property. worn to u der the pains and penalties of perjury this 7— day of 19?. ( gnature) (Please Pri t Name) : COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss: AFFIDAVIT I , I'MoelC_/(✓ 7- being on oath, depose and state as follows: 1 . ) I reside at 9,7 e94 o/ 7_61k)Al /V 2 . ) I am the owner of the property located at shown on Barnstable Assessors ' Maps as : Map .26�C , Lot �6%Z Af� � 3 . ) On /yoU /a 19 k3 , the Zoning Board of Appeals, on Appeal No. granted me a special permit to maintain a family apartment at the above address . 4 . ) I understand that the family apartme►-,t may only be occupied by members of my family who are persons related to me by blood or by marriage . 5 . ) The following members of my family will be the sole occupants of the family impartment at the above address: ( 1) Name: 10 Relationship to Owner: T")K_ (2) Name: Relationship to Owner: 6 . ) The family apartment will be the primary year- round . residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment , I will immediately notify the Building Commissioner in writing. 8 . ) I understand that no subletting or subleasing of said family apartment is permitted. 9. ) 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 . 10 . ) I understand that I am required to;.comply with all conditions imposed by the Board of Appeals in Appeal No. 10 . ) I agree to immediately notify the Building Commissioner in the event of the sale of the above-listed property. Sworn to under the pains and penalties of perjury this day of 19�?O . (S ' nature) (Please Print Name) : goseph D. DaLuz Telephone: 775-1120 Building Commissioner Ext. 107 TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING HYA.NNJS , MASS . 02F0.1 May 17 , 1990 Mrs. Marilyn J. Smith P. O. Box .354 West Hyanni8port , MA 02672 Re: Family apartment located at 97 Old Town Road Dear Mrs. Smith: A year ago you filed an affidavit with this office re the above referenced family apartment . It is required, by Section 3-1 . 1 (3) (D) (1 ) of the Town of: Barnstable Zoning By-law, that an affidavit be submitted annually for the duration of such occupancy. Enclosed is an affidavit form for- your- convenience,. Please (30mPIP-te this fot-m and r-eturn it t'o this, C).f:tice as soon as possible. Peace e- h D D Uilding Commissioner JDDlkrn enclosure i COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss: AFFIDAVIT I , /yW 14.Yll S SIV O' r being on oath, depose and state as follows: 1 . ) I reside at 97 OL.A/ T 4411V Ae0Ab A/Es r 1-1y,A111/V/is PO/P 7 r'JA Da G J.� 2 . ) I am the owner of the property located at -5 4/,7, shown on Barnstable Assessors ' Maps as : Map `r 6 , Lot 0 9 3 . ) On /V/9tz /D , 1993 , the Zoning Board of Appeals, on Appeal No. / Y granted me a special permit to maintain a family apartment at the above address . 4 . ) 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. 5 . ) The following members of my family will be the sole occupants of the family partment at the above address: (1) Name: 42/f ly 4SM/T& Relationship to Owner: 15&IM (2) Name: 4-0/e/ T 17',01 Relationship to Owner: 1)/91fC 117_01 - /t/ - Z_4ed r 6 . ) The family apartment will be the primary year- round residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 8. ) I understand that *no subletting or subleasing of said family apartment is permitted. 9. ) 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 . 10 . ) I understand that I am required to comply wi'cii all conditiony� imposed by the Board of Appeals in Appeal No. /9e.3 - 9t/ 10 . ) I//agree to immediately notify the Building Commissioner in the event of the sale of the above-listed property. Sworn to under the pains an penalties of perjury this ,eS day of ✓I76f y (S gnature) (Please Print Name) : Joi5epn D. DaLUZ Telephone: 775-1.120 Bu i i cl i ng Commissioner TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING HYANNIS, MASS. 02601 April 19, 1989 Marilyn J. Smith P.O. Box 354 West Hyannisport , MA 02672 Re: Appeals No. 1983-94 Dear Mrs. Smith: On November 10, 1983 , as applicant(s) you were granted a Special Permit for a family apartment. "The intent of this by-law shall be to allow one ( 1 ) additional living unit, complete with kitchen and bath to supply a year-round residence for a member or members of the property owners family, . . . . . . . . . . . " In addition, the by-law also states that "The property owner, and the person or. persons who will reside in the family apartment shall sign affidavits before occupying said family apartment and further, all shall sign said affidavits each year said family apartment is occupied. . . . . . " . Within sixty (60) days from the date the person or persons residing in the family apartment vacate the premises, the owner or his representative shall remove the kitcr)en facilities and request the Building Inspector to inspect the premises. It is important that you understand that there are restrictions which relate to the applicant's family living at the same premises. The use cannot be transferred. Conviction of a violation of this by-law is subject to a fine of $1 00 per day for each day from the established date of offense and, also, subject to a criminal complaint to issue from the First District Court of Barnstable. Affidavits must be signed and filed at the Building Commissioner's office between the hours of 9:30 A. M. and 1 :30 P. M. Monday through Friday. This by-law shall be strictly enforced. Peace, jo�s'ep n D. G uz Building Commissioner JDD/Km cc Boara of Appeals Town Counsel g oA � n 120 sq. ft.) ertificate of Appropriateness is needed -Pt. LF255-04 R255-04 MONTHLY RENTAL AGREEMENT THIS AGREEMENT, ptered into this I S'r clay of l r,� 20 , by and between VA A N(-) jy-WV ('W4C,!�y 7-� ,t,-LE� , hereinafter Lessor, and Y , hereinafter Lessee. WITNESSETII: That for and in consideration of the payment of the rents and the performance of the covenants contained on the part of Lessee, said Lessor does hereby demise and let unto Lessee, and Lessee hires from Lessor those premises described as: located at: 'I )I 1 J (?JJ tJ ti, A (A o for a tenancy from month-t -month commencing rni the clay of , 20 and at a monthly rental of VC- V--.u ti n Q,.c�n� 4 ,�_-7�o11 ra a,S Dollars ($ 5 "`' ) per month, payable monthly in advance on the 1 S'T day of each and every month, on the following'FERMS AND CONDITIONS: 1. Occupants. The said premises shall be occupied by no more than adults and children. 2. Pets. No pets shall be brought on the premises without the prior written consent of Lessor. 3. Ordinances and Statutes. Lessee shall comply with all statutes, ordinances and requirements ' of all municipal, state and federal authorities now in force,or which may hereafter be in force, pertaining to the use of the premises. 4. Repairs or Alterations. Lessee shall be responsible for damages caused by his negligence and that of his family or invitees and guests. Lessee shall not paint, paper or otherwise redecorate or make alterations to the premises without the prior written consent of Lessor. All alterations, additions, or improvements made to the premises with the consent. of Lessor shall become the property of Lessor and shall remain upon and be surrendered with the premises. 5. Upkeep of Premises. Lessee shall keep and maintain the premises in a clean and sanitary condition at all times, and upon the termination of the tenancy shall surrender the premises to Lessor in as good condition as when received, ordinary wear and damage by the elements excepted. 6 Assignment and Subletting. ,Lessee shall not assign this Agreement or sublet any portion of the premises without prior written consent of Lessor. 7. Utilities. Lessee shall be responsible for the payment of all utilities and services, except yqS which shall be paid by Lessor. i- 8. Default. If Lessee shall fail to pay rent when due, or perform any term hereof, after not less than three (3)days written notice of such defjult.given in the manner required by law, Lessor,at.his option, may terminate all rights of Lessee hereunder; unless Lessee, within said time, shall cure such default. 