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0063 EBENEZER ROAD - Amnesty
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Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM TO: File FROM: L. Barry DATE: 9/21/09 RE: Transfer from Amnesty to Family Apartment Tom Perry said to go forward with the family apartment permit for 63 Ebenezer Road, Osterville,transferring from Amnesty. Growth Management wants to have a rescind fee, but will have to go to the Town Council for approval and that could take months. Called Cindy re above. She will start rescind process on 63 Ebeneezer Road. I� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2 Parcel Application /© Health Division Date Issued 3� e Conservation Division Application Fee l Planning Dept. Permit Fees "— Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village s Owner Address sse.-t- Telephone 3; Permit Request "4L, 2_)'.,_ �- �� ce l -C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family � Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing — new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: a, Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ r Commercial ❑Yes ❑ No If yes, site plan review # r.y Current Use Proposed Use _ APPLICANT INFORMATION 4� (BUILDER OR HOMEOWNER) Name Make McCarthy Construction Telephone Number PO Box 52 Address West Dennis, MA 02670 License# Cell (508) 250-6964 rSl-,-58633 HICA 69393 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATEs-- FOR OFFICIAL USE ONLY N APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: Y FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable RegWktory. Services T, � Richaid''V.ScA Director ►,ud�' B"dib. ivislon Tom Perry Bniiding Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barastable.ma.us Office: 508-862-4038 ' pax: 508-790-6230 PropeAy Owmer:Must Complete-and Sign This Sectdon If-U. - ging�,A'Builder I, �Lwi j ,as C?wra.ex o the.subject propeny hereby authorize to act aii znybehalf; in all matters relative to work authorized by this building permit application for. (Address76f ob)''J Pool fences and alarms are th6 rt'sspons b�..of the'applicant. Pools are notto be fi11 d orutdized'.be6re fenoe is,installed. nd all final pectioxis are.performed and accepted. ig atnre of Owner Signat=,of.A.pplicant Lyj��J Lfi� Print Name ,Nat Nance Date MAY 1 1 2015 QTFORMS TO WNEUU M1SS1oNPOOLS Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS-058633 MICHAEL J MCC R 4` PO BOX 52 W DENNIS MA 0267 f Expiration Commissioner 04110/2016 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massach•L.tsetts 02116 Home Improvement C6n actor Registration Registration: 169393 Type: Individual ` Expirati 16/2017 Tr# 264961 MICHAEL MCCARTHY ,-� MICHAEL MCCARTHY P.O. BOX 52 WEST DENNIS, MA 02670 4 r•, ``' Update Address and return card.Mark reason for change. - ;`� Address Renewal (__� Employment ❑ Lost Card 20M-05111 The Commonwealth ofMassachitsetts Department oflndttstrialAccidents 1 Congress Street,Suite 100 Boston,MA 021I4-2017 www.mass.gov/din Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Phimbers. TO BE FILED WITH THE PERhflTT1NC AUTHORITY. Applicant information riot Le ibl Name (Business/Organization/Individual): Mike C Address: West Dennis, MA 02670 e - 6964 City/State/Zip: CSMeM633 HIC-169393 Are yor an employer?Check tF propriate box: Type of projeef(required): m a employer with employees(full and/or part-time).* 7. ❑New construction � 2.❑1 am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling any capacity.[No workers'comp.insurance required.] 3. I am a homeowner doing all work myself t 9. ❑Demolition ❑ g y [No workers'comp.insurance required.] 4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ]0❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.❑ROOF repairs These sub-contractors have employees and have workers'comp.irtsumnce.t 6.❑we are a corporation and its officers have exercised their right of exemption per MGL c. 14.dOlher 152,§1(4),and we have no employees.[No workers'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. tContractors that check this box must attached 9n 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 lhnt is providing Ivorkers'compensation insurance for my employees. Below Is the policy and Job site Information. Insurance Company Name: A-1lM M,4,,( �r,S. IMPS r v Policy#or Self-ins.Lie. Expiration Date: k- )IN 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 MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER•and a fine of up to SM0.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un tl al s and alties rjrrry that the:informallon provided above is true and correct. Signature: Date: is Phone#: 77 Official ttse only. Do not Ivrite 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 Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: J , WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATiMPA.GE A.I.M. Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876-2765 NCCI NO 26158 POLICY NO. I VWC-100-6017656-2014B PRIOR NO. I VWC-100-6017656-2014A ITEM 1. The Insured: Michael McCarthy Construction Inc DBA: Mailing address: P O Box 52 FEIN:"-"'3862 West Dennis, MA 02670 Legal Entity Type: Corporation Other workplaces not shown above: See Location. 2. The policy period is from 12/15/2014 to 12/15/2015 12:01 a.m. standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance:Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000.each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C.. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of - Annual Remuneration Remuneration Premium INTRA 0712979 INTER SEE CLASS CODE SCHEDU E Minimum Premium $550 Total Estimated Annual Premium $29,332 GOV GOV Deposit Premium $7,748 STATE CLASS MA 5479 State Assessments/Surcharges. $28,601.00 x 5.8000% ' $1,659 This policy,including all endorsements,is hereby countersigned by 12/15/2014 Authorized Signature Date Service Office: Bryden &Sullivan Ins Agcy of Dennis Inc 54 Third Avenue PO Box 1497 Burlington MA 01803 So Dennis, MA 02660 WC 00 00 01 A(7-11) Includes copyrighted material of the National Council on Compensation Insurance, \ `� used with Its permission. v Barry, Lois From: Dabkowski, Cindy Sent: Tuesday, November 03, 2009 1:23 PM To: Barry, Lois Subject: RE: Do you know Yes, I will submit a copy to you as soon as it gets through the process. I transmitted to the Board on 10/29/09 it will be up to fourteen days from then. -----Original Message----- From: Barry, Lois Sent: Tuesday,November 03,2009 1:21 PM To: Dabkowski,Cindy Subject: RE: Do you know Yes we did. Now we just need the document from you to complete the process. Lois -----Original Message----- From: Dabkowski,Cindy Sent: Tuesday, November 03, 2009 11:04 AM To: Barry, Lois Subject: Do you know Hello Lois Did you receive the letter form Lynn Marble (63 Ebenezer) requesting to void her family apartment application?. Cindy . 1 � 6 - � �- , A N _ - _ __ 6 c .ry � � ° � � s . - �, � � � � _ � e � .. -• 4 _.1 .._.. o �� � � S - v%� � .. W �._., .x. �,...'a,. �:., 'F3�" Ei-'�..'G'�•.3'�.'.®-',��@ IFi�!?86i'J.�':^_?:-L3-E.'E3.'L:'�..�4T�Y�t:.lv..ex1.L�S.'E�'-�n. � y � �tTti Town of Barnstable Building Department - 200 Main Street * BARNS TABLE, ' Hyannis, MA 02601 MASS.. 1639. (508) 862-4038 Certificate of Occupancy Application Number: 200904407 CO Number: 20080423 Parcel ID: 123060 CO Issue Date: 09/21/09 Location: 63 EBENEZER ROAD Zoning Classification: SPLIT ZONING Proposed Use: SINGLE FAMILY HOME Village: MARSTONS MILLS ? Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: FAMILY APARTMENT ISSUED TO LYNN MARBLE FOR THOMAS COX, BROTHER Building Department Signature Date Signed Town of Barnstable Building Department - 200 Main Street * ASTABLE. • Hyannis, MA 02601 9 MASS 1639. . 1508) 862-4038 kh Certificate of Occupancy Application Number: 200904407 CO Number: 20080423 Parcel ID: 123060 CO Issue Date: 09/21109 Location: 63 EBENEZER ROAD Zoning Classification: SPLIT ZONING Proposed Use: SINGLE FAMILY HOME Village: MARSTONS MILLS r Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: FAMILY APARTMENT ISSUED TO LYNN MARBLE FOR THOMAS COX, BROTHER Building Department Signature Date Signed f t � > , TOWN-7 OFBARNSTABLE ti Building Application Ref: 200904407 BARNSTABLE, Issue Date: 09/21/09 Permit 9 MASS. �A 1639• Applicant: MARBLE LYNN M rFG�.I A Permit Number: B 20091745 Proposed Use: SINGLE FAMILY HOME Expiration Date: 03/21/10 Location 63 EBENEZER ROAD Zoning District SPLTPermit Type: FAMILY APT W/NO CONST Map Parcel 123060 Permit Fee$ .00 Contractor PROPERTY OWNER Village MARSTONS MILLS App Fee$ License Num Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND TRANSFER FROM AMNESTY TO FAMILY APT FOR BROTHER, THIS CARD MUST BE KEPT POSTED UNTIL FINAL THOMAS COX INSPECTION HAS BEEN MADE. WHERE A. CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner,on Record: MARBLE, LYNN M . BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 63 EBENEZER ROAD INSPECTION HAS BEEN WDE. OSTERVILLE, MA 02655 Application Entered by: LB Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF;EITHER TEMPORARILY ZKPERMANENTLY. 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 PUBLICSEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF.THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. 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). