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Home My WebLink About0023 FORTES WAY - Amnesty a� �-- LL� o � i � � �li 1 4 k �! ,1 yam- t4a7'I Qt YOU WISH TO OPEN A BUSINESS? For' .)ur Information Business cer ticates (cost$z :).00 for 4 year; . A business ce 1,ificate ONLY R SISTERS YOUR .IAME in town (v )ich you mus do by M.G.L. - it: toes not give yo .permission to t )erate.) You m st first obtain tl necessary sign atures on this fc qn at 200 Main :t., Hyannis. Tak< the completed arm to the Toys. Clerk's Office 1st FI., 36' Iola St., Hyannis, 02601 (To.v Hall) and get t e Business Cer ricate that is reqL red by law,. „ DATE: Fill in please: 41 APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: 9 � X3 F � TELEPHONE # Home Telephone Number - NAME OF CORPORATION: NAME OF NEW BUSINESS T TYPE OF BUSINESS�� . IS THIS A`HOME OCCUPATION? YES NO . ADDRESS OFBUSINESS MAP/PARCEL NUMBER0T 9A (Assessing) M�4 Orb When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST O TO 200 MaiN St. - (corner a Yarmouth Rd. Main Street) ) make sure ya ,have the appr :�riate permits nd licenses rec: sired to legally i ierate your bu! ness in this tos n. 1. BUILDING COMMISSIONER'S ICE This individual has be fo ed of any mit requirements that pertain to this type of business. Authorize S=",, re** COMMENTS: o 2. BOARD OF HEALTH This individual h�s-b n inf r e f thepermit re irements that pertain to this ty WITH ALL Authorize ignature** -HAZARDOUS MATERIAL""S REGULATIONS. COMMENTS: 3. CONSUMER AFFAIRS IC LASING AUTHORI This indivi has a fo e o the sin re� " ments that pertain to this type of business. Authorized Si na re** COMMENTS: Town of Barnstable r Regulatory Se�ilees o Richard V.Scali,Director anxxsrnsr.E, Building Division M' Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 5087790-6230 Approved: Fee: Permit#: . i Wo HOME OCCUPATION REGISTRATION Date: Name: Phone#: Address: Q� X l 12"l Zz�s G U� WZillage: � � Name of Business: o��C � �GJ Type of Business: M\ & lrtEic'�irsci��Map/I ot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: a The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. e Such use occupies no more than 400 square feet of space. e There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. No traffic will be generated in excess of normal residential volumes. The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. e There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. e Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. ® There is no exterior storage or display of materials or equipment. a There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. a No sign shall be displayed indicating the Customary Home.Occupation: e If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. 9 No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the und, rsi ,have read and agree with the above restrictions for my home occupation I am registering. Applicant Date: ,J /�f- HnmcYu_dnc Rev.10.111 /. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Vj Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address X3 1 vr'6i 0--y Village O S �-'_r v t\ ILc Owner r w.:n G,. Os loo,r L Address -2 3 )(�I:LE s (Je4 I/ Telephone ,�� _ -7-7 f�1 ] r/ ! I / t ` Permit Request 1�Q.�-.Tk.an� -z.v.t't u✓� — C,t l(�. f�5 � j<� �- 302 �T�" (, / f rjs .Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation r�' 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 S (J Historic House: ❑Yes ❑ No On Old King°s,Highway:-.�❑Yesy- ❑ 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 news I "J Number of Bedrooms: existing _new , c�+ Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name S C h '' elephone Number Address 1"--0 . J' 4 to License # csS L /V -77 1 r r t/1�4c oorl 1 Home Improvement Contractor# J6 0 L/& Email a zr • qT7 k:�' u, /L U Worker's Compensation # U6 —L(70 Y_4 IS--I 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO o I r21J-K . SIGNATURE DATE �3o- `"� h FOR OFFICIAL USE ONLY R APPLICATION# , d DATE ISSUED w MAP/PARCEL NO. :F ADDRESS VILLAGE OWNER h a DATE OF INSPECTION: FOUNDATION ' FRAME F , INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL k� FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. K k_ I _ The Commonwealth of Massachusetts r� Department of Industrial Accidents .41 Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 r www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationdndividual): ��S C9'Y11% Address- R..() • &x City/State/Zip: szo-Lpn m o Phone#: O �' Z J s Are you an employer?Check the appropriate box: Type of project(required): 1. I am a emplo�.er«ith /O ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no emplo-y-ees These sub-contractors have g. ❑ Demolition working for me in any capacity.. employ-ees and hm-e�orkers' P 9. ❑Building addition [No workers' comp.insurance comp.insurance.-, required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.El Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs ur , insance required.]t c. 1_>2, �1(�),and we have no employ-ees. [No workers 13.�ther `VFst m ,/ram comp.insurance required.] 'Any applicantthat checks box 91 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. XContractors that check this box must attached an additional sheet showing the name of the subcontractors 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 thepolicy and job site information. n /� Insurance Company Name: !c C l_I r4y _/o11 — Policy#or Self-ins.Lic. #: 10 s' (�(a k S^- 4 3 Expiration Date: `d' Z- I Job Site Address: aJ 4 II 1 e'✓t I(T City/State/Zip: Qc) D� - �,J�l oS f_l? 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. ' Tdo hereby certi der the pains and enalties o er' n that the information provided above is true and correct. Siogmature: Date: ��d_-f Phone# '�1 Official use only. Do not rite in this area,to be completed by city or town official City or Tony: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector b. Other Contact Person: Phone#: ' Rightfax N1-1 8/8/2013 5: 56: 12 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE =DATEI�U�I�DIYYYYI TWAX�FRTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WANED,subject to he terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: VIVEI ROS INS AGCY INC PHONE FAX 140 PLYMOUTH AVE (A/C,No,Ext): (A/C,No): FALL RIVER,MA 02723 E-MAIL ADDRESS: 759RC INSURER(S)AFFORDING COVERAGE NAIC 4 INSURED INSURER A: ACE AMERICAN INSURANCE COMPANY RETROFIT INSULATION CORP INSURER B: INSURER C: PO BOX 105 INSURER D: SEEKONK,1vLA 02771 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED B LOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY'THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADD SUB LTR TYPE OF INSURANCE POLICY EFF GATE POLICY O DATE L R POLICY NUMBER (MKDD1YYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY Is CLAIMS MADE OCCUR. DAMAGE TO RENTED $ REMISES(Ea occurrence) ED EXP(Any one person) is GEN'L AGGREGATE LIMIT APPLIES PER. ERSONAL&.ADV INJURY $ POLICY =PROJECT F'�LOC ENERAL AGGREGATE $ RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE $ LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR r7OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE is RETENTION $ is A. WORKER'S COMPENSATION AND WC STATUTORYOTHER EMPLOYER'S LIABILITY Y/N UB-4705PS15-13 08/022013 0810�014 X LIMITS ANY