11' Lessee abandons or vacates the property, while ih default of the payment of rent, Lessor may consider any property left on the premises to be abandoned and may dispose of the same in any manner allowed by law. NOTICE,: Contact your local county real estate board for additional forms that may be required to meet. Your specific needs. I Co)1992-2(Nll Made fi-Z.1'rnducts;Inc. Page Rev. 10/0I This product does not constitute the rendering of legal advice or services.This product is iniendcd for informational use only and is not a substitute for legal advice.State Iaws vary,so consuh an attorney on all legal matters.This product was not necessarily prepared by a person licensed to practice law in vour state. AZAB zk f � t 9. Security. The security deposit in the amount of$ 550-0r' shall secure the i performance of Lessee's obligations hereunder. Lessor may, but shall not be obligated to, apply all or portions of said deposit on account of Lessee's obligations hereunder. Any balance remaining upon termination shall be returned to Lessee. .Lessee shall not have the right to apply the security deposit ill payment of the last month's rent: 10. Right of Entry. Lessor reserves the right to enter the demised premises at all reasonable hours for the purpose of inspection, and whenever necessary to make repairs and alterations to the demised premises. Lessee hereby grants permission to Lessor to show the demised premises to prospective purchasers, mortgagees, tenants, workmen, or contractors at reasonable hours of the day. 11. Deposit Refunds. The balance of all deposits shall be refunded within two(2)weeks (21 days in California) from date possession is delivered to Lessor, together with a statement showing any charges made against such deposits by Lessor. 12.Termination. This Agreement and the tenancy hereby.granted may be terminated at any time by either party hereto by giving to the other party not less than one full month's prior notice in writing. 13. Attorney's Fees. The prevailing party in an action brought for the recovery of rent or other moneys due or to become due under this lease or by reason of a breach of any covenant herein contained or for the recovery of the possession of said premises, or to compel the performance of anything agreed to be done herein, or to recover for damages to said property,or to enjoin any act contrary to the provision hereof, shall be awarded all of the costs in connection therewith, including, but not by way of limitation, reasonable attorney's fees. 14.Radon Gas Disclosure. As required by law,(Landlord)(Seller)makes the following disclosure: "Radon Gas" is a naturally occurring radioactive gas that, when it has accumulated in a building in sufficient quantities, may present health risks to persons who are exposed to it over time. Levels of radon that exceed federal and state guidelines have been found in buildings in Additional information regarding radon and radon testing may be obtained from your county public health unit. 15. Lead Paint Disclosure. "Every Purchaser or lessee of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence quotient, behavioral problems and impaired memory. Lead poisoning also poses a particular risk to pregnant women.The seller or lessor of any interest in residential real estate is required to provide the buyer or lessee with any information on lead-based paint hazards from risk assessments or inspection in the seller or lessor's possession and notify the buyer or lessee of any known lead-based paint hazards.A risk assessment or inspection for possible lead-based paint hazards is recommended,prior to purchase" 16. Additional Terms and Conditions. I_ r '0 (LS n05C,t,::yjnc Cry fl rz C)/, ���✓L wA 8CF D/g'�o� i9ivdz_040 19" r"�'/yfi�.t✓T /E'o E c'J/� •C o/c .S 19/P G IVJ Y S06LEr 44�Rsr- Page 2 r IN WITNESS WHEREOF,the parties hereto have executed this Agreement in duplicate the day and year first above written. Signed in the presence of: t Witness Lessee WitnessT Le sor C411't►�Yi,r� GOZ( Q 2 ZUD7 � / NOTICE: State law establishes rights and obligations for parties to rental agreements. This agreement is required to comply with the Truth in Renting Act or the applicable Landlord Tenant Statute or code of your. suite. If you have a question about the interpretation of legality of a provision of thisagreement, you may want to seek.assistance from a lawyer or other qualified person. j Page 1 AZAB t 7 a_61 .row/i 1 3 Cape Cod Five Cents Savings Bank Account: 85200860E Period: 3/21/2009 TO 4/20/2009 Page 6 DEBORAH TAYLOR _• .: 417' DE RAH TAYLOR P.O.BQ\5!9 N'la1'MANI➢5PUKT,31A^T6]_O3J9 ll'GS117A\11fPORT,f1A Q:L:T-0SJi .. 51]iwMtl � TwMI, �j��c�I ti ilL'�Err�+Ma IU E r$ -7000 $ 7 p CAPE COD FIVE CENTS SAVINGS pb CODFIYECENTS ic VINGGi, K - ome.nx.Nmn) ra, s'fa7 Jl�C 1Ei i(1 on°1au°s'u<mav �It�on� __ �., 00 1:.2 1 i 3 7 LO?Eli: 8 5 2008606u• 01.17 a'00017000.' - 1:2113710781: 85 2008606r 0419 0000 7000/ 417 3/27/2009 $70.00 419 3/30/2009 $70.00 DEBORAH TAYWR 420 DEBORAH TAYLOR 421 R 139 15'fSTIn IN.Y1JPURT,AN RT6M-0534 P.O-ROTJJ9 ZOQ�) �)—N] IVESf)1)A.\NBPUKT,1Ll UT6T:OJJ9 � f] 51],w➢))f 20�nn N Ayn• $ C� UD `�-9., \'� V.>l\��a.�t�i.t�w+,.�i.s I$ ��711io(a CAPE COO FIVE CENTS SA INGS BANK P ) CAPE COD FIVE CENTS SAVING BANK - W)FMR.Nnws PO.epx)0 - 1773 OPYN4.N�w611 1:2L1,37L0781: 85 20086d r 0420 �''C0006 9000." 1:2113710781: 85 2008606", 0421 420 4/1/2009 $9.0.00 421 4/14/2009 $240.00 DEBORAN TAYLOR 422 DEBORAH TAYLOR 423 ,VO:R61 U9 P.O.R¢C J39 ' G M'ANYIS)Y1RTFLIM_G:bll:l L 51)iwRi)1 11•LRlfl'A�SIwpRT,TN➢T6i:-0JJ9 sl)Iw.TN] $ Ob CAPE COD FIVE CENTS SAVINGS BANK CAPE COD FIVE CENTS SAYINGS BANK CM �nx)e P.o ooxm ameaRs,r.uwm> •. onlFa)xuxm•s) ^- 1:21137L0781: 85 20086060 0422 )''❑ ❑70000x'' 1:2LL37L0781: 85 2008606r 0423 e''000 02000.+ 422 4/13/2009 $700.00 423 4/14/2009 $'20.00 DEBDxAHTATwx VD 424 - NTSTHSA\:TSPORT)LI O_6:-n339 Doll nlm � �til Ae-' D.ru» 8 CAPE COD FIVE CENTS SAVINGS B fIK� vo acx io - oxIFWS.MSOMss _ 1:21L3730781: 85 2008606r 0421, ,''0000 2000�' 424 4/20/2009 $20.00 2927 -10634 t i I w ? _ 0 4j.�( ,_ C 128 DE90RAH �R TAYL r \ P.O. BOX;539 ,�� r�\ WEST HYANNISPORT, MA 02672 0539 Date: of `� 53-7107/2113 s � Paq.ToThe Order Of r < " `` V Dollar14 _ Cold ' P.O.BOX 10 ORLEANS,MA 02653 q \ 1 e:- 2 L 3710781: 85 200860F3 01 28 o �F � � r '. : t at t• rr� s--� �S333v. F,s -�.st 7.....:�?>I a � � fir". x P rp I F +4 1 'r e t7 153 DEBORAH TAYLOR ° C P.O. BOX 539 WEST HYANNISPORT, M A 02672 0539 Date a< 53-7107/2113 � PagToThe •1 :> Yam' _ �.'" 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A ," as ,S.Z *x.; r `k 3, Qet d A licatiq ` 2009087=1 s 1 7 ,w `r= ,pp - � t Ovine ( Status x _ ` �'EXP.IRED. �" 1 � Close f Deny .> '^. h FOLEV,'JOHN': Department 6300 BUIL©IMG DEPART �i Workflow Project/Activity435 RESTOREsTO SI GLE$FAMILY` ,` >=Y' t ' �- Active . r a gusinessk� .. ParWncjJMisc Descripban l' RESTORE'TO SINGLE FAMILY DWELLING "REMOVALfOF KITCHEN.SINK tot Statu.code CLSD C 0 - Descriptian 2 STOVE ANDCA BIIVETS REPLACE Ti2IM;CL`AF�EXTERIOR1 OX10 R04F f v'. Pro ert '• � Ska*us m- FAMILYdART:;P p.. Y }> A licantx Business Estimated cost '+ '¢ y300 Fees eFFective 06 081 2009 s w. r Assigned tom , , . _ ,as Reactivake �� _ .. _ � � •. �� .ter �„ __� � „�� v� ��` � , Property!Use �' Non ConForrrringDates!Mist Permits `, AdJUstFees aYCeI $ a 26$Ur2 � �s ' �' ° km 31 Existin use 1090= .. MULTIPLE�F 97 OLD TOWN ROAD " �� F ` `� � 9 .w OCakl4n ,r x ' �c 4, HYANNIS MAx zoning RB iZESIDzRB ;' Aunlcipalikyr'f HY� Mis�$Chgs � mema° Paymk tlistary; X, . P Floadzone' , r.x Proposed us" 1090 ... MULTIPLE t Audit History. ot Section!Phase 0. 