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HomeMy WebLinkAbout0600 MAIN STREET - Amnesty h r 0 Floe n SrtfJf� %�,; I � �� Soy l� C' � o Y�� ,N ST � 2�� 1�' Is� � I c �"E r � Town of Barnstable Building Department Services ` B""1 ss"81E'� Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.maxs Office: 508-862-4038 Fax: 508-790-6230 July 11, 2019 Sean Kenney 600 Main Street West Barnstable MA 02668 RE: 600 Main Street, West Barnstable MA Map: 157 Parcel 002 ,Dear Mr. Kenney: This letter is in response to application number B-19-1279. Your application is denied as submitted for the following reasons: 1) Incomplete construction documents as required by Chapter 1 Section R107.1 of the MA amendments to the 2015 IRC (9th edition 780CMR) Scope of work does not address Dwelling Unit Separation walls as required by AJ601.3 You will need to demonstrate compliance with R302.3 Two-Family dwelling units shall be separated from each other by wall and floor assemblies having not less than a 1-hour fire-resistance rating, and R302.3.1 Supporting Construction where floor assemblies are required to be fire-resistant rated by Section R302.3, the supporting construction of such assemblies shall have an equal or greater fire-resistance rating. And, if aggrieved by this notice; to show cause to why you should not be required to do so,you may file a Notice of Appeal (specifying the grounds thereof) with the State Building Appeals Board within forty-five (45) days of the receipt of this notice. Respectfully, Edwin E Bowers Local Inspector Edwin.bowers@town.barnstable.ma.us (508) 862-4025 Received b Date Town of BarnstableRPECEIPT KAM200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-19-1279 Date Recieved: 4/18/2019 Job Location: 600 MAIN ST./RTE 6A(W.BARN.),WEST BARNSTABLE Permit For: Building-Amnesty with Construction Contractor's Name: State Lic. No: Address: , , Applicant Phone: (Home)Owner's Name: KENNEY,SEAN J ET AL Phone: (Home)Owner's Address: PO BOX 566, WEST BARNSTABLE,MA 02668 Work Description: Install 2 20 minute fire doors hardwire smoke detectors creating amnesty apartment Total Value Of Work To Be Performed: $2,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: KENNEY,SEAN J ET AL 4/18/2019 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total.Project Cost : $2,000.00 Date Paid � Amount Paid Check#or CC# Pay Type Total Permit Fee: $110.00 4/18/2019 j $110.00 514 Check Total Permit Fee Paid: $110.00 '971,ri, 3 THI ISNt�TAPE I'I' r RA R S TA R�i_E Town of BarnstableWN { 'Zoning Board of Appeals Comprehensive Permit Decision and Notice AccessoryAffordableApartment Program Comprehensive Permit No.2018-061—Kenney/Felker Decision: Granted with:Conditions Applicant: Sean Kenney and Constance A.Felker Property Address; 600 Main Street,West Barnstable, MA Map/Parcel: 157/002. Zoning: RF—Resid'ence F Zo,ning District Summary: Allow the,conversiorl of 468square feet to a one 6edroom;;acee"ssory affordable aparfine'P., located within the existing dwelling pursuant to the Code of the Town of`Barnstable,Chapter, 9,.Article If Deed;Reference Book 27729''Page 231.. Applicant./Site Control The Applicants are Sean J. Kenney:and Constance A.,Felker,the owners and occupants of property addressed as.,600 Main Street; West Barnstable, NIA. The Applicant-;has been the,ow'ner o.f the`property since October 1, 2013,.as evidenced by a deed recorded at the Barnstable County Registry of Deeds o'n Book 27729 Page 23,1 recorded October 1,2013: A signed Affidavit dated August 30, 2018 declares that 600 Main Street,'West Barnstable';MA; is the primary residence of Sean J. Kenney. andtonstarice A,:Felker. Locus The subject property is a 161 acre lot that is accessed by Main Street/Rte 6A,West Barnstable. The praperty::is improved with a 3,226 gross square. foot'three-bedroom single family dwelling,(1,83'5 square feet of living area) constructed in 1946. The accessory apa:rtriient•is a one-bedroom unit located withinn the existing dwelling:. It:is` served by a well and an on-site septic system. Background Sean J. Kenney and Constance A. Felker seek to convert468 square feet'of area within the existing dweling`to a. one-bedroom Accessory Affordable Apartment :by .a Comprehensive Permit` pursuant to Chapter 4.08 of the Ge;nerai Laws of the' Commonwealth-of Massaeh:usetts, a`n.d in`aceordanc`e with:§9-15'of the Code of the Town,of Barnstable, more coin.monly termed the"Accessory Affordable Apartme"nt Program a Procedural&Hearing Summary i Sean J. Kenney and Constance A. Felker submitted:an application for ai Site, Approval:.Letter as prescribed i`n the a Code of Massachusetts Regulations 760:Section 56.00 and provided for within 'the Accessory Affordable: Apartment Program of the Town of Barnstable. The application was.submitted as a local initiated Chapter 46B:. Notification of the application was submitted to the Department of Housing and,Commumty Development; A Situ Approval Letter was'issued to the Applicant for the subject property by'T'own Manager, Mark Ells, on August 30. 1. 2018. Notice ofthe Site Approval Letter was sent to the Department of`Housing and Community'Development in accordance with.the requirements'of CMR 760 5&00, l An application for a Comprehensive Permit was filed at the Town.Clerk's Office on October 5; 2019, X.public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the,Barnstable Patriot on October 26, 2018 and November 2,2018 and notices:were sent'to all abutters in accordance with Sectiori;1:1 of NI G L Chapter 40A. i Town of Barnstable Zoning Board of Appeals Decision&Notice Comprehensive Permit No.3018=061—Kenney&Felker Findings,of Fact At the hearing-on November 14,2018,the Hearing:.Officer made the following findings of fact::. Concerning standing,the right of the applicant to seek a comprehensive°permit,the Hearing Officer fo.undi The Applicants, Sean.J. Kenney and Constance A. Felker, are"the.owners:'ancl occupants of the:property I'' ated at 600 Main Street,West Barnstable MA,as evidenced by deed recorded'at the Barnstable County Registry of Deeds on 27729 Page 231 recorded October 1, 2013." A signed Affidavit dated August 30", 2018, declares th0t.600 Main. Street,West Barnstable,MA; is the primary residence of SeanJ. Kenney and Constance-A: Felker; 1. The appli.cation`for a Corn prehensive'perm it;was made in accordance with the,Town of`B.arnstable's Accessory Affordable Apartment Program, Chapter 9 Article II of the Code of the Town of Barnstable. That program is structured as a self=regulating income.limiting local initiated housing"prog"ram; a`qualified, funding program. accepted under the Code. of Massachusetts Regulations 160 Section 56:00 that governs grant. of comprehensive.permits. 