PROPERfrOR/PARTNER/EXECUTIVE - OFFICERIMEMBER EXCLUDED? E:] N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT IS 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING W OREKERS COMP COVER AC-F. THE INSUREDS MA WOP cER s CO-MIPENSATION POLICY AND ITS LIMITED OTHER STATES ENDORSEMENT ATJTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY THE INSURED'S MA EMPLOYEES IN STATES OTHER THAN MA_ NO AUTHOR727ATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER THAN MA IF THE INSURED HIRES,OR HAS HIRED EMPLOYEES OUTSIDE OF MA THIS POLICY DOES NOT PROVE COVERAGE FOR ANY STATE OTHER THAN M.A. CERTIFICATE HOLDER CANCELLATION THIELSOH ENGINEERING SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED 195 FRANCIS AVE BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B DELIV D IN ACCORDANCE WITH THE POLICY PROM AUTHORIZED REPRESENTATIVE CRANSTON,RI 02910 ACORD 25(20101 The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPO rights'eserved. J/46aj I a,f"",/�w 11 4/6 lel fr-g f irl, M i {r �T 1 .1 Of ice of ConsL finer Affairs and Business Regulation K,.. : . =y 10 Park Plaza - Suite 5 ] 70 Boston, Massachusett- 02116 Home Improvement Contractor Registration Reqistration: 160461 Type: Private corporation Expiration: 7/29/2014 Tr# 227004 RETROFIT INSULATION, INC. JOSEPI-I REIL_LY P.O. BOX 105 SEEI.40NK, MA 02771 _ .. . . _.. Update Address and return card. Mark reason for change. Address Renewal Ltnployment. _.....; Last Card .. ;r License or registration valid for individul use only Office of Consutner AffM s & Busi�iess Regulation r�-1 V �OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1tegistratlon: 160461 Type: office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 ;.Expiration: 7/29/2014 Private Corporation Boston, MA 02116 RETROFIT INSULATION, INC. . . JOSEPH REILLY 644 RODMAN ST FALLRIVER, MA 02721 Undersecretary Nu d witlf6ut signature °°uWIM v@ ! , ¢a G �«l2r ® . mde; r p _10,2 7 » �. : . 02 § \ :gi \ , \ . m152p 5 . . . r OWNER AUTHORIZATION FORM (Owner's Name) owner of the.property located at (Property Address) (Property Address) K-hereby authorizeS �/ �� O(� (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Xwner's Signature Date ., T n z l� � of r Town of Barnstable Regulatory Services 9'" 'ns"S. Thomas F. Geiler,Director �ArFDpAA'�a�0 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 December 13, 2006 Dawn McKenzie & Fermin Osborne 23 Fortes Way Osterville, MA 02655 Dear Property Owners: Enclosed is the Certificate of Occupancy for the Amnesty apartment at 23 Fortes Way, Osterville. We have prepared the Amnesty Certificate of Compliance and forwarded it to Madeline Taylor, Amnesty Program Coordinator. Sincerely, Lois Barry Division Assistant Enclosure amnco y4. - . 10 Amnesty Program IN 33 ' 5 .. �x Herg Ad l in to make affordable housin oss�ble. 0 g _. a 9 Town of Bamstablle: . ... ��..-. WO R h J } 4 = Certificate o, Com il.an:ce. OMM { _(]]" MM4,, �R This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building Code * e�A. and Town of.Barnstable zoning ordinances in accordance.with.the Amnesty program Owner Dawn 1VIcKenzie & Fermin,G: 0 borrme , Looafion 23 Fortes W ay,Osterville, MA Unit Ca acit One Bed m `not' exceed two eo le p y InsP ector M/P 1Vo '142.-062 003 12/1 U2006 y.. Town of Barnstable o� Building Department - 200 Main Street � * Hyannis MA 02601 MASS i639. , (508) 862-4038 Certificate of Occupancy Application Number: 20064837 CO Number: 20060163 Parcel ID: 142062003 CO Issue Date: 12/11106 Location: 23 FORTES WAY Zoning Classification: RESIDENCE C DISTRICT Proposed Use: RESIDENTIAL Village: OSTERVILLE Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: AMNESTY APARTMENT ISSUED TO DAWN MCKENZIE & FERMIN OSBORNE 2 Building Department Signature ate S g ned THE TOWN OF BARNSTABLE Building �► Application Ref: 20064837 BARNSTABLE, Issue Date: 11/28/06 Permit 9 MASS. �Ar163.IN Applicant: MCKENZIE,DAWN& Permit Number: B 20061841 Proposed Use: RESIDENTIAL Expiration Date: 05/28/07 Location 23 FORTES WAY Zoning District RC Permit Type: AMNESTY APT NO CONSTRUCT RES Map Parcel 142062003 Permit Fee$ 25.00 Contractor PROPERTY OWNER Village OSTERVILLE App Fee$ License Num Est Construction Cost$ 0 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND EXISTING UNIT,AMNESTY THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: MCKENZIE, DAWN 81 BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: PO BOX 1 129 INSPECTION HAS BEEN MADE. 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 THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON.PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET.ORALLY GRADES AS WELL AS DEPTH AND.LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF.PUBLIC'WORKS." THE ISSUANCE OF.THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. 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). s q : ► 0 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS ap 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 2— Parcel �6 2— t� (� 3 p Application# Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Aa©n Fee S',C2 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 3 F 6y tO-D V V Village 0 v L�& Owner IAJiN (,� /UP/rl Z 11 (�,1�r/!M� 0 Sbff-Ad rd ess Telephone `/ Z l) Permit Request h AJAA Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District /C orQ Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. `® Two Family ❑ Multi-Family(#unit s)DwellingType Single Family .�, Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No .M 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 13 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 love: D.l�es ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size, 0 Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: —J Zoning Board of Appeals Authorization Appeal# 2 D 6 J Recorded Commercial ❑Yes ❑No If yes, site plan review# s- Current Use Proposed Use C' ° BUILDER INFORMATION Name 7Lirn P Ow lf er!Z Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE f� DATE A(DV • oZ7, Zoa (o FOR OFFICIAL USE ONLY R PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ^l DATE CLOSED OUT ASSOCIATION PLAN NO. f Bk 21411 F'9331 624 r 4 10—i 6-2i 06 & 08 n 59'ct BARNSTABLE TOWN CLERK • aA SrABM '06_ AUG 10 P 2 :17 Fp MPi Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Appeal 2006-063 Decision - Chapter 40B Comprehensive Permit Applicants: Dawn McKenzie &Fermin G. Osborne Property Address: 23 Fortes Way, Osterville,MA Assessor's Map/Parcel: Map 142,Parcel 062-003 Zoning: Residential C Zoning District ' Applicants: The applicants are Dawn McKenzie &Fermin G. Osborne, who reside at 23 Fortes Way, Osterville; MA. Ms. McKenzie and Mr. Osborne were granted title to the property by deed recorded in the Barnstable County Registry of Deeds on April 21, 1989 as recorded in Book 6707,Page 074. Relief Requested: The applicants have 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 Apartment 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 attached to a single-family owner-occupied residential dwelling. The issuance of this Comprehensive Permit would allow for an accessory affordable apartment unit attached to the principal residence. Locus and Background: The property at issue is a 0.82-acre lot located at 23 Fortes Way in Osterville. The lot was developed in. 1930 with a single-family cape style home. The effective living area of the main residence is 3,566 square feet. The accessory apartment is a one-bedroom unit located attached to the principal residence. The square footage of the rental area is approximately 650 square feet. The lot is served by public water and on-site septic, and is located within an Aquifer Protection Overlay District. The town of Barnstable's Public Health Division reviewed the application, and on June 8, 2006, approved a total of three (3)bedrooms at the property with the existing on site septic system,providing that no doors be erected to the sitting room. Procedural Summary: A site approval letter was issued for the property by Elizabeth Dillen of the Growth Management Department on June 12, 2006, 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. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on June 30, 2006 and July 7, 2006, and notices were sent to all abutters in accordance with MGL Chapter 40B. a� n July y 26, 2006 Hearing Officer Gail Nightingale presided over the public hearing. The applicants, Dawn McKenzie and Fermin G. Osborne, were present at the hearing. Madeline Taylor of the Growth Management Department was also present. Ms. Nightingale reviewed the file with the applicants to assure compliance with all of the program requirements. Findings of Fact on the Comprehensive Permit: At the hearing on July 26, 2006 the Hearing Officer made the following findings of fact: L 'The applicants are Dawn McKenzie and Fermin.G. Osborne who reside at 23 Fortes Way, Osterville, MA. They are requesting a Comprehensive Permit to convert an existing one-bedroom apartment attached to the principal residence into an accessory affordable apartment. The conversion of the unit into an accessory affordable unit within a .single-family owner-occupied residential dwelling qualifies for the "Accessory Affordable Apartment Program." 2. Dawn McKenzie and Fermin G. Osborne were granted title to the property by deed recorded in the Barnstable Registry of Deeds on April 21, 1989 as recorded in Book 6707, Page 074. 3. On June 12, 2006 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 650 square feet, and is located attached to the principal residence.. 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 Aquifer Protection Overlay District. The town of Barnstable's Public Health Division reviewed the application, and on June 8, 2006, approved a total of three (3)bedrooms at the property with the existing on-site septic system,providing that no doors are erected to the sitting room. 7. On April 19, 2006 the applicants signed an Accessory Affordable Apartment 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 their principal 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 the Barnstable 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 July 26, 2006, 6.8% 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. 2 asu Finding Summary: Based upon the findings, the Hearing Officer ruled that the applicant has standing to apply for a 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 applicants, Dawn McKenzie and Fermin G. Osborne. It is issued to allow for a one- bedroom accessory affordable apartment unit in accordance with the following conditions: 1. Occupancy of the affordable unit shall not exceed two persons. 2. The total number of bedrooms on the property with the existing on site septic system shall not exceed three.(3). 3. The property owners shall occupy the principal dwelling as their principal residence. 4. This unit shall not be occupied by a family member of the owner(s). 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 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 applicants 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 applicants may select their 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 applicants 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 applicants 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 applicants 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 its Hearing Officer shall have the ability to hold a hearing to show cause as to why this permit should not be revoked. 3 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. 13. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its issuance or it shall expire.. Ordered: Comprehensive Permit 2006-063 has been granted with conditions. A written copy of this decision shall be forwarded to the Zoning Board of Appeals as required by the Town of Barnstable Administrative Code Chapter 241, section 11. If after fourteen (14) days from that transmittal 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 July 26, 2006. Fourteen (14) days have elapsed since the transmittal to the Board, and no Board Member has taken action to reverse the decision. NL l0 ZOO PGail ightingalng Offi r Date Signed I Linda Hutchenrider,.Clerk of the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision ha- beg/filed in e o ice of the Town Clerk. Signed and sealed this( d o der tg pains and pen aities.of perjury. r Linda Hutchenrider, Town Clerk 4 :'. ►!' L'k 2141 1 P:9 335 -or 7 1 0-06-20�6 a i 8 = 59a REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS THI�GULATWe265 EMENTand DECLARATION OF RESTRICIIVE COVENANTS,is made this II day of /� 2006,by and between Dawn McKenzie &Fermin G. Osborne,23 Fortes Way Oste5 and its successors and assigns (hereinafter the "Owner"),and the TOWN OF BARNSTABLE (the "Murnicipaht/,), 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 I s follows: I. PROJECT SCOPE AND DESIGN: A. The terms of this Agreement and Covenant regulate the property located at 23 Fortes Way, Osterville, MA 02655 as further described in deed recorded herewith as Barnstable County Registry of Deeds Book 6707 &Page 074. B. The Project located at 23 Fortes Way, Osterville,MA 02632 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. 2006-063 and any plans submitted therewith and all applicable state, federal and munici al laws and regulatio Said permit . recorded herewith as Barnstable County Registry of Deeds Book &Page '-��--. D. The Owner agrees to occupy the principal dwelling unit located on the property as their principal residence in accordance with the terms of the comprehensive permit. II. THE OWNER'S COVENANTS AND RESPONSIBILITIES• A- THE OWNER HEREBY REPRESENTS, COVENANTS AND WARRANTS AS FOLLOWS: I In receiving the comprehensive permit to create the Designated Affordable unit,the Owner agreed that the Designated Affordable Unit.shall beset aside in perpetuityfor the public purpose of providing safe and decent housing to persons earning at or below 80% of,the area median income of Bamstable Metropolitan Statistical Area (IZA) and that the.Designated Affordable Unit shall be deemed to be impressed vrith a public trust. 2. The Designated Affordable Unit shall be rented in perpetuity to a household with a maximum income of 80% of the Area Median Income (AMI) of Barnstable MSA and that rent (including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent level. 3. The Designated Affordable Unit will be retained as a permanent,year round rental dwelling unit with at least a one-year lease. 