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 T 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health Town of Barnstable Building Department - 200 Main Street BARNSTLE " , * Hyannis MA 02601 MASS 9$A s639- . (5081862-4038 rFo�s Certificate of Occupancy Application Number: 20060353 CO Number: 20070092 Parcel ID: 123060 CO Issue Date: 05/17/07 Location: 63 EBENEZER ROAD Zoning Classification: SPLIT ZONING Village: MARSTONS MILLS Gen Contractor: ALBERT ROY BROWN Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: AMNESTY APT. CERTIFICATE OF OCCUPANCY ISSUED TO LYNN MARBLE Building Department Signature Date Signed 4 t IME> , TOWN OF BARNSTABLE Building Application Ref: 20060353 m• * BARNSTABLE, Issue Date: 06/09/06 Perl l lI� 9 MASS. Q�Ar�G 339. A Applicant: ALBERT ROY BROWN Permit Number: B 20060364 Proposed Use: RESIDENTIAL Expiration Date: 12/07/06 F Location 63 EBENEZER ROAD Zoning District SPLI Permit Type: AMNESTY W/CONSTR RESIDENTIAL Map Parcel 123060 Permit Fee$ 25.00 Contractor ALBERT ROY BROWN Village MARSTONS MILLS App Fee$ 50.00. License Num 065525 r Est Construction Cost$ 950 I Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND AMNESTY,EXISTING APT,REPLACE SLIDER,WINDOW FOR EGRE�S THIS CARD MUST BE KEPT POSTED UNTIL FINAL BASEMENT APARTMENT _ _ _ INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: MARBLE, LYNN M BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 63 EBENEZER ROAD INSPECTION HAS BEEN MADE. OSTERVILLE, MA 02655 Application Entered by: DB Building Permit Issued By: THIS.PERKIIT CONVEYS NO RIG HT'I O OCCUPY ANY STREET;ALLY OR SIDE;JVALK:OR AN ,PART THERE ,tSIT ER TEMPORARILY OR PERNI,ANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTEDUNDER THE BUILDIN G 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 NOT RELEASE THE APPLICANT FROM'THE CONDITION&OF ANY.APPLICABLE SUBDIVISION RESTRICTIONSs 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). x x BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 �-- 3 1 Heating Inspect'on Approvals Engineering Dept w Gvi 01 1 Fire Dept f 2 r of He lth 41'I( Y "A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION -� C)& 0S' Map 3 Parcel �/� ;r� , Permit# �C Health Division 0 17 Date Issued _ Conservation Division d 17' ''t 1 Fee o`?� Tax Collector Treasurer Y in Planning Dept. Checked Y Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis -e s Project Street Address 119 Village / Owner Address Telephone Permit Request �p_¢2l sz. :: I daZ d oAf L404 iL W 1U door a IT �e(�l�cp, !mil f1c j�P S 4fn!!4Q ;n Square feet: 1st floor: existing proposed �1c nd floor: existing —� proposed -- Total new Valuation q 9Z vo Zoning District XE Flood Plain Groundwater Overlay Construction Type Lot Size A V Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. .R Dwelling Type: Single Family Z Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 1, No On Old King's Highway: ❑Yes t &_910 Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Au horizationZAppeal# 7 f— Recordetz Commercial ❑Yes No If �Y es site P lan-review-#_ �-� 01 Current Use _ Proposed Use �T �'p sTTll�.trl��,,��rT A.TT n.1�7 s, �`RUILDER iN 171R1V1A IO Name Telephone Number Address t'CI3cLk. � License# �,'S (oS S �� Y y" Home Improvement Contractor# - _s2p 0 Worker's Compensatio # —n ti• ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO V_x),N!,f44bZ, SIGNATURE DATE —h. FOR OFFICIAL USE ONLY 4�1 PERMIT NO. ` DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER — DATE OF INSPECTION: — FOUNDATION FRAME a, INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL - GAS: ROUGH : FINAL FINAL BUILDING DATE CLOSED OUT•'' ASSOCIATION PLAN NO. 5 The Commonwealth of Massachusetts Department of Industrial Accidents z Office of Investigations 600 Washington Street Boston,.CIA 02111 ^M �•�' www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): pa,At rz)ax N f Address: City/State/Zip: Phone#: ? '7 S 4e �'�► Are you an employer? Check the-appropriate bog: Type of project(required): i.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. t Remodeling 2.�I am a sole proprietor or partner- ❑ ship and have no employees These sub-contractors have 8. Demolition working for me 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.❑ I 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 tContractors 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 pai and penalties of perjury that the information provided above is true and correct: Signature: Date: b Phone# Official use only. Do not write in this area,to be completed by city or town off ciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building]Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I 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-contractors)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 5-26-05 www.mass.gov/dia r Town of Barnstable 0;6 Regulatory Services '"TsT"B Thomas F.Geiler,Director 16.19: 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 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: C Estimated Cost Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): FlWork excluded by law ❑Job Under$1,000 OBuilding not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING.WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent the owner: ♦ J Date C ntractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav no CUR App-Ak J Table JS=b(eoatioued) prescriptive Packages for One and Two-Family Residential Buildings Elected�h Fob FaeL MA)dMUM MINIMUM Wall Floor Buesuent Slab H m nt Em ing Glazing Glazing Ceiling p�meter Equipment t;ff�aeoey' Area'(%) U-valuer R-value R values R value° Wall Rvalue� R values Package 3701 to 6500 Nesting Degree Days Normal Q 12°/, 0.40 38 13 19 t0 6 6 Nonni R 12% 0.52 30 19 19 10 6 BSAUE g 12% 0.50 38 13 19 10 N/A wormal -- --.T__----15'h.�.._.036 .._.__38. 13 ?S NIA 6_ —Normal_ -- ----- 19 19 10 U:.. .. . . 15% 0.46 38 13 25 N/A N/A 85.AFUE ° 38 ` 0.44 6 85 AFUE �y 15% 0.52 30 19 t9 t0 Noal 13 25 NIA X 18% 0.32 38 NIA rm N/A Normal y 18% 0.42 38 19 25 N/A 13 t9 10 6 90 AFUE Z 18% 0.42 78 6 90 AFUE AA 18•/. 0.30 30 19 19 t0 1.-ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS:. 3. SQUARE FOOTAGE OF ALL Gt,AZING: - 4. %GLAZING AREA(43 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FORTIES INFORMATION. BUILDING INSPECTOR APPROVAL: YES: N0: q-for=4980303a 780 CMR Appendix J Footnotes to Table J6.2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed w a percentage.Up to 1%of the total glazing area may be excluded from the U-value a quirement. of decorative ass may be excluded from a building design with 300 ft=of glazing For example,3 ft glass =After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3.a. U-values are for the National F g • whole units: center-of-glass U-values cannot be used. The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may .be substituted for R738 _._ insulation and'R S insulation maybe"stab tituted`f0r-R-49 insulation: Ceiling R-values=represent the sumo .cavity—•.--- insulation plus insulating sheathing(!f.used).For ventilated ceilings, insulating sheathing must_bo..placed between . the conditioned space and the ventilated portion of the roof. - Wail R-values represent the su .of the wall cavity insulation plus insulating sheathing(if used). Do not include m exterior siding, structural sheathing,and interior drywall.For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R 6 insulating sheathing. Wall requirements apply to wood-fraifie or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. °The floor requirements apply to floors over unconditioned spaces(such aS unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned. basements must be included with the other glazing. Basement doors must meet the door,U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. if the building utilizes electric resistance heating use compliance approach 3;4, or 5.•'If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment,the equipment with the lowest efficiency most meet.or exceed the efficiency required by the selected package.. For Heating Degree Day requirements of the closest city or town see Table J5.2:1a NOTES: Grazing areas and•U-values are maximum acceptable levels.Insulation R values are minimum acceptable-levels. R-value requirements are for insulation only and do not include structural components. must have a U-value no greater than 0.35.Door U-values must be tested b)Opaque doors in the building envelope and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value ' in Table 11.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 t. °F�►+E�q,,, Town of Barnstable Regulatory Services a►axAM Maas.j;q. ' Thomas F.Geiler,Director 6 g Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 1"Ai&J KWA2 ,as Owner of the subject property hereby authorize 00`f e3aj A) to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of job) Signa of Owner Date Pant Name QTORM&OwNER PERMISSION L DAT ACORD- CERTIFICATE OF LIABILITY INSURANCE 6/ (MM/D 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance Agency, Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 02655 INSURERS AFFORDING COVERAGE 508-420-9011 INSURED Roy Brown Home Repair INSURER A: National Grange Mutual In 34 Horatio Lane INSURERB: CNA Insurance com nl Centerville, Ma. 02632 INSURERC: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE MM/DD/YY) DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 3001,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fare) $ CLAIMS MADE a OCCUR MED EXP(Any one person) $10.,000 A MPK34477 05/05/06 05/05/07 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $6001,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 600 .000 POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY.AUTO (Ea accident) $ ALL OWNED AUTOS _ - •- - BODILY INJURY .__.. $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ _. NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR 71 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ 'WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY TORY LIMITS ER E.L.EACH ACCIDENT $ E.L.DISEASE:-EA EMPLO.Y_EE $ E.L.DISEASE,.POLICY LIM_T $ OTHER , - r �. 6 Z-;t# DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS u •• tr✓ IN M CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Yarmouth DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABIL F ANY KIND UPON THE INSURER,ITS AGENTS OR REPRE 4TATIVES. 