2. In accordance with;.MGL Chapter 40B and:760 CMR 56:04 (4), a Site .Approval Letter was issued- to the AppI cant for the subject property by Town Manager, Mark Ells on August 30, 2CIA. Notice of4h'e Site. Approval Letter was sent to the Department:of Housing and.Community Development, in accordance with the requirements, of 760 :C'MR 5U4 (2) and. no issues were communicated from the Department o:n'this application. Regarding consisfeacy with loeafneeds;the Hearing Officer found-.: ; 3: The Applicant is proposing to convert an area:withi' the d"w.tilling to:an AccessaryAffordable Apartment The. i apartment is 468 quare'feet,one bedroom,"a;nd located within the existing dwelling"at 600 Main Street ,West Barnstable.MA:To permit the apartment as an accessory.affordable:unit.under.Ghapter 9;Article'JI ofthe:Code. would.represent no perceivable change in the;neighborhood. 4. The Building Commissioner performed 'an 't,.nitial "review of the property.and determined that'an accessory` ap"artment unit can be created. in conformance with: applicable state building:codes. Prior to occupancy, a: building permit shall be required and hardwired smoke detectors and carbon monoxide detectors"shall be> upgraded/installed and"the un:it.shall.meet all requirements of the:Ruilding':Cod'e. 5:. The property is-,served by an on=site septic system adequate to accommodate the addition of'a one-bedroom- unit on the property with a:restriction from the Health Department`if required: 6; The,Applicant has been informed that`:building and.occupancy permits�sh"all be obtained prior to:occu"panty of the accessory apartment; This step is required to assure.final approval"that the apartment unit conforms fully i to all applicable building,fire,-and health codes and this decision. 7, The Applicant has been informed that upon certification of this Comprehensive;Perm. . by the Town.Clerk,"a` Regulatory Agreement and Declaration of Restrictive Covenants, restricting the:accessory apartment unit in perpetuity as an affordable rental unit shall be executed'. Thereafter both the"Comprehensive Permit'and the, Agreement shall be reco.ded at the'Registry:of Deeds as binding covenants on the"property, The documents; limit the apartment to that-of.a.n'affordable unit rented to a:person or family whose.income is80%or'`less of the Area Median income (AMI of the.Barnstable Metropolitan Statistical Area (MS'A) `and cap the monthly rental income Onclud;ing utilities)to not;exceed 30%of the monthly household income of a household,earning 809/.of the median income; adjusted by household.size Inahe event that.utilities are separately metered,Ahe utility allowance established by-the Town of.B"arnstable shall be deducted from,rent level so calculated:: 8. According to the Massachusetts Department of Housing.and Community: Development, Subsidized Housing: Inventory., the Town of Barrstable has 7..14%of1ts year round housing stock qualified as affordable housing units. The town has not reached the 10%.statutory minimum affordable housing."required"in;MGL:Chapter' 40B or met any the"Statutory Minima provided for in 760 CMR 56.03(3), 2< i i i Town of Barnstable Zoning-Board of Appeals Decision&:Notice .Comprehensive Permit No:l 2019=b61-Kenney&Felker 9. The town of Barnstable's Comprehensive Planencourages the adaptive useof existing h isiqcklqcreate affordable:units.and the dispersal of these units throughout'Barnstable. This application and the location.' the unit conform to that objective. Based upon the findings, the Hearing Officer rul'ed that the application of Sean J. Kenney and..Gonstance A. Felker is deemed consistent with local needs because it adequately promotes the;objective of provid'i'ng affordable housing.:. for the Town of Barnstable without jeopardizing, the health and safety of the occupants provided,lcertain conditions are:imposed.. Decision&:Conditions; The Hearing,Officer ruled to grant Comprehensive Permit No..201.8-061 to Sean J. Kenney and Constance A._(Felker for 600 Main Street, West Barnstable, MA.to allow the conversion of the area within the rriain dwelling to a-one-- bedroom affordable apartment unit:at 600'MainStreet,West Barnstable MA::as provided for in Chapter 9,Article' II of the Code of-the Town of Barnstable and in conformity to the following conditions and restrictioris: 1. Occupancy of the affordable unit shall not exceed two(2),persons. 2. Then U m ber of bedrooms in the Accessory Affordable Apartment shall be limited to.one(ib. 3. Family members of the applicants%owners shall not at any time occupy the accessory unit. 4. All,leases:shall.have.a minimum. term of one-year and have,provisloris that require the tenantto provide dny and al information necessary to verify eligi.bility with the Accesso"ry:.Affordable Apartment Program Including income information ofthe tenant and.rent and utility payments. 5. All parking for the accessory apartment and the: principal dwelling shall be on=site. Overnight on-street: parking is expressly prohibited. 6. Accessory or renting of rooms is prohibited for the duration of this Comprehensive Permit. 7. The appl'icants.shall, after certification of this GomprehensivePermit by the Town?Clerk a. execute a Regulatory Agreement and beclaration.of Restrictive Covenants, as approved by the Town: Attorney's Office,..and b, "make application for.a,building permit with he Building Division:for the accessory apartment: Work> required to bring)the unit into compliance with present day code standards shall be completed prior j to issuance of a Certificate of Occupancy for.the accessory apartment. 8.. It is the explicit"inten:t that the applicant secure an occupancy permit and,the unit,be:occupied by qualified tenant(s) as restricted by this comprehensive permit within one-year of the certification of thepeWto The, Building Comm issionerand/o.r'monitoring age nt.may extendahis time for°goad cause.:,. 