4 s= � ;¥ w ietween .a s r zarnng RBA,RESIORBA Summ Permit g{ . t. b �e i . nd p k ?f Lw 2 � rr .;r i memo Copy ocationdesctRz ANN gg ,2-0 �Permik�Alerks� � - __ •� �� '' - "�I=1- ti *•� +� rs,'.. .yam, 3.x'"x�€�.pt''�t+ .av !�., ., t '': —ti .k .T. 1�' 3 Prerequisites �Hazrd�Reskr;c° Lei Nam'-I ���B4�nds� f�Sub-Addrs (�=Text [�v Plan Rev _ 'Y .-ri `-,�,': .� .t - .y,,.afi:'� 'L s.� � 9-•..s.. --'�- MKF3 Prior„Hrstory ( =Inspectlons,4 ` Violations " �I�Reviews ��Open Items �,Warrnngs' .� � a� mo.,3 :.:; r ,.s: ;. �safi'a; -7 ,§^,.�..- a``i'x.- . . t. .. :��" ros .=a o 4 ..e. - r k Km- 3'W, ::y ,ay t. w @ �`. ' a�,� � a- Y,'�t.• Close!Deny khe current application , 49, "rP'. ,.S ," 'K -�� 'a=�' +7a `""n*' 3r� A.y s• y;k•# ,m., r.^TJ'` � r; `" ,. kw as" ,., fir', "`,�#,, t . . TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION-.,- Map Parcel Application # Health Division Date Issued Conservation Division = Application Fee Planning Dept; Permit Fee; Date Definitive.Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address Village V\ V\ 03L �. Owner v�.v• :�\e:� Address Cl� y1� l ov l^ ENV\[ S oC-1 Telephone c nn cs v Permit Request k � 4, RcP1c.�L �c rr. \mQ, r�.5 �� �,�,�bEC 2,x��c.s-te;�..' 1-,� a �7a�h1 Ctr�1 > ���� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation - Construction Type Lot Size ' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,0 Two Family ❑ Multi-Family (# units) ` t C= Age of Existing Structure Historic House: ❑Yes ❑ No On Old King' ighway:, 0 Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other co Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft Number of Baths: Full: existing new Half: existing rnr Number of Bedrooms: I existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas '❑ Oil ❑ Electric UdOther c0 cAL Central Air: ❑Yes a No Fireplaces: Existing New Existing wood/coal stove: ❑Yes X No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes Xf No If yes, site plan review#_ Current Use ����� p� Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ame C' r. ��� Telephone Number address T) CP L-0 License # Home Improvement Contractor# i, Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE CI s FOR OFFICIAL USE ONLY jAPPLICATION# DATEI - t ISSUED t MAP/PARCEL NO. i ADDRESS F VILLAGE ' r OWNER DATE OF INSPECTION: _ i FOUNDATION _y 1 FRAME tt INSULATION FIREPLACE 7 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING C r, r I DATE CLOSED OUT ASSOCIATION PLAN NO. ` The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations• 600 Washington Street . Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ` Please Print Le 'bl Name (Business/Organization/Individual): Address: City/State/Zip •.:� � \C% � s('^ e�� Nw 0 :6 Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I h hired the sub-contractors 6. El New construction have employees(full and/or part.time). Remod ..2:0 I am a'oleprpprietor or partner-' listed on the attached sheet 7• .❑. elin g ship and have no employees These sub-contractors have g,'❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers'-comp.insurance comp. insurance.$ 5. ❑ We are a corporation and its •10.❑Electrical repairs or additions required.] 3. I am a homeowner doing all work officers have.exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required]t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp.insurance required] "Any applicant that ehccks 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. YContractors 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. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure io secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a finq tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a-STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insu.nncc covers e verification. I do hereby certify under the pains-and penalties ofperjury that the information provided above is true and correct. Signature: Date: Phone# S®� 11> 6o:� L Official use only. Do not write i i this area,tb be completed by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle one): • 1.Board of Health '2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M Information and Instr-uctions W 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-engagedin ajomt en rpnse a -inclu-dmgth8 leg represenFa�ve 6f- lec�ase�izmpiuyer, orthe =--.-.- -- receiver or thatee 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 in.�ance 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-contiactor(s)name(s),addresses)andphone number(s) along with their certificates) of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than th ur e members or partners,are not required to carry workers'compensation insurance. If an LLC or UP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly..The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(ifnecessary)and under"Job Site Address" the applicant should write"all-locations in (city or t.own).".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 permifs or licenses. A neyv affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (Le.a dog license or permit to brim 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 MassachUSC:tU Departmwt of Industrial Accidents Ofee of Investigations 600 Washington Street Boston,MA 02111 TO. # 617-727-4900 ext-406 or 1-977-MASSAFE. Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Town. of Barnstable Regulatory Services t sAxt�srA.13LE. Thomas F. Geiler,Director Building Division plED Tom Per ry,Building Commissioner - .200 Mairi.-Strcet;--Hyah nis;MA-026-01 — _.._. . . _._.._..... www.town.barnstable_ma us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION (, e� Please Print DATE:C/o I1 T JOB LOCATION: �� DEC \,J e T H�C" •• number street village �- "HOMEOWNER": Jule \t:- S 08 " -7 S " 6 os"C SO g -C� name home phone# work pliant E.hT # CURRT MAIL]NG ADDRESS: P,O. ,�OX �JeSI ��Cv��naSporl 111Qv 0a`6 -7 city/town state zip code The c7arrent exemption for"homeowners"was extended to include owner-occupied dwellium of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended Lo- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeovimer. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildintr permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned."homeownee'certifies that.he/she understands the Tpwn of Bazpstable:Buildia Dr, arhnent minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Horncowncr Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any bdn=wner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1D9.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homcovena shall ad as supervisor." Many homeowners who use this excnvtiem are unaware that they are assuming the responstbilitics of a supervisor(see Appendix Q, Rulcs&Rcgulations'for licensing Construction Supervisors,Section 2.15) This lack of awarzness often results in serious problems,particularly when the homcowna hires unli=nsed persons. In this case,our Board cannot proceed against the unlicensed Parson as it uvuld with a licensed Supervisor. The homeowner acting as Supervisor is uhimate}y responsible. To ensure that the bomeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homcowncr certify tbkt l cfshe understands the responsibilities of a Supm-visor. On the last page of this issue is a form curn=tly used by several towns. You may can t amend and adopt such a formfcatifieation.for use in your community. Q:farms:hcmccxcmpt z r ti Town of Barnstable Regulatory Services per$; Thomas F. Geiler,Director 16 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town-barnstable.ma.us Office: 508-862-4038 Fax: SOS-790-623C Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this binding permit application for. .