5 0 8-7 7 5-18 3 6 AUTHO ED REPRESENTA VE ACORD 25-S(7/97) 0 ACORD CORPORATION 1988 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration' 126560 Expiration t/21/2008 '�Type hq DBP ALBERT ROY BROWN HlJME REPAIR ALBERT BROWN try = 34 HORATIO LN CENTERVILLE,MA 02632 Deputy Administrator t I ✓ Pa , BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Numbei,. CS 065525 j J 13irt'hdate02112/1942 t EXp1res 02112/2008 k Tr.no: 16902 Rest 4ctetl,j,Op IALBERTR BROWN I 34 HORATIO LM CENTERVILLE, Mq`"` `' Commissioner i Town of Barnstable Building Department - 200 Main Street MUMSTABLE, # Hyannis, MA 02601 MASS 0 9. . (508) 862-4038 rFD MA't a Certificate of Occupancy Application Number: 201000012 CO Number: 20100003 f Parcel ID: 123060 CO Issue Date: 01104110 Location: 63 EBENEZER ROAD Zoning Classification: SPLIT ZONING Proposed Use: SINGLE FAMILY HOME Village: MARSTONS MILLS Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: AMNESTY APT. CERTIFICATE OF OCCUPANCY REISSUED TO LYNN MARBLE /0 Building Department Signature Date Signed "i T AA 31 Amnesty PrograE. ■ srrs Hel in to make affordablehous�n egr. p g g p I 4. .f Bam tao . Towl" -4 Nr, g, s '. s Certificate! of CO*mD lance x This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building Code , and Town of Barnstable zoning ordinances in accordance with the Amnesty program. Owner Lynn'Marble Location 63 Ebenezer Road, Marstons`Mills, MA Unit Capacity One, room notto exceed two eo 1e Inspector N" No. 123-060 5/17/2007 ff- Fo Town`of Barnstable; diailU" ' " ,Zoning Board of,Appeals Decision and.,NIotice Marble Comprehensive Permit No. 20051.07 Summary Permit,is.not rescinded and"it remains in'full'force'and'effect Applicant: Lynn M.;marble Property Address: 0 Ebenezer Road, Qstgrville, NIA A"ssessor's-Mao/Parcel: Map 123;Parcel 060 Zoning: Residential F Zoning District Recording Information Deed"Reference:" Book 09255.Page'252' Permit Reference:° Book 206G5 Page.65` Background: CorllprehensivePermit;No"."2005-107 was issued to Lynn Iv1:. Marble,on.January 5, LOO6. The 'Permit was issued under the Accessory Affordable Apartment Program pursuant to Chapter 9 Article Il;of the.General Qrdinances.ok g Code.of the"Town of"Barnstable.The F:ermit was issued to convert an e'xist}ngunpermitted one"bedroom apartment`located in the ower level of the dwelling into an accessory affordable;apartm.ent." The;Permit, along with'the Regulatory Agreement and Declaration of Restrictive:Covenarnts'were recorded at the Barnstable County Registry of Deeds in Book 20665.-Page 65.. In September of'200"9, lvts Marble"req'uested'to convert her accessory affordable apartment into a family apartment. Ms.'Marble has started the pro'cess"for a famiiy.;abartment with the:Building Department. The Program"Coordinator initiated to rescind"' he comprehensive'permit'as family ;apartments units do not q pal ify°under the Accessory Affordable Apartment"Pro:' Procedyral & Hearing:-Summary A public hearing"to rescind Comprehensive;Permit N.6 2005=107 was duly advertised and notice .sent to abutters and the property owner all in accordance with MGL Chapter"40A. The notice;-was published in the-Barnsfable Patriot on September 25,. 2009:and October 2, 2009. The Public" Hearingto rescind thePermit.was opened on October"21, 2009: Af.the opening"of the learing, Lynn til.,tvlarble submitted a written request to discontinue with her original request to,rescind. Ms. Marble.cited that.circumstances"have changed and she now intends"to`'contiriue to utilize,the apartment 8 an,affotdable accessory apaetment:ih conformity to all condit.'rons of Comprehensive Permit No 2005407,.,, Tov)n:of Barrsstable 7,oning Board,of Appeals Comprehensive PersnitNo.-20Q5 107 Lynne,M.Mart?te u noCrescxaitei#` Findings of Fact: At the.hearing on;October 21, 2009 the�Zoning Board.of Appeals Hearing Officer made:the following findings of fact: I., On January 5,.2006,-Comprehensive-Permit No:`2005-.1`07 was issued'to Lyti ,M. marble The Perm itauthori zed,the,conversion of'an existing un perm itted one bedroom apartment located.In the,tower level of the dwelling into an accessory affordable apartment.The property is shown. on Assesso,r's Map:1;23 Parcel 060 and is+commorlly addressed as�63 .Ebenezer Road; Osterville, Iv1A and is located in:,a IResidential F Zoning.District: 2 In Septem4e"r'of'2009, Ms:,MarblIe requested.to convert her accessoryrapartmentto°a_6mily apartment:As family apartrnerits,are not;permitted.in the Accessory Affordable Housing Program, the Program Coordinator took action'to:assist vts. M.arbl:e in.her request and notice this.:h.earing to,rescind Comprehensive Permit No 2005-107 3. As communicated at this hearing,Ms. Marble no longer intends to convert the unit to that of a. family apartment.and now requests.that the permit notF e resci'nded.as she desires to maintain the unit as an accessory affordable.unit'in''accordance with the Perm t issued-;and the program requirements. Decision• At.the hearing on>October21, 2009 the Hearing Officer rule&to grant Ms Marble's request withdraw this request to,rescind Comprehensive Permit No 2005-107.. Transmission.:: In accordance with Part.11,Section 4.02 and'Part lll:, Section 3.72 of the Town.of Barnstable Administrative:Code, the Hearing Officer transmitted the_,written.decision:to,the'Zoning Board of Appeals on 06tober28, 2009. As fourteen days�have,elapsed since said,transmittal with the Zoning.,,Board.of.'Appeals taking no action to:reverse,'theAecision,this decision t ecomesJfnal.. -Ordered• Comprehensive'Permit200&08.9 i"s not rescinded acid shall:;remains in full force.and effect.Appeals of this decision, if'any, shall,be made pursuant to MCL Chapter 4.OA, Section 17, within twenty f 20? days afterthe date"of the•filing of�this decision. A.copy of which must be:filed,in the office of the Barnstable;Town Clerk. Laura F. Shufelt,.Hea ng Offices Date Signed I;Linda. Hutchenrider,;Clerk of the Town of Barnstable, Barnstable County,, .assachusetts, hereby certify that twenty (20) days have elapsed since th:e,Zoning Board=of Appeals filed-this alecisi:or arad that no appeal of the decision hid been filedyin t"e;.offce of the Town.Clerk r Signed and sealed this:,. da of �' , anderthe.rpa�ns and pial'ies of p er u rr �s y ✓ %� � f t b= da Hutchenrider, Town Clerk 2 OUR t 29 09 01:46p Resort And Conference Cen 508-775-3674 p.1 Lynn Marble 63 Ebenezer Road, Osterville,MA 02655 508-428-9135 *lynnmarb&&QMGAst.net C> .n -10 October 29, 2009 I Town of Barnstable co Building Division Fax: #508-790-623D Dear Ms. Barry, For reasons beyond my control, I am forced to request that all paperwork to change from Affordable Housing Program to Family Apartment Program be voided. I wish to remain in the Affordable Housing Program. Thank you for all of your assistance. Sincel�ly, ,f Lynn Marble s^ TOWN OF.BARNSTABLE BUILDING PERMIT,APPLICATION Of � r kl Map Parcel ,,-d y Application Health Division %Date Issued ��021q Conservation Division 'Applibation Fee Planning:Dept: -Permit Fee Date Definitive,Plan Approved by Planning Board A 5— Historic OKH _ Preservation/Hyannis Project Street Address f� Village ,(,( Owner LAW Address G3 T ele hori e (� p - a Permit Request I�2DLX( : LIU� Zt� GxfZ' -s- �c:� k AN) Square feet: 1 st floor: existing proposed ;2nd floor: existing proposed To#o never Zoning District Flood Plain Groundwater.Overlay ' lij Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family -0 Two Family ❑ Multi-Family (# units) �— Age of Existing Structure Historic House: ❑Yes QVI-b On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl Ml3 alkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 0`6as ❑Oil ❑ Electric ❑ Other Central Air: Y es ❑ No Fireplaces: Existing _New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION / (BUILDER OR HOMEOWNER) Name klit Telephone Number OF 7 d-F,q1 Address r� LZ 7 a License # I ff"ffV1—15; Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a ��� �t pw FOR OFFICIAL USE ONLY r JkPPLICATION# DATE ISSUED MAP/PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION.- FOUNDATION FRAME t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL l S 1 ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL } FINAL BUILDING DATE CLOSED OUT - ASSOCIATION PLAN NO. .j - Bk 24032 F'986 0`52839 09-15-2009 a o9_ 5ocx • ' WE Town of Barnstable CF Regulatory Services, w BARNSTABIA Thomas F.Geiler,Director &603 .� Building Division °pE0 MAr A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 63 EBENEZER ROAD, OSTERVILLE, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book , Page , or as Document No. being shown on Assessors' Map 123 as Parcel 060, 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 THOMAS COX, BROTHER, OF OWNER, LYNN MARBLE, 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 l of the property as herein stated. ,rl\VI 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 ay'-Yay of &�P200_�_ TOWN OF BARNSTABLE OWNE By: Building Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date r r Then personally appeared the above-named (owner), �� and made oath as to the truth of the foregoing instrument,before i Not ry.Public My Commission Expires- y0 n � ERICA R •�, �, .ABNEY �u ,, i�." NOW PublIc cannimmeft 011W8688CI1 EbenezerRd63 My reran EVInry13,20 BARNSTABLE REGISTRY OF DEEDS `. 1 �FTFiP T Town of Marnstable Expires 6 monthsljror issue date Regulatory Services FeeO` ?AA.R& Thomas F. Geiler, Director �plf0 MpY� Building Division Tom Perry, CBO, Building Commissioner 0 200 Main Street, Hyannis, MA 02601 v,ww.town.barnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number O-3/ow l q I"\ Property Address � 3 M❑ LZ1c eb [►]✓Residential Value of Work43—?()Q Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address -�l�-1� Ut Contractor's Name Telephone Number Home improvement Contractor License #(if applicable) Construction Supervisor's License#(if applicable) ESS PER ❑Workman's Compensation insurance �� Check one: AUG 17 2-009 ❑ I-',n a sole proprietor i am the Homeowner ❑ I have Worker's Compensation insurance TOWN �F BARNSTAB� Insurance Company Name Workman's Comp. Policy# Copy of insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of root') Re-sid.e ❑ Replacement Windows. 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: roperty Owner must sign Property Owner Letter of Permission. ome Im emen ontractors License& Construct Supervisors License is required. SIGNATURE: Q:1WPF(LESIF0RMS1Express EXPRESSPERMIT.DOC The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lefribly �NamT G:(Ruus ness/Organization/Individ.,I : cAddress �Ci_ty-State%Z-p:_t~ � S1t t Q Mft DZ Phone.#:CSUB)yZ — Are you an employer? Check the appropfr.j to box: Type of project(required): 1.❑ I am a employer with �4. I am a general contractor and 1 6. ❑New construction employees (full and/or part-time).* have hired the sab-contractors 2.El I am a sole proprietor or"partner-' listed on the attached sheet. T. 0 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 ZL[NNorkers' comp. insurance comp. insurance.ed.1 5. We are a corporation and its10.❑Electrical repairs or additions w3. homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 ❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.