Loading...
HomeMy WebLinkAbout0008 ERIN LANE - Amnesty ,r ?' � �� j-?"` c 1. `�,_p r�.•.�.' ... _ _ � ._. — -� S� I`e M r . I { { S{ 1 1 1 1 i I li i I c I c4t.isi 0 N a I x. R • �r r t i 1 { I 1 I I I y i :�- �y � ,,�� _ �� „ - _.� �,�-� I - /� � �f � �o �04 �� m� , _s�fs ,,�� ;_ s� -s��;, 5a� 9 �' �� ; ��- o�°f l s 5 vas . . �.� Amnesty Program l Helping to. make affordable housing possible. - t own 0 Bamstab�le Certificate of Complidnce This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building Code and Town of Barnstable zoning ordinances in accordance with the Amnesty program. I Owners Joana Oliveira Location 8,Erin Lane, Hyannis Unit Capacity One B oorn not to: xceed 1 Person . Inspector M/P No. 291/017/001 7/1./2015 I s Town of Barnstable Building Department - 200 Main Street * ASTABLE. • Hyannis, MA 02601 y MASS $ 16g9. , (508) 862-4038 CFO MA'i A Certificate of Occupancy Application Number: 201503196 CO Number: 20150155 Parcel ID: 291017001 CO Issue Date: 07101115 Location: 8 ERIN LANE Zoning Classification: RESIDENCE B DISTRICT Proposed Use: SINGLE FAMILY HOME Village: HYANNIS Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: AFFORDABLE ACCESSORY APT. 1 BEDROOM NOT-TO EXCEED 1 PERSON Building Department Signature Date Signed �tHE TOWN OF BARNSTABLE Builds - ing., 201503196 BARNSTABLE, * Issue Date: 06/02/15 Permit 9 MASS 0,39.�A�� Applicant: DEOLIVEIRA,JOANA Permit Number: B 20151370 Proposed Use: SINGLE FAMILY HOME Expiration Date: 11/30/15 Location 8 ERIN LANE Zoning District RB Permit Type: AMNESTY W/CONSTR RESIDENTIAL Map Parcel 291017001 Permit Fee$ 40.80 Contractor PROPERTY OWNER Village HYANNIS App Fee$ 50.00 License Num OWNER Est Construction Cost$ 8,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND INSTALL EGRESS DOOR EXIT FOR AN EXISTING APT. IN BASEMENT TOHIS CARD MUST BE KEPT POSTED UNTIL FINAL PRESENT DAY CODE FOR AN AFFORDABLE ACCESSORY APT. INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: DEOLIVEIRA,JOANA BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 8 ERIN LA INSPECTION HA BEEN MADE. HYANNIS,MA 02601 Application Entered by: PF Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER MPORARILY OkbtRMANENTLY. :ENCROACHMENTS-O UBLIC PROPERTY,NO 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 SUBDIVISION 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). "M • BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2. , 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 ar of H alth f 1�7h TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel- T'/ ® Application #Q>10/'S�03/Te 01 Health Division Date Issued Conservation Division Application F4 Q:::O ``////�� Planning Dept. Permit Fees `w'(� Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address , //� ��/✓ , Village Owner az Address Telephone 11 5-0 3� .5Z.� Permit Req st �l�In J Tg ��G�s OO)e Cjt/T- EQ22 �4✓rr Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation :6W Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 3-'*" Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes C9-P�o On Old King'.s Highway:. 0 Yes �No Basement Type: null ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 9_;2_ Basement Unfinished Area (sq. ) - i Number of Baths: Full: existing .1 new Half: existing new Number.of Bedrooms: existing new h �' Total Room Count (not including baths): ex ing new First Floor Room Count Heat Type and Fuel: Uas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes &No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization d"Appeal # S�-t� Recorded Ll— Commercial ❑Yes L94o If yes, site plan review # Current Use Proposed Use I APPLICANT INFORMATION (BUILDER OR HOMEOWNER) -Name !tOAAM r.�2i(.1 1162-141 Telephone Number- 2� 6-2,4ZB f Address ;�� ✓✓ A .4-lt' License # _J)�VXAIN I A 'A - Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE-- DATE Z�S • .2A 15 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 40-23774 Ur q Town of Barnstable ` F Zoning Board of Appeals -1 Comprehensive Permit Decision and Notice Accessory Affordable Apartment Program Comprehensive Permit No. 2015-018-DeOliveira Summary: Grant ed ted with Conditions Applicant: Joana DeOliveira Property Address: 8 Erin Lane, Hyannis MA Map/Parcel: 291/017/001 Zoning: RB-Residence B Zoning District Summary: Allows a studio apartment located in the basement of the dwelling to be transferred from a family apartment to an accessory affordable apartment pursuant to the Code of the Town of Barnstable,Chapter 9,Article II. Deed Reference: Deed: Book 16369 Page 190 Plan: Book 373 Page 10(Lot 1) Applicant—Site Control The Applicant is Joana DeOliveira,owner and occupant of property addressed 8 Erin Lane, Hyannis, MA. The Applicant has been sole owner of the property since 2003,\as evidenced by a deed recorded at the Barnstable County Registry of Deeds on February 10, 2013 as Book 16369 Page 190. A signed Affidavit dated January 8, 2015 declares that 8 Erin Lane, Hyannis is the primary residence of Joana DeOliveira. Locus The property is a .24-acre lot created by a 1983 subdivision plan recorded at the Barnstable County Registry of Deeds as Book 373 Page 10. It is a corner lot with frontage on Erin Lane,a cul-de sac street, and Pitchers Way. The property is developed with a one and''/:-story,two-bedroom, 3,132 gross sq.ft. (1,170 sq.ft living area)single- family dwelling. The lot is served by public water and a private on-site wastewater disposal system sized for two bedrooms. Background Joana DeOliveira became the sole owner of the property at 8 Erin Lane, Hyannis on February 10, 2003. Ms. DeOliveira formerly had a permit for a family apartment in the basement of the dwelling. The family member that occupied the apartment has moved out and Ms. DeOliveira seeks to convert the 397 square foot unit into an Accessory Affordable Apartment by a Comprehensive Permit pursuant to Chapter 40B 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 January 22, 2015,Joana DeOliveira submitted an application for a Site Approval Letter as prescribed in the Code of Massachusetts Regulations 760 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 Department of Housing and Community Development.-A Site Approval Letter was issued to the Applicant for the subject property by Town Manager,Thomas K. Lynch on February 23, 2015. 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 March 11, 2015. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on March 20 and 27, 2015 and notices were sent to all abutters in accordance with Section 11 of MGL Chapter 40A. Town of Barnstable Zoning Board of Appeals . Decision& Notice—Comprehensive Permit No. 2015-018—DeOliveira The Hearing Officer, Craig G. Larson opened the Public Hearing on April 8, 2015 at 6:30 p.m. Present at the hearing were: the Applicant,loana DeOliveira, Principal Planner Elizabeth Jenkins, and Kate Thompson, recording secretary. Joana DeOliveria presented her request for an accessory apartment to the Hearing Officer. Mr. Larson confirmed that she had read and understood all of the conditions. He confirmed the dwelling was her primary residence. Public comment was requested and no one spoke. Findings of Fact At the hearing on April 8, 2015, the Hearing Officer made the following findings of fact: Concerning standing, the right of the applicant to seek a comprehensive permit, Mr. Larson found; 1. The Applicant,Joana DeOliveira, is the owner and occupant of the property located at 8 Erin Lane, Hyannis, MA as evidenced by a deed recorded at the Barnstable County Registry of Deeds on February 10, 2013 as Book 16369 Page 190. A signed Affidavit dated January 8, 2015 declares that 8 Erin Lane, Hyannis is the primary residence of Joana DeOliveira. 2. The application for a comprehensive permit was 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 760 Section 56.00 that governs grant of comprehensive permits. 3. In accordance with MGL Chapter 40B and 760 CMR 56.04(4), a Site Approval Letter was issued to the Applicant for the subject property by Town Manager,Thomas K. Lynch on February 23, 2015. Notice of the Site Approval Letter was sent to the Department of Housing and Community Development, in accordance with the requirements of 760 CMR 56.04 (2),and no issues were communicated from the Department on this application. Based upon those findings, the Hearing Officer ruled that the application of Joana DeOliveira has met the requirements for standing and to consider the merits of the..application regarding consistency with local needs. Regarding consistency with local needs, the Hearing Officer found: 1. The Applicant is proposing to convert an existing family apartment in the basement of the dwelling to an accessory apartment. To 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. The Building Commissioner preformed an on-site initial inspection of the property and determined that an accessory apartment unit can be created in conformance with applicable state building codes. An egress door in the proposed bedroom and hard wired smoke and carbon monoxide detectors to present day code standards shall be required prior to occupancy. 3. The Health Director 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 property. The property is approved for a total of two bedrooms;there is currently one bedroom in the principal dwelling and one bedroom in the proposed accessory apartment. A second bedroom in the principal dwelling was removed and converted into a living room. 4. The Applicant has been informed that a building and occupancy permit shall 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 2 Town of Barnstable ZoningBoard of Appeals pp als , Decision &Notice—Comprehensive Permit No. 2015-018—DeOliveira 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 eve nt 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 40B or met any of the Statutory Minima provided for in 760 CMR 56.03(3). 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 findings, the Hearing Officer ruled that the application ofJoana DeOliveira 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. Decision &Conditions: The Hearing Officer ruled to grant Comprehensive Permit No. 2015 018 to Joana DeOliveira for 8 Erin Lane, Hyannis to allow the creation of a 390 sq.ft studio accessory affordable apartment unit in the basement of the existing dwelling 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: I. Occupancy of the affordable unit shall not exceed one (1) person. 2. The total number of bedrooms on the property shall not exceed two (2). 3. The accessory unit shall be a 390 square foot studio accessory apartment unit. 4. Family members of the applicant/owner shall not at any time.occupy the accessory unit. 5. 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. 6. All parking for the accessory apartment and the principal dwelling shall be on-site. Overnight on-street parking is expressly prohibited. 7. Accessory lodging or renting of rooms is prohibited for the duration of this Comprehensive Permit. 8. The applicant shall,after certification of this Comprehensive Permit by the Town Clerk: a. execute a Regulatory Agreement and Declaration of Restrictive:Covenants, as approved by the Town Attorney's Office, and b. make application for a building permit with the Building Division for the accessory apartment. Work required to bring the unit into compliance with present day code standards, including installation of an egress door in the bedroom and hard wired smoke and carbon monoxide detectors shall be completed prior to occupancy of the apartment. 9. 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 the permit. The Building Commissioner and/or monitoring agent may extend this time for good cause. 10. 10. To meet affordability requirements, the rent charged (including utilities) shall not exceed 30%of 80%of the median income for the Barnstable MSA, adjusted for family size, as calculated and published annually by 3 Town of Barnstable Zoning Board of Appeals Decision & Notice—Comprehensive Permit No. 2015-018—DeOliveira the Town of Barnstable. 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. 11. The applicant shall engage in open and fair marketing of the unit and provide documentation of the activity to the Housing Coordinator/Monitoring Agent. 12. Information regarding the income level of any prospective tenant shall first be submitted to and approved by the Housing Coordinator/Monitoring Agent before any lease is signed. 13. 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. 14. Whenever a vacancy occurs, notice shall be given to the Housing Coordinator/Monitoring Agent before reengaging the selection process previously cited. 15. Annual Income, to determine program eligibility,will be calculated per 24 CFR Part S. 16. 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 shall be responsible for the fee for Housing Quality Standards (HQS) inspections. 