4. The Owner has the full legal right,power and authority to execute and deliver this Agreement. r 5. The execution and performance of this Agreement by the Owner will not violate or, as applicable,has not violated any provision of law,rule or regulation, or any order of any court or other agency or governmental body,and will not violate or, as applicable,has not violated any provision of any indenture, agreement, mortgage, mortgage note, or other instrument to which the Owner is a parry 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 maximu.rn income of 80% or less of the Area Median Income (AMI) of Barnstable Metropolitan Statistical Area (MSA) and that rent (including utilities) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that utilities are separately metered, a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. 2. The Owner shall annually deliver to the Municipality and to the Monitoring Agent,as designated by the Town Manager,proof that the Designated Affordable Unit is rented,the tenant's income verification,a copy of the lease agreement and the rent charged for the unit or units. Such information shall also be forwarded to the Monitoring Agent within 30 days of the occupation of the dwelling unit or units by a new tenant. The Owner shall notify the Monitoring Agent,as designated by the Town Manager,within thirty(30) days of the date that a tenant has vacated the Designated Affordable Unit. III. MUNICIPALITY COVENANTS AND RESPONSIBILITIES 1. The MUNICIPALITY,through the monitoring agent designated by the Town Manager agrees to perform the duties of verifying that the Designated Affordable Unit is being rented in perpetuityto a household with a maximum income of 80% or less of the Area Median Income (AMI) of Barnstable MSA and that rent (including utditie ss) shall not exceed an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA In the event that utilities are separately metered, a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. IV. RECORDING OF AGREEMENT: Upon execution,the OWNER shall immediately cause this Agreement and any amendments hereto to be recorded with the Registry of Deeds for Barnstable County or,if the Project consists in whole or in part of registered land,file this Agreement and any amendments hereto with the Registry District of the Barnstable Land Court(collectively hereinafter the "Registry of Deeds"), and the Owner shall pay all fees and charges incurred in connection therewith. Upon recording or filling,as applicable,the Owner shall immediately transmit to the Municipality evidence of such recording or filing including the date and instrument,book and page or registration 2 r h.- number of the Agreement. V. GOVERNING OF AGREEMENT: This Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any amendments to this Agreement must be in writing and executed by all of the parties hereto. The invalidity of any clause,part or provision of this Agreement shall not affect the validity of the remaining portions hereof. VI. NOTICE: All notices to be given pursuant to this Agreement shall be in writing and shall be deemed given when delivered by hand-or when mailed by certified or registered mail,postage prepaid,return receipt requested,to the parties hereto at the addresses set forth below, or to such other place as a parry may from time to time designate by written notice. VII. HOLD HARNZESS: 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. VIII. ENTIRE UNDERSTANDING: A This Agreement shall constitute the entire understanding between the parties and any amendments or changes hereto must be in writing,executed by the.parties,and appended to this document. B. This Agreement and all of the covenants, agreements and restrictions contained herein shall be deemed to be for the public purpose of providing safe affordable housing and shall be deemed to be, and by these presents are, granted by the Owner to run in perpetuity in favor of and be held by the Municipality as any other permanent restriction held by a governmental body as that term is used in MGL Ch. 184, Section 26 which shall run with the land described in deed recorded herewith as Barnstable County Registry of Deeds Book 6707 & Page 074 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 6707&Page 074. IX. TERM OF AGREEMENT: The term of this Agreement shall be perpetual,provided,however,that the Owner of a Designated Affordable Unit or Units may voluntmilycancel the granted Comprehensive Permit and the terms and restrictions imposed herein. Such cancellation shall only take effect after: 1) expiration of the lease terms entered into between the Owner and Tenant occupying said unit and 2) notification by the Owner of said dwelling to the Zoning Board of Appeals of his/her desire to cancel the Comprehensive permit upon a date certain and the recording of said notice at the Barnstable County Registry of Deeds or Barnstable County Registry of the Land Court as the case may be,thus rendering said Comprehensive Permit void. Upon the cancellation of the comprehensive permit,the propertywhich is the subject matter of this restrictive covenant shall revert to the use permitted under zoning and the restrictive covenant shall be rendered void. X. SUCCESSORS AND ASSIGNS: A The Parties to this Agreement intend,declare,and covenant on behalf of themselves and any successors 3 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, (1i, are not merely personal covenants of the Owner,and (iii) shall bind the Owner,its successors and assigns and inure to the benefit of the Municipality and its successors and assigns for the term of the Agreement. XI. DEFAULT: If any default,violation or breach by the Owner of this Agreement is not cured to the satisfaction of the Monitoring Agent within thirty(30) days after notice to the Owner thereof,then the Monitoring Agent may send notification to the Municipality that the Owner is in violation of the terms and conditions hereof. The Municipality may exercise any remedy available to it. The Owner will pay all costs and expenses,including legal fees,incurred by the Monitoring Agent in enforcing this Agreement and the Owner hereby agrees that the Municipality and the Monitoring Agent will have a lien on the Project to secure payment of such costs and expenses. The Monitoring Agent may perfect such a lien 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 rn . Cbw-t for Barnstable County: A purchaser of the Project or any portion thereof will be liable for the payment of any.unpaid costs and expenses that were the subject of a perfected lien prior to the purchaser's acquisition of the Project or portion thereof. XII. MORTGAGEE CONSENT: The Owner represents and warrants that it has obtained the consent of all existing mortgagees of the Project to the execution and recording of this Agreement and to the terms and conditions hereof and that all such mortgagees have executed consent to this Agreement. IN WITNESS WHEREOF,we hereunto set our hands and seals this �q}day of gyp'- 2006. OWNER OWNER Y: fjv»c.�..._ cXJoa-2i-e Printed:Dawn McKenzie Printed:Fermin G. Osborne COMMONWEALTH OF MASSACHUSETTS County of Barnstable,ss: n this day of re me,the undersigned notary public,personally appeared ltiih—Y,4 &=,the Owner(s),proved to me through satisfactory evidence . of identification,which were /.