[]Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 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 crunirial penalties of a fine nip to$1,500.00 and/or one-year imprison-neat, 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 u de thepains and penalties ofperjury that the information provided above is true and correct. Si afore: 1 Dater l� _ Phone#• -- ��d✓�� ���� r6. O al use only. Do not write in this area, to be completed by city or town officiaG r Town: Perrait/License# g Authority(circle one): rd of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector er Information any Instructions a Laws chapter 152 requires all employers to provide workers' compensation for their employees. Massa chusetts General p q . 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,partrership,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-contiactor(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 confimmtion 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 cornplete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event th.-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 aecessarv) and under"Jo)Site Address" (.he 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 maybe 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 to any business or commercial venture (i.e. a dog license or permit to btirn leaves etc.)said person is NOT required to complete this affidavit. ue Office cflnvesfigations u o»td ht-e to ttharlk,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 Conmonwealth of Massachusetts Department of ladustri,al 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 11-22-06 www.mass.gov/dia �i �VEr, Town of Barnstable ` Regulatory Services a a r a Nsrk13M , Thomas F.Geiler,Director o; Building Division 0 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: S08-790-62 Property C)-PVnerMust Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, m all matters relative to work authorized by this building permit application for: (Address of. Signature of Owner Date, Print Name If Property Owner is applying for permit please. complete the Homeowners License Exemption Forin on the reverse side. , n Town of Barnstable Regulatory Services R Thomas F. Geiler,Director ' Building Division �rFO `t a Tom Perry,Building Commissioner -. ......200 Main=Street—H}amis,MA-02601 O rt'ww.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ffOT�I OY NER LICENSE EXEMPTION Q Please Print DATE " �I-1�9 JOB LOCATION: 1``� ;u " ' illage number street •HOMEOWNER': L`Ku q -6s rnLIw— Gq nj name home phone 9 work phone# CURRENT MAILING ADDRFSS: 1 t/ L"11` Za<� _ QS1 IL5- D&V� cityltown 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 be/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" m shall submit to the Building Official on a for acceptable to the Building Official,that be/she shall be responsible for all such work performed under the building permit (Section 109.1.1) ibility for compliance with the State Building Code and other The undersigned"homeowner'assumes respons applicable codes, bylaws,rules and regulations. The undersigned."homeowner"certifies that-be/she understands the Town of Bgrnstable,Building Departmcnt mum' ection procedures and requirements and that he/sbe will comply with said procedures and require en Signa f 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. EDMEOWNER's EXEMPTION The Code states that: "Any homeowocr 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 homcowncr engages a persons)for hire to dosuch work,that such Homeowner shall ad as supervisor." Many homeowners who use this exemption a:t unaware that they arc assuming the responsibilitits of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisora,Section 2.15) This lack of awarcriess often results in serious problems,particularly when the homeowner hie nst the unlicensed ac ' unlicroscd persons. In this ease,our Board cannot proceed.agait son'as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware ofhiAer responsibtilitics,many communities require,as part of the permit application, that the homeowner certify thit he/she understands the responsj'bilities of a Supervisor. On the last page of this issue is it form currently used by several towns. You may care t amend and adopt such a fom-✓certifi cation.for use in your commun i ty. P`��T ,wti The Town of Barnstable BAR RR- E.M ASS. ` Department of Health Safety and Environmental Services V 1679• �0 plFOMP+A Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection ( l /,4 I Location 493 [--J;'e nee7 e' PJ Permit Number Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: 00y", WNAC 0(10 raus� cable, -k C1op,� U3 I{ 14 �1 C���W21 11 S Q1JOrAd5 or r r14' � ,nrA�CA -911, J ! r�a�- e�, �aovti. win ©�.� 'n�' �S �C `i—� �,�5�e M F f Please call: 508-862-403&for re-inspection. Inspected by Date 03/06/2007 TOWN OF BARNSTABLE PG 1 13 : 07 EJ APPLICATION PROFILE piappent GENERAL APPLICATION ------------------- Application ref 20060353 Department BUILDING DEPARTMENT Location 63 EBENEZER ROAD Parcel 123060 Cross streets Add' 1 loc desc LOT 37 Municipality MARSTONS MILLS Subdivision Lot 0 Existing use SINGLE FAMILY HOME memo . Current Zoning SPLIT ZONING Applicant GENERAL CONTRACTOR Proj /Activity AMNESTY W/CONSTR RESIDENTIAL Class of work NEW CONSTRUCTION Description AMNESTY, EXISTING APT, REPLACE SLIDER, WINDOW FOR EGRESS BASEMENT APARTMENT Proposed use SINGLE FAMILY HOME memo Proposed zoning SPLIT ZONING Non-conforming N Applic received 05/10/06 Estimated cost 950 Estim start/end Actual start/end Impervious Surf Status ACTIVE Status code desc ACTIVE APPLICATION Multiple submissions N Next action Government owned N memo Ordinance ref Reason for app Parent app ROLES/NAMES Role Name/Address PROPERTY OWNER MARBLE, LYNN M 63 EBENEZER ROAD OSTERVILLE, MA 02655 GENERAL CONTRACTOR ALBERT ROY BROWN 34 HORATIO LANE Phone : (508) 775-6582 CENTERVILLE, MA 02632 Tradesman Name Lic Type License number Class Expires ALBERT ROY BROWN 065525 02/12/08 PREREQUISITES ------------- Prereq Action Dept Needed By Approved By Status AMNESTY APPROVAL 4310 05/10/06 05/10/06 MTAY APPR 05/10/2006 e pFTHE Tqy, Town of Barnstable �O Regulatory Services * anx �' MASS. Thomas F.Geiler,Director v nss. �, �A s63q. ♦0 lE1639.�A 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 September 7, 2005 Ms. Lynn M. Marble 63 Ebenezer Road Osterville Ma. 02655 AI Re: Illegal Apartment—63 Ebenezer Road . , Ma. 02655 Map 123 Parcel 060 Dear Property Owner: 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 two-family home. Please contact this office immediately to tell us what direction you wish to take. Smc e , Lind dson esty Program Zoning Officer Building Department gforms:zoning3 f Barnstable Assessing Search Results Page 1 of 2 ,✓/ ""*-mom", Z! � � '� � '/ , , r Home: Departments:Assessors Division: Property Assessment Search Results 63 N Z Owner: MARBLE, LYNN M Property Sketch Legend Map/Parcel/Parcel Extension 123 /060/ Mailing Address MARBLE, LYNN M 0 63 EBENEZER ROAD OSTERVILLE, MA.02655 Kira, 33 i 2005 Assessed Values: Appraised Value Assessed Value Building Value: $ 113,600 $.113,600 Extra Features: $5,900 $5,900 Outbuildings: $600 $600 Land Value: $ 163,000 $ 163,000 Interactive Property Map: ap requires Plug in: Totals:$283,100 $283,100 1 have visited the maps before Show Me The Map April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: MARBLE, LYNN M 6/15/1994 9225/252 $ 105,000 SULLIVAN, ROBERT F&TRACY 6/15/1986 5143/220 $ 1 SULLIVAN, ROBERT F 4/15/1983 3723/ 164 $57,900 BATCHELDER, 10/15/1981 $52,500 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $51.38 Town Fire District Rates Other 1 $6.05 Barnstable-Residential $2.12 Land B. Barnstable-Commercial $2.80 C.O.M.M. FD Tax(Residential) $285.93 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,712.76 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/... 9/7/2005 Barnstable Assessing Search Results Page 2 of 2 Total: $2,050.07 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.81 Year Built 1981 Appraised Value $ 163,000 Living Area 1056 Assessed Value $ 163,000 Replacement Cost$ 129,081 Depreciation 12 Building Value 113,600 Construction Details Style Ranch Interior Floors Carpet Model Residential Interior Walls Drywall Grade Average Grade Heat Fuel Gas Stories 1 Story Heat Type Hot Air Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 2 1/2 Bathrms Total Rooms 6 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,600 $2,600 SHED -Shed 90 $600 $600 BFA Bsmt Fin-Aver 252 $3,300 $3,300 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/... 9/7/2005 CAPEC Qi LINE.0 SUNDAY, SEPTEMBER 4, 2005 — 640 Commercial' 645 Rooms to Rent 715 Apartments 7 0 Houses Land _ yv� HARWICH:4 lots Approx FALMOUTH,N: YARMOUTH, W: Furnished, HYANdNI t,,,)wund full riBa, BA1R�N baA$2500+a Ya pond rivate bath, cable, fridge, ya 508- furnished $1500+. 1,acre,deeded access Rte.151 and Sandwich Rd. private Wldy rates incudes al698 14 (50S)778-181E trave18188@rah0o.com five Pius acres$2,200,000 Tidewater 50B-7 5 6322 7781134, Ovate ion rentalsinc. Several lots available... New RE/MAX Bayside HYANNIS/CENTERVILLE: Seabury, Forestdale and Commercial 508-563 9777 Apartments 720 apartments $g 0/month &2 bedroom B2BaS2AaBcres,fulll Ran, South Mashpee. For more p details Call our office. No pets.1st lasts security ty(508)775 6880 Century2l Regan 477-5200 Real Estate,General 660 Bwwalkoutt pt w/full bath & No peg 06a,lanth st security $13(5+,no al clud- Centuryll ReganReakors.com walkin closet.Spacious tam- required. in Hyannis.Yr-round BARNSTABLE, W: Sr First Time Homebuyers d rm & separate kitchen on TRURO,N:WATERFRONT Free Report le garage dvileges. Call Mon-Fri.508 775 9316 Ideal for 1�ory 2- 4 acres, 3 buildable house All You Need to Know HYANNIS: mo+util'ities.1st,las : lots,500'prate beach. 1-877-info-line A1482 $1s000�0securcritltuyy sarefereoc Takingg appli170E Owner.Eves.561 251-7913 es.508 294 0466 CROMWELL COURT. Our sty. 508 362 706 loans oversized 2 bedroom apart ( )___ WELLFLEET: For Sae BY merits offer wall-to-wall car- 1BREWSTER:3 Br.,2 Owner. 3/4 Acre Lot ppleas 6 BARNSTABI E. W: Ultimate, ful alp lanced opted,$1400lino. ant,pretty street,$340,000. MORTGAGE RATES: Sea tali e, 1 Br. eat-in kitchen, patine, h P, security. 