17. 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 stating the rent charged and income of the unit tenant along with all required 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. 18. 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. 19. 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 prior to application for a building permit. 20. 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. 21. This Comprehensive Permit shall be exercised as conditioned herein or it shall expire. Ordered Comprehensive Permit No. 2015-018 is granted with conditions to Joana DeOliveira for property addressed 8 Erin Lane, 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 a studio accessory affordable apartment unit within the basement of the principal dwelling. 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. 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 4 Town of Barnstable Zoning Board of Appeals Decision&Notice—Comprehensive Permit No. 2015-018—De0liveira shall be filed with the Town Clerk's Office. It shall then become final only after 20 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(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 outlined in MGL Chapter 40B, Section 22. Craig G. Larson, Hearing Officer Date Signed 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 oft erdemus-'bn� h4 been filed in the office of the Town Clerk. .•••""•• Signed and sealed this day of M tOM a D l S� under the pains and pen ft��of � == • W � 7 J a rn M yY. r1 Ann Quirk, Town Clerk ��` ��. .•�� 5 I I • `own of Barnstable MAS& Assessing Division 16jg.c► 367 Main Street,Hyannis MA 02601 Office: 508-8624022 www-town.barnstable.ma ms FAX: 508-8624722 Jeffery A.Rudziak,NIAA Director of Assessing ABUTTERS LIST CERTIFICATION March 19, 2015 RE: Adjacent Abutters List For Parcel(s) : 291-017-001 8 Erin Lane Hyannis, MA. 02601 As requested, I hereby certify the names and addresses as submitted on the attached sheet(s) as required under Chapter 40A, Section 11 of the Massachusetts General Laws for the above referenced parcels as they appear on the most recent tax list with mailing addresses supplied. Board of Assessors Town of Barnstable i " AbutterRe ort p Page 1 of 3 Zoning Board of Appeals (ZBA) Abutter List for Map & Parcel(s): '291017001' Parties of interest are those directly opposite subject lot on any public or private street or way and abutters to abutters. Notification of all properties within 300 feet ring of the subject lot. Total Count: 35 Close Map&Parcel Ownerl Owner2 Addressl Address 2 Mailing CityStateZip Country Deed EDWARDS, 269166 CHARLES& 417 PITCHER'S WAY HYANNIS, MA C20Z984 CRYSTAL 02601 270104 TATARA,SANDRA C 173 FAWCETT LANE HYANNIS, MA 02601 C196589 270105 PETERSON,JAMES HYANNIS,MA W 183 FAWCETT LANE 02601 C170373 270106 SCHLAGETER, HYANNIS, MA REGINA R 193 FAWCETT LANE 02601 C170946 TORRES,FERNANDA TORRES REALTY 270107 GONCALVES 7 KITSY LANE HYANNIS, MA C202893 GARCIA CID TR TRUST 02601 270108 PERRY,CATHY R 213 FAWCETT LANE HYANNIS, MA 02601 C103050 DEMELO, 270109 VALDVOGEL L& HYANNIS, MA LOUZADA,JOELMA 223 FAWCETT LN C179042 R 02601 270132 CRICHLOW,IRVING CRICHLOW FAMILY HYANNIS MA E&ALICE M TRS TRUST OF 9/1/11 230 FAWCETT LANE 02601 C195644 KONDAUR CAPITAL MATAWIN VENTURES 333 S ANITA DR 270133 CORPORATION TR TRUST SERIES 2012- ORANGE,CA 3 SUITE 400 92868 C203956 MARICHAL, 270134 LEONARDO R& 210 FAWCETT LN HYANNIS, MA C161340 DARKYS 02601 BAPTISTA, 270135 NATHANEL M& 61B TOWNBROOK WEST MARCONDES, ROAD YARMOUTH, MA C200373 MIRIAN 02673 BARNSTABLE 270136 HOUSING 146 SOUTH STREET HYANNIS, MA C59283 AUTHORITY 02601 270137 PHILLIPS,BERNICE P 0 BOX 653 HYANNIS, MA 02601 C127142 GIAR 270141 A TR DINI,STEVEN ACHILLE TRUST 1125 BLOSSOM SSOM ARLINGTON, MA C193721 02474 270146 KHADKA, BIMAL 431 PITCHER'S WAY HYANNIS, MA 02601 C191129 270147 FERNANDEZ, BRIAN JACKSON HILLS, J&CARLOS H 35-58 93TH STREET C198119 NY 11372 291015 JEANSANDERS,VALERIE 405 MITCHELLS HYANNIS, MA WAY 02601 12627/83 291016 RIVERA,ALPHONSO HYANNIS, MA &DIANA 458 PITCHERS WAY 02601 16184/284 291017001 DEOLIVEIRA,JOANA 8 ERIN LA HYANNIS, MA 16369/190 02601 291017002 LAVERTY,THOMAS HYANNIS,20 ERIN LANE NIS, MA &PATRICIA HYAN 10356/208 02601 291017003 WEINTRAUB,JACOB NORTH EASTON, &SHERI 22 SERENADE PARK 23310/346 MA 02356 AbutterReport Page 2 of 3 291017004 DASILVA,JOSE F WEST PO BOX 755 HYANNISPORT, 26814/268 MA 02672 291017005 SPEID,SHEILA M& DAVIL C 48 ERIN LANE HYANNIS,MA 02601 15314/341 HUTCHINGS, 291017007 SAMUEL M& 43 ERIN LANE I HYANNIS, MA KATHLEEN G 2601 6955/75 ----------------- 291017008 MATTOS, LEANDRO 35 ERIN LN HYANNIS, MA 02601 19996/95 291017009 COPPOLA, MARIA TR COLLE MAGGIO WN WATERTO TRUST 121 EDWARD RD MA ERTO 4145/141 291017010 CARNEIRO,JOAO M &IVONE L 19 ERIN LN HYANNIS, MA 02601 14993/75 I I I i I I i I -AbutterRe ort p Page 3 of 3 291017011 ALMONTE,REBECCA 176 GENERAL JEFFERSON,MA &MICHAEL HOBBS RD 01522 21977/257 DONELAN, 291017012 CHRISTOPHER J& 186 WALNUT HILL ORANGE MA MAUREEN L ROAD 01364 23933/288 291018 GANGI,ROBERT M&, LAWRENCE,MA GLORIA I 181 FERRY ST 01841 17874/111 291018001 GOLARZ, EVA& HYANNIS,MA PATRICK 418 PITCHER'S WAY 23423/160 02601 291023 LEMON,MARK& WEST JAYNE PO BOX 423 HYANNISPORT, 13085/286 MA 02672 291024001 MINOR,ANNE M PO BOX 2312 HYANNIS,MA 02601 12602/37 CALLE,LUIS G& 291024002 FERNANDEZ,ZOILA 418 MITCHELLS HYANNIS MA M WAY 02601 20518/133 291025 ROSARIO, HILDA M HILDA M ROSARIO HYANNIS,MA TR FAMILY TRUST PO BOX 1147 02601 21828/153 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.It a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 311712015. I f ' LEGAL NOTICE TowN of BasTaB :_ TOWN OF MOM, iik soaRuoFAPPFAI zormac oFAPPEAM - NOTICE OF PUBIIC HEAtLNtiS UNDER THE ZONING- NOTICE OF PUBLIC HEAMCi UNDER THE 20NWG ORDDiANCE ORDWANCE APti1L$2015 APRIL$2015 z To al persons utterested in or affeected by the actions of Cie ' To Persons lriter6d m w affected by the actions of the `Zoning Board ofAppeals you are hereby notified pursuant ZonGt9 Board ofAppeals you are hereby notifiedirsu 3rit to Sedron_.11 of CFiapler 40A of_Cte General Laws of the Section 1i of Chapter 40A of the General Lawsof the Commor>weatth of Massachusetts and a0 amend Commonwealth of Massachusetss,and a0•amendments-. meets . `theretol that a public heanng on•the following appeals unll. thereto that a pubifq hearng on the following app Wm beheld on;Wedrtesday Apia 8,2015 at ttte time mdtcated. :: held on Wednesday Nil 8,2015,'at ttie lane indicated, '. Accessary A(fordabk Apnr6netit Ptogram .6:36 PM aY,A�ordahk Ap trhnert!Program=6t30 PM i— Apub�ic heanngbefore Cie Hearing Officer be hetd on_ AP hearing before Cie Heaing pw�be held oil the . the follawi_ Corn erisive Pemvt application made pursuant.: !ig Cariiprehensnre PermrCapplighori niacle pt n9:.. P rwan to Chapt&40B of tto General taws of Cie Commoi wealth. Pt?►40B of the Gerieral Laws of the _. of Massachusetts acid Chapter B,S0,!, r l S of Cie'Code :of Massa`diusetls and Chapter;8 Section l5 of the.Code' of Cie Town of Bamslabie the AccessoryAtTordab(e Apart :i of the Town of Barnstable the ^meritPlogram 4. :mant gram n YAf�ordableApart 6:30 PM Appel No.2015-018 6ii6b ra 6d0 PM Appeal No.205-018 DeOfiYepa-,- loaria DeOliveira has appled fora ComprehensMi Permit- Joana DeOliveira has applied fw a Comprehensive Permit to establish a 397 square foot accessory athxdable apart- to establish a 397 square foot accessory aCordable apart meet within an exsting dwelling.The subject property is' meet within an eiasflrigl dwelling The subject Property Is addressed.8 Fsui Lacier Hyannis;MA as shown on Asses -addressed 8 Enn Lane Hyannis,MA as shown on/asses :sons Map.. sons Map 291 as Parcel 017 001 ft is m the Resdence B Zani P 291 as Parcel 017 WI R Is in Cie Residence B ,Zoning District _a i ng OistrbtJ.I a �r .2ori ng Ilmd of Appeals 7�0 PM �� : Iom9 Boa id of Appeal; 7�O PM; 7 O PM Appeal No.2015-017 Walace , `TAO PM Appeal Na 2015-0I7 V ~i Davd — David Aand P A and Patrida Wallace have petitioned for`a.Spe- al►xaa VI/aliace have petitioned for a S" "dal Permit"ai accordance wiC►Section 241k131.,4(D)(2) _�Permit tit aocordaiioa wiCi Sectton.2, -131.' X2j to change:alter and expand The Petitlo Pp!"shuchua rt :change;alter eigtand an e>osNrg s6uchire.file PeU tlon ers seek ib,tivad a and enclose an eidshng staircase 'i ers seek k)build a 9 9e and epdose an etastirtg staircase I portioru of an existing deck and^dm'reway will be rerrioved:; Pot4ons of an exutirig deck and:d tMll be n ntoVed: rrveway . ;.The_subject property is addressed 112 L orig Beath Road, The sublectprope►ty-is addressed 112 Long Beadi Road.,: Centervipe,MA as shown an Assessat's Map 206 as.Parpel Centefvlle Was shaven ort Ass ,s Ma- p 2(lG as parry i M.@(s N the Craigville Beach District(CBD)and the Lorg -:004 It is in the Cralgville Bear3i District(CBO)acid the Long BeadrlShort Beach(I B8B)Neighbortiood Overlay District. BeadtlSFiortBeacti`(LBSB)Nelghtiortiood pverla)District These public hearings tvi➢be held at Barnstable Town Hall, These public hearvigs tinll be held' Bani3fable Town Hall, 3q Main Street,Hyannts,MA,Hearug Room bcated on the: 367 Main Street Hyannis MA. the 2nd Flooron W H�rtrg Room lasted 2nd Floor on Wednesday April 8,2015 Plans and appdca ednesday,Aprt7 8,2018 Plaits and eppfira ! bons may be reviewed at the Zori Boarti.ofAppeals OtTice, irons may be reviewed of the Zoning Board ofAppeals Office, Growth Management OeWbrien Town��ir 200 Main .G^ Management Departrnerit Town �.$�t,Hyannis,NIX!, ' � c *� ,#.i S�Hyaena MA - 200 Main a Craig G.Larson Chad' _ Larson Chao r I Zb;jirg Board of Appeals Zonlm.Boaid`ompp•eajs The Barnstable Patriot `The Bamstable Patriot _.Marift_20 acid Mardti 27 2015 :` ;� Mardr20 and March:t j,:2015 BARNSTABLE REGISTR Y IF DEEDS John R Meade, Register �1!n if ULU ! ,r I �C ►'1 p Y1 / 0X9 y n Av PALL wa c lay«/w4y ; L(ving Rim o i � i✓ i n 5 I�oal�i / pc, ti� � �ec.G Qoon� .3 9 s •RI-Qf LA - t Vage t ot7 P.k 2839 1 F':9 3i 13 23771-5 i t 1-28-20 1 c a 09 = 42oL REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS THIS REGULATORY AGREEMENT and DECLARATION OF RESTRICTIVE COVENANTS,is made this `5 day of�A auV , 20 15 , by and between Joana DeOliveira of 8 Erin Lane,Hyannis, MA aiYd 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. PROTECT SCOPE AND DESIGN• A. The terms of this Agreement and Covenant regulate the property located at 8 Erin Lane, Hyannis,MA, as further described in a deed recorded herewith as Barnstable County Registry of Deeds Book 16369 Page 190 and shown on Plan Book 373 Page 10 as Lot 1. B. The Project located at 8 Erin Lane, 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. 2015-018 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 Z-T$y�5 Page D. The Owner agrees to occupy the principal dwelling unit located on the property as their principal residence in accordance widl the terms of the comprehensive permit. II. THE OWNER'S COVENANTS AND RESPONSIBILITIES: httlisI//mail.capecodliealtli.org/owa/WebReadyV]ewBody.aspx'?ratt&id=RgAAAAB4dZLUeGLXS KD8Y3117C... 4/6/2015 t Page 2 of 7 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 shall be set aside in perpetuity for the 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 (VISA) 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 tlus Agreement to constitute restrictions and covenants running with the land shall be littps://mail.capecodhealth.org/owa/WebReadyViewBody.aspx'?t=att&id=RgAAAAB4dZLUeGLXSKDSY3li7C... 4/6/2015 Page 3 of 7 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 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. V. GOVERNING OF AGREEMENT: This Agreement shall be governed by the laws of-the Commonwealth of htt /s:/mail:ca ecodliea th _ P p I .org/owa/WebReadyViewBody.aspx'?t=att&id—RgAAAf1B4dZLUeGLXSKD8Y3h7C... 4/6/2015 Page 4 of 7 i Massachusetts. Any amendments to this Agreement must be in writing and executed by all of the parties hereto. The invalidity of any 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 HARbJLESS: 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 16369 Page 190 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 16369 Page 190. IX. TERM OF AGREEIMENT: 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 littps://mail.capecodhealth.org/owa/WebReadyViewBody.aspx?t=att&id=RgAAAAB4dZLUeGLXSKD8Y3ii7C... 4/6/2015 Page 5 of 7 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 may be, 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. 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 tide, (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 an default,violation or breach b the Owne r er of this Agreement y gr ent 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 https://mail.capecodhealtli.org/owa/WebReadyViewBody.aspx?t=att&id=RgAi\AAB4dZLUeGLXSKD8Y3li7C... 4/6/2015 Page 6 of 7 and that all such mortgagees have executed consent to this Agreement. IN WITNESS WHEREOF,we hereunto set our hands and seals this ` 4day of 20 L. OWNER BY: re Printed Name: �f3?