9. To meet affordability:requirements,the rent"charged(including utilities)shall not exceed 30%of'80% of'the median income for the Barnstable MSA, adjusted for family size,as calculated and published annualiy`by the: Town of Barnstable. In the event that:utilities are separately.metered,,the utility allowance established by the: town of Barnstable,shall be deducted from rent level so calculated.. 10. The applicant shall engage In open and fair marketing of the.unit and provide documentation of the activityto the Housing Coordinator/Monitoring Agent. 11: Information regarding.:the income level of any prospective tenaritshall first be submitted to and approved by the Housing Coordinator/Monitoring Agent before any lease issigned: 12. Annually,: the applicant shall work with the Housing Coordinator/Monitoring Agent to provide necessary' information and documentation of tenant income eligibility and conformance with the Accessory Affordable Apartment Program. 1 Town of:Barnstable Zoning Board of.Arpeals. Deci.Sion,&Notice-Comprehensive Permit NO.,2018-06.1—Kenney&,Felker. 13, The:Applicant must.register the unit with the Regulatory Services De:partrhent at'200 Main Street, Hyannis: 14. Wh:enev&. a vacancy occurs, notice shall be. given to the Housing Coordinator/Monitoring Agent, before. reengaging the tenant seledi0_1 process previously Cited. 15, Annual.lncome,,to determine program eligibility,will be calculated per 24 CPR Part:'5. 16. The Housing Coordinator.of the Planning and Development Department;stall be the monitoring;agent'for the accessory apartment. Annual monitoring shalt include verification of tenancy; affordability, and compliance With Comprehensive Permit: The homeowner shall'be responsible for the fee for Housing Quality Standards; (HQS) inspections. 17. Every twelve months. the applicant shall review: the income eligibility of the tenant of the Accessory Affordable Apartment unit. No.later than,a year from the date of issuance of this Comprehensive Permit,the, applicant shall file,.with the Housing; Coordinator/Monit(Y riing.Agient an annual affida"vit stating the rent charged and income of the unit tenant along with all requi"red supporting documentation: The property owners and/or tenant shall provide an.y additional<information deemed necessary to verify the information. provided'in the affidavit and znnual monitoring documents. 18..Upon any.report,from the Housing Coordinator/Monito"ring Agent that the terms and condliloo of this permit are not being upheld;the.Hearing Officer of the Zoning Board of--Appeals may hold a hearing:to revoke this permit or cause enforcement action to betaken for compliance. 19. This Decision,,the Reguiatory Agreement and Declaration'of Restrictive Covenants and all other necessary documents shall be recorded at the Barnstable Co:u.nty Registry of Deeds prior to application for a'building: permit: 20. Should ownership of the subject property transfer;the permit holder identified herein shall notify the Housing: Coordinator/Monitoring Agent:and provide, within'60 days of the:date 'of transfer.., the name and current contact.information for the new owner.of the subjectproperty: 21., This Comprehensive Permit shall be exercised as cond.itioried Me in it shall expire, Ordered Comprehensive Permit No. 2018-061 is granted with conditions'to Sean I `Kenney and Constance A. Felker far property addressed -as 600 Main Street,'West Barnstable, W. This permit,is not transferable without prior' permission of the.Nearing Officer: The zoning relief issued in this Comprehensive Permit IS that of a variance to Section 240-13;(A) Pfincipal Permitted Uses in the. RF Zoning Districts to permit a one-bedroorri accessory affordable:apartment unit within the dwelling. A written copy of this decision will be forwarded to the Zoning Board of Appeals;as required 'by`the Town of Barnstable Administrative Code Chapter 241, Section 1L If after fourteen (14) days from that transmittal and provided that the members of he Zoning Board of Appeals take no action to reverse the decision, this decision shall be filed with the Town Clerk's Office. It shall then:become'final only-after 20 days has expired,and certified: by the Town Clerk that no'appeal was filed;on the.decision: Appeals of this decision, if any;.shall be made to::the'Barnstabie Superior Court"pursua fit'to MGL Chapter 40A,. Section 17,within twenty.(20)days after the date of the failing ofthis decision in the officeof the Town Clerk. The, app icant has the right to appeGI this decision as outlined:in MG L Chapter 40B;;Section:22 Alex K odo aki earing officer Date Tgned 4. Town of Bamstable.Zoning:Board of,.Appeals [decision&Notice—Conipreherisive Pe mit No.20187061—Kenney&,Felker I, Ann.Quirk, Clerk of the Town of Barnstable, Barnstable County., Massachusetts, hereby certify that twenty(2O) days have elapsed since the Zon,ing Board of Appeals filed this.decision and that no appeal of'the::decision has been filed in the office of the Town Clerk. Signed.and sealed'this. day of � under the airs and'penalties,of perj:u. ,.;. g � Y c� p p rY • II Ann.Quirk;Town Clerl. ua Y •;. l� Z.. r J ' J i i ARNSTARIE REGISTRY'OF DEEDS John E Meade:Rooster 5 f REGULATORY AGREEMENT AND DECLARATION:OF RESTRICTIVE COVENANTS' THIS REGULATORY AGREENMNT and DECLARATION OF RESTRICTTVF.COVENANTS,is made: this 14 day of November 2018 by and bct<veen Sean;J..Kenney:and Constance.A. Felker of 600.Main Street;West Barnstable.MA and its successors and assigns (hereinafter the•"Owner'l; and the TOWN OF BARNSTABI.F,(the"Municipality"),,a political subdivision of the'Commonwealth, WHEREAS the'Owner'has beeri;grantc&a Comprehensive Permit under'Ma`ssachusetts General•I aw`Chapter 40B and local-regulations by the Zoning.Board of Appeals to.,permit the creation of an accessoiyaparf tit;in ail owner.occupied dwelling which will tie:rented'to a Low or IYloderate Income:Person f'Family(hereinafter "Designated Affordable Unit");and. NOW THE REFORE,.inmutual consideration of the agreements,And covenants contained herein,and othei good and valuable consideration,the receipt andsuf dency of which is l ere by.acknowledged.