� ,to be the person(s) whose name(s) is signed on the preceding or attached document and acknowledged to be that he/she signed it voluntarily for the stated purposes. � , _/- Notary Pub Printed: illtla f�/l My Commission Expires: iC-\ ELIZABET,y ANN DILLEN 4 Notary Public Commonwealth of Massachusetts My Commission Expires ;Ctober 27, 2011 f TOWN OF B TABLE BY: TO AGER COMMONWEALTH OF MASSAC'HUSETTS County of Barnstable,ss: On this �Sday o �006 before me,the undersigned notary public,personally appeared John L, ,the Town Manager for the Town of Barnstable,proved to me through satisfactory evidence of identification,which weree �„a��,� n,ate, ,to be the person whose name is signed on the preceding or attached document acid acknowr edged to be that he/she signed it voluntarily for the stated purposes. _ J l % / Notary Public Panted: ,(./,UJJ!¢ j� �� .eJ My Commission Explw,`�� LMM R WHEELDEN NOTARf PUBUc Cd�ALTHOF MMUCHUSETTS 14 C=6�02-a2007 5 /�� ..gyp otst�e�v;►►� rA& -- SNP 1qz A�< I(��c�^4Z'e �erm�� W(3J�.J2 _ Z 3 'Vi4i- 4 .K n ��#1�•�.'C�� tt�'. jI.V�+`�•'G��'a }�� r'� ��dJ+ LS 9,.i"i 3 [k�'c.g.:G!v0� >p. kb:y`k ..?'�''�"•#�t'"S�J!"- #� � � J �' v. ... .sRi a, P :.}.' y ."t, ,'? .+ ..7 ! a , `4 r L. 2�T'�t„ *`{�.�3' „'r�' p rh'� �• �• !t, �qt a "�;'',;, 3 r.-* r � u»rF` ek' X.y` rd' .'�y" e"f t .: -✓ s.{ if'2�r ;/i' Lf iS, �y,,�' Its „ " '' ? yY'b ,tom a' ,.k#t3 .,,�9 'f.�.* f .,`:EM +a-'"!�. r.'t1=:. �,w � ` 'i�',.wikl $ �.' � �s,�.��. �.�..v, �t •�,.',� aisnw tWtw'oit.t. -� . -. ,, �-�`i,• ' �.+.':�-�'� '��'�'�.t'd7��t3.,:..'G �.,��';�:w.iwas..r•w:..�� ...3 ._ M La6tMG SKtd � VK•"�"r i r �.'i['i 3}.�'�+N; `�pyw^'� w �' .° , i,: h �rtA"7e �"� .1� -� �^•£rYM �r~: �t�Ry�YA._1 ., .. � ��' } �� P ��y.�'�,,.`� ��'T�,��. ;O�•NA;`: DEW( t in{�' w., .t'��y ,;, . 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JR. k:v �tMME� Town of Barnstable ABBE : Regulatory Services MAn Thomas F. Geiler, Director RFD MA'S A Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 October 17, 2006 Ms. Dawn McKenzie Mr. Fermin G. Osborne 23 Fortes Way Osterville, MA 02655 Re: Proposed Accessory Affordable Apartment Dear Property Owners: We have received the recorded Regulatory Agreement and Comprehensive Permit for the accessory affordable apartment to be created at your 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 F THE T The _Town of Barnstable ! !! * SARNSTABLE. j`� i C E y MASS. g Growth Management Department 163y �0 367 Main Street;3�d Floor Hyannis, MA 02601 !SION Tel:508-862-4678 Fax:508-862-4782 May 5,2006 John C.Klimm,Town Manager Henry C.Farnham, Town Council President Barnstable Town Hall 367 Main Street Hyannis,MA 02601 Re: � Stephen Hilghbanks - 92 Gooseberry Lane,Marston Mills - a single-family accessory unit i Kerry Casey- 44 Marks Path,Hyannis - a single-family accessory unit Paloma McLardv- 3 Franbil Road,Hyannis - a single-family accessory unit. /Diana Pontieri- 600 Phinney's Lane,Centerville- a single-family access cry unit i Dawn McKenzie -,C23 Fortes Way, Osterville;a single-family accessory unit Gentlemen: This letter is to inform you that the Accessory Affordable Housing (Amnesty).Program has received a request for a project eligibility letter under the Community Development Block Grant (CDBG) Fund and under Article II of Chapter Nine of the Code of the Town of Barnstable and the criteria for the Local Chapter 40B Program This office is reviewing the request.If the Town has any comments on the project,please forward them to me so that they can be addressed in the site approval letter. This letter gives you official notice of our receipt of the above application(s). We will issue a decision as to the acceptability of the sites and the consistency of this development within the guidelines of CDBG. Sincerely, Madeline Taylor- Amnesty Program Coordinator Growth Management Department cc\Building Legal Department Department Public Health Department Town of Barnstable Regulatory Services BA"STABLE9 'g Thomas F.Geiler,Director �A i6gq. �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 April 5, 2006 Ms. Dawn McKenzie Box 1129 Osterville, MA 02655 Re: Illegal Apartment—23 Fortes Way Osterville, MA 02655 Map 142 Parcel 062-003 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 multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincer , inda Edson Amnesty Program Zoning Officer Building Department gforms:zoning3 �- - '1� ' • ` � ;, �'` - s T:9 � x. � r 1��T � �jr•t"��„•,.;srzi C , -'�' ~�-3`p�t�•�-- �• ", * ' x .y t, e.� - ` ! w r c tr t �ti1r s r 'fit •t{ '.'�+ '.-�,. � •�� '� x:i 't j. a� r ♦, `;t;I� �� o �1. i c •w d y:-x"�'+rf .y ,�� {'•t f!w . S0.yy�y,"__.r. ..,t a r,s r=� r Z 1:r' � r+.�4,ni'�.�i �"`'*t k.,�'y�+^��„ S�•^"t`},� �� *wp ��F. °+�� \ .;;+>!r i�U •` .,;y r. r � �+.`xar~�f ,Y°2•+.*•rr%°,n a^r`-`:' + �'�^RJ:v ��`"Jr? .�'.�' �XP . � + / t � ev 3` ,�i+Y. ` �� 4• �}.0 +, ,t� • r ` a^_�`s,_. •r a t J' a. 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" y'1. ��'�X�•�•.a`•, t t!Y ti .r, V+.��i' ,��•�r3 �F `„ ��'"ra�ir y�ez•_*. - a > .h.` ;, a ate'• "�' r^ atf r-*i` �j°'��•"K`'�•�a � t l'•i 'y -•�,y '+iy t ,.r' + r•* ,/ a._ • _ "__,Va 4 r��x `��fir,.y"► �` Y�� '``^ �`� � �' ,:. � A'M � rh _• n _. --• _, ,.t„;` ` •.� r,*.L �i� -.�3_.,-��_'�ti._/$Lx�'""r �� R '•..# �5�"�'"vr�. ., t '-+� w�y .�P �;!: �,. �#.J"��s, _,�"#�w -d�a - ..tw_.!.4ii �. s-.i:_4.rl;i�yJ.7f hl:� Wry,s 1•+t r` Town of Barnstable P��F THE f�n.ti Regulatory Services Thomas F.Geiler,Director • snarrsTABM • MASS Building Division ArE p 3't° Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# FEE: $ UU S D REGISTRATION 120 square feet or less Location of shed(address) Village }w,-F e e..r7r E �P�vrr `� J c�'3. � `f 7-8 4 6& :T Property owner's name Telephone number Z6? 4�2 Size of Shed Map arcel# s ,Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) r a PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 PLOT PLANT — LOT 4A FORTES WA Y 3ARNSTA®LE, MA SCALE ? " 40 ' SEPTEMBER 8,, 1997 EAGLE SURVEYING 6 ENGINEERING, INC. ,441 ROUTE .130, SANDWICH! MA THE DWEL L ING SHOWN ON THIS PL AN WAS L OCA TED 6Y AN INSTRUMENT SURVEY ON 9119197 AND EXISTS ON THE GROUND AS SHOWN. OA E PROFESSIONAL LANDS EYOR P�-\\'OF MASS DO PAUL q°� !�2• RYLL m ' No.32448 C i 1 I - 10• B3.5+ �`24 O�c• co ' + I clz' ; ` -ti- o - ' ,' LOT 4 A 1 t% 35731 f S.F. t � % ; CL� ` F�rnln C�.Os�cx * ., Town of Barnstable ' THE Tp� Regulatory Services 'Do Thomas F.Geiler,Director Building Division BARNSTABLE, i v� MASSS. � Tom Perry,Building Commissioner 1 iOlED 39. a 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: 4?1`5 o 0 Permit#: HOME OCCUPATION REGISTRATION Date: 3/2 Y/bS Name: R.naEeT' 50fbEL.l.0 Phone#: 568 - IL Le,-9 320 Address: _S W bSt� Village: 0 5=U L LL E' Name of Business: .T. .�E LL[� gOuxER S 4fypeofBusiness: &)tLoe"-, Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the.Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: I Date: 2 O Homeoc.doc Rev.5/30/03 i TO ALL NEW BUSINESS OWNERS DATE: daS : 0��.i�' <� � Fill in please . „ � APPLICANT'S 0 WAM YOUR NAME: �Ek-T- ' YOUR HOME ADDRESS: Z-3 BUSINESS TES W/t-1 776'IkZBy � �� o5,�2v�u.� 508- H2a-43za TELEPHONE ' Tele. hone Number Home NAME OF NEW BUSINESS O u L S TYPE OF BUSINESS l�(C7�12 IS THIS A HOME OCCUPATION?