(Address of Job) Signature. of Owner Date Print Name If Propedy Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. i W 7 X l i C1� aoX � L� L �- .o r CI, iv s -� i Li i MASSACHUSET[S`,UMFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:� j rn , MA: Date: I ) 'ermit# (ja 9 Owners Name: Buildin Locationvl Type of Occupancy: Commercj'a1r Educational 0 Industrial Li Institutional Residential �y, New: L__._i Alteration:10 Renovation Replacement:� Plans Submitted: Yes No0 O t 4 Lei c L FIXTURES z 0 wi cn rn v m m ¢ m aam } Q l2k 0 w 0 W ;U) a -le n Q z _ Z U, Z � n LLJo O wi X w ❑ i 1 z W c� z W z 0 a. —LL ❑Q¢ m m ❑ ❑n u C7 = Yw ❑ JO ❑ to i o� zQ - n. 1 -1 w aw0 � �1 � Q o Cn } 0 0 o aa o a0 cC cn cn I— ❑ O SUB BSMT. k BASEMENT k 1 rFLOOR N 2 FLOOR 3 FLOOR �► 4 FLOOR 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR Check One Only Certificate# Installing Company Name: °"n f Zl f Corporation P06 Address ;JI _- cCityliown ��. cfState MA I _ 0 Partnership Business Tel: Fax: 44 _ Firm/Company Name of Licensed Plumber:lW� � - INSURANCE COVERAGE. I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes NoF If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity Bond OF OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement Check One Only Si nature of Owner or Owner's Agent Owner [ Agent Lj I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my . Knowledge and that all plumbing work and Installations performed under the permit issued for this application will be In compliance with all Pertinent provision of the Massachysetts State Plumbing Code and Chapter 142 of the General Laws. Icity[Town Typeof License: itle� Plumber Signature of Licensed Plumber Master „1 Journeyman {� License Number: APPROVED OFFICE USE ONLY Town of Barnstable *Permit#�� � Expires 6 months from issue date Regulatory Services Fee Thomas F. Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION. - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number X0 Property Address J ® � -�J �/1_� ��'t/�'� esidential Value of Work e ,006 Minimum fee of$25.00 for'work under$6000.00 Owner's Name&Address ,�C �-� Contractor's Name_4Eae Z;A Telephone Number Homelimprovement Contractor License#(if applicable) Z 'CIF1 4/20 ;Zc Supervisor's License#(if applicable) rkman's Com ensation Insurance I am a sole proprietor ,�, , ❑ I am the Homeowner ®p I ❑ I have Worker's Compensation Insurance APR 05 2007 Insurance Company Name- ✓Y� ,� � I TOWN OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) roof(stripping old shingles) All construction debris will be taken to Z4AD;C1 ; ❑Re-roof(not stripping. Going over. existing layers of roof) -- ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) E *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic, onservation;etc. "4 ***Note: Pro erty Owner must sign Property Owner Letter of Permission. opy of the e o ement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 f h . Department of Iridustizal Accidents Office.of Investigations; ' a 600 Washington Street Boston,M4 02111 sy` www mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers kpplicant Information Please Print Legibly name(Business/Orpnizationdndividual): � � ��D✓c�J ()��'l�7 Udress•_ 5� � Q City/State/Zip:_ 71VA4 Itll S C Phone#:tee —3 4c —�� ►re you an employer? Check the-appropriate box:: Type of project(required): ❑ 3 am a-employer with' 4. ❑ I am a general contractor and I 6. ❑New construction s(full and/or part-time).* have hired the sub-contractdrs amtole proprietor or partrter- 7.listed on the attached sheet $ ❑ Remodeling ship and have no employees These sub-contractors have ' 8. ❑ Demolition working forme in any capacity. workers' comp,insurance 9. ❑ g ig addition [No workers' comp.insurance 5. ❑ We are.a corporation and its required] officers have exercised their 10.❑ Electrical repairs or.additions. ❑ I am a.homeowner doing all work right of exemption per MGL 11.ElPlumpb repairs or additions ' .Myself-[No workers' comp., c. 152,§1(4), and we have no 12. oof repairs insurance required.]t employees. [No workers'- camp.ms,rance required.] 13 ❑ Other oy applicant that checks box#1 must alsp fill out the sectiot.below showing their workers'compensation policy information: iotneownerS who sabmittbis affidavit indicating they ate doing all work and then hire outside contractors must submit anew affidavit indicating such. mtractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers comp.policy iafoxmation . sin an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site Formation. mrance-CompanyName:_Oe, 7, /L-A licy'#or Self-ins.Lie.#: Expiration Date:__1y�i' O'er b Site Address: 97. 4!24D ZQ ;PJD' City/State/Zip: tach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ilure to,secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a e up to$1,500,00 and/or orie-year imprisonment; as well as civil penalties in die form of a STOP•WORK ORDER and a fine. up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of restigations of the DIA for insurance coverage verification. 'o hereby certify u r the pain d pe ies of perjury that the information provided ab,ve is and correct ` attire:. �f M Date: � one#:. 3./.a-7 _ S Official use only. Do not write in this area,.1d be completed by city.or town offccial: City or Town: Permit/License# . Issuing Authority(circle ones 1.Board of Health L.Building Department 3.'City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact person: Phone#• Information Mid. Instr' etions : r iassachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. arsuant to this Statute;an employee is defined as"...every person in the service•of another under any contract of hire, xpress or implied,oral or written." Ln employer is defined aP:"aa mdividAal,.partnersbsp,:association,corporation or other legal entity,.or any two or baore f the foregoing-engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the eceiver or trustee of an individual,Partnership,association or other legal entity,employing employees. Howcv..er;the -caner of a dwelling house having not more than three apartments and who resides therein,or.the ocaapant of the welling house of another who employs Prom to do maintenance, construction or repair wont on such dwelling house, "not because of such employment b e deemed to be an employer." IT on the grounds or building appurtenant thereto AGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or -enewal of a license or.permit to operate a business or to construct buildings in the commonwealth for any ►pplicant who has not produced acceptable evidence-of compliance with the insurance coverage required." kdditionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its-political subdivisions shall ;ntar into any contract for the performance of public work until acceptable.'evidence.of compliance with the insurance requirements ofthis chapter have been presented to the contracting authority. 4.pplicants Please fill out the workers' co4ensation affidavit completely,by checking the boxes that apply to your situation and,if aecessary,supply sub-contractor(s)name(s),address(es) and phone niimber(s)along with their certifieate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members orpartners; are notrequired to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required Be advised that this affidavit may be•submitted to the Department of'Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retained to the city or town that the application for the permit or license is being requested,not the Deparmmei t of Industrial Accidents. Shouid 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 Dep artment 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 pemiittlicense 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 L(city or town)."A copy.of tlie:affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proofthat-a valid affidavit is•on.file for.fiture permits.or licenses.•Anew 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 t4 complete this affidavit. The Office'ofluvestigations 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 mmiber: , The Commonwealth of Massachusetts . Department of Ind4strial Accidents . . .. - '. . >: .Office Qf Investigations .. fi00 Washington Street 4 Boston,MA 02111 Tel.