=the parties agree. as follows: f L PROJECT SCOPE AND,DESION: k The terms of this Agreement and Covenanrregulatc the:;property,located.at 600.Mai hi Street]`West Barnstable,MA,as further described in a deed recorded herewith as Barnstable County Regstryso€:Deeds Book 27729 Page.231. B. The Project located at 600 Main Street,WestBarnstable,MA will consist of.one accesso>_S apai tment! uniitwhich will be rented to an:eligible low or.moderate income-individual or family(the"Designated Affordable Unit"or the"Unit C. The Owner agrees<ao construct the Project in accordance with the.terms of Gompre hetisive Permit` No. 2018=0.61 and. any plans submitted therewith, and all.applicable state,: federal and.municipal laws and; regulations.. Said permit is recorded herewith as Barnstable•County Registry of.Deeds Book Page D, The Ownei•agrees'to occupy the principal'dwelling unitlocated on the p>operty as,theiir•princ pal residence:in.accordance with the terms of the comprehensive permit: 11. THE OWNER'S C:OVENAN'I'S AND RESPONSIBILITIES:., A. THE OWNI R.TI;ERFBY REPRESENTS,COVENANTS AND 1YtA1Z1tANT5 AS FOLLOW.--; 1 In.receiving the comprehensivepermitto create tlre'Designated,Affordable unit,die:O,',vner agreed that. the Designated Affordable Unit shall beset aside in perpetuity for the,public purpose of providing safe and: decent housing to:persons;earning at or:below 80°(0 of the area median income of Barnstable'Metiopolitan Statistical Area(MSA).and that the Designated Affordable Unit shall be;decmcd to be impressed with;:a public trust. 2. .he Designated Affordable Unit shall be rented in peipettiity to a household`with a-maximum income; f 80%of the Area Median Income(IlIv1I) of Bariistatile IvISA and that rent(including'utilities)shall:riot eXceed. An-amount that is affordable to a,Household whose income is 80%0 of the median income ofBarnstabla.MSA; Tr.- dye.evcntthat utilities are separately metered,.a utility allowance:established by the Barnstable Housing Authorlity< shall'be deducted from the,rentlevel 3. The Designated Affordable Unit avill be retained as a permanent;year round rental du%elltng urn tvwith at least a.one-year lease. 4. 4. The Owner has the fuU legal right;power,and authority-to-exectite and deliver t is,Agrcement, 5. Phe execution and.perfdrmance.of this Agreement by the Owner:will not violate or,as,<applicable.,has not violated any provision of law,rule or regulation,or any otder:of any'court oi,other agency or,govek nmental. body,and will.not violate or,as-applicable,has noiviolated any provision of,any.indenture,,agreexrienf,mo11 rtgage; mortgage note,.or other instniinent to.which the Owner.is'a party cir bywhich it or the Owner is bound,will not result in the creation or imposition of any prolubited encumbrance of any nature. G. The Owner;at the:time of execution and.delivery:of this Agteemcnt,.h, bod,clear niAiltemble'titic to the premises. 7. There is no.action;suit or I rocecdi.ng at law or in equity:of byor, c ore any governmental $is:trumenfality or,other agency nouw pending,or,'fo the knowledge of the Owner,thcatened against or affecting it;or any of its properties or rights which,if adversely determined,would materially impair Its.right to carry"ori business substantially as now conducted(arid as now contemplated by this Agrecmetit);or would materially adversely affect its financial condition. B, COMPLIANCE i I The(Owner hereby agrees that.any-and aUrequuements of the laws of the Commonwealth of 3 Massachusetts to be satisfied in order for the provisions:of this Agreement to cons,tihite:restrictions and. covenants r nnir g with the lane: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.. LIMITATI"ON ON PROFIT'S 1, The Owner agrees:to limit his/her prof.by renting the:Designated Af f irdable'Untt in'perpett ity ta;a- l ouseholdwith a maximum income,of 80%0 or less of the.Area,Median Income(AMI)of Barnstable Metropolitan Statistical Area (VISA)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 die event that utilities Ate separately metered,:a.utilityallowance.established by the Barnstable I�ousing,Authority,shall tie' deducted from=tlie rent. 2; The Owner shall annually deliver to the Mutucipality and to the Monitoring Agent,as designated"by the Town Manager,proof than the DesignatedAffordable Unit is rented,the tenant..s income veritip n 'a copy bf the lease agreementand the rent:charged for the unit or units. Such information.;shall also be,fonuarded to'the;i Monitoring Agent within 30 days of the occupation of the dwelling unit:or units:by anew tenant. The>O%.vner 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 COVENAN I'S AND RESPONSIBILITIES 1. 'I'lie MUN:ICIPAL11 Y: through tl e:triotutoritig agent designated by the,Towt °Manager agrees to perform:tare:duties of verifying that the Designated Affordable Unit is being rented in perpetuity to a aiousehold with.amaximum income;of 80%or less bf the Area Median Income(AMD of,Batnstable MSA andahat rent. (iiicli:dit-igutilities).shal.i.note-xc.cedlati.amoLiln.t.tli.ati.s,a,ffotdAble:ibfiho,usell6fdwfio.se.incorhd�is8O%.6fihel. median income of Barnstable MSA.In tare.event that utilities are separately metered,a utility allowance' established by the.Barnstable Housing Authoritj shall be,deducted from the rent. 2 IV. RECORDING OF AGREEMENT: Upon.execution,:fhc OWNER'shall:immediately cause d is Agreement and any:amendments heteto'to' be recorded with.the Registry of'Dee& for Barnstable(ourity or if the Project consists in whole or in part of I registered land, file this Agreement and any amendments l ereto witli 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 shaUt immediately transiiii:t to the Municipality evidence of such recording,or'°Filing including:the date and instrument,book and page.or registration number of the Agreement, V. GOVERNING OF AGREEMENT: This.Agieement shall be governed by the'laws of the Commonwealti-vof Massachusetts; Any amendments to this Agrecrnefit 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 reioA,hiing po tions:hereof VI. NOTICE: All notices to begiven pursuant to this Agreement shall be in wrong:arid shall'be dcenied,given when delivered by hand or when mailed by certified or registered'mail,postage-prepaid;return receipt requested,to fhe- parties hereto at the addresses set forth below;onto such tither place as,a:part),may ftorn time io time.designate by written notice.. VIi. I-IOLD HARMLESS: The Owner,hereby agrees.to indernnify and hold haflni ss the Municipality and/or its':delegate`froim any. and all actions'or inactions by the Owner;its'.agents,,servants or employees which