+%4 �ri VA COMMONWEALTH OF PJASSACHUSETTS County of Barnstable, ss: On this 4h day of 20 /SS before me, the undersigned notary public,personally appeared a :De— O/!V E 1 r , the Owner(s),proved to me through satisfactory evidence of identification,which were 6L I- - ya rS /' 's -*- , 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. Notary Public 1157 Printed: De n Q. M My Commission Expires: Z("F 1 DEANNE MARAJ Notary Public 9rcommonwealth of Massachusetts 'Comm.Expires March 26,2021 TOWN OF BARNSTABLE BY: TOWN NIANA R CO1MIIONWEALTH OF INIASSACHUSETTS https://niaiI.capecodlieaIth.org/owa/WebReadyViewBody.aspx'?t=att&id=RgAAAAB4dZLUeGLXSKD8Y3117C... 4/6/2015 f 1 . Page 7 of 7 i County of Barnstable, ss: On this Sictay of L7A V 20/s'before me, the undersigned notary public, personally appeared X- Ls , L , the Town Manager for the Town of Barnstable,proved to me through satisfactory evidence of identification,which were ;1 !t fe-, ,,` , 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. Notary Public Printed: or f{e My Comtnission Expires: =Zn Publi ]2016 . air-:rsuitt of Massac�res on Feb. BARNSTABLE REGISTRY OF DEEDS John F. Meade, Register littps://ni6i1.capecodheaItli.org/owa/WebReadyViewBody.aspx'?t=att&id=RgAAAAB4dZLUeGLXSKD8Y3li7C... 4/6/2015 8 e5- .Z f7 yE ' .'�j� tip✓it _ �p r4 . W I„clou} `z x, co ' I HALL Wa Cl) 1 nk 13 130 I w¢y_ � 3'•'� 1 � K, 4chPn y� L I v,n 9 2 3 Alt p , 3PcCQoon� I I i J i - ?lie Commomvealth o Massachusetts Dtparwent of Industrial accidents - - Office of Investigations 600 Washington,Street Boston,CIA 02111 n%nvmaxLgov1dia Workers' Compensation Insurance Affidavit:Builder-dCantractursr'Electr cians(Plumbers Applicant Information Please Print UgibIy ►' � - �O N N31I]e Address: g l I (It N r-, City/Sta&zip- �M,(-�Pocs 326o i Phone 4- 5 O-�3 Are you an employer?Check the appropriate biz: Type of project(required): 4. I am a contractor and I 6. ❑New construction I.❑ I am a employer vfith ❑ ��� employees(full and/or part-time).* have hired.the sub-contractors 2.❑ I am a sale etor or partner- listed on the attached sheet. 7. ❑Remodeling. Pe no Pes These sub-contractors have ship and have no employees. $. ❑Demolition woddng for me in any capacity. employees and have woudcers' 9. ❑Building addition [No i4rodcers'comp.insurance comp.msura nrr required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.V� ,,am.a homeoumer doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workm'gip- right of exemption per MGL 12.❑Roofrepairs insurance nce required.]3 c.152, §1(,CX andwe have no employees.[No workers' 13.❑Other camp.insurance required-1 'Any a"hc=&at checks box 9l mmst also faloatthe section below showing dwk wader'compensation policy inforntffCion_ I Flomeoavnen who sabamt this dfidm t mfics=r,&EY are doing all work and duen hire outs&conuactars mast submit a new afdauk indicating such. =Contractors that check this boat must attached su additional sheet doming the n—of the mb-cowcacm¢s and state whether o7 not those¢asides bare employees.If the sub-contactors bare ezaployee%the}'=stpmvide 41&worlters'-comp.policy number. -Taman etrtplger thatisprmriding itrarkers'compensation iumirance for my earpli7jves. Below is thepolicy and job site information. Imsurance Company Name: Policy#or Self-ins.Lic.9: Fxpiration Bate: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and respiration date). Failure to secure coverage as required.under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500 00 and/or one-year imprisons as well as civil peualties.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 finrwarded to the Office of Investigations of-the DIA for insurance coverage verification. I do hereby certify unifer the pains 4nd penalties ofpeduty that the information provided abm a is tare and correct Sienaatuce: Q,- Date: rD Phone,g: D,Jj"€eiat use only. Do not write in this area,to be completed by testy or town a frciaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.-CAyfrov n Clerk d.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: laformation and lastructions ` Massachusetts General Laws chapter 152 reggoars all employers to provide workers'compensation for thei r employees. p = to this side,an empooyee is defined as."_.every person in the service of another under any contract of hire, express or implied,oral or wriftcrL" An empkyer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a Joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do ma_fiiftnance,construction or repair work on such dwelling house or on the grounds or building appurterarrt 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." AdditionaIly,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter mto any contract for the perFomaaam ofpublic work until acceptable evidence of compliance with the insurance.. requir cats of this chapter have been presented to the contracting wafhodty." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub--contractor(s)name(s), addresses)and phone numbers) along with their certificate(s) of innnance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)vathno employees other than the members or partaers,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be snb itb-_d to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be reta ned to ffie city or town that the application for the permit or license is being requested,not the Department of Indusitrial Accidents. Should you have any questions regarding the law or if you are regn to obtain a workers' compensation policy,please call the Department at the number li_st.,�d below. Self insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legmhly. 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/I crose applications in any given year,need only submit one affidavit mdicatmg cLureat policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)_"A copy of the-affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as 'proof that a valid affidavit is on file:for furore permits or licenses_ A new affidavit must be fiIled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial vent=e (i -,. a dog license or permit to bum leaves etc.)said person is NOT req±zed to complete this affidavit The Office of Investigations would at to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Departments address,telephone and fax number The CommawealtbE of Mamac32us-t-M Degalt ent of lndulzial Ac�P-idents Gf ace of dive&dgatio_= 6000 WasbiVGn Sf=t :Qastan.MA G�i 11 Tf,-L 4 617-T47 4M Qx' 406-OX 1-977-MA.S D Fax 9 617-727-7749 Revised 4-24 07 wWWmas.5_go-vjdia r � L ACCESSORY AFFORDABLE APARTMENT ` SEPTIC QUESTIONNAIRE FOR STAFF USE ONLY 1. Is the dwelling connected to Town sewer? ❑ Yes VNo 2. Dwelling located q/INSID Ud OUTSI the Saltwater Estuary Protection Zone 3. Dwelling locat I '1NSID ❑ OUTSIDE public supply well Zone of Contribution 4. Dwelling is connected to ❑ ON-SITE WELL qafUBLIC WATER 5. Disposal works construction permit on file? C7 es ❑ No 09?3`4y9'—; 6. If yes, how many bedrooms were allowed by this permit: 2 bedrooms 7. Were building permits obtained for additional bedrooms? ❑ Yes No t: 8. Engineered septic system plan: a, On file at the Health Division? C�'Yes ❑ Noy, b. If proposed accessory unit is detached from principal dwelling, is that plan on file? ❑ Yes ❑ No 9.. Existing septic system capacity is bedrooms For the accessory unit to receive approval from the Health Department the following action must occur: ❑ Existing system accommodates proposed additional bedroom(s) ❑ Upgrade existing system to accommodate additional bedroom(s) RreMust remove a bedroom from the main house,,(,.,, �,O 40 ❑ Must connect detached structure to the existing septic system ❑ Must install septic system for the detached structure ❑ Other Signed Date 5 _J ro� .emu - -�'o •-� a Gx'� M 6 2 Health Department Drop-Off Flours: 8:00 AM — 4:30 P.M Town of Barnstable oFTr+�r Received by Health °s o Regulatory Services Department on Richard V.Scali,Director ' 7AHNSLAHLE, + \ . MASS. ,�� Public Health Division QED MA'S� Thomas McKean,Director 200 Main Street, % yannis,MA 02601 ; Yf' Office: 508-862-4644 Fax: 508-790-6304 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE . Property Address: � El - 'U it S o( —� Wh Assessor's Map/Parcel Number: Applicant(s) Name: Phone: Dit 36B E-Mail: Size of Lot: 2a. How many bedrooms exist at your property now? 2b. How many bedroom are you planning to add as part of the Accessory Affordable Apartment Program application? 2c. How many bedrooms total are proposed at this property-(including the Accessory unit)? �2__ 2e. Is the proposed Accessory Apartment contained within: A,/the main house; OR a detached.structure 2f. Submit floor plans for all buildings on the entire property. Show all existing rooms in the dwelling and the proposed accessory apartment. Label each room clearly. Label measured Width of all open doorways. Use straight edge for hand drawn plans and be sure all labeling is legible. Signed: r Date: o I. o el S 1 i;: W n `-9J - - _. _ _-_ - -- - --- -- - - -- ---- ; Wayt— —--- ---_.. AV Aft, `,2HALL t C(usv F I � - 0� ) 3 = 130 K, 4c ti.0 Lwinc /�M 13 O Qoorr► L t v in 5 Room �IJ f�ac, tit ►. �94, 0000s� nn y 1a� Val- ml QM rv, - I1 it � � � � � •. � - �. I` . • �Vie- .. t .,._ �.,,�--�.,_,.- , - - -.t r,-�..-...-- �e1.�,5��m�. o L,•.v..it �„ra��-� \/J i n J vtL' �<ly �........_. .-Tur r I / /\ 13,lyK AM PA LL I =� � w 7 o� 13 130 r�xt K, 4c r) �3 O L(Yln jU � L t v in9 RGCCA 3 e cl P. fk Q,00rr\ I f3Q4-h i 1 I sofa l Fee JLA Y F-f o C) ►- Ian cl �. 1 IV LA /V� l���� � r) iS MA �•1 A/el,e r- .J oer no, C) i V'G l P A. _ _l OPT I ►.1Ta ct W ALA .. o LrIN D t �. ��MC vc •"c�� � � c L ) tyy,w U ,12.E L a Window, ILI/ r = � S k a Vu Q.._.� Oxg _ YO I —� • LL 'WA ................-..-.._........_. . i i - .... -.... V U - a 13 = 130 ,t y" f n i i L(Vinq RM �� 0 L, t v i n 5 l`(aam 3,j P(:,,, A,( , v 3Pc P QUor» Rc-f y cy F—loo r �j LA 1V r /Y t/ a n n /S' Ail�4 vEIP-.A a �S 6 t • Y KrZ PUT- ��, — v c • 410 f ����, to ' • i 3 ., r-: ;t,;� a �..r',x„w�.r...... �_.�� :•w. .. � � . .. UA �4M . , L i ' - r ITS. i • h V i:� f. K,-2 Put- LV ALZ - a C�uN� 7cTtYIL %lelv �i LI N e� oil At WInClow �x�7 - -e.+rl i V 8 M 94......----............. 7 I 4 Y Z d' 1<1 4C I 1��,O 0 1 L(ving RM j ' L v n CJ' i�ca�1 t3 cj f�vc, ��l 32c D Qc�orn I f 6ci+h PLo m• t j ) S F 04 i /,P 4 WindoW ....... Alr f4 I / oxg _ � n U.7 a 13 1.30 /9,C4 Wf Y .. lip i RM Ltvinq 13 O 1 I ofa C .fief i er SINE a TOWN OF BARNSTABLE Building Application Ref: 200904573 * BARNSTABLE, * Issue Date: 10/15/09 Perm it MASS. 1639. �� Applicant: DE OLIVEIRA JOANA Permit Number: B 20091991 Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/14/10 Location 8 ERIN LANE Zoning District RB Permit Type: FAMILY APT W/CONSTRUCTION Map Parcel 291017001 Permit Fee$ 25.00 Contractor PROPERTY OWNER Village HY ANNIS App Fee$ 50.00 License Num OWNER Est Construction Cost$ 1,200 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND CONVERT EXISTING APT TO FAMILY APT FOR KARITA CAMPOS( IECIS CARD MUST BE KEPT POSTED UNTIL FINAL OF OWNER-PUT EGRESS WIND IN BEDROOM- 1 ST EXT EXP 10/13/10 INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: DE OLIVEIRA,JOANA BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 8 ERIN LA INSPECTION HAS BEEN MADE. HYANNIS, MA 02601 Application Entered by PR Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EI R TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS'ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY 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,THECONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.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). » � v nn RR BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health 4 f Appeal,or Perrrtit No �,. 2009 4573 .Appeal ,Building Permit w, >Status. New irst'. .ast .. r »�' F �`� z " .e a .