______YES NO Have you been given approval from the building division? YE NO� `,/z ADDRESS OF BUSINESS 2 3 fbQ W h 7 MAP/PARCEL NUMBER r/ When starting a new business there are several thjhgs you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below,you may apply for a business certificate at.the Town Clerk's Office (Ist floor-Town Hall). You MUST go to the following office to make sure you have all the required permits and.licenses.. GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONE ' OFFICE This individual has n inform d f any.permit requirements that pertain to this type of business. Authorized ignature* COMMENTS: k--->d 12 c-,r Le � 2. BOARD OF HEALTH This individual has been&inred of the per equir ents that pertain to this type of business. prized Signature** COMMENTS: 3. CONSUMER AFF IRS (LICENSIN AUTH ,RITY) This individual has ormed of t lic n uirements that pertain to this type of business. Aut orize Signatu COMMENTS: Business certificates [cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permission to operate-you must get that through completion of the processes from the various departments involved. **S/GN/F/ESAPPROVAL FORA BUS/MESS CERT/F/CATEONLY. � r�• t• Engineering Dept.(3rd floor) Map Parcel 0 63 Permit# House# eza- Date Issued 2 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) ' A Per Fee �/SS• � Conservation Office (4th floor)(8:30- 9.30/1:00 2:00) Planning Dept. 1st floor/School Admin. Bldg.)P .( S.) IKE� � Definitive Plan Approved by Planning Board '19 • BARN9TABLE. MAM TOWN OF BARNSTABLE Building Permit Application Project Street Address Village U( , Owner QAWAJ < INk C �I Address — Telephone Permit Request evi S w — 1 6 r )�'I �-y l V`f L ; PLO& 6' �. W 4- -U� cal V\1d ICL cAJL T1W F-Uu--., u First Floor I square feet Second Floor STY square feet Construction Type Estimated Project Cost $ Zoning District A- C Flood Plain Water Protection Lot Size Grandfathered ❑Yes /❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) N(� Age of Existing Structure Historic House ❑Yes 4No On Old King's Highway ❑Yes 4No Basement Type: J4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) N /,4 n Basement Unfinished Area(sq.ft) cD t q Number of Baths: Full: Existing Z— New y Half: Existing New No.of Bedrooms: Existing Z- New -G.— Total Room Count(not including baths): Existing 1 New Z First Floor Room Count Heat Type and Fuel: ❑Gas P§Oil ❑Electric ❑Other F 14 W Central Air ❑Yes 9No Fireplaces: Existing r 0--.New -a" Existing wood/coal stove ❑Yes ANo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) C%None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Pk No If yes, site plan review# Current Use S"j�L W O-y 1`"f 0, Proposed Use (�LIEF - f 10&V&r ,,� Builder Information !�' / Name W6-n �f � �� I V l ��5 Telephone Number U �b Z-` Wf 7 Address e, 0, 60,)( �-1� License# 1170 k 1 . 6 A Home Improvement Contractor# U 7 � V JP-gf' ASS ram-3Lt,- ► "1�`1�� Worker's Compensation# W C\1 2,0Qfl '-H� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ® c 1 Y 0 vvvf 9T62 SIGNATURE DATE 2-4 / 7 BUILDING PERMI NIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. .rr t i DATE ISSUED MAP/PARCEL NO. ADDRESS - _ VILLAGE OWNERi DATE OF INSPECTION: - FOUNDATION FRAME 2" r /� �' r `� - INSULATION f C s a FIREPLACE ELECTRICAL: ROUGH - FINAL PLUMBING: ROUGH FINAL GAS:` '` ROUGH FINAL f - FINAL BUILDING T w DATE CLOSED OUT* - ASSOCIATION PLAN NO. The Field Controls ComDanv SIDE WALL VENT HOOD INSTALLATION LOCATIONS I E SIOe WAS VEnT HOOD r.I I MUST 25 I.tJUNT'ED A `1 ML•PVUM O�AT.LEAST L. •� I FOCI ABO'1E DOORS ~ i AND WINDOW$ II I ! I r--WALL VENT Hoop Mus- SIDE WALL VENT LZnS-7 FEE.'ABOVE MOOD)JUST @F AT LEAST L. '•v'ALRWATS \ 7 FEET ABOVE ANY OUTSIDE ' AIR INTAKE WITMIY A •"� " " I10 FOOT RADIUS SIDE WALL VENT MOOD MUST 9E SIDE WALL''ENT NOCJ AT LEAST A FEET 6ELOW ... MUST eE A.,LEAS'•:_' `� WWDOWS SIDE WALL VENT r TO THE SIDE OF ANT ODORS rAuS- DOORS BE MOUNTED AT LjAS-3 OR WINDOWS ..SIDE WALL VENT 4000"us-, FEE', FROM INSIOL CORNEn'a BE MOUNTED AT LEAST I From ABOVE GRADE `—cation of the termination of the vent pipe should be instal�s �" " 2 M �.T:.S.1..?�? • -t accordance wltn the National =uel Gas Cooe; 3 I,See reouirements below) anc any local codes which are applicable.All indivleual or multiple ao- ollance- vents must enter the vent system on the inlet side of venter. I ne exit terminals of mec'nanicai draft systems snail be not less than 7 feet aoove grade when located !, adiacent to oublic walkways. �. A venting system shall terminate at least 3 feet aDove any forced airC. The venting system of other than a direct vent appliance shall) ermmatelet at leaslocat feet b lwithin10ow, 4 feQ horizontally from or 1 foot aoove any door, window or oravity air inlet into any building. f»„t d. The vent termination of a direct vent appliance with an inout of 50.000 STU per hour or less shall be located at least 9 inches from any openlnc tttroueh which vent gasses could enter a buiiding, and Such an aDDiiance with an input over 50.000 STU per hour shall reowre a 1.2 inch vent termination clearance. I he bottom of the vent terminal anc any air intake snail be located at least ast 1 2 inches above -- -_e. Power venter SHOULD be located as close as Dossible to the ott!side wal!. ^Ort: all po^Ions of induced craft systems under positive pressure eunng oberatlon sred drab systems and installed SO as to orevent learcaee of vent oases into building, al be aeslgned and f• The vent termination point snail not be instaiied closer than 3 feet from an inside comer I snaDed structure, or not less than 12 incnes aoove grade. of an i PLOT PLAN - LOT 4A FORTES WA Y, 3ARNSTA9LE MA - SCALE 1 " = 40 ' SEPTEMBER �18, 1997 EAGLE SURVEYING 6 ENGINEERING, INC, t 441 ROUTE 130, SANDWICH, MA �•9��s .119 THE DYELLING SHOW ON THIS PLAN WAS LOCA TED BY AN INSTRUMENT SURVEY ON 9112197 AND �L EXISTS ON THE GROUND AS SHOWN. o DA TE PROFESSIONAL LAND SbPFEYOR / 4 00 PAUL i R. N RYLL o No.32448 Z� a su r !o•o A 3.5+ . ri 41 t O m� ' LOT 4 A 1 t � ao 35731 S.F. t .. °�TMETQry� The Town of Barnstable _ N �' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crosses Fax: 508-790-6230 Building Commissic: For office use only 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. I Type of Work: 4)0/-n Est.Cost Address of Work: 217 d S7-0-V(/ti' Owner's Name D�lf� C �4`JJ Z Date of Permit Application: y I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME 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 t of th er. r L1A b� � Date C tractor Name Registration No. OR Tllc Calll»loltlrcalth of 1 farsachusern Deplirtlllet" of Indzlstrial.4ccidents \� `1 ►' Olficc af/ffYzS lgalfans 6(It7 !t'osllilrhtull Street Workers' Compensation Insurance AMdavit ctl'Piic intinttirnsati�n• — Plc'tse PRM7lebiiii��v r , (lumr• Inc^tin• ' rite• rlhnnc 1 am a homeowner performing all wort:myself. 1 am a sole proprietor and have no one working_ in any capacity KI am an employer providing workers' compensation for my employees working on this job. 1 + cmm m�a ' namr: � i � 1 atltlrrcc• ! [-� U A�1 city• w `J"Y`'�/ �I!