result m claims made against' Municipality and its delegate;iricluduig`but not lunitcd to awards,judgments;nut-of-pocicet;expenses:and attorney%fees necessitated by such actions. VIII. ENTIRE UNDERSTANDING: A. This Agreement shall constitute the entire understanding between the parties.arid atiy amendments or' changes hereto must be in writing,executed by the parties,and appended to this document. B. This Agreement and all of the coventuits. agreements and restrictions contained herein shall''be deemed: to be for the public purpose of providing safe affordable housing and shall, be.dcem ed to be; Arid by these`- Presents are 'granted by the Owner to run in perpetuity in favorof and be held by the;Mutucipality as any other permanent restriction held by a-governmental body as that t1.erm is used.in MGI C h. 1$�t,Section 26 which shalt run-with the land,described in a deed recorded lierewith'as Barnstable County Registry of Deeds Book 27729: Page,231 and shall be binding upon the; Owner and all successors ii title; This Agreement is made fern,the benefit of the M nicipality and the Municipality shall be deemed to be the holder of the ies.triction 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'Iacic of privity.of estate; The covenants and restrictions contained in this Agreement shall be deemed to affect the title to the property.described in a deed recorded herewith as.Barnstable County Registry of Deeds Book 27722 Page 231. IX. Tl:Rini OF AGREEMENT:: Th.e,terni of this Agreement shall be oetbetual,provided;however;that the Owner of.a.Designated 3 Affordable Unit or Units may voluntarily cancel the granted Compicherisive 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 SRId unitand 2)notification by the Owner�of.said.: dwellingto the.7onuig:Board of Appeals of his/hcr desire to cancel the=.Comprehensive pa t:upon a date certain.and°the,recordingof said notice at the Barnstable County Registry of Deeds or:I3arnstablc County Registry of the Land Court as the case may be,thus rendering said Comprehensive'Permat,void: Upon the cancellation of the:comprehensive permit'..the prop11 erty which'is:th'e subject matter of this restrictive.covenantG shall revert to.the use permitted.under robing and the restrictive covenant shall be rendered void: X. SUCCESSORS AND ASSIGNS: A. The Parties to this Agreetiaent intend,declare,and covenant,oil behalf of:themselvcs-.and any successors;. an.dassigns their rights'and-duties as defined in this Regulatory Agreement.and:the attached comprchensivc permit: B. The Owner inten.ds;,declares,and covenants on behalf of itself and its successors;and assigns,(i) that this; Agreemen.t and the covenants,agreements and restrictions contained hereinshall be and are covenant.&running with the land,exicuffiberibg the.Proj.tect for,the term of this Agreement,and are binding upon the Owner's successors in title,(4) are .not merely personal:covenants of the Owner,and(h shall bind the Owner„its- successors and assigns and inure:to the benefit of the Iyiinieipality 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 rwitivntl irty(30)days after notice"to the Owner thereof,then theMoni, in Agent.rriay semi notification:to the Municipalitythat the Owner is in violation of the.terms and conditions hereof, Th Municipality may exercise any remedy available to;it. The Owner willpay all costs and expenses,uicluding,legal fees,incurred bythc Monitoring,Agent' enforcing this.Agreement and the Owner hereby agrees`that:al e Municipality and the.MonitoringAgent will•have a lien on the Project to secure'payrncnt of such costs and expenses. The.Monitoring Agent may perfect such a lien on the-Project by recordinga certificate setting forth: 1 the amount of the costs;and expense due and owing iri the Registry of Deeds or:the Registry of the Disttict:Land Court for Barnstable County. A,purchaser of the Project or any portion..thereofwill be:liable for the payment of any unpaid eo5ts and expenses t atwere'the subject of a perfectedaen prior to the purchaser's acquisition of'fhe Project or portion thereof. XII. Iv10R I UAGEE CONSENT-c The Owner represents and,.varrants that it has,ob.tained.die consent o(all existing inoetgagees;of did-pro Jlect to the execution and recording of diisAgreernent and to the terms and conditions.hereof and that all such rnortgageeshave executed>consent:to this Agreement. .IN'MTNESS WII;EREOF:we hcreun o set our hands-and seals.this _..1.4 th._ day of Novertiber 2018 OWNERS / I?iint4d.:Name /' �„il�rA try' , L' a COMMONWEALTH OF MASSACHUSETTS BA'RhISTABLE,.ss. On this 14 th day o'f November ,201$,befotexne,:the undeislgt cd notary public,•;, personally;appeared ,proved to ine through satisfactory,evidence of identification,being(check whichever applies)" (,) d'river'.s>.license or other state or federal government, document bearing a photographic image,; ( ) oath or.affirmation of a creel blew mess known..6 tne. who knows the above,signatory;or my own personal knowledge of the identity of the s gnatoxy;'to be the.person whose name is signed on the preceding document,,and.acknowleiiged to,:me diat s/he signed it voluntarily for its stated purpose as :Regulatory Agreement as his/her;;,, free act and deed. }\titi, • ` ,y` r Notary:public Not Public. My xp Commission.h ues; ra0 My Commission ExOkea 4y�� •CQ M�A August 21. 2020 TOWN OF B'ARNSTABLE BY; WN`MANAGER COMMONWEALTH OF MASSACHUSE ITS J BARNSTABLE,ss. ^ On.th s / day of } to 201.8 before me the undersi ned.nota'r ub11c 1 y 7rr« personally appeared,� � S; r'S ,proved tame through satisfactory evidcnce:of , rdentifacation,.being (check whichever:applies)" ( ) driver's license, of other state or federal governtiientr ' document bearing a photogra, c image,( )'oath or affix ination of a credible witness known to me who knows the above signatory; or( iy own personal knowledge of the identity of the signatory,to be the person whose name is signed on the preceding document„acid acknowledged to the that s/he signed it voluntarily for its,stated purpose as ,as lus/her free act and deed YQ JOYCE A. P"RSU(TTE N' yPublic ( `�� Notary Public Corninission E% LteS: C.OMMOWEALTH OF MA33ACHUSEl TS y p My Commisslon Expires 5 �:r✓ January 27; 2023 RARNSTARLE REGISTRY OF DEEPS John F, Meade,;Register Town of Barnstable �VE Building Department Services Brian Florence, CBO Building