508 385 508-349-7957. ^Economy°m Sunday Cape full batMaundry, separate kitchen bright,Ova -midis Cod Tomes or Internet entrance,1st,last&secun ea and laundry facilities in BREWS YARMOUTH PORT: Internet ry references requ!red each building. Oversized 2 gara e r round,g DREAM LOT www• o $1200/mo.508 292 n07. edrooclude heat,apartments howater and +utilgs,(508)240-E '50 Marshside Drive. Last BOURNE/SAGAMORE BEACH: cooking with 24-hour erne. ------ aapp gency maintenance service. new kit available lot on Sanworks ) �k merit lneab�canal. $900- Annual income from BUZZARDS BAY. Cove. An exdusove setting -., $26,251-$67,391, depend- bsmnt, /D hooks north of 6A.Build your Cape $1150+/mo.lst,last,recur Cad dream.$549,000 iN+ 1 year lease reqquired. ing on household size & $1400lino. No of (508)am.$5 9, M0 pets.508-564-5900. Section 8 certificates wei- security,. Refereno BR beautiful new 1 come. Open 9-4. For rental 789-187 or 50&' YARMOUTHPORT information, pease cal bedroom, on Pond, utils/ 508 771455 .EHO TOOUNTA BPo�DingleBA fair : * 1.86 acre parcel, north _ cable included,$1000 ( )1-800-232-0782, front,28r,(1Ba,$ of 6A, rare and beautiful m B&B 703 round fir.Large 08) 2 n5 lovely Lease, t lot 25n,$90 (s. 5�2= piece of end. Seller will 9 g, MASHPEE 1Bedroom, 1 Security Deposit Apt pert....................$569,900 705 BREWSTER: Large 2 rooms, Bath,Quiet location,$900+. No pets. 781 9: Wanted to Rent gg CENTERVILLE House Sitting 707 house/grounds.New KhJBa. * Lake Wequaquet views g long/short term. Furnished MASHPEE: Mashpee Com- CENTERVILLE: 2 from this gorgeous 1h acre Roommates 710 or not.Ideal for i.No pets. mons.Very large new 1 BR, *Centerville-3 8 with deeded access.3 bed- Non Smoking.$80Imo,in- rivate entrance, hardwood family rm.,F.P: room approved se ic. Home Sharing 712 Gudes utils.508-446-3001 Cors, Washer/ Dryer, and Walk out bs! n 499,900 more.$14001mo.mate W Barnstable Rooms to Rent 715 BUZZARDS BAY:2BR,$1075 Dorn ideal for balm,, beautiful CENTERVILLE RIVER 508 477 5400. annisport- 3 * Dock/fighthouse. .37 �ts 720 Includes heat & hot water. ( ) acres. Bin dable7 Great No Pets,references. MASHPEE, S. Very• p home for your boat! Houses Yearly 725 08-394-7221 a studio r magnificent setts $1,100,000 730 cepecodcanalpartments.com 1 � furnished or urdur- *Falmouth- t ...View all my listings,0 Condos Yearly nished, fudge utils includ home,very spat View my listing at CATAUMENT: Spaaous 1 BR ed,$650/mo�08-477-6889 Ba Cape, dial( CALL MARGO Summer Rentals 732 waterview pl with deck, C21 Shoreland RE Winter Rentals 733 Jacuzzi, includes all app►i- MONUMENT BEACH: Water- antes,AC, P. 50Shoreland ances even washer/drryyer� & front, 1 br in lower level of .Harvard Off Cape Rentals 734 utilities $1400mo. RE/MAX private residence,,pan yj fur CENTERVILLE: Bayside 508-563-9777 nished.$1000 includes. E YARMOUTHPORT: Florida Rentals 735 (518)759-5190 south of 28 Introduang HAWKS WING CATAUMETBOURNE: RaaIN deck e, how t FARM ESTATES.20 New o x Vacation Properties 737 alloy waterfront anna. Weer MONUMENT beach,B1�rr !ease, no In per.$152! ceptional homes to be built p $750(508�230-2326 4164 or cell 7E by Dublia Construction. Nursing Homes 740 views from every window. Capes,Ranches and Coloni- t ommercial 745 Marble,hts Wcuzzi geade w/ NEW BEDfORD: Luxury 2/3 CENTERVILLE: ails are available. Lots are 750 jofsoof space.bus &cool. bedrooms. Excellent area. room,2 bath, priced from $220,000 and Space For Rent From $650, ask about sari- $1700.917 6` Builder's Packages are � 755 Y dud s all utils.14 0/mo for discount.508-998 2227. NIfrom$499, Rentals Wanted m'508-563-7136 ext 14 COTUR: 2 bed, Cal Dublin Construction for 760. ONSET:Oceanfront studio on spacious rant details.508 4304700. Rental Services Butler Cove suitable for one borhood. $12 CENTERVILLn 1 Br studio, non-smoker, one parked ties.Call 781 $299,900 Build your 4+ BR no kitchen,non smoking,no car,one small pet,one boat _---- Mashpee dream home close Wanted to Rent 705 Pei,$60o includes. at pier. Year lease COTUrT:3 Br, to Shoestring Bay, Willow (508)778-0659 $1200month includes utils. screened or bend Golf. LOWER CAPE: Winter rental new $1550+(5 •$329,999 Great Sandwich wanes for orh usba husband wife. C ATHAMcarpes bath. lsUtasY Darlene 508 759 2524 81 locale for this private 1.37 town.Have references. security. $1100mo includes ORLEANS, E: Year round 2 COTRR:3BR E acre. 508 367 6922 utils.no pets 508-945-4535 bedroom,w/d,$1200/mo+ *Marstons REEF Realty Ltd.394-3090 ( ) (508)255-4503 large ranch, 710 CHATHAM/HARWICH: 1 8 2 Roommates ner bedrooms No Its.Begin at ORLEANS,EAST:2 bedroom. $1,5 645 Both require CommerClal U'W $800.508-945p5350 ext 40 Al eWg erdryer.tDeCpkabig credit check BOURNE: New 3660 sq.fL BREWSTER•3 Br,2 Ba Cape, COTUIT,clean 1 BR,ideal for yard. $1075 plus utilities. no smoking, w/d, pond rights, Pools, one, al de os'its $900 Available now! Ann Quir Commercial Warehouse w/2 sauna, private yard, $1751 includes(508)362-2327 Call 508-255'2036. contractor bays, office, full wk avail now 508-737-8421 #> bath, storagge. Great loca DENNIS:1 BR$725 Ind;Stu-' OR LEANS: Studio year lion, off IJIacArthur Blvd- DENNISPORT'Female Cute 2 dio, $625/mo. or $200/wk. round,furnished, $800 mo. tl $685K 508-566-6202. br 1 ba cottagge $;00+ ih includes; • YARMOUTH: 3 • BOURNE Off MacArthur Blvd., utilities 50&776-4149 BR,$1350+;•HARWICH: iso ,SMART.GROWTH'61DO ssq. H1fANNIS: Share home by BR, $950 includes; #GE _-OSTERVIL r 1 o ftsi I it;didrV ft mutts usa wi115 th excel. null Veterans Beach,ideal for 1, T RVI ecu'BR red t ref. 4'"fsmoking o pets b$875n n- N BtScar®0 parking near Bourne Bridge non smoking,no pets• rrdityyGudes_utils._508 428 9135 avail. $Sg'K RFJMAX Wide $500/mo.Includes. B.fit.Props. &,,credit ORE:2 a 908- Commercial 508-563-9777 (508)364-4394 DENNIS: 1 br,deer storage, 5 ems„1 ba near canal,lst, FALMOUTH: 2 commercial HYANNIS: Share home by laundry, utils. included. last sa0urmrlyy $100/mo. DENNIS: 2 lots on Tradesman Circle Melody Tent, no lease. $80lino.508-922-9101 Avail now.50E{888-0553. $120 uA totaling 17,000 sq.fl-Unit $500/mo. +utits. Avail. 9n DENNIS, W: Fabulous spa SAGAMORE BEACH160URNE: last,secun A incudes 1600 sq.f.tole (508)367-7777 Claus owner's custom 1 BR, __ __ eenario i ion R fron ale WtApn evinn.tamiN/office, Large ?^bedroom nn- DENNIS, S i oFtrq,,, Town of Barnstable BARNSfABLE, : Regulatory Services 1639. ��� Thomas F. Geiler,Director QED MA'S A Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 January 24, 2006 Lynn M. Marble 63 Ebeneezer Road Osterville, MA 02655 Re: Proposed Accessory Affordable Apartment 63 Ebeneezer Road, Osterville Dear Property Owner: We have received the recorded Regulatory Agreement and Comprehensive Permit for the accessory affordable apartment to be created at the above-referenced address. A building permit is required whether the unit is new or pre-existing. We look forward to receiving your building permit application for the apartment. Please call me if you have any questions regarding the building permit process. Sincerely, Lois Barry Division Assistant J040616a a r 01 � t �y �s � Amnesty Program; � k A He ping to. make affordable hou ing possible. Y n , Barn gR as e Certificate . of Compliance This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building Code . and Town of Barnstable zoning ordinances in accordance with the Amnesty program. Owner Lynn Marble Location 63 Ebenezer Road, Marstons Mills, MA One,Unit Capacity room note exceed two people Inspector KZ M/P No. 123-060 5/17/2007 Ek 20 665 p:9�,� =3615 �tWE • 9AANMOLE. . YQ Mjg, Town of Barnstable Zoning Board of Appeals o o D Comprehensive Permit Decision and Notice � M s J Appeal 2005-107—Marble D �Decision - Chapter 40B Comprehensive Permit o 1'T'1 Applicant: Lynn M. Marble Property Address: 63 Ebeneezer Road, O.sterville, MA Assessor's Map/Parcel: Map 123, Parcel 060 Zoning: Residential F Zoning District Applicants: The applicant is Lynn M. Marble, who resides at 63 Ebeneezer Road, Osterville, MA. Ms. Marble was granted title to the property by deed recorded in the Barnstable Registry of Deeds on June 7, 1994 as recorded in Book 09225, Page 252. Relief Requested: The applicant has applied for a Comprehensive Permit under Chapter 40B of the General Laws of the Commonwealth of Massachusetts, and in accordance with Article II of Chapter Nine of the Code of the town.of Barnstable, more commonly termed the "Accessory Affordable Housing.Program." The zoning relief necessary for this.Comprehensive Permit to be issued is that of a variance.to Section 9- 14 of the Code—Amnesty Program to permit an accessory apartment unit to a single-family owner- occupied residential dwelling. The issuance of this Comprehensive Permit would allow for an accessory affordable apartment unit in the lower level of the principle residence. Locus and Background: The property at issue is a 0.81-acre lot located at 63 Ebeneezer Road in Osterville. The lot was developed in 1981 with a single-family ranch style home. The effective living area of the main residence is 1,191 square feet. The accessory apartment is a one-bedroom unit located in the lower level of the principle residence. The square footage of the rental area is approximately 595 square feet. The lot is served by public water and on-site septic, and is located within a Groundwater Protection Overlay District.The town of Barnstable's Public Health Division reviewed the existing on-site septic. system, and approved the property for a total of three (3)bedrooms on October 18, 2005. The applicant has agreed to remove the door to a bedroom in the principle dwelling and widen the opening to five feet to comply with this approval. Procedural Summary: A site approval letter was issued for the property by Elizabeth Dillen of the Growth Management Department on November.4, 2005, in accordance with MGL Chapter 40B and 760 CMR. Notice of the site approval letter was sent to the Department of Housing and Community Development in accordance with the requirements of CMR 760. An application for a Comprehensive Permit was then filed at the Town Clerk's Office and the Office of the Zoning Board of Appeals on November 9, 2005. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on November 4, 2005 and November 11, 2005, and notices were sent to all abutters in accordance with MGL Chapter 40B. On November 30, 2005 Hearing Officer Gail Nightingale presided over the public hearing. The applicant, Lynn Marble, was present at the hearing. Elizabeth Dillen of the Growth Management Department was also present. Ms. Nightingale reviewed the file with the applicant to assure compliance with all of the program requirements. Findings of Fact on the Comprehensive Permit: At the hearing on November 30, 2005 the Hearing Officer made the following findings of fact: 1. The applicant is Lynn M. Marble who resides at 63 Ebeneezer Road in Osterville MA. She is requesting a Comprehensive Permit to convert an existing one-bedroom apartment in the lower level of the principle dwelling into an accessory affordable apartment. The .conversion of the unit to an accessory affordable unit within a single-family owner-occupied residential dwelling qualifies for the "Accessory Affordable Housing Program." 2. Ms. Marble was granted title to the property by deed recorded in the Barnstable Registry of Deeds on June 7, 1994 as recorded in Book 09225, Page 252. 3. On November 4, 2005 a site approval letter was issued for the property by Elizabeth Dillen of the Growth Management Department, in accordance with MGL Chapter 40B and 760 CMR. Notice of the site approval letter was sent to the Department of Housing and Community Development,in accordance with the requirements of CMR 760, and no issues were communicated from the 'Department on this particular application. 4. The proposed accessory affordable unit is approximately 595 square feet, and is located in the lower level of the principle dwelling. 5. The applicant is aware that the unit must meet all applicable building codes to be occupied and that the Building Division and Fire Department will also be inspecting the unit for compliance with all applicable building and fire codes. 6. The house is served by public water and private on-site septic and is in an identified Groundwater Protection Overlay District. The proposal has been reviewed by Thomas McKean, Health Director, and he has approved the use of the existing on-site septic system for a total number of three (3) bedrooms. The applicant has agreed to remove the door to a bedroom in the principle dwelling and widen the opening to five feet to be in compliance with Title V. 7. On October 4, 2005 the applicant signed an Accessory Affordable Housing Program Agreement Affidavit that commits, upon the receipt of a Comprehensive Permit,to the recording of a Regulatory Agreement and Declaration of Restrictive Covenants at.the Barnstable Registry of Deeds. That document will restrict the unit in perpetuity as an affordable rental unit and requires that the dwelling be owner-occupied as her year-round residence. 8. The applicant understands that the affordable unit will be rented to a person or family whose income is 80% or less of the Area Median Income (AMI) of Barnstable-Yarmouth Metropolitan Statistical Area(MSA) and further agrees that rent (including utilities) shall not exceed 30% of the monthly household income of a household'earning 80%of the median income, adjusted by household size. In the event that utilities are separately metered, the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated. 9. According to the Massachusetts Department of Housing and Community Development, as of April November 30, 2005, 6.3% of the town's year round housing stock qualifies as affordable housing units. The town has not reached the statutory minimum of affordable housing under MGL Chapter 40B Section 20-23 or its implementing regulations: The Town of Barnstable's Local Comprehensive Plan encourages the use of existing housing to create affordable units and the dispersal of these units throughout the town. Finding Summary: 2 f t Based upon the findings, the Hearin Officer ruled that t P g , g he applicant has standing to apply for an affordable housing Comprehensive Permit under MGL Chapter 40B and the Town of Barnstable's Accessory Apartment Program. The proposal is also 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 all conditions of the Comprehensive Permit are strictly followed. Ruling and Conditions: Based upon the findings, a"ruling was made to grant the Comprehensive Permit in accordance with MGL Chapter 40B to the applicant, Lynn Marble. It is issued to allow for the creation of a one-bedroom affordable housing unit in accordance with the following conditions: 1. Occupancy of the affordable unit shall not exceed two people. 2. The property owner shall occupy the principal dwelling as her year-round residence. 3. This unit shall not be occupied by a family member of the owner(s). 4. The total number of bedrooms on the property shall not exceed three (3). 5. All parking for the accessory apartment and the main dwelling shall be on-site. 6. To meet the requirements of affordability, the cost of housing (including utilities) shall not exceed 30% of 80% of the median income for a single individual for the Barnstable-Yarmouth MSA. 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. 7. All leases shall have a minimum term of one year. 8. The Growth Management Department shall serve as the monitoring agent for the accessory apartment. 9. The applicant must apply for a building permit for the accessory unit,whether the unit is.new or pre-existing. Before securing an occupancy permit and certificate of compliance, the Building Commissioner must determine that the unit conforms with the approved plans as submitted with the building permit application and meets state building and fire codes. The Health Division must determine that the dwelling is in compliance with applicable on-site wastewater discharge requirements. 10. The applicant may select her own tenant, provided the tenant meets the requirements of the program as cited above and provided that person's income is reviewed and approved by the Growth Management Department of the town of Barnstable as a qualified individual. The applicant will be required to work with the town to provide information necessary to document that the tenant qualifies. The unit shall be rented on an open and fair basis to an income eligible individual or family. Whenever a vacancy,occurs, notice must be.given to the Growth Management Department and the unit must be listed with the Town. 11. Every twelve months the applicant shall review the income eligibility of the individual occupying the unit. No later than a year from the date of issuance of this Comprehensive Permit, the applicant 3 shall file with the Growth Management Department of the town of Barnstable an annual affidavit listing the rent charged and income level of the occupant of the unit. The applicant shall provide the town any additional information it deems necessary to verify the information provided in the affidavit. Upon any report from the town that the terms and conditions of this permit are not being upheld, the Zoning Board of Appeals or it's Hearing Officer shall have the ability to hold a hearing to show cause as to why this permit should not be revoked. 12. This Comprehensive Permit shall not be transferable to any other person or entity without the prior approval of the Hearing Officer or Zoning Board of Appeals. This decision, the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed at the Barnstable County Registry.of Deeds. If the ownership of the property.is transferred, the Growth Management Department of the town of Barnstable shall be notified within 60 days of the name and address of the new owner. Fh-is]:��elisive Permi_t_must_b_e e.xercised�and the unit occupied within 12-months-of-itspire. Ordered: Comprehensive Permit 2005-107 has been granted with conditions.'A written copy of this decision shall. be forwarded to the Zoning Board of Appeal as required by the Town of Barnstable Administrative Code Chapter 241,section 11. If after fourteen (14) days from that.transmittal the Members of the Zoning Board of Appeals takes no action to reverse the decision, this decision shall become final and a copy shall be the filed in the office of the Town Clerk. Appeals of the final decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision in the office of the Town Clerk. The applicant has the right to appeal this decision as outlined in MGL Chapter 40B, Section 22. In.accordance with Chapter 214, section 11 of the Town of Barnstable Administrative Code, the hearing officer transmitted a written copy of the Comprehensive Permit decision to the Zoning Board of Appeals on November 30, 2005. Fourteen (14) days have elapsed since the transmittal to the Board, and no Board Member has taken action to reverse the decision. ,y Gail ightingale earing icer Date igned I Lin a Hutchen 'der, Clerk f the Town of Barnstable, Barnstable County, Massachusetts,-hereby cortify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has bean file i he office of the Town Clerk. Signed and sealed this _day of cyder the pains and&nalties'o'perjury. Linda Hutchenrider, Town Clerk 4 Bk 20665 Po69 3616 01-19-2006 a'1 09 Z 57ct REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS THIS REGULATORY AGREEMENT and DECLARATION OF RESTRICTIVE COVENANTS,is made this _day of LAUAfy 2006, by and between Lynn M.Marble of 63 E beneezer Road, Osterville,MA 02655 and its successors and assigns (hereinafter the "Owner"), and the TOWN OF BARNSTABLE (the "Municipality"),a political subdivision of the Commonwealth; WHEREAS the Owner has been granted a_Comprehensive Permit under Massachusetts General Law Chapter 40B and local regulations by the Zoning Board of Appeals to permit the creation of an accessory apartment in an owner occupied dwelling which will be rented to a Low or Moderate Income Person/ Family(hereinafter "Designated Affordable Unit");and NOW THEREFORE,in mutual consideration of the agreements and covenants contained herein,and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged,the parties agree as follows: I. PROJECT SCOPE AND DESIGN A. The terms of this Agreement and Covenant regulate the property located at 63 Ebeneezer Road, Osterville, MA 02655 as further described in deed recorded herewith as Barnstable County Registry of Deeds Book 09225,Page 252. B. The Project,located at 63 Ebeneezer Road, Osterville,MA 02655 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. 