�_ ' Applicant De Oliveira Joana ``N Addr b Addr2. , 8 Erin Lane t Village Hyannis MA 02601 <w' " k r �Aff Received: Map Par 291017001 Zoning g i FI 3 Decision: l Notes: `,Apt: Karita Campos, niece. Permit issued 10/15/09. Needs CO after egress window. No inspections as of 4/15/10. Called r; her 4/15,she will submit extension request today,wants to wait ;-=-- 5- — s until summer to put in window. i y Close C a p s Town of Barnstable Regulatory Ei6§'1 5ervz �j �` ' �9 ;� y �p114E rp� ti Thomas F. Geiler,Director Building Division All + BARNSTABLE, MASS. Tom Perry,Building Commissioner � i639.nw'ta 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us;t i-.'i 4.j,,,: Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: S, — Permit#: a 010(1) HOME OCCUPATION REGISTRATION Date: - U I C I g I j o Name: "GCL Phone #: 6OS 6 5 Sa o Address: O P(^ n Village: I L Nanie of 13usiuess:_ -- / Q1L__1� 4)R�]_C1�� -- —=---- ----- -- "Type of Business: I Pn a h(' h n Map/Lot: o2 00 ' 001 INTENT: It is die intent of thus section to allow[lie residents of the"Toiwn of Barnstable to operate a home occupation et2tliin single family(lavelliugs,subject to the provisions of Section i6-l./l of the Gouiug ordinance, provided that the activity,, sliall not be discernible from outside the dwelling: there shall be no increase iu noise or odor;uo Visual alteration to tine premises Nvlriclr would suggest anything other thaii a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with[lie Building hispector,a customary home occupation shall be permitted as of right subject to the fol owing Conditions: • The actin ity is carried on by the perrnauent resident of a single f uriily residential((welling unit, locate(I Nvithiit that dwelling unit.. • Such use occupies no more than 400 square feet of space. ' • There are uo external�dte.rations to the dwelling which are not customary in residential buildings,and there is uo outside eiridetice of such use. • No traffic drill be generated 11.1 excess of normal residential volumes. • `The use does not.involve the production of offensive noise,vibration,smoke, dust or other particular matter, odors,electrical disturbance, heat,glare,humidity or other objectionable effects, a '1'he.re is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot coirtaiuiug the Customary Home Occupation,and not vtitliin the required front yard. • "There is no extepor storage oi•display of materials or equipment. •' There are no commercial vehicles related to (lie Customary Horne Occupation,other-than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in letrt�h and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayer(indicating the Customary Home Occupation. • If the Custoivauy Home Occupation is listed or advertised as a business,the street address shell not be included. • No person.shall be employed in the Customary Home Occupation vvito is not a permanent resident of the dwelling unit. I,the tindersigrred, have read and agree with the above restrictions for my home occupation I ani registering. Applicant: Date: O�J10 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE:` 1I C Fill in lease- v,b Ur APPLICANT'S YOUR NAME/ !'c� BUSINESS YOUR HOME ADDRESS: MCP,i n Ln �!+ect n n�.� rn R � no 1 d �j 9r t e TELEPHONE # Home Telephone Number 5n 5f--((i 03 NAME OF CORPORATIO G'I - C NAME OF NEW BUSINe t/L TYPE OF BUSINESS IS THIS A HOME OCCUPATIO ? >= YES !� n ADDRESS OF BUSINESS K r o? MAP/PARCEL NUMBER oG q! O I1— 001(Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to.assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate;your business in this town. 1. BUILDING COMMISSIONER'S ICE This individual has b ed of ny ermit requirements that pertain to this type of business.. uthorized Sign e 9UST COMPLY WITH HOME OCCUPATION COMMENTS: C RULES AND REGULATIONS. FAILURE TO COMPLY MAY R U t . 2. BOARD OF HEALTH This individual has been i r ed of the p r it re r ments that pertain to this type of business. o ed Signature** MUST COMPLY WITH ALL; A COMMENTS: u VjAZARDOUS MATERIALS REGULAT!0,"' 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha info d f licensF g requirements that pertain to this type of business. Authorized Signature** `" COMMENTS: TOWN OF BAiRNSTABLE Y` =3 15 Pig i= 35 To = V13_ Town of Barnstable Building Division 300 Main Street Hyannis, MA 02601 At: Inspector Paul Roma Due to the whether element and extending circumstances I was not able to perform the work I requested on the Building Permit number 20091.991 dated of October 15 2009, therefore I am requesting a extension of three month to perform the work. Sincerely, 1.wa de Oliveira V 8 Erin Lane ( �� Hyannis,MA 02601 ® 1{ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2D Parcel Q 00/ Application # �2 Health Division Date Issued v Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address 00-7/A7 ��!►'Z Village A/(/dtNNi:s Owner " ` _i 44�-tV l� `�<, O�Ce y��r /ZA Address g'44'Al 1i9-rv-& Telephone 3 Z Permit Request a e/.. -AV T `W.�*c� o C_,C c l i ( c 49, o Square feet: 1 st floor: existing Yoposed 2nd floor: existingJr rproposed Total new Zoning District Flood Plain Groundwater Overlay Na,lroject Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. t.,, --e `Dwelling Type: Single Family LP- Two Family ❑ Multi-Family(# units) ZE Age of Existing Structure _n2 3 Historic House: ❑Yes C-No On Old Kinonp Hi hwaq❑Y ❑ No Basement Type: U-Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) �/ 5�9��` Basement Unfinished Area (sq. a Number of Baths: Full: existing 3 new Half: existing nel co %.n rv, Number of Bedrooms: -Z existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas mil ❑ Electric ❑Other Central Air: ❑Yes QYNo Fireplaces: Existing Y New Existing wood/coal stove: ❑Yes LANo 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 Flo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name - 1 Telephone Number ��� �S 32 (6 Address ` 2 1N cJ License # Home Improvement Contractor# Worker's Compensation # Q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN SIGNATURE DATE j L FOR OFFICIAL USE ONLY -APPLICATION# _DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE -OWNER ' , DATE OF INSPECTION: FOUNDATION FRAME INSUL ATION N 0 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s GAS: ROUGH FINAL 1 FINAL BUILDING ` DATE CLOSED OUT ASSOCIATION PLAN NO. i :C The Commonwealth of Massachusetts Department of Industrial Accidents _ Office of Investigations (' 600 Washington Street If Boston, MA 02111 ` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): il,p, �� ALL�`a✓ 2:1J Address: q. Xf City/State/Zip: 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.E6,i am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.U 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other 5 90m wi rn�o comp. insurance required.] Any applicant that checks box#I 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: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the-information provided above is true and correct. Signature: Date: �- O Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia II - - 4oftt+�ray - Town of Barnstable o Regulatory Services RARNSTABLF- Thomas F. Geiler,Director KARS- 163¢ .,erg" Building Division '°rev►Aay Tom Perry,Building Commissioner 200_Main-Street, Hyannis,MA 02601 vt4w.town.barnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 HON EOWNER LICENSE EXEMPTION Please Print DATE: ®9 . — JOB LOCATION: g {� ir•� i��� c�1 � l� NNE i``/� A�Z�I®`� �3 i number street k 1 village - ——HOMEOWNER": �Q lJ R �C' i .l C I k r\ O 8 name home phone# worlc.pbone# CURRENT MAILING ADDRESS: ('1 `I✓ city/town state ap code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such `°homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner'assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner'certifies that_he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. C`'gnature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building p=Tnit is required shall be exempt from the provisions of this section.(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a pason(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case;our Board cannot proceed against the unlicensed person as it would with a liccnscd Supervisar. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responnbilitics,many communities require,as part of the permit application, that the homeowner certify that helshe understands the responsrbilitirs of a Supervisor. On the last page of this issue is a.form currently used by several towns.You may care t amend and adopt such a fomriccrtification for use in your community. Q:forms:homccxcmpt 'I � r Tawn of Barnstable Regulatory Services . . 9�'' Lg; Thomas F_ Geiler,Director 16.19- 16N. Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Usina A Builder as Owner of the subject,property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Prove rty Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO RMS:O WNERP ERM[S810N r:(OaiQno► �`v�� V� 8 �iti►cY• lao� &lot% .tM 3 i �� c\00 crc. j! . � � y o•a�nnt� _ gyp, ex�9*�Nf J �,- I i , li f �C � on 7t` _ �/� / op = y° v q HjAL L � C lulv-t� I � t I3 = 130 K 4c A4 n 3 I Liv,rg RM / 3 0 L t v in 8cl*h PLOP-) :3 Affidavit To Whom It May Concern: I, KARITA OLIVEIRA CAMPOS-BIDWELL, attest that JOANA SOARES DE OLIVEIRA we are related by maternal and paternal links. My mother's name is MARILIA DE OLIVEIRA CAMPOS, and she is sister of JOANA DE OLIVEIRA. If you have any questions, contact me: Cell 508-6852203 Work: 508-8625261 (from 1 Oam to 6pm) Sincerel Karita Campos-Bidwell P� J �i To Whom It May Concern: This letter is to attest that, Joana de Oliveira, is the sole owner of the propriety Map 291, Parcel ID 017-001, ID 291017001, commonly know as 8 Erin Lane Hyannis—MA, accordingly to the deed recorded at Barnstable County, Book 16729 Page 1 IN Instr 44186. Sincerely, '---'Ioana de Oliveira 8 Erin Lane Hyannis-MA Bk 24092 PS 139 0-58461 10-14-2009 a 09 a �r9m �FIME T ' Town of Barnstable Regulatory Services snaxsTABM Thomas F.Geiler,Director 9`bA 1639. �•� g Buildin Division rECMa�° 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 8 ERIN LANE, HYANNIS, MA, holding title under a deed recorded with the Barnstable ounty Registry of Deeds or Barnstable County District Registry of the Land Court in Book ��j�p ,, Page�40 , or as Document No. , being shown on Assessors' Map 291 as arcF el 017001, 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 KARITA CAMPOS, NIECE OF OWNER, JOANA DE OLIVEIRA, 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 13' day of OCf&b,l- 200 10 TOWN OF BARNSTABLE OWNER(S) By. Building Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date i 0-13—D�► Then personally appeared the above-named (owner),), _'�©GL.tnc� and made oath as to the truth of the foregoing instrument, beforeme. BARNSTABLE COUNTY Notary Public REGISTRY OF DEEDS ATRUE COPY,ATTEST My Commission Expires: L411?11U <IJLQ„ JOHN F.MEADE 19@4I9Tl:R ANNE MARIE TORRES Notary Public Commonwealth of Massachusetts My Commission Expires E"nLnB BARNSTABLE REGISTRY OF DEEDS �n18.2o,e - . . a .-- .l � , Bk 24092 P:u 1.39 58461 10j=•14-2009 & 09 : 49U OF THE Tpk, ` Town of Barnstable Regulatory Services * an NSTAB s, ► Thomas F.Geiler,Director F16_19. � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-403 8 Fax: 508-790-623 0 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 8 ERIN LANE, HYANNIS, MA, holding title under a deed recorded with the Barnstable �ounty Registry of Deeds or Barnstable County District Registry of the Land Court in Book i �„a& 1 page�_ or as Document No. , being shown on Assessors' Map 291 as Parcel 017001, 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 KARITA CAMPOS, NIECE OF OWNER, JOANA DE OLIVEIRA, 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 13 day of OC fbbC_,T 200 TOWN OF BARNSTABLE OWNER(S) By. Building Commissioner THE-COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date i 0—13-0 g Then personally appeared the above-named (owner),), and made oath as to the truth of the foregoing instrument,before me. BARNSTABLE COUNTY Notary Public REGISTRY OF DEEDS A TRUE COPY,ATTEST My Commission Expires: y III lv- JINN F.MEADE R€�19Tf3f� _ A14NE MARIE TORRES Notary Public Commonwealth of Massachusetts My Commission Expires AprI18,2016 ErinLn8 BARNSTABLE REGISTRY OF DEEDS ---� 10 n § m.4 tl" myx9 j ,paa ,i E $}F p u x.vw t . File.,Edt Tools Help Detail P plle�n# O' u' licatio 21�95T3 + 11-P OPERTY M A Collect us m ACTIVE i Owner 251 {l artment 341f3-BUILDING DEPART1AM Close/Derryy _ _ _ - �. �w,i � �E C3LIt�EI'RA lOA�i" . 'ect/Adivity }-�TYAPT WCONSTRUCTIOIw1 &�, l " Woilc#m scription 1 CON RT`EX18TING APT T6 FAMILY APT TO F3E OCCUPIED BY t - _ Business cription 2 KARITACAT POS(N9ECE tjF O I�lER PUT EGRESS Ultlt�Ll Itd BECJROO.ht ,Fees effectiue Parking/Misc Assigned to 4 Property erty/Use Nan-Conforming Iaatesf S`iG I Permits Business Mast w ation Unit Eustu,g use 1811} a SIPJGLE Reactivate et ERl# LASE - _ zoning R$ PES1D RB rljust fees < el 21M11 = Escrownicipality HYAtd .H'fANNIS m u division flood zonegSr /Section/Phase ;. Prrmposed use 7ltlt3, SINGLE Payrr Historl weep zoning . RB-RESID RB and memo Audit History- , ation dese .__ LOT1 rl Summ Permit #1¢6d zany Copy p Pemft Alerts rerequisite7s [.�,"Hazed/%-tr t�lames Bands r p Sub Addis Text r Plan Review [-] Link Ins s rior'Hstory, Ia lnspectians :' ; ialatians f Reviews _[ Open°Items' i[ +luiamrngs Find Related " p 9arntarn pr>3ject,activity"detail for the current application r1 s le .-Edd Toots Help plicate 2CM 573 + AQpl�carat O V hJ PROPERTY 1 us ACTIVE {k �� vx Owner 251 _ . artmert 63,00 BUILDING DEPARTMENT � I OEOI I�tEII�A,°JOAN�t: y 3. ject/Activity F MILYAPT MCONSTRUGTI01~Jmm $,� t;orhractar - - . 