Commissioner BARNSTABI;E B"NSTABLB 9 MASS. 200 Main Street, Hyannis, MA 02601 i63q �� 1639,2014 Argo p www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 AAAP Report To: Anna Brigham, Housing Coordinator From: Brian Florence, Building Commissione Date: 7/30/2018 0� Re: 600 Main Street West Barnstable-Connie Felker—609-502-8078 BuildingOfficial: Brian Florence, orence, Building Commissioner Inspection Date: 4/27/2018 Bedrooms(Unit): 1 Minimum Size: Pass Emergency Egress Windows: Pass Window Height: Pass Number of Egress Doors: Fail Smoke/CO/Heat Detectors: Fail Tenant Separation: Fail Egress Component(s): Doors Pass Conditionally-See Below Stairs/Deck/Landing/Balcony: Pass Guard Rails/Hand Rails: Pass Egress Path to Area of Refuge: Pass Notes and Other Compliance Requirements: • Only one dedicated means of egress where two are required. • Second means passes through owner's area on the first floor. • Smoke detectors are required to be hard wired and interconnected... detectors are battery operated. • Tenant separation does not exist as the structure was constructed as a single- family dwelling. • Second means of egress can be obtained with two (2)twenty(20) minute doors installed in the area of the front entrance. • Recommend considering a variance from the MA Building Code Appeals Board. I t The building components listed above do not represent the totality of 780 CMR,the Massachusetts State building codes requirements. Other Code related matters may be listed as Notes and Other Compliance Requirements(above)and may be included on a j separate page where needed by the code official. Town of Barnstablermit Expires 6 months from issue date arrwsreste Regulatory Services Fee MAe`' Thomas F. Geiler, Director Building Division Tom Perry, CBO, Building Commissioner Q ( 200 Main Street, Hyannis, MA 02601 www,town.barnstab le.ma.us Office: 568-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �} 7 Not Valid without Red X-Press Imprint Map/parcel Number Property Address (c, IW A 0 Z 66 (Residential Value of Work 9 [jtj,(`» Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address er,, ICU) r) mci, t— &—en jilAe Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X-PRESS PERMIT Check one: JUN 1 8 2009 W❑��am a sole proprietor _ I am the Homeowner SOWN OF t13ARNS El have Worker's Compensation Insurance TASL� Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on rile. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to NO b l)C-n rX►S 005 StJ ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. me It pvement Contractors License& Construct Supervisors License is required, SIGNATURE: Q:\WPFILES\FORMS\Express\EXPRESSPERMIT.DOC Revise06O4O9 Q The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Narne(Business/Organization/Individual): Cyr+✓l 2e-A ing (/1 Address: Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-tim.e).* have hired the sub-contractors 6. ❑New construction .2.0 1 am'a sole proprietor or partner-' listed on the attached sheet. T. 0 Remodeling ship and have no employees These sub-contractors have 8. '0 Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp. insurance.$ ] .re uired. 5, We are a corporation and its '10.0 Electrical repairs or additions q 3. 1 am a homeowner doing all work officers have exercised their 11.0 PI mg repairs or additions myself. [No workers' comp. right of exemption per MGL 12. oof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *My 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. xContractors 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 maybe forwarded to the Office of Investigations of the DIATor insurance coverage verification. I do hereby certify under he pains and enalties ofperjury that the information provided above is true and correct. Signature: Date: �a —l go"Q Phone#: U�' -3ca—�t Ito Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: a' In formation rmation and Instructions no ' their employees. e requires all em to ers to provide workers compensation for Massachusetts General Laws chapter 152 r q p y Pursuant to this statute,an employee is deemed as"...every person in.the service of another under any contract of hire, express or implied,oral or written." An employer is define d as"an individual,partnership,artnershi ,association,corporation or other legal entity,or any two or more P Y of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or tiustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwells house having not more than three apartments and who resides therein,or the occupant of the g 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 onto 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-con6actor(s)name(s),address(es)and.phone number(s) along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not.required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the perniit/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 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 home owner or citizen is obtaining a license or permit not related Eo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, Please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSA-FE Fax# 617-72777749 Revised 11-22-06 www.mass..gov/dia Town of Barnstable Regulatory Services sAxtvsrwsr.e. ` Thomas F. Geiler,Director 6 ��� Building Division prED A Tom Perry,Building Commissioner 200 Mairi=Streeter Hyannis; A 02601 __...._. www.town.b arnstabl e_m a.us Office: 50 8-862-403 8 Fax: 509-790-6230 110MMOYMER LICENSE EXEMPTION J Please Print DATE 6 JOB LOCATION: 600 number //_ - street village ri "HOMEOWNER": Sen `42-11 leln �025 - 36._� 1�- 7 R/O name �h-o+mr phone# work phone# CURRENT MAILING ADDRESS: Rib ✓�Goc J I C®G /� / / eityhown state rip 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,Hiles and regulations. The undersigned."homeowner"certifies that.he/she understands the Town of Barpstable,Building Department minirnum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any hoi=wocr performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1 o9.1.1 -Licensing of construction Supervisors);provided that if the hameowner engages a person(s)for hire to do such work,that such Homcowna shall ad 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 liccnsr SupcMsar. 