#617-727-4900 ext 406 or•1-877-MASSAM Fax#617-727,7749 . wised.5-26705 wwwmass..gov/44 'J " °*IKE Town of Barnstable 7 � ° Regulatory Services * snMMBM ' Thomas F.Geiler,Director' r�nss. g Buildin Division '°lfo ran+' Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I , as Owner of the subject property hereby authorize �-~-- ��- �^ r--� to act on my behalf, in all matters relative to work authorized by this building permit application for: CV 0C)\ (Address of.Job) - Signature of Owner Date , Print Name I Q:FORMS DWNERPEPJM SION I3o,ard of Bwltjmg>22egulations and.Stan ► +, H,ME I PROVEJpIE, fT CONTRACTOR x z� , �r r teglstrfidb.: - �. x 149475 ,c y I4 {E'Xplrajop 1%1�/2008 f i 4 ry§ r 11��TYPQ;:A� (, 1" d :� ESLhtl COIT�2UCTIOIV I ERfC E'NAELSEN Ad, WStr . TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY--FAMILY APARTMER-4. Y PARCEL ID 268 072 GEOBASE ID 17067 ADDRESS 97 OLD TOWN ROAD PHONE HYANNIS ZIP - i LOT 17 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY i i PERMIT 91209 DESCRIPTION EXISTING FAMILY APARTMENT PERMIT TYPE BFAMCO TITLE FAMILY APT. CERT. OF OCC. CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: $25.00 BOND $.00 pf CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY * BARNSTABLE, MASS. tbg9 FO MP'�A BUIL IN . DIVISION BY DATE ISSUED 04/03/2006 EXPIRATION DATE V TOWN OF BARNSTABLE r� BUILDING PERMIT--FAMILY APARTMENT ; t ' y!PARCEL riD 268 072 GEOBASE ID 17067 ADDRESS 97 OLD TOWN ROAD PHONE HYANNIS ZIP - LOT 17 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY .PERMIT 91010 DESCRIPTION FAMILY APARTMENT-EXISTING,FORMER ZBA DECISI li PERMIT TYPE BFAM TITLE FAMILY APARTMENT CONTRACTORS: PROPERTY OWNER Department Of ARCHITECTS.: � Regulatory Services TOTAL FEES: $25.00 ' BOND $.00 O� CONSTRUCTION' COSTS $.00 ' 434 RESID ADD/ALT/CONV ` * BAMSTABLE, Mass. 039. A, ED MPy � BUILDING�DIVISIO\NBY DATE ISSUED 03/27/2006 EXPIRATION DATE J .;,•/ram �. x - •J � �} +�' -r TOWN OF BARNSTABLE BSIT ING PERMIT--FAMILY APARTMENT � r IL c� IPARCEL yPD 268. 072 GEOBASE ID 17067 .ADDRE sS' 97 OLD TOWN ROAD PHONE., µ HY'ANNIS ZIP LOT lri Y. BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT ffY PERMIT 91010 DESCRIPTION FAMILY APARTMENT--RXISTING,FORMER ZBA DECIST PERMIT TYPE BFAM TITLE FAMILY APARTMENT CONTRACTORS: PROPERTY OWNER Department of ARCHITECTS: Regulatory Services TOTAL,,FEES: W $25.00 BOND $.00 oY CONSTRUCTION' COSTS $.00 434 RESID ADD/ALT/CONY BAMSTABIZ, Mass. FD IIA�A BUILDIAY DIVISION I` BYV `. DATE .ISSUED 03/27/2006 EXPIRATION DATE �+ THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR 1 ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. I MINIMUM OF FOUR CALL INSPECTIONS REQUIRED ' FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERI THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS .PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH).- PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. ' -- a 0 001*6 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 1 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL I' WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I ,I I I ; I I 11 I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Permit# -[ / / C9 Health DivisionPA Date Issued Conservation Division — Fee " de1W 4 fTax Collector A#**tioft-Fee Treasurer D D °ol Planning Dept. Checkl �r SEPrM SYSTEM: Date Definitive Plan Approved by Planning Board Awmv 3 tc Historic-OKH Preservation/Hyannis �,a. ,fie f-- , Project Street Address � § r ev Village \Owner � � � � Address 0\ _ ' ; oZ. Telephone _ q aw � Permit Request 1�►'1— L Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ZTwo Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: 0 Yes ❑ No Basement Type: ❑ Full al rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric Q'Other CUB n Central Air: ❑Yes i No Fireplaces: Existing New Existing wood/coal stove: ❑Yes JA,IQo Detached garage:0 existing ❑new size Pool:0 existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing ❑new size Shed: 0 existing ❑new size Other: Zcbing Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION C-611 CIO (�7 S� Name Telephone Number '5_06— 7 7,'--6 Address License# _ �6 _7 Home Improvement Contractor# .� �eT Worker's Compensation# A/M ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE I DATE k FOR OFFICIAL USE ONLY ' PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE — OWNER — DATE OF INSPECTION: ' ry. FOUNDATION FRAME INSULATION FIREPLACE - ELECTRICAL: ROUGH -, FINAL" PLUMBING: ROUGH r.t m FINAL c GAS: ROUGH O� FINAL FINAL BUILDING 0 0o j DATE CLOSED OUT - ; ASSOCIATION PLAN NO. Q i i 7 IL Town of Barnstable OF THE�p� Regulatory Services MU NSCABM ; Thomas F.Geiler,Director 'V4, 16,39. A.O� Building Division �fD MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508462-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 97 OLD TOWN ROAD, HYANNISP.ORT, MA, holding title under a deed recorded with the Barnstable County Registry`of Deeds or Barnstable County District Registry of the Land Court in Book Page , or as Document No. being shown on Assessors' Map 268 as Parcel 072, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended for use as a family apartment,for year-round occupancy. The intended and authorized use is for DEB TAYLOR, COUSIN OF OWNERS JOHN AND TRACY FOLEY associated with the residential use on the same premises: This unit shall be used for a"Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a.violation of the Town of Barnstable's rules,regulations,and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants.are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. . WITNESS our hands and seals this _day of t' 200 �a. TOWN OF BARNSTABLE OWNER(S) .By: Building Commissione THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date D w Then personally appeared the above-named (owner),John J /'d l-�l N zry 1'e", and made oath as to the truth of the foregoing instrument,before me. Notary Public. My Commission ExpiresPIANE M.DONALSON i OTARY PUSUC COMOSSiON EXPIRES OCT.4,2007 Qoldtownrd97 3/1/06 Re: 97 Old Town Road,Hyannis Paul, John Foley called today, said he had spoken to you re the family apartment application and would be submitting floor plans. He also said David Lawlor would be calling to set up an appointment with you. Tracy Foley's mother, Marilyn Smith, died last year. She had a family apartment in the existing barn,ZBA 1983-94 (see attached). I explained the situation to Art Traczyk, who said if the situation is as described, that they have moved into 97 Old Town Road and have a family member who will be a year-round resident, he wouldn't make them go back to ZBA. As this is a family apartment without construction, I'll call the Foleys;ask them to submit the floor plans to me, and I'll have Tom review them and sign the affidavit. I'll keep the family apartment application for now, so if you hear from David Lawlor, refer him to me. Let me know if you have questions. Lois TOWN: OF,:.BARNSTABLE ABLE. PUSS. Zoning Board of Appeals '83 NOV 18 AN 8 49 Marilyn J.-Smith Deed duly recorded in the Property Owner County Registry of Deeds in Book Same Page _- Registry Petitioner District of the Land Court Certificate No. Book -_.__._w- Page�.�._. Appeal No.___ _�983-94 " November 17, 83 19 FACTS and DECISION Marilyn J. Smith Petitioner__ __ ... _ filed petition on October 21 , „ 19 83 requesting a MUM-permit for premises at _.."._.57_QLd...3.awa..-Raa_d __ , in -the village (Street) HYann i s o�rt �"µ- adjoining ' premises of __. _ (see attached list) Locus under consideration: Barnstable Assessor's Map no.268 lot no. _ 72 Petition for Special Permit: Application.for Variance: ❑ made under See. of the Town of Barnstable Zoning by-laws and Sec. �_ _ „ _„. 9„ _.