77 criptlon 1 STINGrPTT� YAPTOREUPh Business _ cr ption 2 KARITACAMP08(NIEDE)OF 0 iJER PUT EGRESS WIND AN BEDROOIdt �Fees'effective Assigned to N erti/Use Non-Conlarming Datesr'II�sc 'Petm€�s a� .: - Status Issued Re!m,h ontrac3or. SADD/ALT ISSUED 10/15.42DOS PROPERTYOWNE'R 0 RESDNT RE'VIEVVING al fees 11}4 Total unpard � rerequisite� { �Hazrr� E?estr Narraes % Birds 1 u dtrs IImo*T��i Fa�}t PlanPevi itr5r li:i f` _ ' Insq =fiacr3� ( 'A 10l =borfs F t3er ' 0�7elli r13 W ti:�di�afrtQS iru F'rfi t3 e. .. x ,... .. e_ 77 777 My File Ed#„ Tools Help : Schedule Type Requested `.Scheduled)-y T€€ne Inspector, . ,' Performed' ;Res€1ts f€eld.Sheet i - FOUND 1 I s Ptpp Profile FRIA"ME 1 t INS INSP 1 � € -- -- - ------ -- - -- , - _........ .... .................. �� .. Miew Schgdule J.. Ft > Town of Barnstable 0 Regulatory Services • BARNFrABLE. « MASS. $ Thomas F. Geiler, Director 039.�p�e Building Division y 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: 7/28/09 RE: 8 Erin Lane, Hyannis Joana De Oliveira came in today with a family apartment application with construction (a window in the basement apartment). She said no other construction was necessary. The apartment would be for her niece, Karita Campos-Bidwell, who she said has lived there for two years. Paul came to the counter to review the plan, and he told her that she should deal with you on the application because of the history: Illegal apartment, discussion of family apartment and Amnesty apartment and Amnesty site visit, family apartment application, which was denied, removal of apartment to restore to single family (which was done and he did the final inspection), and now a family apartment application showing an existing apartment. 1 She will call on Monday, August 3,to make an appointment with you. I have the file. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel 00 Application#cQ6 6)c�7 S Health Division Date Issued ) 1i Conservation Division Application Fee Tax Collector Permit Fee oZ OZ Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address I P- ) rV 4 N- Village N N 0�S Owner �ORN "�F 01.1 V 61 ie-4- Address V,F,le-i'0 - Telephone sm Permit Request �C_ rn,ov�6 '7jF5 Ch, 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 `� 0 0. 00 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic Ho ❑Yes ❑No On Old g's Highway: ❑Yes -❑ No Basement Type: ❑Full ❑Crawl ❑Walkout Other Basement Finished Area(sq.ft.) Basement Unf' shed Area(sq.ft) NuAer of Baths: Full:existing new /.new alf:existing new Number of Bedrooms: existing new Total Room Count(not including ths):existing First Floor Room Count Heat Type and Fuel: ❑ s ❑Oil ❑ Electric ❑0 er Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached gara ❑existing ❑new size Pool:❑existing ❑new size Barn:❑existin ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: a o Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ c� Commercial ❑Yes ❑No If yes, site plan review# Current Use - Proposed Use BUILDER INFORMATION C OD t7 Name O&V's, 9,- Telephone Number ' Address e Srni 1..,,,- License# vtk.A- OZAO Q Home Improvement Contractor# Worker's Compensation# I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_' to �e SIGNATURE _0,Lkr, ,_ DATE FOR OFFICIAL USE ONLY ;APPLICATION# DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING �x DATE CLOSED OUT i P. ASSOCIATION PLAN NO. Y ti4 ' The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations _ 600 Washington Street - Boston,MA 02111' www.mass.gov/dia Workers}Compensation Insurance Affiddvit: Builders/Contractors/Electricians/`Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): � Address: City/State/Zip: A ✓� Phone.#: Are you an employer?Check•the appropriate bog: :Type of project(required):, 1,[] Lam a employer with 4. [� I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. []New construction . 2.❑ Tama'sole proprietor or partner- listed on the'attached sheet 7. El Remodeling ship and have no ernployeps These sub-contractors have 8. []Demolition' employe6s and have workers' �orldng for me in any capacity. 9. ❑Building addition [No workers' comp•insurance comp,insurance.$' 5 10,❑Electrical repairs or additions • t] We arq a corporation and its required-)I am a homeowner doing ill-work officers have exercised their 11•❑Plumbing repairs or additions 3 . myself. [No workers'comp. right bf exemption per MGL 12•[]Roof repairs insurance.required.]t c. 152, §1(4),and we have no 13.❑Other 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. f Iiorneowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating'such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contrantors and state whether ornot those entities have employees, If the sub-contractors have employees,they must provide their worker;'comp.poHdy number. I ani an employer that is providing workers'compensation insurance for my employees. Below is-the policy and job site' information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: r Job Site Address: City/State/Zip' Attach a copy of the workers'compensation policy declaration page•(showing the policy number and expiration date). Failure,to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK,ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the.Office of Investigations of the CIA for insurance coverage verification I'do hereby certify under the pains•and penalties of perjury that the information provided above is true and correct SignatureC rk c�,�� `� Date: Phone#: Offi cial use only. Do not write in this area, tb be completed by city or town official City or Town: ' Permit/License# Issuing Authority(circle one): .J.Board of Health 2,Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other ` I Town of Barnstable VE Tp�� Regulatory Services + BARNSTABLE, Thomas F.Geiler,Director MASS. 16.19. A,� Building Division rED 1 v`� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION n Please Print DATE: I ( J' [.Jy h �'✓/1/l j �t%t✓I J 2—ro G JOB LOCATION:— G(L���' number street village "HOMEOWNER": � l� � C J � � V 6- e� name home phone# work phone# CURRENT MAILING ADDRESS: �/� Y`J /_ ,, -/C / Fztlz C u 2 o / . city/to state zip code. The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s).who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Aki�aFure_of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fomi/certification for use in your community. o�VEr�. Town of Barnstable Regulatory Services " MASS. E Thomas F.Geiler,Director y Mass. � q'prE1659. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us 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 autho 5relative to act on my behalf, in all matters work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners .License Exemption Form on the reverse side. �'. E.aTl TEA. ': T.. IS SH.OWN : ON. T:#!�S' PLAN ., �V :per r .-..:. ,e..:_....-.':.:,-`t+r1%:•;c4•NJ.'! T .'.c-'.xry a:r1 - - .. _ . .l� v fit, n 4 i TI p �`� L KrzN-r - 2E 14J vu- . C ZA2 10 Al2A G j" 1 , W.I n U Ull.� Comic�7' S o w LL 'WA .Q�--3L- ............_ ...._.. �7 i /lfi.cz toty ; x �/ r l ; �\ r 4c hP rn 3•; t L(vin9 RM /vim O j 3ecD Qoon-� 13 of� C Z)P ,z CC) vJ�e► NIS Eb 0 GPETC 1 NTL+ hZti r' / d G November 13, 2007 Mr. Tom Perry CBO Building Commissioner 200 Main St. Hyannis, Ma 02601 Dear Mr. Perry: On November 131", I was told by the Building Inspector, Paul Roma,that the application number 200706900 for a family apartment was denied. He cited the reasons as being: inconsistencies, and that a great lapse of time had passed since my original request for a visit from the Amnesty Program Department. Outlined below is the succession of events in my trying to obtain a permit for a family apartment from the Town of Barnstable and why it took so long. In the Spring/Summer of 2005 I was told by a friend to call Madeleine Taylor from the Amnesty Program to come to the house and see if I would qualify for the Amnesty Program by bringing my basement apartment up to code. She mentioned that I had to add steps below the window in the bedroom. I had the steps built and installed that week. After she visited, my brother passed away and I had to go to Brazil. Madeleine came again after I got back and said I did not qualify for the Amnesty Program, but was okay for an existing family apartment if a family member were to live there. I told her that a friend who I was helping out from the Kingdom Hall was living there until he got married in April 2007; I want to inform you that during this time I never advertised the apartment for rent. In March 2007, the Zoning Enforcement Officer, Linda Edson, came to check the apartment. She took some pictures of the bedroom window. I informed her that Joshua Perry, a friend I was helping out from the Kingdom Hall, was still living there for one more month and then my niece, Karita Campos-Bidwell, would be occupying the apartment. Meanwhile, on September 2007, 1 was notified of being in violation of zoning. On September 25th, I went to the Town and got an application for a family apartment, application number 200706417. At the same time I requested an inspector to come to the house and tell me what I needed to do to rectify matters. On October 41", Jack Lebouff came to the house and advised me to eliminate two bedrooms and do the Egress window in the bedroom in the basement. I got a quote from a two different construction companies to make these changes. On October 61", I received a letter from Linda Edson, regarding my conversation with Madeleine Taylor from the Amnesty Department. On October 1 Ot", I replied to Linda. At the same time I applied for a permit fora family apartment, to eliminate the two bedrooms and to put in the Egress window. On October 30t", I went to the Town and asked to see the Hyannis Building Inspector. Mr. Paul Roma came to the house, inspected it and took the required measurements. He told me what to do, including requesting a permit for a family apartment since my first application number 200706417, from October 1 Ot", was canceled due to the way I worded it: namely"family apartment", and I scratched those words and rephrased the changes and alterations. When Mr. Roma saw how it was written, he said there were inconsistencies and it had to be changed. On October 31 st, I applied for a family apartment in harmony with Mr. Roma's instructions (copy attached) number 200706900. On November 13t", I called Mr. Roma, and I was informed that I had been denied by the Commissioner, due to inconsistencies in my application and a lapse of time since my request for the visit from the Amnesty Program. I was unclear as how to comply. As you can see, all this took time. I am pleading. I beseech you to reconsider your decision. Please, allow me to make all of the necessary changes in order to comply with the Building Inspector's requirements to make this a legal family apartment. Respectfully, Aka de Oliveira 8 Erin Lane Hyannis,Ma 02601 Cc: Building Inspector, Paul Roma To Whom it may concern: I,karita 0. Campos-Bidwell- attests that Joana de Oliveira is related to me by maternal links. My mother is her sister-Marilia Soares de Oliveira. I have been residing with Joana for about 2 years.This past April I moved to the basement appartament that had been occupied by Joshua Perry, a friend of the family. If there i can be of any other assistance to the process of obtaining the necessary permits for the said appartment,or should you have any other questions,please feel free to contact me. My contact information is as follows: cell phone: 508-685-2203 work phone: 508-862-5261 ( from loam to 06pm) Sincerly DEBORAH MENDOSA karita Campos-Bidwell c� Notary Public Commonwealth of Massachusetts My Commission Expires Feb 20.20M IF 1W bob ti, 1"o Whom it May Concern: This letter is to attest that,Joana de Oliveira, is the sole owner otthe propriety Map 291, Parcel ID 017-001, ID 291017001, commonly know as 8 Erin Lane Hyannis—MA, accordingly to the deed recorded at Barnstable County, Book 16729 Page 1 IN Instr 44186. Sincerely, ana de Oliveira in Lane Hyannis-MA In OAWN L.CORCORAN o. Notary Public Commompe f-in GI f"I r achusetts My Commission Eypires 6=011 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C C10 Map C Parcel V —a, Application#. Health Division Date Issued Conservation Division Application Fee Tax Collector _... Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning'Board S2,Q - Historic-OKH Preservation/Hyannis '1 (c' f t Project AStreetdreshj-Villager �� Owner S. V L1� Address T- !' Telephone(] Permit Request = C( -=1t eu Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain. Groundwater Overlay Project Valuation t '�'�, Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑L,,' Two Family ❑ Multi-Family(#units) Age of Existing Structure_ 3 . Historic House: ❑Yes ❑-P4o On Old King's Highway: ❑Yes ❑ No Basement Type: Vull ❑Crawl FMalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing 0 new Half:existing ---"- now -----� Number of Bedrooms: existing E3 new Total Room Count(not including baths):existing new_ :a�, First Floor Room Count _ -- Heat Type and Fuel: ❑Gas rITil ❑ Electric ❑Other Central Air: ❑Yes Ulo Fireplaces: Existing _ L 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❑ ('.nmmor^W fl V. r-k hi- iX..__ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map Parcel Application#Jffnu Health Divisio 1� Date Issued Conservation Division Application Fec_'59 Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by, Planning Board Historic-OKH Preservation/Hyannis Project Street Address__ Village Owner �I� !` A DG Address ., /Z) Telephone 5-of 5 2 D 1 i Permit Request l ® A .4 lei Square feet: 1 st floor:existing proposed f nd-f[Q.or:existing proposed Total new Zoning District Flood Plain Groun water Overlay Project Valuation Construction Type \i Lot Size Grandfathere : ❑Ye ❑ If yes, a su porn entation. Dwelling Type: Single Family } Two Family ❑ M - ly(#un's) Age of Existing Structure se:Historic Hou es o 0 d Kin 's Highway: es No Basement Type: 11-Full ❑Crawl Walkout ❑Oth er---� Basement Finished Area .ft. � f(sq ) seme t Unfinished A (sq.ft g -) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existingnew Total Room Count(not including baths):existing — new First Floor Room Count Heat Type and Fuel: ❑Gas 401 ❑ Electric ❑ —er---- Central Air: ❑Yes�LpAo Fireplaces: Existing N w Existing wood/coal stove: ❑;Yes ..4No Detached garage:❑existing ❑new size Pool:❑nfnng ❑n w size Barn:❑existing ❑new; size.- Attached garage:❑existing ®new size Shed:❑existing ❑n aw size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# f \\ 3-o 7-0 TWd Ya of S 6 rr E-/� E L'Wrro oy S /-i r P S ALL Lars ���! _.., ���'`:�t�_•�` e Cie. co c-)C RE 7— C7 P7 S P-S J r� _S r r v d I -- - 1 j Fie. tait Tocais, "60p g Detad Application N PROP��j ..... ...... � Collect Status Ei1 11ED �.: . ' Owner. l Department �63� $UEL03t�1Ca�E3�4RTh�]ENT; Close/Deny Project/Activityr FAMILY,APT WCONSTRUCTEON Contractor 1 ._j ottcNovr�� Description 1 1=r`MILl'APA -TP4�NTFOC R t lEC1 RITA D'J=OLJY C`E tPt�S Busyness 11-1 Description° ra ' WILL.,,HAVE 2 BEDROO IS ON dggju t�ItT1t G 2!,�'/`�'ivr'�SELI OP£t~111 S 3 Fees effectrue;71 I31/ Elt}7 Racking dfisc 7ii� . SSigned I -Business Mast b,m n s i Property/Use a � t�lon�onfor�rrng . ��ates�hrl sc ��Ferrnrgs � � i ftecruate l Location' �, Unit � � �� , E: �4dust Fees, - � � , . I✓ast>ng use , � 11 ' i� `S Scree# B $ n° anrg R R 8 1 1=scrou»+. .a Pastel 291�#1��4}1 � � rner�p It [r�isc Ch s ` �atunicipality, RY 9 E�Y�kN'f�11S 9 ] Srybdiuision 11aod aone �istarjC ` E r Lot/Secti©ilIf1has"e ]� l r Proposed use 1 tE1 FE L 1 Sl audit Erstor}r m Betneen caning RB R'1=SE7 RB j and 4aeroo r j St3lTlr',, efTI11t .. "� _ } Location desc LOT"1 CopY+ P ne— e P it,Rlrts a a_ �,�.,, � �. . �....""". 3 � 'S1 ', ��w""°ry 4 Link Iris s frj�Prer�equis�ftes�— �13azrd estr [ dames 'Bcannds Sob ddss ( Text e i [�FEan ier eua " t p _ ^ i ( Briar History ( lnspectrons Violations ( Revlev s j ;~Open Eta I rl+amin gs ��find belated MIN PIP�- of Maintain projectl'activity"detail for the currin application µ so- r' s1777 , .sic'. • — m; � �� g` -Edit Tools Insfft Je1p .,, P!PLf i Ti t�11NlT ALLY WENT IN AS ADD/ALT NEEDS Ta BE.F.A ILY,AP:T,-i 1�#,,31/ 7- 1E€r�'aE1�I�lTrNt�2 J 1�,ALL SIGN OFF�t?�1`7l iIS��(l. u r a r s k — p 4 r i r K a a� b ko Al . r 2 .. �.. _ l-... �. :J ',: p,..nh.tl -. .:: n. M6,i� .. •. '._ �.,. -J&,eve,. Y - ti m-. r Joana Oliveira `' t� 8 L rE_ 8 Erin Lane �: �;� Hyannis,MA 02601 01 V F§1 tj Linda Edson Amnesty Zoning Enforcement Officer Building Department 200 Main St.. Hyannis,MA 02601 Dear Linda: I received your letter concerning the conversation I had with Madeleine Taylor from the Amnesty Program. I want to let you know I'm on the course to apply for a permit to conform my property to code. Sincerely, a Oliveira �'�'. �y m�la :�����, r �,��, f t ij,�` < ��� �. /�- �/ i- f Town of Barnstable °^ Regulatory Services y�MASSS. Thomas F. Geiler,Director 'OIfDMA.�a,0 Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 October 3, 2007 Ms Joana.De Oliveria 8 Erin Lane Hyannis Ma. 02601 Re: Illegal apartment- 8 Erin Lane Hyannis MA 02601 Map: 291 Parcel: 017-001 Dear Ms. De Oliveria, It has come to my attention that you know that you can not have the illegal apartment at the above address. You were told by Ms. Madeline Taylor of the Amnesty Program earlier this year that you do not qualify because you have too many bedrooms. You can not have any kind of apartment and you must remove the kitchen and a bedroom to conform. Regards, Linda Edson °FtTa,� Town of Barnstable Regulatory Services yni ssB $ 'Thomas F.Geiler,Director �iOIF13.A10 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4024 Fax: 508-790-6230 September 18, 2007 Ms. Joana De Oliveira 8 Erin Lane Hyannis MA 02601 RE: Illegal Apartment: 8 Erin Lane Hyannis , MA 02601 Map: 291 Parcel: 017-001 Dear Property Owner This letter is to inform you that you currently are in violation of Barnstable Zoning Ordinance 240-11 You must contact this office by October 15 , 2007 to arrange to bring the above address into compliance or be subject to fines of no more than $300.00 per day of non-compliance. Thank you for your attention in this matter. By Order, coda Edson Amnesty Zoning Enforcement Officer Building Department Q zoning5 Town of B * . 01�2�3� o arnstable Permit# � Expires 6 months from issue date Regulatory Services Fee •`''' Thomas F. Geiler,Director , r;' ®� Building Division fAi -on Perry, CDO, Building Commissioner 00 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint p/parcel Number perry Address �-- ._ , .',. : : aj, Residential Value of Work Q Minimum fee of$25.00 fo work under $6000.00 er's Name&Address (2), mtractor's Name Telephone Number ome Improvement Contractor License#(if applicable) �a-sf�c=�i��Srvisot's-I✓iceirsn��-applieabiej _ _ .. ]Workman's Compensation Insurance Check one: ❑ I am a sole proprietor [9 I am the Homeowner ❑ I have Worker's Compensation Insurance surance Company Name orkman's Comp.Policy# opy of Insurance Compliance Certificate must be on file. ;rmit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to Q Re-roof(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission, A copy of the Home Improvement Contractors License is required. [GNATURE S_J�CIN la_ Forms:expmtrg :vise061306 • oq - I i.r... vv••-••.v•..r..r-rr•. J -............�......�_.- Department oflndustrialAccidents 'i Office of Investigations 600 Washington Street' Boston,MA 02111 y J' www.mass.govldia ' 'porkers' Coxripensationi hasurance Affidavit: Builders/Contractors/FIdctricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Orgenization/Individual): L\ 4 Address: City/State/Zip: Pt N N. . s A °Phone.#: V ,0 3 Z l04 Are you as employer? Check the'appropriate boa: -Type of project(retluired):• . 1.❑ I am a em to er with 4. Q I am a general contractor and I P Y 6..❑New construction . employees (fall and/or part;time).* have hired the mb-contractors 2.❑ I am&'sole proprietor or partner- listed on the•aitached sheet, 7, ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition' working for me in any capacity. employees and have workers' •#. . 9.-•[]Building addition [No worke=s' comp,insurance comp,insurance. required.] 5. ❑ We are a corporation and its 10.El-Electrical repairs or additions officers have exercised their 11. Plumb' repairs or additions '3.® I am a homeowner doing.a7I work ❑ ?n8 P myself [No workers' comp, right of exemption per MGL•• 12•❑Roof repairs iasunnce required.]t c, 152,§1(4),and we have no employees. [No workers' 13:❑Other comp,insurance regtired.] *Any applicant that checks box 01 nntst also fill out the section below showing their workers'campensation policy infomnatien. 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 ornot those entities have employees. If the sub-contractors have.employges,they must providt+their workers'comp.polidynu nber, I urn an employer that isproviding workers compensation insurance far my employees. Below is.the policy and job.site information Insurance Company Name: Policy#•or Self-ins.Lic•#: Expiration Date: Job Sits Address City/State/zip.- Attach a•copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Faihze.ta secure coverage as required under Section 25A of MGL a 152 can lead to the imposition of criminal penalties of a fine uP to$1,500.00 and/or one-year im risonment, as well as civfi penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator, Be advised that a copy of this statement maybe forwarded to the Office of -- - Investigations of the DIA-for in�ce coverage verification. I•do hereby certify under the pains•and penalties of perjury that the inforrnatian prgvided above•is true and correct,' Si a e Date: r I Phone 4• 3 Z �' Off cLd use only,--Do not write.in this area, to be completed by city or town officiaL City or Town: Permit/ icease# Issuing Authority(circle one): :1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector b.Other Conta-t Person: Phone Inform' anon And Inktucti®ns Massachusetts General Laws chapter 152 requires all employdrs to provide workers'compensation for their employees. pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a-deceased employer, or the Te���Vp.T or ttictee•of an individual,partners ' ,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 notbecause of such•employmentbe deemed to be an employer." MCiL chapter 152, §25C(6)also states that"every state or.local licensing agency shall withhold the issuance or ,renewa 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 ohapter 152,•§25C(7)states"Neither the commonwealth nor any of its political subdivWons shall enter into any cordract for.•theyerformance of public work untd•acceptable evidence-of oompliaaeeY ththe insurance requirements of this chapter have been presented•to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, it necessary,supply sub-cont'ractor(s)name(s),addresses)and phone number(s)along with their certificates)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnershipa(LLP)with no employees other than the members orpartaers,are not required to carry workers'compensation MsUrarce. If an LLC or LLP does have employees,a policy is required, B.e 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 the city or town that the-a' lication for the ermit.or.license is be' requested,not the Department of be returned to ty pp p �g q ep , Industrial Accidents.; Should you have any questions regarding the Iaw•oi•if you are require$to obtain a workers'.. compensation pblicy,please call the Department,at the number listed below, Self-insured companies should Winter 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 numb er 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'infoumation(if necessary)aid under"Job Site Address"the applicant should write"all•locations'in . (city-or town)."A•cbpy of the affidavit that has.been officially stamped or marked by.the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses, A new`affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related io any business or commercial venture (i.e.a dog license or permit to bum leaves-etc.)said person is NOT required to.complete this affidavit, The Office of Investigations would like to thank you in advance for your cooperation and should yeu have any questio, a,_-- ,ple'ase do not hesitate to give us a call., The Department's address,telephone-and fax number;: Dqpaztm=t ofh&aWal AQ64=ts Offic4 of In-Vem4gAtions • . �0Q��shi�t�t€�Str�� • Roo ton,CIA 02111 'pet.# 617-727-49-0.0 ext 4.06 ar 1 0 77 MASSAFE Fax T'r' 617-727-7 49. Revised 11-22.06 w �t.i�ass,gat� di ' oFt�E ra,, Town of Barnstable Regulatory Services * B msrABLE. 9 MASS. g Thomas F. Geiler,Director �A .s6gq ♦0 rE1659 Building Division Thomas Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 February 28, 2007 Ms. Joana DeOliveira 8 Erin Lane Hyannis , MA 02601 Re: Illegal Apartment: 8 Erin Lane Hyannis, MA 02601 Map: 291 Parcel: 017-001 Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerely, Linda-Edson —Amnesty Zoning Enforcement Officer Building Department gforms:zoning3 0 K2 •.:, tic -���. .}�.. se 3�.� �p 'r i ,. . . �o`,�. M,3 ....: ¢?^ 3 3 � �� '�"`ii�..�i, �� ;� is c � g `� `s' �i ry 't 7�; � A r Y �r -ti-€ 3 s` � �;;� �., F., s s � � a �' '� tit'u�' �y II � �� � � ( -�+��-i�N � a� c y $° �j 1 `rt Alf", L Van: PLI ? s i �:. �.. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 Map Z%C, J j: Parcel C�o L Permit# t Health Division "r'lsr�, ,•�. yn{n Date Issued 6�_ R c Conservation Division Fee Tax Collector _ 2: 4 j Application Fee Treasurer _ Planning Dept. � 1)1 V tS "--- Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address g 1 1'-Q k��� tC,` Y/f✓!