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 thit he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by i several fawns. You may care,t amend and adopt such a fomrlcertrfication.for use inyour community. Q:forms:homccxcmpt t. oFTTati Town of Barnstable ` Regulatory Services 9 xABM is Ba Thomas F.Geiler,Director "' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must " Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. .,(Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. rY � Parcel 6o Permit# LS'I ,2.. Conservation Office(4th floor)(8:30- 9:30/1:00-.2:00) Date Issued lA-a 1 R n1CF-C° 1 T Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) ry`L-;-o 0w!;_raQ �" Fee �13 Engineering Dept. (3rd,floor) House# P-laEn.i t-floor/5-choro1 Adrnin-.-Bldg.) s • BARNSfABLE, pproved®by-Planng Board' J 19 b TOWN OF BARNSTABLE Building Perinit Application �T Proje Stre Address CQoo Village \�, :2=57 .4ja31 - __Q r Owner -- �} �L�, vy J Address & Telephone , ,?k2 Permit Request -%© t First Floor 5& square feet Second Floor �4 square feet Estimated Project Cost $ Zoning District .Z5 Flood Plain A A, Water Protection ^z* Lot Size _�;?i J ACJZ�S Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use' i✓ r�r�� Construction Type �,� - � Commercial ,y,t/, Residential / Dwelling Type: Single Family S Two Family Multi-Family Age of Existing Structure �_� Basement Type: Finished Historic House Unfinished vim' Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel c;o JJ-—-Ak!nrr A ,4 Central Air Fireplaces ) Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number A� Address 1 License#' Loe3%, -.lad Home Improvement Contractor# &Lx,_42�� Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESU TING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - - - DATE BUILDING PERMIT tENIED F R THE F OWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL-NO. ADDRESS J VILLAGE OWNER DATE OF INSPECTION: FOUNDATION L V t f y II FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL-BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. - - � 3 � ♦ t 3 � ; ° C ~ Barnstable The Town of Health lth Safe and Environmental Services � De ariment of t3' Building Division Ma - 367 Main Streck- Hyannis MA O2601 Ralph Ctossea OIIice: sos-79o-6227 Banding Commi F= 508 T75 33" i For office use only Pcanit no. Date AFFMAVIT HOME 3WROVEMENT CONTRACTOR LAW SUPPLEMENT TO PE MM APPLICATION MGL c. 142A requires that the"taonstruction,alterations;renovation,repair,no k=b2tion,conversion, improvement,.remm-4 dentoiition. or construction of an addition to nay pm-ccisting owner 0=1 ICd bniIding caataining at least one but not more than four dwdling units or to sUuc=m which are ad}ac= to such rcsideaoe or banding be done by registered contractors.with certain ercceptrons► along with other tequimraeats. Est. Cost !®. Type of Woric: Address of Work: r� 0vmer.Name: Date of Permit APPiiction: I hereby certifp that: Registration is not required for the following rtason(s): Work coduded by law Job tinder SLOW Budding not oW=_oo=pied OMW pulling MM permu Notice is hereby gh*cn that: OWNERS PULLING THEIR OWN P FOR DEALING I N OT -A CONTRACTORSS TOME FOR APPLICABLE HOME DER ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIG-,MD UNDER PENALTIES OF PERMY I hereby apply for a permit as the agent of the owner: Date Con name Registration No. w .. .►�.. ... ......L' ' T'... . .. ► .• .. The Cuntinat 'ealth of Massachusetts Department of Industrial Accidents A. Oi fceollai lgatfoas 600 !i iexhin uin Street - Buxton,Mass. 02111 �- Workers' Compensation Insurance.A171davit 77 wint T. _ -- -.—, .2 -a3 6 1 am a homeowner performing all wort:myself. I am a sole proprietor and have no one working in any capacity L= PT ❑ 1 am an employer providing workers' compensation for-my employees working on this job. address! ���••• phone#: ' insunince co nnli_n•# ❑ 1 am a sole proprietor,general contractor,or homeowner(cdrrde one)and have hired the contractors listed below who have the following workers' compensation polices: S4QLnm name, 02 address-- phone insurnnce ce�J+ 1�',/�ry/i��� /� �+�1- petict•# �?-C� 1:...�.. ••••^%• •. . •' yGl7/3"..'Q.•'.it1�"�•�.«��.►R'!!KI'a 4�� _ _ _ •77CEiF7�J►E!�••�7..-R.Z'��.T7�.'_=�. _ �-:'_-:�S itimnam•name• address- city: phone#: policy# i�$u■a■rl.e ca Atiach addititioafsheet if tie � —�_ _ _ _r•_�_ Failure to secure eoverace as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to$1.500.00 and/or one.•ears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a cop}•of this statement may be forwa to the OMce of Investigations of the D1A for cores nge verification. t here , c �•under t c n penalties of pedury that the injornmtion provided above is tote and correct Sis►n ate tint name c= H fJ /t'hone official use oniv do not write in this area to be completed by city or town official pertuMieesse#- 7ng Department an or town: �1.1ceusing Board. ` check if immediate response is required OSelectmen's OMcc (3llesith Department contact person: phone fh nUther -Information and Instructions - - - - Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers* compensation for their employees. As quoted from the"law",an empinree 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 ; gal entity, or any two or more the fore�_oing 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 Nou. or on the`rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 1.52 section 25 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. i Additionally. 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 hz been presented to the contracting authority. 7:�;:,�•..:� •:v� .,. •��..:;•T�1:.'.�:i i'ra.. 1 i a.: .,:+ 1. �;.i-;*p r. h� .. "Tr �It•r ••µ'.w.�:,•!9s;.flr..r2'�:.a 1.'Y•'• -•.y•.•_". Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the afiidavit. 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 for regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. '. ,... �....b.r.•,_. ....{ti:. ....., :.•� ?�•: �'i,.•Xa�Y�Tia•�'i+•�L:•.1�(y••::•> T fA� lE7�;r; �.�4 •,�.• City or Towns 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. Plea: be sure to fill in the permitAicense number which will be used as a reference number. The affidavits may be returned tc the 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 questions please do not hesitate to give us a call. r+ r.w..rr..�n.�.nglse�• ...,'; �i �+r.. y......�-►R�..,,nai..r•w.i�..►'i er.i•�ir.•i,:.r'n ^fir ti.aas.e�•:..a• �.