��Y / " ► nftonc#• b Z ! b• % 7 in-mrnnrr rn '�'` �✓ "`' V 1 " nnlicvd `' " ?.rK I am a sole proprietor. general contractor. or homeownn�er(circle one) and have hired the contractors listed below wrio the Iollo%ving workers compensation polices: omminy n•ttnc• :ltlrlrrcc• City- nhnne H- incnr^nrr rn nnlicv 0 cmmnnnv nitnr* adrlrrcc• rin•• nhnnc#• in-mrnnre rn nniic`•# _ 77 Attach additional sheet if necessary __,_ _;�.;; ""'��'�•�� F:ttiurc to secure cin-craec as required under Section:SA of i11GL 152 can lead to the Imposition of cnmtnai penalties of a tine up to SI.:00.u0 andiur une �cars' imprisonment a.s %%6I :ts ciVil penalties in the form of a STOP NVORK ORDER and it tine ufS100.00 a dad•against me. I understand th.t a copy of this srttcntcnt ma► tic forwarded to ttte Orrice of Im•estigntions of the DIA for coverage verificaeion. 1 do irrrcnr crrriit r ri the pr 'rs and penalties of perjure•that the information provided above is true attd correct. Sic.^.awrc Date Print name ►M-t-- -Llt -• 1Gt Phone# 3 7 6 K 7 otTiciai use univ do not write in this area to be completed by tiny or town otTicial t' �. tin•or tnw n• permidliccnsc ritluilding Department ❑Licensing llaard ' t i. CZ, Check if immediate respunse is rcyuircd ❑Scicctmcn s orrice C t. [tllcaith Department ' contact person: phone r-tUther Information t' and Instructions Massachutictts Gettcrtl Laws chapter 15'_ section _5 requires all employers to provide workers' co 'PenstttiotI f,�r employees. As ducted loom the -jaw-. an emplaree is defined as every person in the service of :ntii�ther undc-:.::t.. contract of hire. express or implied. ora..1 or written. An einplorer is dcf-ined•as an individual. partnership. association. corporation or other Iegal entity. or any 1%%'k) or the forc�_oing cnuased in a joint enterprise. and including the le'aal representatives of a deceased employer. or the recclver or tntstee of an individual . partnership. association�or other legal entit}, employing employees. HoNve. er rnN-ncr of a d%vellinu house having not more than three apartments and who resides therein. or the occupant of the dwcllin`_ house of another N%,Ito employs persons to do maintenance ;construction or repair work on such d%vellin,_ or oft the __rounds or building appurtenant thereto shall not because of such employment be deemed to be an e.,,, MGL chapter 152 section �5 also states that every state or local licensing agency shall withhold the issuance or 1!1-11%111 of a license or permit to operate a business or to construct buildings in the commou'vealtlt tar any• icant who has not produced acceptable evidence of compliance with the insurance coverage required. ,Ad�•:ionall\-. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the per iormz::ce of public work until acceptable evidence of compliance with the insurance requirements of this chap:- been prescnted to the contracting authority. �IiPlicants Plrasc„'ill in the Nvorkers' compensation affidavit completely, by checking the box that applies to your situation ::i: suci in_ compan} names. address and phone numbers as all affidavits may be submitted to the Department of industrial .Accidcnts for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The -Javit should be returned to the ciry or town that the application for the permit or license is being requested. r :he Department of Industrial .Accidents. Should you have any questions regarding the "law" or if you are reeu:- 0 obtain a Workers* compensation 'policy.'ple-se'call the Department at the number listed below: � City or Towns Ple�re be sure that file affidavit is complete and printed legibly. The Deliartment has provided a space at the boron- the for you to J-111 out in the event the Office of Investigations has to contact you re`arding the applicant. P' be - : to fill in the permit/license number which will be used as a reference number. The affidavits may be returner -ae Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any quest', please do not hesitate to _ive us a =11. Tile Department's address. telephone and fax number- The Commonwealth Of Massachusetts ,. Department of Industrial Accidents -• Office of Investigations 600 Washington Street Boston, Ma. 02111 fax r: (6177) 727-7749 + nhone -. 6 i ) 72- *900 car. 406. 409 or .377 I zu, o�✓� c/ s. f. f DEPARTMENT OF PUBLIC SP.FET° CONSTRUCTION.SUPERVISOR LICENSE Number: Expires: Restricted To: 00 . MICHAEL L KINGSTON 11 POPPLE BOTTOM RD SARDWICH, MA 02563 0L HOME IMPROVEMENT CONTRACTOR Registration 120878 Type - PRIVATE CORPORATION Expiration 03/13/98 WEST BARNSTABLE BUILDERS INC MICHAEL KINGSTON �t,� 70 RT. 6A/PO BOX 516 ;. ADMINISTRATOR WEST BARNSTABLE MA 02668 . f _.._ .......:..:. .......... .. :: : .> DATE(MM/DD/YY) ACORD CERTIFICATE O LIABILITY INSURAN � 10/10/97 . PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Drake, Swan & Crocker HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 14 Lot's Hollow Rd. ,PO Box 429 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orleans MA 02653-0429 COMPANIES AFFORDING COVERAGE Deborah L Kelly COMPANY Phone No. 508-255-3212 Fax No. A Assurance Co. of America INSURED COMPANY B Eastern Casualty Insurance Co. COMPANY West Barnstable Builders, Inc. C P 0 Box 516 COMPANY W. Barnstable MA 02668 D co� s THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE POLICY EXPIRATIO L R TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $2000000 A X COMMERCIAL GENERAL LIABILITY RGM27962910 01/24/97 01/24/98 PRODUCTS-COMP/OP AGG $2000000 CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ 1000000 OWNER'S&CONTRACTOR'SPROT EACH OCCURRENCE $ 1000000 FIRE DAMAGE(Any one fire) $50000 MED EXP(Any one person) $ 10000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS - BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WC STATU- WORKERS COMPENSATION AND TORY LIMITS OER EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 100000 B THE PROPRIETOR/ INCL WCV2000436 06/11/97 06/11/98 EL DISEASE-POLICY LIMIT $ 500000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Contractor . CERTIFICATE HOLDER ............ CANCELLATION ..... . _ .. .......... ........._................. ................_ ... DAWNMC1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Dawn McKenzie & Fermin Osborne BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. Box 500 Cruz Bay OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. St. John USVI 00830 AUTHORIZE P TIYEM I k ACORD 25-5(11". ACURD CORPORATION 1988; Assessor's office(1st Floor): Assessor's map and lot numb o 00 {c SYT : Conservation tQ— 114STALLED IN E- Board of Health(3rd floor, WITH Sewage Permit number21� 3�t ENV`R®NME o t ' Engineering Department(3rd floor. j TOWN REG House number Definitive Plan Approved by Planning Board t9 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only' TOWN - OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO "-V ti" 0_, TYPE OF CONSTRUCTION z 2- 19` TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 2-� -C),z-rE Proposed Use ib2 Zoning District 7:2 Fire District G-7L'f g�3Jj l Lfr L�� V I L-Uip Name of Owner C=EetiKiE CS-BO P-1,#4 Address D C.JD�� Name of Builder Csu C- Address 7BC>c, Si g lre� .`sue Ca`yz, • (/fit�A tOZ � Name of Architect f'A%Z=- Address Number of Rooms ��- Foundation �' ®"A, Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area i- 3 Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnst d e ction. ✓Name iA16-..V *v / Construction Supervisor's License __ A McKENZIE, DALON & FERMINE OSBORN No 35981 Permit For BUILD DECK. Single Family Dwelling b 23 Frtes Way -. Osterville Owner Dailon McKenzie & Fermine Osborn - Type of Construction Frame Plot t 'Lot !M =- � � � ,; •;_ ,, r _ Permit Granted un'e 23 , 19 93 Date of Inspection 19 Date Completed 19 1 c t� ,, �t Y ✓//E C:b)tiNK!