__ _ Chapter 40A., Mass. Gen. Laws . for the purpose of Fa Apartment in existing.. barn J, Locus is presently zoned in _ RB Notice of this hearing was given ,by mail, postage prepaid, to all persons deemed affected and by publishing in Barnstable Patriot newspaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town of Barnstable was held at the Town Office Building, Hyannis, Mass., at _ Z:3.Q P.M. LVsiuemlaeX 1� ._ _ - _ 1983 upon said petition under zoning by-laws. . Present at the hearing were the following members: '`yank P: Congdon-Vice Lake P. Lally Gail Nightingale Chairman e conclusion of the hearing, the Board took said petition.under advisement. A "view of the was made by. the Board.,: .: Appeal No 1983'94 Page 2 of _ On November 10 1983 19 _- The Board of Appeals found Marilyn J. Smi-th represented.'herself at the hearing; and is seeping a special permit to- allow--a family apartment at 97 0ld Town Road,.W. Hyannispprt in an RB Zoned District. The petitioner explained' that she would like to-.make the apartment in' an existing barn on.her property .for her- son and daughter-in-law - they would be the only inhabitants of-the- apartment. . The apartment would consist of one room 20X16 with a 12X16-- loft bedroom. This barn is not used, at the- present time: There is.' Town water;: but no, sewe':rage'"at, present: The petitioner submitted a list of her abutters who are- in favor-of granting: the special permit for the apartment'. No- one appeared- at the hearing in objection to'- the petition. The Board. voted unanimously to grant the. special permit for a family apartment. u LU __At�lerk of the Town of Barnstable, Barnstable County, ,Massachusetts, hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decision in the above entitled petition and that no appeal of said decision has been filed in the office of the.Town Clerk. Signed and Sealed thiQ ._. `( __ day of . __ _ -��c- ___ 19 under the pains and penalties, of perjury.!-,.,: - t C„oc_l� Distribution:= Pory Owner rt 0 - To- h Clerk ' ' Board of Appeals Applicant Town of Barnstable Persons interested Building Inspector Public Information Board .of Appeals. hairma I p er i N, 1983-094 a Special Permit t 5 Pending Ap• t n, Smith IMarilyn J. :gyp Old Town Road illage, West Hyannisport MA. 02672 AF- Vie. 02/23/2004 a 268072 �ng RB _ e a Book 16594 Page 18 a 4/13/05 Tracy Foley,daughter,called T.Perry to say M.Smith i • � died. She returned aff.,daughter is in fam apt and property in LL limbo. T.Perry said we'd check back in 2 mos. 12/l/05 John &Tracy Foley live at 109,will move to 97 and apply for family ; apartment for cousin. Y i Town of Barnstable Regulatory Services a MASS. '$ Thomas F. Geiler, Director �ArEDMA'�A,O Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax`. 508-790-6230 MEMORANDUM TO: Tom FROM: Lois DATE: 12/7/10 RE: 97 Old Town Road, W. Hyannisport Attached is the family apartment affidavit completed by Tracy Jean Foley after your meeting this morning. Are you approving the family apartment with this affidavit? y Or do you want a family apartment building permit application and a CO? They had a permit to restore to a single family, which I'll close out. Town of Barnstable Regulatory_Services OF THE roq, Thomas F. Geiler, DirecttR-N OF 3AR'l&S i A F5 LE Building Division +I MMSTAB[E. ' Thomas Per CBO Building.Co'n miss oner { 9 MASS. �.. Perry, f �Al i639 200 Main Street, Hyannis, MA 02601 fD MA'S www.town.barnstable.ma.us Office: 508-862=4038 qtf ~� ' Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being.on oath, depose and state as follows: My name is «C T �E'�► ��` I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: X7�C �o�� 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. 1 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. 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-e t_6;4�201 D Signature U 0. U Phone Number Print:Name V<-ct I �.t9tllj f up! Appeal or Perm-it No 91010 Appeal Budding Permit �� Status • Pending Last gat_ *first � i -Applicant Foley ITracy Jean z :Addr "Addr2 . 97 Old Town Road •&�,a 'r Village: ' West Hyannisport MA 02672 " � a" �. `V� ` ' � � Aff Received 02/12/2009 v z Map Par 268072 2oningi RB Decision CO issued 4/3/06 a •' ,..W ,''d'',t , bar Notes: Apt: Deb Taylor(cousin)Tracy Foley's mother, Marilyn Smith issued family apartment, 1983-94. After her death,the Foley's moved in, applied for family apt for the cousin who was not a - cousin(see file). 200902571 to restore to single family issued 6/11/09 4/20/10 no inspections t Close •y,. i e ti s t r 1 k -v; t x'zX 4 R ti.HY By 54 sf ` d z b nt -§��,':n .. .t�..,'�,". #tw,.i ..,h, •, -.T i';iS K -. *i' '°. #r' N`ps a. `,' a .a File Edit Tools Help X 7x Rt a( . ( 44 = ( C' C ® 914 Applied Status ;Prvjed Use ipe 12.,"(11/2004, COMPLETE Y F:AMILY APT W/CONSTRUCTION MULT HSES RB U/05,120€17 11,'24i'2009 EXPIRED ROOF-RESIDENTIAL 41ULT HS'ES RB 16'42.,'2,N8 06/08,,'2003 COMPLETE PLUMBING RESIDENTIAL MULT HS'ES RI BS-f?8:f2i7t} ,ACTIVE RESTORE TO SINGLE FAMILY MULT HSES RB 12/06/2010 11/06./2010 STOP WORK GAS RESIDENTIAL MULT HSE.S RB i --Searchl Faker. Record } JI opt m w r e r.. 1. ,. .. Town of Barnstable oFt�r� Regulatory Services BARNSCABM AS Thomas F. Geiler, Director A'FD1�`a Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 6, 2005 Ms. Marilyn Smith 97 Old Town Road W. Hyannisport, MA 02672 Re: Family Apartment Affidavit. SECOND REQUEST Dear Ms. Smith: Our records indicate that you have not responded to our letter of letters of January 12 and March 7, 2005 requesting you to complete and return the Family Apartment Affidavit. Today I attempted to reach you by phone at 508 775 3404, but I found that the number is not in service and there is no other listing for you. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. If you are no longer a year-round resident at that address or no longer have a family member residing in the family apartment, please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home Apply to the Amnesty Program If you have any questions, please call Lois Barry,Division Assistant, at 508-862-4039. Sincerely, Tom Perry Building Commissioner J030403b °FtME r, Town of Barnstable Regulatory Services a s San MM�i.Eg* Thomas F.Geiler,Director �iOTE039. Building Division Peter DiMatteo,Building Commissioner 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 November 15,2001 Marilyn Smith 97 Old Town Road Hyannis,Ma 02601 RE: Illegal apartment 97 Old Town Road,Hyannis,R 268-072 Dear Ms.Smith: Our records indicate that your house at 97 Old Town Road is currently being used as a 2-family home contrary to Barnstable Zoning Bylaws. 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 this is a legal 2-family home. Sincerely, C� Gloria M.Urenas ZONING ENFORCEMENT OFFICER GMU/km forms:g990317a C ]ER' 6S 072. 3 LOC.10097 OLD TOWN ROAD CTYj07 TDS1 400 HY KEY3 170674 ----MA I L I Ni ADDRESS----.--- PCA31011 PCS300 YR300 PARENT3 0 SMITH, MARILYN J MAP] AREA 355BC JVI MTG30000 P 0 BOX 354 spil SP23 SP31 UT13 UT21 . 35 SO FTI 1664 14 HYANNISPORT MA 02672 AYB31945 EYB31975 OBSJ CONSTI 0000 LAND 61100 IMP 11000 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 174800 REA CLASSIFIED #LAND 1 61 , 100 ASD LND 61100 ASD IMP 113700 ASD OTH #BLDG(S)-CARD-1 1 73, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #BLDG(S)-CARD-2 1 40, 100 TAX EXEMPT #PL 97 OLD TOWN RD RESI DENT'L 102500 174800 174800 � #DL LOT 17 OPEN SPACE #RR 1177 0082 AMMERCIAL INDUSTRIAL EXEMPTIONS SALE300/00 PRICE] ORB33068/133 AFD3 LAST ACTIVITY300/00/00 PCRIY - R268 072. A P P R A I S A L D A T A KEY 170674 SMITH, MARILYN J LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 61 , 100 113,700 2 A-COST 174,800 B-MKT 102, 500 BY oo/ BY FR 1/85 C-INCOME PCA=1011 PCS=00 SIZE= 1664 JUST-VAL 174,800 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 55BC' -- -MAY NOT BE COMPARABLE— NEIGHBORHOOD 55BC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 611001 LAND-MEAN +0% 1748001 73020 IMPROVED-MEAN +56% 25% 1 FRONT-FT 1 100 DEPTH/ACRES TABLE 02 100%7 LOCATION-ADJ APPLY-VAL-STAT I LNRILAND LFT/IMPIADJS/SB/FEAT STRISTRUCTURE ARRIAREA-MEASUREMENTS NOR3NOTES COMIMARKET INCIINCOME PMRIPERMIT'S ORRI GRAPH IC FUNCTION-C 3 STRUCTURE-CARD NUJ-10003 DATA-[ I XMTE'?] 