2005-107 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 and Page low D. The Owner agrees to occupy the principal dwelling unit located on the property as their year round residence in accordance with the terms of the comprehensive permit. II. THE OWNER'S COVENANTS AND RESPONSIBILITIES• A. THE OWNER HEREBY REPRESENTS, COVENANTS AND WARRANTS AS FOLLOWS: 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-Yarmouth Metropolitan Statistical Area (MSA) and that the Designated Affordable Unit shall be deemed to be impressed . with a public trust. 2. The Designated Affordable Unit shall be rented in perpetuity to a household with a maximum income of 80% of the Area Median Income (AMI) of Barnstable-Yarmouth 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- Yarmouth MSA_ In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authorityshall 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 f - body, and will not violate or, as applicable,has not violated any provision of any indenture, agreement,mortgage, mortgage note, or other instrument to which the Owner is a party or by which it or the Owner is bound, will not result in the creation or imposition of any prohibited encumbrance of any nature. 6. The Owner, at the time of execution and delivery of this Agreement,has good, clear marketable title to the premises. 7. There is no action,suit or proceeding at law or in equity or by or before any governmental instrumentality or other agency now pending, or, to the knowledge of the Owner,threatened against or affecting it,or any of its properties or rights,which,if adversely determined,would materially impair its right to carry on business substantially as now conducted (and as now contemplated by this Agreement) or would materially adversely affect its financial condition. B. COMPLIANCE The Owner hereby agrees that any and all requirements of the laws of the Commonwealth of Massachusetts to be satisfied in order for the provisions of this Agreement to constitute restrictions and covenants running with the land shall be deemed to be satisfied in full and that any requirements of privileges of estate are also deemed to be satisfied in full. C. LIMITATION ON PROFITS 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-Yarmouth 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-Yarmouth 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. IV. 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 perpetuityto a household with a maximum income of 80% or less of the Area Median Income (AMI) of Barnstable-Yarmouth 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 Bamstable-Yarmouth MSA.In the.event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. V. 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 2 registration number of the Agreement. VI GOVERNING OF AGREEMENT: This Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any amendments to this Agreement must be.in writing and executed by all of the parties hereto. The invalidity of any clause,part or provision of this Agreement shall not affect the validity of the remaining portions hereof. VIII. 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 parry may from time to time designate by written notice. IX. HOLD HARMLESS: The Owner hereby agrees to indemnify and hold harmless the Municipality and/or its delegate from any and all actions or inactions by the Owner,its agents,servants or employees which result in claims made against Municipality and/or its delegate,including but not limited to awards,judgments, out-of-pocket expenses and attorneys fees necessitated by such actions. X. 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 deed recorded herewith as Barnstable County Registry of Deeds Book 09225, Page 252 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 deed recorded herewith as Barnstable County Registry of Deeds Book 09225,Page 252. XI. TERM OF AGREEMENT: The term of this Agreement shall be perpetual,provided,however,that the Owner of a Designated Affordable Unit or Units may voluntarily cancel the granted Comprehensive Permit and the terms and restrictions imposed herein. Such cancellation shall only take effect after: 1) expiration of the lease terms entered into between the Owner and Tenant occupying said unit and 2) notification by the Owner of said dwelling to the Zoning Board of Appeals of his/her desire to cancel the Comprehensive permit upon a da-.e 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 rende_nng 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. 3 XII. 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 title, (ii).are not merelypersonal covenants of the Owner,and (1) 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. )III. DEFAULT: If any default,"violation or breach by the Owner of.this Agreement is not cured to the satisfaction of the Monitoring Agent within thirty(30) days after notice to the Owner thereof,then the Monitoring Agent may send notification to the Municipality that the Owner is in violation of the terms and conditions,hereof. The Municipality may exercise any remedy available to it. The Owner will pay all costs and expenses,including legal fees,incurred by the Monitoring Agent in enforcing this Agreement and the Owner hereby agrees that the Municipality and the Monitoring Agent will have alien 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. )CV. MORTGAGEE CONSENT: The Owner represents and warrants that it has obtained the consent of all existing mortgagees of the Project to the execution and recording of this Agreement and to the terms and conditions hereof and that all such mortgagees have executed consent to this Agreement. IN WITNESS WHEREOF,we hereunto set our hands and seals this day of ,�AIVA-i ,2006. OWNE R BY: A� 4-- 71:ynmM.'Ma-rble COMMONWEALTH OF MASSAC�IUSETTS County of Barnstable,ss: On this ;day of 2006 before me,.the undersigned notary public,personally appeared the Owner(s),proved to me through satisfactory evidence of ide tification,which were baglx 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. IV ry Public Printed: My Commission Expires: ItK ELlZZABETH ANN DIU.EN Notary Public 4 Commonwealth of Massachusetts My Commission Expires October 2',2011 TOWN OF BAIIN LE BY: ST T AGER COMMONWEALTH OF MASSACHUSETTS County of Barnstable,ss: day o 2006 before me,the undersigned notary public,pers onally appeared On this�� J00Af 07kLlki ,the wn Manager for the Town of Barnstable,proved to me through satisfactory evidence of identification,which were so11, 11AWA , to be the person whose name is signed on the preceding or attached document.and acknow edged to be that he/she signed it voluntarily for the stated purposes. Notary Public Printed: I ND My Commission Expires: i oZL 2,3.07 LINDA R.WHEELDEN NOTARY PUBLIC COMMMWMTH OF MSACHUSETTS IV Comm.Expkm 02-23-2007 ' 5 rr^ P�o�T1iE Tp�y Town of Barnstable *Per #' ( cna (,012 o Expires 6 mardhs from 'sne date Regulatory Services Fee + BARNSTABLE, ' Thomas F. Geiler,Director pTED MAt �Qi Building Division b"V Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstab Ie.ma.Lis Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION_ - RESIDENTIAL ONLY Not Valid without f ed X-Press Imprint Map/parcel Number Property Address U� � L' ��L� �- ✓ ; d�/�r Qt� S� [Residential Value of Work 3t 7y0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Vicif Li Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License# (if applicable) ❑Workman's Compensation Insurance Check one: X-PRESS PERMIT Wam a sole proprietor am the Homeowner MAY - e5 ❑10 ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) [�Re-side # of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum .44)# of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is requi SIGNATURE: O:\WPFILES\FORMS\building permit forms\EXPRESS.doc t� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 . � fvww.rnass.gov/dia Workers' Compensation Insurance Affidavit: ]Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /4�IV/V Address: City/State/Zip: toOzyS�bone#: #1 35 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hued the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp.insurance.$ quired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.L✓J I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions Worke>s.'_cozrrP,.....__.__._......_...__._ right of exemption per MGL^ __ _ _.A2.❑.Roof,repairs - insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑a' Other �Sf�T4,!6 comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. 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 can r he pain and penalties ofperjury that the information provided above is/true /and correct. Signature: Date: Phone#: Offcial 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 r. O �p Info rats®n and Instruct • ns workers' compensation for.their employees. ers to provide work Massachusetts General Laws chapter 152 requires all employ p P Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, or express implied, oral or written." P 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 joist 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 full 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 T. ' ^members or partriers,are not required to carry workers'compensation insurance. If an`LI C of 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 retuimed 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 r.0 mber which will be used as a reference number. In addition, an applicant that must submit multiple permitlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and unde-"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 maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be fulled 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 your 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 wwtiv.mass.gov/dia Town of Barnstable P�D�THE T�'1' o regulatory Services ' Thomas F.Geiler,Director aA.xrasrasr.E, Mass. 1639. ,�� Building Division ATFD '�a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION (� / Please Print DATE: `J �//bU j' q� "� JOB LOCATION: 6 3 �'✓�—/��—�14 number r street village "HOMEOWNER": /t7'/V{41/ name home phone# work phone# CURRENT MAILING ADDRESS: (Q 03'enimDac.