�.'v •r?irr: :w:��:• i:..r...» �- '." +."�`�•�'•.'. _ ,. •_�i•..�..:::ra• r corn+ •¢t -++.: 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 fax#: (617)727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 Application to PNEG 0`E�IN � 9 96 p 6 9 Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTI FICATE'OF APPROPRIATENESS Application is hereby made, id triplicate, for the issuance of a Certificate.of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of.Massachusetts, 1973, for proposed_work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ibli� Addition , _ 'Q Alteration .0 4it: .Y Indicate type of building: R House ❑'Garage yr.t4i.0 Commercial Other 12. Exterior Painting: bsi iLp,3' fit$ :yS`, * ? 3 I^;{ olio.: %1 3. Signs or Billboards: ❑ New sign ❑ Existing sign :> ❑ Repainting existing sign 4. Structure: Q Fence r',, ❑ Wall _ c„�,❑ Flagpole ': :ii❑ Other (Please read other side for explanation and requirements). 't•.i_r3 s a rs,^r;i,.itLi? s': T"i! s'i:l"..O s' e0[ f,a { n;y•; 'TYPE OR PRINT LEGIBLY �' DATE - .. •+....- ADDRESS OF PROPOSED WORK Z4-, fAalv4-S-Z"NJ�'��ac�hl-y' ASSESSORS MAP NO. A97 OWNER " ;',4:, , ` ",.. „ '' ASSESSORS LOT NO... ' '40A HOME ADDRESS A29aslzl TEL. N0.�!Z'�?�`L FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public -street or way. (Attach additional sheet if necessary) jJ a'r14r_nsro��. .n2e..w � �(-/rv�� � �Y/drd,2 � �t �LCmaiLLi1Z7 T�/1�' _�+ �4! dJ}p �i� /1L31Z1�Q� ��+0 ��Al Jy+.W E 09 /nG Tut i `AGENT OR CONTRACTOR TEL. NO. �"�- � ADDRESS &--n d-:k-"Zr-;1 �B DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations o--f.new signs. (Attach additional sheet, if necessary). e" n Signed Zn _ Space below line for Committee use. Relceived`b (� p } ; r _ xsts:' 2" Date "°The C ificate is�er y "' } - - Date Time I 1 1996 .� e OI DBYr f, u'Ar3t -' 4 f�vt%1Y TOwigji - Approved ❑ IMPORTA pprov T: If Certificate is a f �li��ltifect�C$the 10 day appeal period — provided in ttie Act.- --- Town of Barnstable Old King's Highway Historic District Committee W SPEC SHEET FOUNDATION ,s,P,�. L "err -•ram SIDING TYPE ' �1,iri 1_ COLOR���-z� ,�� CHIMNEY TYPE f COLOR Or ROOF MATERIALyA,;,4p,} Q PITCH WINDOW7�0' 5,�_ �ze__- k a;ZCw S SIZE/r TRIM COLOR DOORS COLD ,_ SHUTTERS ,6,//j9 GUTTERS DECK �A GARAGE DOORS f /yQ- COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan and elevation plans, when applicable. Plot plan need not be "Certified", but should show all structures on the lot to scale. SPECSHT THE TOWN OFIBARNSTABLE mum NSPECTOR BUILDING I APPLICATION FOR PERMIT TO ........... --.. —.. ................................................... TYPEOF ........................................... .____.. _./.�7_]o~7Z) TO THE INSPECTOR-OF BU1i0NGS The undersigned hereby 000ios for o permit according to the following information: Location —' ...... .�. --------_—.,----------_.. ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. --_-- 1-1 Nome of Owner .—..A66resu ���� ..��°�.. ___ Nome of Builder —. ������'---A66nss ---------------------------.. Nome of Architect ----------------------A66reu -------------------.'________. Number of Rooms --'-------------------Foundotion -----.------.--,__________^. Exterior ---------'RooGng .. '.~���\�!�6�1�� .----- F|oom ' |n���r--.��------------------------. ---.-----------.------------. Heating ---_-----------------------Mumbng ----.. Fireplace ----------------_--..-------.Approximote 4* .........____________. Definitive Plan Approved by Planning Board --------------- ------------ Diagram of Lot and Building with Dimensions SUBJECT TOAPPROVAL OF BOARD OF HEALTH SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE WITH A-J|CLE || STATE SANITARY CODE A'N'D TOWN RE�ULA`/"'', _ �. _� �« ° xe,�Av } � . r ^c,42-- I hereby agree to conform to all the Rules and Regulati f the Town of Baarabl reg rding the above - construction. N 7Ne ... `` .� ~ � � Joo�x�z D. Kenney, Joseph | ' � 161n6 �n� �a �nm .. Permit for ....................................No ............... , ' w * ----.�/������--._. A �~~ ---'���'-------'' � [ -- Main Stree Location ........................ � West Barnstable ' .------------------------- �ommo� D� Owner ----_---����___�������____. frame Typo of Construction -------------- ^ ` ' -------------------'------- ` Plot,----._--- Lot ------.---- ' ^ . - ' ' . ' - 'Permit Granted --Akll..~I�.-----.lg .-�� ' Dote� of Inspection ---..--------lg � Date Completed -- .............................. Y ' � � PERMIT REFUSED . . --.�------------. 19 � —. — ' .. � . 7_^f6��O���r —..����..--.�..—.....—.....----- ^-----.—..--.—.-------------- ~.—.-----.------------.----- ` » --^--------'—'---^'—^—'—^----'''' � ^ Approved ............................................. lV � ^ -----------------------'^--' > ` ................ ^ . f U'. r— f 1 i '.N-1 f 1 I I 1 SCALE: 1 APPROVED BY: DRAWN BY, D K. DATE: , ' _ C.;, REVISED `a ti BER DRAWING NUM V O � / t ll I E SCALE: P APPROVED BY: DRAWN BY DATE: �'T/! � � , . REVISED z S N DRAWING NUMBER 0 T .n , ! r Ll Ll is. _1 El - rr SCALE: ° APPROVED BY: DRAWN B%dD DATE: REVISED �• 1 �- J�z W r i s ING�'•�e�NUMBER � 0 1, I I. r,. W 1 i 1± APPROVED BY: SCALE: , DRAWN BYJ)�_K W DATE: t REVISED �f ' A DRAWING NUMBER Xt . "£ 4 �' .- � •Y.2 S•. -��.p�C 1f ._'�fi ?:h 7�',a-� ugsSF' *..,a��., i - i I - • :ij 'LEM SCALE: ll APPROVED BY: DRAWN SY_JDL Z DATE: REVISED y W ! DR WING MBER d . :.j%_,ipCty�.�.._,�g7[j�y.p ..._.•:�.if ^�r� 3"�• -- .��a-..r._._.. _'.t.:,IYS�"_'. .�.r4`""1,�.. ?Y n �-.,>;aaw+.w..y-._'rs� . 1 _ Y---11 V_ I - FF 2 1 , . J 'I !i + F 111 z 1 ' �(. t ► 1, :.,,Z T t -_y ti�-Ik rt-, A: SCALE: r$�1�,1`r APPROVED BY: DRAWN z w DATE: �,f�.9� REVISED H z a N N g DRAWING NUMBER 0 ® Q Y N- RICe M�r,Orn 3 75 00 �1 ,�8+3oE 46 � INS FE-r w1 D� r� 43,Coo 1* V • /87 Iloll 140 (v�2 ° o ° °58 30 W 4�3.25 0 � A � a 70, 1254-fli-lc7m IV Rice , .70 Q sz� w A W.A Y zs FEE,- wloE A ef. 00 VX. W :� s 60'34=�o'W 28574• .. za4•lo•� N ro �oresf R. ,Brower, of ux. a.�co fore Q Z vl � o � 1 3 BARNS RFG1RY F O BDEEDS � MMj PLAN OF LArJo WE:57- BARNSTABLE. . MASS. <`,PP�'.�'.'.: =1`^ ' .:� , �i=�' i�'.',T IT 5ELOfvG 1"0 TD 1� 35 �� � , . �� �� L�'t'v�'s LAWRENC E S. JOWN50N, ET.Ux. RF rORrFn A;,✓ i /{ SCALE 1 IN =SO Pi-: OCT. Z5.1960 NELSON ��/sRSG�RICHlARL7 -AW, c RVEYORS �►► � CENTERVIILL.E • MASS. •'' �, 'A0" 1.�4•Vq � BAPNSTABLE BOARD OF ,Ut;rd Y NOV I ca G