'INC ZONING BOARD OF APPEALS y MASS. q 1639. D MICl PARTIES IN INTEREST MARILYN J. SMITH 1983-94 MARJORIE & JUDSON GAYTON LUCIA & WILSON SMALL. WILLIAM A. BEARSE BERNARD H. & ANN MCGRATH VINCENT A. GIOFFRE MARY M. & MICHAEL STEVENS JOAN L. BIRCH • WILLIAM J. & SALLY L. SCHIAVO EDWARD & MARGARET POWELL MARILYN A. & JOHN A. BYRNE LYDIA NERBONNE ENID W. & RHODA TISSARI MARILYN M. .& PHILLIP R. SOUZA KATHLEEN & SAMUEL STANLEY ANNA F. KASPER RITA & WILLIAM DREW Barnstable Planning Board Yarmouth Planning Board Sandwich Planning Board Mashpee Planning Board r • TOWN OF BAR.NSTABLE �.ht{3T48t�. Zoning Board of Appeals '83 NOV 18 AH 8 49 Marilyn^J. Smith .._........_._._________.......__.....__._______.__.... Deed duly recorded in the .............____......._..._.._...__._ Property Owner County Registry of Deeds in Book _ Same ........................................._............._._---------......._.........._..__ _..____ _._ Page __ ___.._ ..., --_.._-_-----Registry Petitioner District of the Land Court Certificate No. ..._....._.......... __..._... ...._.. Book ._...........: ..._ Page November 17, 83 Appeal No. ..........983-94 .......................... .__..____.. 19 FACTS and DECISION Marilyn J. Smith 3 Petitioner ...._..___.._.._._ .._____...._........._._._........__ .._. :_....._.._.__.___ . filed petition on ,October 21 , 19 8 requesting a �X -permit for premises at ..__.._. .7...._0.1.d...Iowa.....RO.ad..........__._....._....__.._..., in the village (street) of ..__W:'.._Hyann i sport_ .......I adjoining premises of _.._._......._ (see attached list) Locus under consideration: Barnstable Assessor's Map no.268.__ _ lot no. Petition for Special Permit: 1� Application for Variance: ❑ made under Sec. .V..._.._ __....__...._..._.._ .__ of the Town of Barnstable Zoning by-laws and Sec. _.. _.....__.._ ____....._ ..._9._.........---_...--- __._ ..._ __ Chapter 40A., Mass. Gen. Laws for the purpose of Fam i lyAOartment in existing .barn_ Locus is presently zoned in... _....... RB._.. .._. Notice of this hearing was given by mail, postage prepaid, to all persons deemed affected and by publishing in Barnstable Patriot newspaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town of Barnstable was held at the Town Office. Building, Hyannis, Mass., at _ . 7.;.3Q._.__... P.M. 198 upon said petition under zoning by-laws. Present at the hearing were the following members: Frank"P. Congdon-Vice Luke P. Lally Gail Nightingale _................._.... Chairman At the conclusion of the hearing, the Board took said petition under advisement. A view of the locus was made by the Board. Appeal No._._1_983-94__. ._. _ Page _ .2 of __ 2 On ...-...November 10 1983 __ 19 , The Board of Appeals found Marilyn J. Smith represented herself at the hearing, and is seeping a special permit to allow .a family apartment at 97 Old Town Road, W. Hyannisport in an RB Zoned District. The petitioner explained that she would like to make the apartment in an existing barn on her property .for her son and daughter-in-law - they would be -the only inhabitants of'the apartment. . The apartment would consist of one room 20X16 with a 12X16 loft bedroom. This barn is not used at the present time. There is. Town. water, but no sewerage 'at present. The petitioner submitted a list of her abutters who are in favor of granting the special permit for the apartment. No one appeared at the hearing in objection to the petition. The Board voted unanimously to grant the special permit for a family apartment. AL oc?J___. _✓�s--, -Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decision in the above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed This __.._ _ ... day of ...._ .: f c------- ._.. _ 19 3. under the pains and penalties of perjury. Distribution:— Property Owner ___.._..._.______ Town Clerk Board of Appeals Applicant Town of Barnstable Persons interested Building Inspector Public Information B Board of Appeals hairma The following are the names and mailing addresses of the abutting owners of property and the names and addresses of the owners of property abutting the abutting owners of property and the names and addresses of the owners across the street all with their corresponding map and lot num- bers according to the records in the Assessor's Officer at the date of this application: Please type or print only. Map Lot # Name Address Zip Code �,3 1'�y dL d ro,0•1 40' , iY19,VAIIJ ✓��� S/�J�I4G ��C1A ,cC°iY�Ii✓ s Qo� LsoN 4,20 6 �,�s [.z/ oa f! /0 4� 3 � �i9/�'I✓�sfQ�T �7 4,9 ems' plc G,e,9-i A/ />1 i4 A/ CT S:7"EUEN r1/f �'!y1 97/ 1��i�Sr So G�q�To,1B0e�; 7/ ,S c2 o vo ` .SRZ L Y e_ �'�~-do d rz9,01-Y,'0l fj�/,�i✓i✓i s 4l E4l4el,�,e %/ � 11 ✓o?�� �5i � - I ini9,e�13�e�T 7r��1��j �,1��,�'�1✓fs �.�Q/ IyIWI✓1 R 0. 4 4Z I y v° ✓,�� y� 'V410-5_ ^9,e/L yY/19 /OY Oa 750)l ,►�o�i11R 19Nr✓R , " hlNN�s ,�1�� j � )4;T ems- iC`i9 sf'C� e,?6 ? Ca r�/r/� � �� Ige-lsTO L PVC rqN/11,5 ` V/LC./A/V as required under section are as they appear on the hereby certify the above chus tts Generaar .n 3 0 feet or the abutters to I to within 300 2 of Chapter 40A of t(19835Fiscal year) _----most recent tax list ( j the abutters within the 300 feet. obert D. wni y Director of Assessing Oct 7, 1983 The following are the names and mailing addresses of the abutting owners of property and the names and addresses of the"owners of property abutting the abutting owners of property and the names and addresses of the owners across the street all with their corresponding map and lot num- bers according to the records in the Assessor's Officer at the date of this application: Please type or print only. Map Lot # Name Address Zip Code 46 Vu,6.s ✓ ✓ G9� 7-1S/rlgcC, 1_uC1�l ✓ /�' za T�'l'✓'� �yAi✓�s prof �,4 zsaly 41 ✓ alp S�'�U�Ns /mil/fY AJ 9'7/ �9/�Div So Glq�ro,�B�,e');�T7,s 7o 4:2 0 77 S h«vo .SAG L Y ,�dLd ion .C41 '�/°��►'�`'�S ���� , m��/GYr✓A �U� De6l ✓,��� � it.sss9 � o� � ova✓ T�u,� IYAIVI✓Is Duo/�/ a. Y , �Dh�ia/A PO 4 as required under section are as they appear on the hereby certify the ab0`�husetts Gene names and ralrLawsS� feet or the abutters to I h the Massa to within 300 2 of Chapter 40A of 1983 Fiscal year) most recent tax list the abutters within the 300 feet. the obert D•' (/w"' y Director of Assessing Oct 7, 1983 RQ�SJ. TOWN OF,,.,BARNSTABLE Zoning Board of Appeals '83 NOV 18 AN 8 49 Marilyn J. Smith __•_ Deed duly recorded in the Property Owner County Registry of Deeds in Book _ Same Page Petitioner District of the Land Court Certificate No. Book _.._... . _ Page 1983-94 November 17, 83 AppealNo. _ _W __. _ . . ...:.__. _ » ..___-_ __...___._.W._._.. ._... ...__ ___....__._ 19 FACTS and DECISION Marilyn J. Smith Petitioner _.._ _._. _.. . _ ._... . _. _ filed petition on ,October 21 , -^ 19 83 requesting a MXX,6M-permit for premises at _9.7._ Q1d...Tow1D...R�?�.d.. ._..._._..._. ...__... ., in the village (Street) ,of ..•_•• ••••• adjoining remises of see attached list Locus under consideration: Barnstable Assessor's Map no.268_ . __ _ .. lot no. Petition for Special Permit Application.for Variance: ❑ made under See. of the Town of Barnstable I Zoning by-laws and Sec. _._ _..w_._ __ . Chapter 40A., Mass. Gen. Laws . for the purpose of _ _ Fami I artment in exist inq•,barn__ Locus is presently zoned in_.._..._RB _ _ _ ...._. _ _._. Notice of this hearing was given by mail, postage prepaid, to all persons deemed affected and by publishing in Barnstable Patriot newspaper published in Town of Barnstable a copy 'of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town. of Barnstable was held at the Town Office. Building, Hyannis, Mass., at P.M. ......Ko ember.....1.L1, ._ __. _ _ 1983 , upon said petition under zoning by-laws. Present at the hearing were the following members: Frank P. Congdon-Vice Luke P. Lally Gail Nightingale __._.