/�� . HOME IMPROVEMENfaNTRACTOR Registration 160017 II Type - PRIVATE CORPORATION S. Expiration 06/08/94 The West Barnstable Co,,pang, I Michael Kingston 1178 RT, 6A ADMINISTRAroR Jest Barnstable 'MA 02669 -t 1 DEPARTMENT OF PUBLIC SAFETY _ COMMONWEALTH i OF I 1010 COMMONWEALTH AVE. MASSACHUSETTS i BOSTON,MASS,02215 I ENCLOSE CHECK OR MONEY ORDER 9 �, LICENSE FOR REQUIRED FEE, EXPIRATION DATE CONSTR. SUPERVISOR M 06/30/1993 MADE PAYABLE TO RESTRICTIONS 5 EFFECTIVE DATE LIC-NO. l NONE a 06/30/1991 023212 .� "COMMISSIONER OF PUBLIC SAFETY" I MICHAEL L K�NGSTON . j (DOP 110D ). I FORESTDALE BRA 02644 PLEASE NOTE FEE INCREASE { PHOTO(BLASTING OPP ONLY) FEE: ' iFECTIVE FEB.PR 1 �� s 100.00 { E 1, 1989 t�' `L �y�T'''��} + HEIGHT: NOT VAL UNTI SIGNED BY LICENSEE AND OffIC IALIY 3�w STA, NAT E OF MMISSIONER (� D.P.S. . 4 l �--"T DETACH LICENSE STUB r THIS DOCUMENT MUST 0-� SIGNATURE OF LICENSEE 1I!� SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON C,j 1 (i [[ THE HOLDER WHEN ENGA�:+ OTHERS-RIGHT THUMB PRINT EO IN THIS OCCUPATW COMMISSIONER r 2DOM-2-87-81429 ADDITION .rwr TOWN OF BARNSTABLE 32409 .Permit No. . BUILDING DEPARTMENT I """ I TOWN OFFICE BUILDING,619 Cash .M�7 HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Dawn Mackenzie Address Lot 4A, 23 Fortes Way Osterville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 20 89 ....................�...... . 19................. ........ ....... ........ .......... Build,i g Inspector --��r,^..-ti,..--lti,-.��n,..•rr--..�=••`*-1-,..,..y,.•.-c..-.--.,.-tti..�w�1.•r-,^•'-"---•^J"4,,�,,�w.y"'nt"frtin,,,,^+''^."'^.`'"'v.a�e--'�-^�„�"'} ADDITION 0�7MCTC TOWN OF BARNSTABLE .Permit No. .32409„.... BUILDING DEPARTMENT i ' TOWN OFFICE BUILDING t Cash ............... 7 M� i679• .' �'�rour HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Dawn Mackenzie Address Lot_ 4A, 23 Fortes Way Oster°ille, Mass: ^� - USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 20, 19...89................................... ., ...1.!n5�6. T Buildjng Inspector TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING I L. DItVG PERMIT DATE 19 PERMIT NO. APPLICANT - ADDRESS (N0.) (STREET) (CONTR'S LICENSE) PERMIY TO (_) STORY .NUMBER OF (TYPE OF IMPROVEMENT) .NO. ' DWELLING UNITS (PROPOSED USE) AT (LOCATION) ZONING (NO.) (STREET) DISTRICT BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE _PUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION L- TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) �EMARKS: AREA OR VOLUME ESTIMATED COST FEE _� (CUBIC/SQUARE FEET) OWNER ADDRESS BUILDING DEPT. BY a THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP— PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. ! MINIMUM OF THREE —1!*.LL I INSPECTIONS REQUIRED FOR APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR .u' ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. j 2. PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL j 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET B LDING INSPECTION APPROYALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 i V- 2 , z — -- — ag 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT + 1 OTHER --- __—__ —__---- -- __— BOARD OF HEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'Y!L L BECOME N U L L AND VOID IF CONSTRUCTION— INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. ARRANGED FOR BY TELEPHONE ORa'WRITTEN NOTIFICATION. ti FtssesAor'ss offioe Ost floor): THE Assessor's map and lot number ,.,�.A.v...Q.6....:.D0 r �— �,` �",' �' !m r Board of Health (3rd floor): Sewage Permit number Aez.-("lo...�, .�... Y asasTentt. i Engineering Department (3rd floor): S' . a 7 SAO Housenumber ........................................?............................ '` �eyriitiV fiEQU► T APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING 'INSPECTOR 1 APPLICATION FOR PERMIT TO .. :.0-I A.,.......kj;;;��OT q TYPE OF CONSTRUCTION ........ ........... ........................................................... ......... .l ..1............................19. 4 TO THE INSPECTOR .OF BUILDINGS: `' The undersigned hereby applies for a permit according to the following information: .TLt Location ...... Q.\� ........... .C�c ........... ..1,...�1�c„�..l..L��. i .,.....6Lo.l.... A.. ...t.......... Proposed Use ............j. r—.. .F.............—K.M.L.t...................................................................................... .... g � '4:...............................................Fire District ....... �1.�. r .4.�..�.L L ..O.7I. ��I/ Zoning District ............ .... .... Name of Owner .........90-r k . Address .................................................................................... Name of Builder-T/-4.E... 251-WX1:C .Address ..1174....6.�'.. ....6IY:.1,&!&t#"l ..J Name of Architect ... ....( aza ..�f 7 ..............................Address 5 ........T,—a 6/�,f=/., —L..�� Number of Rooms ........... ............Foundation 7?0.( ae,<� ...... n n ( 1 ,C:C� Exterior ...1..,,;:�.�,G4��........4�.!.....��-..�Q. ..........Roofing .....>�S�.X)...... ............................................ Floorsi..6� 7t.:. _.....................................................Interior .i..-bc,. ......................................... Heating .....�Ao L..............Plumbing ....... ..I� ............... .............. ....................... Fireplace ...... ............ _.........Approximate Cost .........A.. .. . dQ. ? �....................... � � . Definitive Plan Approved by Planning Board _��_� 0�____19__ Area .•• ................ ... Diagram of Lot and Building with Dimensions Fee — SUBJECT TO APPROVAL OF BOARD OF HEALTH Y w ' f OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of t own Qf B r stabl ar ing the above construction. Name ............... .. .................../ ...... . r Construction Supervisor's License .. QZ5 2W L. _ I MACKENZIE, DAWN 32409 Permit for ..............Build......................A dd i ti on ................. Single Family Dwelling ........................................................................ Lot 4A, 23' Fortes Way Location .................................................................. Osterville .....................................................................I......... Dawn Mackenzie Owner ............................................................ . . . Type. of Construction .......Frame........................ .. .... .. .......... ......... ......................................................... Plot ............................ Lot ................................ Permit Granted ....Nqyejp)peK... .........)19 88 Dcite of Inspection ....................................19 Date Completed ............. . ...........19 A. --4 . 4 v z Q - Comi MCC WHY ___ _.. ..-JL■■:..;... LrvrL W W ■�■■ ■■■■= ■■■■ ■■■■= 1 • • 1 j z - ■■■■_■■■■—_= 1 1 1 — ava 1. CoiWT snow ®®® is O►1 M. EV_ 1IO.► SCALE-114- 77 32 \\\ wqrf on" AT w TO VWMM is --mcoi now tEpv FLOW us ■■ ■1� 1■1. ■■■ ■■■ ,■■ ■■■ ■■ ■■ ■■ ■■ 1. _--- \ ■■ ■■■■ --- --- ■■■ ■■■ ■■� ` % �� \ % \ �■� \ ■■■ ■---■■ ID ■■■■ ■■■ ■■■ ■■■ ■■■ LJ iii iii 00 ��■ �� . 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