/ /1A� -O 6 O/ Village LJ�� ja/ ,5r CC Owner. �0 IVA "�& Q_/t CJU-_!��Address & �,�i N ��s✓4 L'�� .9�✓�✓f� Telephone 3 �_ }� Permit Request i o -1b Ul zjj�) R- 1 0 1 14 l CAL-- 73,o!�!c2ic eaa> �en Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain fi,)>A Groundwater Overlay Construction Type Q.0 �c�R 2� 1 c �E Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 Multi-Family(#units) Age of Existing Structure 1-2 O Historic House: ❑Yes ;lo On Old King's Highway: ❑Yes ❑ No Basement Type: O Full ❑Crawl L!(Walkout O Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 0 N G- new Half:existing 00 6 new Number of Bedrooms: existing :21 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas Oil 0 Electric ❑Other Central Air: ❑Yes 2P110 Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No 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: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name o, Qk J Telephone Number 3 2.L 9 Address v, -�-00-cr.2 License# a, c_ 1A_X - Olio 01 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE j9 C� 2 .0 FOR OFFICIAL USE ONLY h PERMIT NO. DATE*ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING R:./IJ 1 d-Z l,-O 5 aV� ' DATE CLOSED OUT ASSOCIATION PLAN NO. - _ _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 \y �,M 5�•� www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ley bbll Name (Business/organizatiowTndividual): `� a O I_i JG_ 1 2.c=. Address: City/State/Zip: �, c c��U- Phone#: 5 o cb Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with • ;►4 4• ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet ship and have no employees These sub-contractors have 8. ❑ Demolition working forme in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its • 10.❑ Electrical repairs or additions required.] officers have exercised their 3.El am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct Signature: `,,a Dater © O -D 5 Phone#- Y1 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. , Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or al of a license or permit to operate a business or to construct buildings in the commonwealth for any renew applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners; are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia i - f - oFVE Town of Barnstable o„ Regulatory Services BARNSPA13M Thomas F.Geiler,Director 9L MASS. pr 1639• A,O� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: Q o l I (Q�;JOB LOCATION:— - D E'6 Y� 1 t,Q c9 & • k Pr ' O Zi p O I — Q -S TA3 GC� number street village "HOMEOWNER": name home phone# work phone# r CURRENT MAILING ADDRESS: A city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. ature of omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the pen-nit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forrmhomeexempt e+ TOWN OF BARNSTABLE BUILDING L V�IIT APPLICATION Map �`� O� ParcelO Permit# Health Division - D e Issued �� l✓ Conservation Div?sion App'cation Fee eso L Tax Collector Per it Fee . Treasurer " Planning Dept. l Date Definitive Plan Approv d by Plannin_: oard Historic-OKH Preservation/Hyannis c Project Street Address O ► ( N J JZ d Village Owner 0 +(0P' D Off/ 't �1 Address �i2>-� �,1��/C% - /V ✓/1' Telephone 3 2 g 9 Permit Request0 G4f ore 2 u R e y Square feet: 1 st floor: existing proposed / 2nd floor: existing proposed Total new Zoning District Flood Plain iVI d4"- Groundwater Overlay Project Valuations Construction Type �P A u�) (F-�i^� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family �9-- Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes O-No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑Full ❑Crawl P,' alkout ❑Other Basement Finished Area(sq.ft.) ) 0 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing ,OrY&— new Half: existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas al'Oil ❑ Electric ❑Other Central Air: ❑Yes L o 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 ❑riew size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name e c ,`J F" 9-a- Telephone Number S Z(E,S Address & License# \0 .4 0"O > Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU — ��•_ DATE __ O(-{- tZ� rJ t FOR OFFICIAL USE ONLY PERMIT NO. ti - - '- DATE ISSUED MAP/PARCEL NO. z • t ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION t i' FRAME INSULATION - FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL -� 4 FINAL BUILDING i - DATE CLOSED OUT , °a `? ASSOCIATION PLAN NO. The Commonwv Ith'of Massechusetts Department of Industrial Accidents% 6Q0'Washington Street _ ~` Boston;Mass.. 02111 �~ Workers'. C m ensation.Insurance Affidavit-General Businesses address: � J(P— e-_ � 3 1^-p`. state hone -k P Pr N S work site iocatiali fu$address ❑$ems❑Restaurant/Bair'EatYng F'stablisfimeat I sin.a sole proprietor and have no one $psiness'I�p e; • []Of�ceE]Sales(including Real Estate,Antos etc.)' working inany caP • Other ' r. ❑I am an em to er wi etn to ees(full ' art tune . ❑ Fgi Ni /�///%% ////%/% %%%%/////y%%%%///%%/%///////%//%/%////%////% on this'ob vakers' cbmveusation for my employees worlang 9 % �.� I an'employer pzovidin•g y t �t ... . . • :,. .:, •.+',,.;•' n` . . '�,�.• :r.,;: � •_.' . .. •r JJyy .. .s t. .Lt " r I•.• r.7•yt: •S' ti•ti tl•,h::•.i qi}•+,,. 't t. %tt: 'S' 1�\t't' tN ::�y�'tit}l,•,?'• ' � .«n:•h' d+�t•4'r"'.,i:'::,y.aa' .:S• 'Jt• .. ,'^•;�.1:•l fir• +l _ .{i'' ..a ��t'��.. "t rd,•"' " 9i110j• , - r•j•r','r5�{M• .•7 .l, :4 •Nr, t;i'!%."''•j•^.i:l:. rY t�t•1\: ,.,' ... COli1.8II'� •.tn1,r its• �.p`.?;{tj' e' :i+' • •�.,'t' .� 7 i:.rT'' r.• . .et:;.. a'.�::r•t'i ;d•' •,;, �,• , •y•• v a: v,.:+t fa••t,t:; .;Y••:.,'l,�.:tl:•; ,r t' i , ,'r. 'y,• •(.'.�.,:: 4•, .t�!;i4.�' 't .y mot:..• -1t• ..l i•"•a:..S, • "ii' :;. •it 1 ,,L•. ddi� .. r.• .•,�' •. .tr"'•� a"•Kr,' �y:'s.7r•: .'`•`' a.; `'''YLl!' 4k'''' {• •' Hone.- III%t.' .t; '} � '.tt•.~;t•.yr •S ' Ei' •• ..apt, '•t: ., .i. � 'L•;:'',•°,, ,;1�.�,�', _ 't '1 '{•, \, � , 'F.. ._Sir•. ♦ ""'�j 1 1'u t t •I J ',t+'•r:•t, •••i:,•yy�,' , ' (•'•!.,i.,.'4 1j� � • �• '1•, •!�•^ t•, ':: '{'! �N'•L`•:•/: •ti'I a:t:K:',.. �' .t 01101 ,iF 7 }:1'A•••'�• r sole 'roprietor and'have hired the independent contractors listed below who have the following workers' •w pensation polices: ;• ; . . �tif ,• , •..M1':, • •_, •t, '•y s '' ''};�.�.,. ,l.v 2t ,!.:'r w�{:`\'UC.jy;C':l.'wv.'•'v'�''�y{"rF��,'.{i'''\. :it�':. :r=.•.:111; 'e t• ' 'ri•'tti'F,' ,.J�'J ,l'1'I It•.'it•'�• • . ; • ..: •A:i. CUrIII C r •t •'SMr'; .a.:t• •♦' ... �, ..1 '1••1�j;':.,;% ��•. , .• .. 9II 'haDiet:�' •.v , "' '�"' '' tits' ::i•r���,i'eti•+•s' •t,,:.\ y , ;aF•7• .t;. •r,�r•,�,'�:'�4''t1.i•:•• , :1 Cr .�{i�•i(t .t�. '' vt:i••i r�t'i.i t'.,•' 'ri:•' »f l.�k{:f .!;;�.t• 1 .j•!' t fit:, .t.'S'� .•�r '.•hL\•.t. .ecldLe�9• s' .� :6i :` J •7• r �'`'•ir ,j:il �t ti.;, ' '; it:••!ar• t.- '•",L•:»� • :�� •,r•�df;. y .at. lsr.••rrs{:�'::.tr l:: ..r.. !t,• .L N, 1: •�.'t, � .ti.:'�': t s ' :J$•'•.'I•''p,�";;pt Y;..S:Al hZ t'•'�:' r, i''•' �4' i••'3 •:: .r' 'sue•- 'tt.hJ;:l�.:t,,. ,• •tr •,Y'[•». •'1'••i:r,,,•5.,•A •;. ,,t!:♦,.t.•1'y i110218'�,. .,:, ••.' _..',: •••. . •... r. +•- •�ClI v::t;l.:•,t •' K r.•,,t,,: a• •• •,. ;'j:'••Y�' "t i•Y''i''`A J:''."t!lt;.i•'S.';:. ir$}�i::'' tr,•_T+•y�tt+t'y!l•+!:'.,1t,.�':•. ,.r t t�•.;,+.,•5;,•:.!r':rt.j,4t:"••,'t i�;'i:t.l'':r•.'t.+'i:i}:"tl.:�.'s'tr'•'.•t•},y:•t'i», !•�' t;.. ), '�'• 'C�liu:••:;F.•• .tt iti '' ^t t•• •Y:' •,t:. O11C :Yf''• .r,:tf2'i•s.:3Y.�.L=:•, .r(:•'. •t .;3. '!:`f. i / iusuraII � ,r . ;i\. - ' t .:. • • : • .•.'�•,.J .,.t1`2;•t.•� ••,H4!(( �:• :�{,{• .'::,':., / t 't' ,•t: '�: i!r�•,• fl;:' ie l! •r t' 'j •t•(' a1.\,..', tt�t•}.'''rra tiL;:�,ajJ7 t'•'ti`'' �'• •+,:,yi"t.� •t•.•• rti ;p J.4+ .;,•�:r{,'i " •ti r,•�4 •.rta,.:jn1 .r L '.!' t.{'•.t �dv""::'+Yt :f: 7n- C ' v tom.".t:,,�;`r;..:;r.1• '•• + ty ti: t ,+C %:'`.,t=. ,v:•<+Y.'•t Y.i t-...t.• '• r -'•, ,r' r ".i�.' . ,•, Y da,C:%`r '•t •. •?L.,,n: i' '.' ., �.. ...i t. t ;'' .'�:'�'- coni"aii• iitiIIte:r• i• - i. t. ,; .;r. •t• .: '. ,,•, •aril •r , address . . A t t - F: i '•' '' ,:ru�. = V ' , ,� .a ,. 4 ♦. .ap.. .,y. ...f;i.:+' .:�'t'i i. �•flr:•»S.!t.,i C;.:Y' ••t��t... • M1f .. j, t''t,. •; :•. • , ', �,• .;•4•.a,t: t,,y�:•». }l.'.•Z♦o :i�.l'•.�ys,: , .i, t' �.[y,�•., •� E}:•„:�•i•�=r 'i'. .�`••\'Si:s,{'' \ ,: i''i'!f\:: �,}� t ,is 1�.. s��.» .t: C1 �::'t.. ,,JJ •.{,ft•"r.:r�•`.:t. y ••::: � is .y.r• :i}y, '!:a•.•�i•: ':':ri:�. ••!r;•..� •i :ts; ,�. �,..,,, t ,i:.�' ,{t•,;, ':� ,r»1'h��3ttiM.! :t',;^, !.r,f• 'i;,n.:" ..r1;•.. :'•' '.7. 'f'.s•:�'•'• r•:: .; r. •.., ... { sti:;; :14.5",w'',.J.�" OZIC,':ff''3;-.,,�`,;•^� {.'•• ,"'. .• insiirarieeA, 500.00{ 11 ne sition allure to secure coverage as required under Section 25A of MGL 152PcawnO ORDER nd a fma of�100 00 penalties againstt ma. I understand that Xr one years!imprisonment as well as cfvllpenalties is the foYm of a ti copy of this statement maybe forwarded to the Office of IIIvestigations of the DIA for coverage verification. I do hereby certify under the pains and penalties bf perjury that the information provided above is Prue and cortect ,'gnatllre •i • • �,: . ,I . • • .O% 1 2 t + Print name O Phone# official use only do not write in this area to be completed by city or town 4DMC J, permit/license# ❑Building Department city or town: []Licensing Board ❑Selectmen's Office [}checkif jmnlediate response is required ❑$ealthDepartment , phone#; Q Other contact person: (revised Sept 2M) _ Informatio nstructions• n and I rovi$c Fvorkers a ensatidn for'their• •cha ter 152 section 25 requires all employers top Massachusetts G�eralLaws • . p . . ;. : . , _:,•�• employees: . quoted'fromthe l`la.�', an employee is.defined as every person in the service ofanotherer under any contract of hire;express or imp lire ' oral or written. loyer An emp is defined as an mdm.dual,partnership, association, corporation or other legal eniit�y, or any fwo or more of the foregoing engaged in a']ornt enterprise'and including the legal representatives of a deceased,employer, or the-receiver or artnersbi association trustee of an individual,p . Px or other legal entity, employing employees. 'Howevei.the owner of a . dwelling house having•not'nnore than three apartments•and-who resides therein, or the occupa&bf the dwelling house bf- other who emplb3�speTsb�to do maintenance, construction or repair work on such dwelling fiouse csr on the grounds or enant thereto shall not because of such:employment.be'deemed to be aii employer,- building sppurt t •.. MGL chapter 152 section 25 also'sfates fhat'every. state or lacal Ucensing•ageney shall tiYithholcl the Issuance or renewal of a license p •or • ermit to operate a business or to construct buildings in the.6n=onwealth for any applicant who has not produced acceptable•evidence•ofcoinpliance with the insurance coverage required: Additionally;neither'the' .of its political subdivisions shall enter into any contract for the performance of public work untf acceptable evidence of compliance with t�e insurance requirements of this chapter have been presented to the contracting.. authority: zg Applicants Please frlx the workers compensation afadavit completely,by checking the box that applies to your situation.. Please supply company name address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the Department'Of lndustnal Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returnedto the city or town that the application for the permit or license is being requested, not the Department of Xndustrial Accidents. Should you have any questions regardirie the"Iaw';or if you are requiredtoo btain a•tivorker s.'•compensationppliay,please call the Department at•the niunber listed below. .. '. •. ' ' . City or Towns Please be sure that the affidavit is cbmplete andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to It out in-the event the Office of Investigations bias to contact you regardin The.affidavitsg the applicant Please be sure to fillet the perm t/hcense number wlnch win b'e used as a reference number. maybe returned to mail°T FAX unless othe'r'arrangements have been made. the Aeparfrnentby, . . •. . .. , The Office of Investigations would hlce to thank y'ou in advance for you cooperation and should you have any questions, please do not-hesitate to give us a The Department's address,telephone and r. fax number. , The Commonwealth Of Massachusetts- Deparhnent.of Industrial Accidents . . since of tl�et�tlena ' 600 Washington Street Boston,Ma. 02111 fax#: (617)7Z7-7749 II , .n. i/Km rift Pr.Anne _._t --- I 1HE Town of Barnstable DF Tp� Regulatory Services BARNSTABIZ, ; Thomas F.Geiler,Director y MASS. $ �A i639• Building Division TEo r�r" Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION /�/ Please Print DATE: 0Ir I 2 -01 JOB LOCATION: g e P N 0 0 G W y41,11V S` (9ZL p( - � /'/►/✓�s> 3 C� number street village "HOMEOWNER': 'J cii v6- 1'" �b$- _r_�5 3 2(I 9 n e CC home phone# work phone# CURRENT MAILING ADDRESS: 8� et - 02(e_ 0 I `city/town state zip code The current exemption for"homeowners"was extended to include owner-occoied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. re of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 00 1 �. - o law ly alp � •.. i - f E R T.IFIEPD PLOD` PLAN .w :' moo.k► .