�......_._......._.»......._.....Chairman - ____.__.._.._»»»_._.._.._..._.�__._. ..._._._...._......... ......_._.........__. _ At the conclusion of the hearing, the Board took said petition under advisement. A view of the Focus was made by the Board. Appeal No 1983-94 Page _ 2 of . 2 On November 10 1983 19 , The Board of Appeals found Marilyn J. Smith represented..herself at the hearing, and is seeping a special permit to al.low.a family apartment at 97 Old Town Road, .W. Hyannisport in an RB Zoned District. The petitioner explained that she would like to .make the apartment in an existing barn on- her property .for her son and daughter-in-law they would be -the only inhabitants of- the apartment. : The apartment would consist of one room 20X16 with a 12X16 loft bedroom. This barn is not used' at the present time. There is. Town. water, .but no sewerage 'at present. The petitioner submitted a list of her abutters who are in favor of granting: the special permit for the apartment. No one appeared' at the hearing in objection to the petition. The Board voted unanimously to grant the special permit for a family apartment. u„QE A Ito v J s�Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decision in the above entitled petition and that no appeal of said decision has been filed in the office of the Town Clerk. Signed and Sealed this . _ __ _ day of _ _ _ _'!PC- _ 19 �'3 under the pains and penalties. of perjury. Distribution:—* Property Owner Town Clerk Board of Appeals Applicant Town of Barnstable Persons interested Building Inspector Public Information B — Board of Appeals hairma APPF NO. f..1...J....... .......•... ERK WL TOWN OF BARNSTABLE :i ilf;i 2). AM 9 21 PETITION FOR ���cl/�1 ZIE'ML r UNDER THE ZONING BY-LAW To the Board of Appeals, .... J Town Hall, Hyannis, MA 02601 Date .....���»..........._... ...».._.. 19 The undersigned petitions the Board of Appeals to vary, in the manner and for the reasons hereinafter set forth, the application of the provisions of the zoning by-law to the following described premises. �JQ,g 1 q ,,/ �✓ / � ��yyN Applicant: ...„.�A.LL�..I Y .........V ...»... , .T%1......»........1... ...�� .Y........(....0.. ! /. /..........•��..•» ! ,'/ (Full Name) (Winter Address) �ad-4111 Owner: ..........................»S.A.� ......................._........»»................»...............................................................».................................»............»..».... ................... (Full Name) (Winter Address) Prior Owner of record ..... IS..�...�.��...................................................................................................................__..................................................... ». Tenant (if any) : .............................................................:.......»............................................................................................»..............................................»............... (Full Name) (Winter Address) If Applicant other than Owner of property - state nature of interest .................».............._.........................»».......... »... 1. Assessors map and lot number ... // /A..»» /���»��,/ ....................:�.:f............. �j,...»......._.......».». ..._.»..»»».M 1`1 2. Location of Premises �....•�.....SF........j /�...........�f............»......»... Village %� G�.2 (Name of Street) (What section of Town) 3. Dimensions of lot .......»....». ......_.» .» »......». ...».....»........................ZF2....»..............».............................Z��•.���....».» ». (Frontage) (Depth) (Sgdare Feet) 4. Zoning district in which premises are located ... .. ..........................».....................»................................................•..._................ .. 5. How long has owner had title to the above premises? ... 1 , ..................................................................... 6. How many buildings are now on the lot? G »••••....... -• ••••••-•••- » .�.........U.. 7. Give size of existing buildings ,`f/Y.. �OG� .........................................)(,..2x.................�/9�/�...... Proposedbuildings ...... 0..........h. ....» G. � ..................................... .................................................»».». . 8. State present use of premises ....../':71C:....f,.1•.wt„ . ................... 9. State proposed use of premises ef��Qc4C� ... � %��o�fu Z��f/ . » ............ �....... ........ .... 10. Give extent of proposed construction or alterations: ...•....................................................................................................................... .............::...»mina. F .......P°,a /!�..._..��5.......Z_T••».C• ........1. %Q........Z..fr.?y y•.....41_J4 1"�I ,c4��' ..._............ 1.?2................................_................................................................................................. ............» 11. Number of living units for which building is to be arranged ............/.••••.................................................»..................... 12. Have you submitted plans for above to the Building Inspector? ....... 5.............................................................. .... 13. Has he refused a permit? ....,Y..E...... ............................»........................................................ ....»............................._...».....................»..»..._»........... 14. What section of zoning by-law do you ask to be varied? .............V.:...................................................................»........................ ..................................................................................».........................................................»............................................................................................................................................. 15. State reasons for variance or special permit: ............ ...................................... ........ .......................................»...•..». ..........Mr......... .........,. ........:... .:x...../�..........04t.dff.......... �1�'� gin! ........... .r��tT` .r............ � ...........�. �a.......rrt '"Or. ...:...u�r.. ' ...»........ ................... nr ....... ... .6........:�..Pe. 1,r�! » Y..::.». .........,��:....... y ..............................................._........................................._.............».................................»............................................................................».....»........».........................................»... » ...............................................................».................»............................................................................................................................»...............»........................................................ y ........................................».....» .»............._....................................respectfully..submitted, .....................................................................................•...•...»»»......».» 1 (Signature) . .... . ..... ... ......... . .... ......... ...... ...... (Address) ..../....... .... ..fry;r..................»».. J...... 4'............. �................................................... • Please submit 3 copies of petition form. (Agent) .................... .................................... .................... a • Filing fee of 1. o.. required with this petition (Address) (OVER) <r i I � I I I k. a tAj � v fl I i.ir0lZS[..... lr 0 ji - I a 4 i 1 ' � i nn i