� 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 ection procedures and requirements and that he/she will comply with said procedures and requirem nts Signat4MHomtowner 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. HOMEO'Vv'NER'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:\WPFILES\FORM S\homeex emp t.DOC OFIKETp� Town of Barnstable regulatory Services ELARNSTABL- ' Thomas F. Geiler,Director 3.,A`�� 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 I ,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 Property Owner is applying for permit please complete the Homeowners License Exemption Form on the.reverse side. Q:FORMS:OWNERPERMISSION i Town of Barnstable °^ Regulatory Services * snxxs-rnsLe, MAS& g Thomas F. Geiler,Director 1639• �� ArE039 Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 January 5, 2010 Lynn Marble 63 Ebenezer Road Osterville, MA 02655 Re: Amnesty Apartment Dear Ms. Marble: Enclosed is the Certificate of Occupancy for your Amnesty apartment. We have sent a copy to the Amnesty Program Coordinator. Sincerely, Lois Barry Division Assistant Enclosure amnco TOWN OF BARNSTABLE Permit No. ----------—------------- 1 .,.,n.� Building Inspector • Cash --------------- - oO�O YPY�� I OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ................................................. 19__.._ .........................................................................................__........ Building Inspector I 4 ' q10 ID - ..N p Aa ZQ .. `17f bJZ �:s�v 181 Z,7 ZS .<f3 Vy)df'0�etrll 4 ' r•oLC. f•'any 0 ^� t 6X�p �f� j00 Q a tt �eA Afstt piT.. s �o .r- 37 w T 3 ^ �a T 3 6 0 o 4Y}t UrROBERT vn t { 3' 4 No.22162` Q LEGEND - EXISTING SPOT ELEVATION ' 'Ox CERTIFIED PLOT PLAN EXISTJN6 CONTOUR —_- p -- - GOT 7 FINISHED . SPOT ELEVATION CN7Clzl/�'C_L�' FINI SHED CONTOUR O `U APPROVED+ BOARD OF HEALTH . ��• . ���������� , DATE` AGENT SCALE, / ,,: 6v DATE+ 7/Z, a '/ G2c�n�� �c 1 CERTIFY t LDREDGE ENG/NEERlNG CQ /N CLIENTS ` THAT TI�E4.PR0P08ED F1 o 2-3 EGISTERE RESIST ERED JOB N0. BUILDING SHOWN ..ON THIS... PLAN r LCIVIL LAND it .�l M CONFORMS TO THE , ZONING LAWS" ENGINEER� U VEY R DR.BY+ OF BARNS A E MA .712 MAIN ST. CH. BY HYANNISo 'MASS. / Z- ,,. SHEET—. OF DATE REG. LAND SURVEYOR x �t-k... :. •, a.-. ,. 3,:. n- t{,,,._ $.4.r Y +, ... .. ,: r•,•«< .Y-.. ,. .....,,+�.-n ::_..n�,. .::. ._ ti' ., wi. -+a - .z,. .r ��. �,.. :. ,. fi �..... ,_,.: ,, .,tr'•., .� row. �..., s..rv:;.:�. ..,>'a .... ;2 ......, t:..,, >,. %. ''S q a..;'d-:.. r .r.,:�r 1 •,r±,+,„.�..�' :w,.� � e.w'*, = ,'• fi� ,=',;c ,'�'3�� :,, . .ay.�xrw ,.:�•.n. ,:.y,,w � �> e� 1 r t tr-x; ;. ..�,. ., .'�"�s,::r _?Q F7; M/N.. .,r'. . .` NO• E/, ER77NeS TA >s ,. . Gti'/ivG �P/.?'°..4I!'E�. /►�QRE�; THAA/;/d- BELOJrt/ GR.4O�r f :c'•Q ail /.AM ET.ER COI�IG'R07'IS COPZ-"P' B-e HT: TO-4.1, E':�AN S*7-RA t �.� rk".� •a<'s,h t^' �" § i s., .:`.va 6 .y°_yS'4, d:•~' v .,r ...' a�+PVC'0/P�. CONTCHCRGTB STr% N CCl/�R S .4LL BE USEO ' :�.oER I�,7. dR/VEJ�e%.4 y,,r . g MiK. ` CONCRLTE G DE Co✓ER CLEAN .SANG f Sr Z LAYER: a, Qom' I�8':-J/6 b 'M/N 'P%TtI1l `0 0 0 GAS. o"i�� • . • i • •• A 1'yA SH S& S70ME SEPT%C TA/V%C D/sT. b .. ,.°. . . • • ', _ s, • ► •EFFECT/VC ` •i 314'- !'vaN •` Dl•PTt! o 0 WASHED STONE o •.• • • ♦... �•♦ / /•.Qo e f i r i, *t ^" �r} >,' ry y- 1' O!' ►„•, • •: • ��.• I ••.p... PRECAST�S�EEPAGE. fNfie/=T E6 EYi1TlG�AiS _� � ��� ' ;a J� p��`./�� -� • a _ f 4 - '� /' !//LD/N F N A_ Q dr T 6T T .. a :. SE. /C'•T.4'NK v o FT, FT VIAi M C; SEE 7?9BULATJON� /iSILET' PT , DU7LET SEPT/C Ti�1NK: FT ' Cr D/STIR/pt?/ON @OX FT 4 ORDuNo TEit TAaL E SEG 7" 'OF oCI7zt7o�sTRieuriON BOX ` Q� Fr eyyAGE O/SPO►SA L' SYSTE/rl /JVLE7 LEACW'Aa /m/T r` T�4BtJLATlD/V a f g LEACHING'P/T r r r e "., a�` ..vY" cf'. I .w'.' ♦ - �� DJA/EN.S/0� 0RS1d*t'CR/TER/A O �tEws�cN � F'i' NUMBER OF BEOsR0o"s � u r -r 'CAR0,4GE0/SPO.Sv4' UN Ste! n y.. SFT/L.7r,$7%# TOTAL:E. 'rJ/►9ED FLOrV _0.4LQA, ,�. , . ,... IYUMBE/?QFAGAlNT' EtEY G'i4T OF SO/L TESL' a-" S/OE LGACH/N6'PER PIT. .51� IrT LErgC'If A'RCO`'TS IOW RASSE BOTTOM : CATION RATE / 5 .MJ/V�IINChf: TOTAL`LM4CH1NG ARE#4 �_SQZ..'�fT �U,i),f IJlCOLI4T/ON RATE . Iy/N. /NCH RESIM W LBAC'H!N ARE S4. f -� �, � �.4 3 7: -Y , O ti[1 ' t a i f a f�d..��f/�' t{c �.? 2.)k 1. 3 Ax �'% Y �X,� !,'w � '5 kd..E -�0��®�I��I���'I� ca./sc. Y a`C lL y .>' '� ,�;, ,i; QMk4.,. �y..;;; ',a z>' NOG (!ND''WRTt�'• lfrNCGtlNTle'h"ED r , x s<'•Sd ,'.' G`RO'UN.Q`L►is3.TE.it: 4T Z Z 4 :�, tiJ s �^ � x�.." +r a,l,v a'�'✓ -+J�r wig o'n .a• yy,';s "�;5 y' * .3 �� Assessor's map and lot number .... ? Sewage' Permit number / ....I&..�1................................. SEPTIC SYSTEM MUZ f ' r`' °„ INSTALLED IN C01 VII—INB,SB9TADLE, i House number ..............................�..��............................... WITH TITLE 5 90o Ma39 0� ENVIRONMENTAL CODE Ab 0 MAY a� TOWN OF BARNS10AS''EATIONS r BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................... 'S/ G�..........,. I L �L.�j......................... TYPE OF CONSTRUCTION ............3....C.r'.c k.v ........�`'•�• A.............. ................. , . ..........19. ' TO THE. INSPECTOR OF BUILDINGS: The undersigned hereby applies for permit according to the following information: / Location ..............C.rJ.�............./...7.......... � ��t% . Z..'fol...... ew.......C.-�ix�/A.............................. ProposedUse ................... rIWL�.l..' .......... .................................................................... Zoning District .-- .........Fire District =-� 1��,. Name of Owner ..... Cie✓`�'.CC'/..: -....(Q,.,.P....Address ..........4FO.,X...... /.. ....... ........... Nameof Builder ..................../. ...........................Address ........................5��✓' ...................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .........................Foundation .............��1!?................C.4 Exterior t....` /1...............G�le� .......Roofing ....................o .��(/��l�C..�............... ....�� " Floors .....................C.4 (l........... ........Interior ..........................�. ..�!�-. /�.4.�i .K.. Heating .................. .C` ..:.......19� ....................Plumbing ................. .� ..............0 `.............. Fireplace :.:........................ .-.......,..................................Approximate Cost ......... L. .v.. .,7.............................. Definitive Plan Approved by Planning Board ----------0-_�=_C__197- Area ..........................�........... Diagram of Lot and Building with Dimensions Fee �3....... ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 1r I hereby agree to conform to all the Rules and Regulations of the To4ofBable regarding th ve construction. Name ......... .................................. GREENBBZEIl CORPORAT ON ' \ � o 23404 �0ne Stc»ry ~No ................. Permit for ------------ ~ 8ingle Family Dwelling . ................. . `« Lot #37 63 Ebeoez�r Rd. ^"^~—' '--``—'------^'—'--------' v ' ----- .��� ----�—���������� Owner ....Gr����ub��ie��..Co at.ioo_. , ^~ Frame Type,of Construction —� � -------... �,����������������������'��'' - ' ' . . P|c» ............................. Lot ................................ ' - 25 8l August , Permit Granted --------.�.�---.lq -- , . � , Date of Inspection ----------.—..l9 � 19 ' . ' � ' | ^ PERMIT REFUSED ' ` ' ' lg --~—.'.---�'-----.--^----. , `~ ~ ` . � -.—~—��.�`.�.�..--.--..^-----~..�--..... —_—..��--�..—..--~_—^---...----.- ~ ' . —...-..—.^...-^_—~.~.—^..—_—~......----.. ' ' . ' . . ` ~ —.—~~--~.~~,..—..~--..—..,—.--....~. ' � ^ � ________-------... lA , ' .. ' -------..-----~--....--..~..—.,—. ' ` , . ` ^ / ................................... —. �-~ � | ,._�[.L + � .{... ..Y. ..._.._y.....�-...�- .. .....a_, _._._, _. _.. ._ , ._.•_ — _- ,....- +_,-._ } _.._ .... _. _._ ,._..4.._.i ,_ __ ...�.�...,_.'.___•_ -i , '- r - —..... .._.._ ._.. _ _ -Y_- .. L-... ,, .Y"`-_ r •- I_.- r - Y- w - 1 _ r � 1 - - - ,I t I I i �i® f- \/nr- _ _t r L t t t � P " i_IJ t` _ P) ; r ._ - - ,',... ,._. _.t_-_�st-.. ,..._-y. __ , _ .. - . _t_ _..1_._- .-._..- _.......__•_� -. r..,,_...� - .I,_. ..__, .. �....- __.«.r.�__ {._ _._Y ._ � _-.--y _.__! ..C,«. _. , ., __ —. _., i.... _ .�. _ .... ._ —. ..._ _ .. �`4....t _ _ ,_ _ .—. _�__ � t -_ "c•'��t'i���''r�__ ,,,,,.e�r,� -i _._..w__ _ I •W:�,;:'._...�..-,__µ��_.�_�`��.S :.-->:d,,.. _ #yI_ _ _.IMPORTANT - UPGRADE U P_ GR_A_D-•E REQUIRED-� - �'= � i•�'�`�---` �STATE BUILDING CODE REQUIRES THEUPGRADING OF SMOKE DETECTORS FOR HE—ENTIRE DWELLINGVYHEN_ ON IN AREAS ARE . G 1 E OR MORE SLEEPING ADDED OR CREATED. NOTE: A SEPARATE PERW IS REQUIRED—FOR THE ;r-_ �_:_ � , TOPS— TRI 7 ., .._ V `� r INSTALLATION OF-SMOKE DETEC HE ELEC CAL PERMIT—DOES—TpOES SATISFY-THIS— T REQUIREMENT. NO? . , P , I5 i.._ ,. .. _ � _may]T}u-.�� ._• �--•-__ _ ._. .. - _ - - - -- --...._ _. _- _r _ , ; p SMOKE DETECTORS REVIEWED )04 UILDINGDEPT L DATE : y i f DEPARTMENT DATE Y 4 FIRE BOTH SIGNATURE'S-ARE REQUIRED FOR PERMITTING .��, r s � w r t r i + ' —.5...._. ,.. �. i .+•_ I _. , _.. ".tea"i — .. _. .. • }. —...,�_ ._ _ ' - r --r- � : . ..t - F --'-'-- -i _� !+''C''��, « � , - 1__ - l �1 - •s- 7 _ � r-- �3 6 - _ J 51 I ; }fat , r ((pI p _ � ,!g•i� .__.... ._.fi_.. _... ._ _. . �. - .-... ..�. r - .. + ,. ,.. :_._ .r_. t_. I__. _ .. r - �y{•_-- _. -- -- -- - (� : --'_^'.._ ;...,0 -`-'- al .�r._._ t_-fr•4 RI �,.'� lC... E i,! '.. ..I�i. Ar 51 5 - �. _! 'fit i• -Ni �� ' .:��t�---...i -� � a. ... _. ....:. .. ) -1. _.� ._, _:_.. y. _y. .- .} � , -__•T .._L. _ I ..,..a T t-.�_... _,.....�.. .. -. _ r ... _ ... ', .. ... ._ , ✓�Y'.. (/�._ • I r osrLs Y i '- 4 --• V..__ - .-•. y. _ a_.- ._-. _. i _ .. _'1 _._..�... - -_+ 1 , 1 + , i LJ t • j 1 i ( 1 ' 1 ..j. �'"'�,.. t .t....- i j.- .,;t+.�F. ... �,..,-T � t �..� Y•... '� -�` -:--., i 5 r jj , I — n— , s 3 I i .-_y. r i._ ...__'__._ -. _ �. _.. - ^. _ --s•c..---.cry-. --+—m..b=.�. ga^*; TYs'� •^ _,..._...n.,...,..,.�. .. -- ¢t�,..�"` '��s,._._�. — - '__ Cn�' f ff t.. ,.i,,J�4'.•,'d•i b 10 lc : �� ¢f bdLf Li , _ �I THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) i M A� L DATA ' -"'-� IMPORTANT - UPGRADE REQUIRED STATE BUILDING CODE REQUIRES THE UPGRADING OF SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN , ` ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. -NOTE _ SEPARATE• FOR THE ORS-THE TRICAL P INSTALLATION ERW DOES NOT SATISFY THIS TREQUIREMENLT..0 r; v , SMOKE DETECTORS REVILEWED L UILDING DEPT. DATE ' Aj v FIRE DEPARTMENT DA i 7 � a% I `! F l BOTH SIGNATURES ARE REQUIRED FOR PERt1tTTING ,. } ky (. • 1 ; } 1 IF r , f Z r Y Clij f; � D F 4 t 4 5MOSMIL dtb �. • ys �w . I j , 1 � - _-. �U g r IV 1-4 1 t 1 Y f L f •I � as ` ,~. ,n'� ��� �1..�- � n y