--� ��- - LOT l SA1 ���_ BAD I CIOTIFY THAT WHAT ISSHOWN : OWN TRIS PLANjolm I$ AS IT EXISTS ON TII.� 81����� Al. 0 ��1NF0A fl TO THE T if lli R I LAT L x BOYLE ASSOCIATES.f- M0, .49. ? =��v°ry�y ,�e;E .`M1r+(h.� r e i_Fa ,' :a - a 'a '�., o •ai{ { . 3va.+•.I'� .,` M1"` � �d' -- fit`•' �,•. ,+ 3"F'Ws 3 � .�.� 5 -{ ,.. - s},`�i''�':r� .d �*6i',.�.'�f � t��� ���'3,c��.+� x 2 r�n "i'f't- � ''4'jam°'a 41�r• y" s ,��{¢{y'`�i t.� �r.,�n g - p-l��}�- t �,•v., •i .r',xt, c '.��"-'�:�."`'`�P'E�'�Px'. ? .;y r'r��>/ - � yky�� .",+'sY 'r 'P� "7;�i3�G :-i� =i Jf 4y _-�ri��, }:, 8 'c- s.���—�.8� y.;,,it"�i '..:� .Ytte �r .Sxa' 'i.{ '� 3_. �` :A.§ r•1 i� •��{� `����t 'j } �e:, s c ,r•v, � a. i.r•.* ,�� yak � ! `� a �7 h� r• s<rq�� s" � t r4 =t�� 3 r`: v, � *,� t?r,'•.� f �PlFF r .s. .� ✓ � c''jq::� � a`5x�"F °q� R�,��{�rgry . A 'r:P G � �'�. �'�� 5."f ,w x,F� ya". .a"I. �4+P 1 sCi cd:f ttt7 •�� �. "' -"{ -t. � � ���,,. ?"'. �..�*' .t_�,(ha� ec! �. 1 `?•e�.P t. .s i r"41� � ��,y � ✓�,,.!#.. C � r ;,r�i '..1 � s s ( c ->, '' �^ ' se::• a '9>F'a •. t � '`t;��P' $°f< r 1._ ''�• �! .e4' 'irt't e a,� i'+n:3..s y E t 'a. '�.•.31 c ''^ i # x'--;''S k s � - f$ � r". r �^•.��! .h v`''� � ,{g * F � ;g i�YS ?, ��• I •-as'�"�,s. �s __ �' , v 'P �;�,,�p{a 2t I L k �j. a r �a,., at, :g u�rx�.�n �.q '' � a a •��3ky cgd � .}e?yd� '� n i t ..ea n-i +� 3�. 'A� � �:'r.t �'v�T �^� .,� 3 '.{ �y1" 4`3��. ":N�..�}� N�:'['`�J •� � zt .. �"r�'�• � 1f 'Sa ry:P „'�,.� 5 f��a ��P'4.�r��� .� - <y}x"Yf"4 Q'� Py£.��'. h �� .. ",,:*+, '�'i:"' ? 1 r�,t. +t'j{ �'..' d` 1 ,/,'^�.,..,r,»i3.�.y7'r8�+^•;,�? 'f - rr b.'. •! G..+"""' �iR Y a�p-M' ,iF+•'s' Y �., ��: .'�, � �� �y c,� � • '�= y` #t7 d sera ,, �: � j �; f � �� a �u . 4p��...;�"",.e� �',•,-�., ' � ,t?�vS �"� '*a.ma;R,:^k <a=b'- / � �1:+ y e t r~ ,; P� - r >! �;��f ,+{�yn�� .�. JwA ✓ ��_ .�` �"i` c .F;y T.l� if R '7 .F' �� ,Iiv>t'�,_, ky '%fi t-Y'. 14 S.A p.r,.� �!,§?c . ._ i.- ,.� v _ ,� ? .1' :$s,td. .3't4.a:. e. �2'.",� r.� f. .r✓^ •:r ,2.^r .�v.r-r*�. ` ;ay ``.._Y t 41 ,�C��-'�_ i�'�•- �� 3 ;�F�`o-f1 ? �?hit' fir. . .. z t =."�.�. 7i !r�`t?` .�4ifkS'� � � i� � r ,�,n.�. gip;'• CE C6 g ; • ♦ z t . Aso -F0t Cape Town of Barnstable f1HE Tp� y� tio� Regulatory Services Thomas F.Geiler,Director BARNSTABLE, i M6 ss. �g Building Division �prED 39. MA'S A, Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038S/a a Fax: 508-790-6230 /� PERMIT# U 6 Cl `� 3 FEE: $ SHED REGISTRATION 120 square feet or less Location of shed(address) Village. erty owner's name Telephone number >C 9l O � 7 00 f . � 1 2 Size of Shed Map/Parcel# =ture Date Hyannis Main Street Waterfront Historic District? nn O Old King's Highway Historic District Commission jurisdiction? C.. Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 ly U7 .06 ul 1 GERT F I ED PLOT PLL.A TOW SCALE DATE 1 9E11TlI:Y THAT. WHAT IS SHOWN AN TNIS PLAN � , p AS IT EXISTS 8N T#�:E- IS. SON AND CONFORM T-0 THE T O*W N atoL LAT 10A ith i c. CAI. Uft Assessor's map and lot number .............. Sewage Permit number XA.-.Y.?........... VAUSTAML House number .... ............................................. 2639. 0 NO A,- TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... ................. TYPE OF-CONSTRUCTION .... .. .......................................................... ................ . ... ...................a ................................... ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .......... Location ......................... _,7" � ..�..................................... ...................... .................................... ................... ProposedUse ......... ..................................................................................... ZoningDistrict ............. ........................................................Fire District .............IX ........... ............................................ _ C. ..................................Address .. . ... CL. Name of Owner. .................................. Nameof Builder ........... .........................................Address .................................................................................... Nameof Architect ............... ....................................Address..................................................................................... Numberof Rooms ................ ..................... ......................................................... Exterior .. . ...A... . ............................. . .... .......Roofing ...... ......................... .......................... . .....................Floors ,�Z.............................Interior ..... Heating ... .. LoJ��/.a.L.O ...........Plumbing A .......................................... .................. ................................................ Fireplace ......................:...:. ...................................................Approximate Cost ........<9,3' e5oo ............................................................ Definitive Plan Approved by Planning Board ---------19------2. Area .... ................. t Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL-OF BOARD OF HEALTH A &3 V, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name,/:. ............. ..... . ................ . Construction Supervisor's License /........... R W J CONSTRUCTION A=291-17 00 No ... Permit for .... ........... .............. Location Lo.t...I...... ...Erin Lane ........................................ Hyis .......................an...n................................................... Owner ...R W J Construction ............................................................... Type of Construction ..KKAIRP........................... ................................................................................ Plot ............................ Lot ................................ r. ..............19 83 Permit Granted ... July 14.................... Date of Inspection ....................................19 Date Completed ......................................19 0 sue $ �3z 9"'C.. . 1 � A '�t•; "� zeI G.S.es o .77.. a 1.4 �� N 1-t.8lR. le"c; fI PLO" '" PL .AN LOT jam J. • GERTIFY THAT ' WKAT.: IS SHUR. . ON. T-Rit FLAN � p : [l. Al IT EXISTS 44 In- 8A0'X ANC 9. NF0-AMS S . :. T0 1HE T4 V. 00,91ATE. �� � O` I� t1' S T \ ZA oi- t 1 � Y I a 1MZ r MKI .k.�,.^v+^-psJr!'^ 4r>•:.,+. s.. -F ,*ziy,{, � S.c �.t� t `'+S .:w. s' '. r x -N Y „ r A;�.:;_ t.;y.-.. fF ;a 'ri.:r Ys�y r k y '4n.'. `' �' - wKK � � RI .a+`�:x.�s Y,� 3 f� � � � 1 es a ,`e. y. �+,.r_:y ^,.r.t3, � �•silt '�F :�'t.-:� 11 5..t „_yNA €�, ^ Ca '3' Y f*�xµ 't•Fr;; ..Y.' - ;.iT s r Me. �-�t.t,_ -qet�`5�k•+arc� �re c z`s � :�`. y r-s .��...� r � � � r:�m x r � ��, -. y a s a.. r �. d .�• uxa:z ri� a a � "� 4 . � � t ryk u c s "a,x a �°. �t :s—. �` ''} �.y, y -• �s'�.k*.. •-'. ,iPXy�+r, F.74Fk4'.Y�.*. I`V'tsr i�ri � "'ffts•. ri..w.�k.. 'M. '�Os �" .4.F,t`^ M• »r.`;a, ���E(;-.�.u.��'.�. �k4.� �' ry� xu�lr3� '��r� � [h �" ti` - :r F�,::fi E, ..:1 .s v,-s "E„. � ,�,a x �`;#x f '.�xra •-�- :A, �."p�rke r._ _. .,�,.8�z._d_, a'..l�S' a F-tvt, +,w`�s.E }. + 'vr �. t „t +$ �: ••rF�a`. w +;., '�a wT� ;,;,� .�'�7.+ y ,Sp i � � #� �,a " '�' f} �. �i ��� �:-���c� - � � ���.�� s,�s�4 ��4 �,.��, ,���'•��i+' � �r ti�Y L��k. -�Li� T� i�'a 9 'Td. �����r •1 .� rw .-, '*^ � } .a. :3' : �� i '_ i N_, u�,* $; rs .fit ITCHELL'S WA Y M L=24.37: R=691.4B, i L=75.69 �q_891,4B' ' 43 L,15.39'. L=100 �g25.58 jr75.56' i. R=B25.5B i i 6p.16 " B= 825.5E LOT 2 i LOT 3 i LOT 4 10 2 C1 a� S LOT 1 ' w �I m S89 03'30 E 12. 'NB9 0330"W 75.p0' SB9 0330 E 100.00' NB9 03"30""W F� NOTE.- ABUTTER ON LOT 5 APPEARS TO BE ENCROACHING' RECOMMEND INSTRUMENT SURVEY. Pi an is For FLOOD ZONE.- "C" RES, ZONE.• ' 'RB" This MORTGAGE INSPECTION Bank Use only THE DISTANCES AND MEASUREMENTS ON THIS PLAN SHOULD HE VERIFIED BY AN INSTRUMENT SURVEY. TOWN: 14 ----------------------- REGISTRY OWNER: RARRARA_-J___COLLINS ----- - ----------------------- REGISTRY REF: _ 646- _M8---------------- BUYER: _P_L4��.4__RIVER------_---- ------------=--_:__60---FT. --- PATE: _9������-------=-------------- PLAN REF: _13131__ ----SCALE:1"= — I HEREBY CERTIFY TO=TODAY MD&TGAG�'SBR_VICES ___ ��y, YANKEE SURVEY THAT THE BUILDING CONSULTANTS SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS PAULx r SHOWN AND THAT ITS POSITION DOES —_-- CONFORM x MgMEIW (SUITE 1) TO THE ZONING LAW SETBACK REQUIREMENTS .OF THE N0.SM INDUSTRY AD TOWN OF ---BARNSTABLE-------------AND THAT p i MARSTONS MILLS, MA. 02648 IT DOES_NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD l �d55w�PQ TEL: 428-0055 AREA AS SHOWN ON THE H.U.D. MAP DATED_9_/18.-00 _ qNp SuRy0• FAX: 420-5553 Co nit —Panel 250001-0005—C 29480 LM THIS PLAN NOT MADE FROM AN IN NT SURVEY ------ NOT TO BE USED FOR FENCES, BUILDING PERMITS ETC. I * • R TOWN OF BARNSTABLE permit No. _- 25313 — — Building Inspector { saueT.n Cash OCCUPANCY PERMIT Bond 7* Issued to R vi J Caistnict on Address L n-- 1, 8 Prin L;7 p-n P, HYaru� Wiring Inspector r ' Inspection date PlumbingIns ` Inspector 7 f/ � Inspection date Gas Inspector d Inspection date Engineering Department % zl _' Fvt� ^ Inspection date Board of Health ^ �x" i .�: Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. j A Building Inspector i l 0 88 k 3 f ' p 5�-Z �a�� N� 1 �� 4Z'7' s•�• �N � 4-4 LZ g9 �' 8©" .4 µ. 3a �4�1« z LL Lil } F:F, A Kj e � I Lcspr ` T:>a Is. r-tca-- tE . .H CEPTI E I ED PLOT PLAN FOR : F�.�o.! :" Ca►� s��r �-��c� LOT SCALE DATE Lit,./ -T iq8 CERTIFY THAT WHAT IS SHOWN, ON THIS PLAN p'° ` IS A'S IT EXISTS ON THE GROUND AND CONFORMS TO THE TOWN REGULATIONS _ tlt, L_16YLE ASSOCIATES FALMO S. F Assessor's map and lot number M Sewage Permit numb ...Q..14 ... ...... :�--. SEA', C SY� Q N +► !NS AALLELA IN C01 Z BASB9TIIDLE, • House number ..... . ... % �OVI�a-� T�T�C 5 , rasa Zt...................... ENVIRONmtNTAL CODE �N °° aMpY�.O� T N O F BAR 19T,3k1' E r, BUILDING INSPECTOR APPLICATION FOR PERMIT TO `% . �,UJ� r .............. ........................................................... 1 . 2_ �-�. a.iu . � . TYPE OF CONSTRUCTION ....��: :... ... t�1 ���.................. ............ .......... ` .... ..... ....................................19.�?. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the folk wing wing information: FR,1) L9A)C Location ....................... ....................................... ....................... ...............................................................:...................... ProposedUse ......... ............. . �� 5.. .................................................................................... Fire District ........ .. .. Zoning District ....... ............................................ Name of Owner��3 ..�.....%.�......................................Address .C^-.... .�?r ....` s........... Nameof Builder .......... , .........................................Address ............... ....:`...... .............................................. Nameof Architect ...............:�7�..--�....................................Address .......................,.....,.(...................................................... Numberof Rooms ................`I.............................................-Foundation .�C�.. .. .....?................................................... Exterior ...................... .. . .......Roofing ..... ................................................. Floors .Interior ......CT .c � , f Heating ....:i-1 ���- ........Plumbing Fireplace � ........Approximate. Cost ...........................................................��' d ,� L Definitive Plan Approved by Planning Board __________� __I_-----------191M. Area .... /7..�4...�C..................... Diagram of Lot and Building with Dimensions Fee o SUBJECT TO APPROVA OF BOARD OF HEALTH 14P OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above, construction. Name �1... � Construction Supervisor's License ...�2;�K2ng. I r�R ,Y J CONSTRUCTION '�No 2 5 313 Permit for 1 z Story .•.•.•.•.•••• Sincfle Family Dwelling Location Lot...l.r......8..Erin...Lane.+.......... { H annis ......... X.......................................................... Owner ..R.W J Construction Type of Construction Frame ........:� ...............f................................................. Plot ............................ Lot ..:..............:.... ........ t t : "July 14, 83 � - Permit-Granted ........................................19 Dote�of,•Inspection . ..............................19 :r ' Date Complete ......................J7 191 ' f4f R 1