HomeMy WebLinkAbout0054 WALNUT STREET - Amnesty & MULTI-FAMILY -� o
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Town of Barnstable Permit
Regulatory Services EFee6mor s issr e
s s
• lARNBTABLE, •
Musa. $ Richard V.Scali,Director
Building Division
Paul Roma,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Lnprint
Map/parcel Number
Property Address IA J ML�J tJ T S &Z (G 01
Residential Value of Work$ 3yCC�1. 60 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
4-y 14 AM uT 9 , 14 t kpv ' , MA n z co I
Contractor's Name 7QrA_N Q �2A6LbaX Telephone Number
Home Improvement Contractor License#(if applicable) Email: Se s o rr y C�1 ov S 3_VAjj66Xor—
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one: BU1L®1NC DEPT.
❑ I am a sole proprietor
Z I am the Homeowner 201�
❑ I have Worker's Compensation Insurance
Insurance Company Name r nxjnjta nF BARNSTABLE.
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 'iO uJ P— _WJ 0 N
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
[�Re-side
Replacement Windows/doors/sliders.U=Value N ry�SOR9(maximum.32)#of windows 2
#of doors:
'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
r
SIGNATURE:
QAVYT LESTORNIMbuilding permit formsTMESS.doc
01/25/17
I
The Cowwompeakk ofMaysrdirrsdts
'Department ofinihaftidAcciderds
Qe Of�aficrns
600 Washington S bf wt
Gastrin,CIA.02.M
' tt�v►�tm��aP�iiia
Wkw1mrs' Cgffipensatian Insurance Af Erfiavih Bider-dCiantmchw-, lectdcians/Phm hers
AlmUcant luf6rmatioII -r- P'lease Prim f e F
Addle i� l-�V .�l , �[A tv i J ri� �Z (o O
076o I ten,,• ��S . - bq � - 0311 I
Are you an employer?C heckthe appropriate boor ' Type of project(reqmired}-
I_❑ I Mn a employs With 4 ❑I am a general caairactrr and I 6 ❑New oansfmCtiaa
employees
(fii11 sndfor part-time). listed a
* have hired.the Sub-contradws .a the at died sheet. F. ❑RPmoBe g
2.El I am a sole prop:detoir orgartner-
Eby sub-conffradors base
slip and have no employees &,Q Demolitioa
worling farnm in any capacity: empla $andhace wars' 9. ❑Building addifina .
IMda ' comp.fi m =5 comp_*�+��
5_ ❑ We are a�corpora6oa and ifs ME]Ek#dca repairs or ad&f=
-red] officers have exercised thek
3_ I am.a honumm-er doing a>'work 1L0 Plnmb agrepairs or additions
mysdf a wokkers'ocamp-
eight of ex=pfion per MGL
c.152, hiaveno 1�' Rflofrepairs
instganre re�nir•ed�i §1(�'andwe 13. Ofhe[ W 11\1 D iJ<<J S
employees.[To workers
a.
comp.iasrx mw required_)
`�¢Y gFF&cm�Bsst ched3haa�l must also ffica�ti��secBoab�Taarg�eirarorlcexs'cvmpeIIsatiaupo�yiaforma6o¢L
eawIra submit dais affida[ic ingrea g thv_p aiedai�sIFwaQic and tbeaLrx�a7LtS7dCre ntrarense�s{6abm]tanews8idamt o rnrFt
TCaa�actps$s2d>ecYi}risb�xmmtattarasaddid—slshedsbawingthenameofftsab-cam rs.amdstatewhEdheror not tmseeafdesbxm
emplapes.Ifthemnb-caatradafs1aveemp1gm s,they pmvi&their wwkers'romp.palkynumber_
I out atr eutp�sr$errtisprauidit�it�ar&ers'tattrperisaitart iaszirar�cs,�`ar rri}*empin}�ees ,Se&ity is fhepaTiGy�nazi jef�spa
inforazado L
InsmanceConapany.Nt ame:
Poficy 41 or Sr
If-ms..Lie_ 1piFaliBaDate:
Job Sife A-ddm= CO/Stawrip.
Attach a copy of the markers'coaapensationpolicy declacxtianpage(shacvirig the porky number andpiration date).
Failure to seemm coverage as requiredunder Section 25A of MCL c.IV—can had to the imposition of criminal penalties of a
fine nP to$UOa.Oa andfar one-year imprisonn2wk a$w6ll as civil penalties,in ihe fora of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be adcdsed drat a copy of This zbdemed.may be fkwarded to the Office of
Investigations o€tbe REA far iusumcff coverage 1,Wfrcafion..
I'ri'a&erRFiy car*ituder id s pidns curd peualtixs*fferjuj}'th&;lts irzfarrsra&7t-prm r£rd a jbm g is bars and correct
SiMAUre:f �" Bate- /
Phone ik 1.648-- 6 3` l
t?�rciaL uss rrrtF}. Da oat t�rtte itt tt�axaa;bt Fie i:rrusptetesd�F�artatt�u n,�eiaL ,
City or Toww Pern>iffrA ease#
bmingAmflmr€ty(cudeone):
L Board of He2Ith Bnflding Deparfm•eat 3.City!£own Clem 4.Electrical Fnspector S.Phrmbing Inspector
6.Other
Contact Person: Phone#:
Information and las c-ions
M�ccar-Tmae fS Cretm-1Laws c M reggaes �°y�t° �e onforthen e�fhfir,s. i
13us sib,an elzrploy is defraed as¢— YP�s°nim service of�m ffid=amY tank °f1i�e,
or bnplied,'oral or wryf
as"an indyidual,par(n ,assoflon,coip=Hoa or ofher legal=r y,or any two or more
A CPkt fid $ie I e ives of a deceased employer,or fl= .
of f31e foregoing engaged m&joint else,and including er
associalzon or.. 'rlegal entity,emp10m npmY -- However tho
receiver or trustee of an andrvidaaI,part ship, or the o of ffie-
ow�ner of a dweIIisighnnsehavmgnotmorethmf3=apadmeufs andwho rmddesfi�.erem, -
dweIIiag house of mover who e3ploys perms to do mahtmaa.cet,consk,,, on or=pair woik on such&Ml mg house
or on.f3ie grounds or building agpur[un.anf thereto shallnntbezaase of sanh 121oymedbe deemedto bean.roployer-7
MG`L du pt r 152,§25C(6)also sf�s that¢eymT state nr to c2..t fir=n m9 agency s a withhold ffie issuance or
r ene al of a licex�se or permit to op�E a'iussmess or to contract bwIffings in tfie co�nonwe2lth for any
aPPh�i vvho has notproduced acceptable evidence of cumpr m widx the ks-urance-coVexage required_
Additionally.MCA chapt=152,§25C(7)statas-either the nor;�hy of its political subdivisions shall
enter into any con tract four the perfmmaace Ofpobho work until acceptable evidence of compli.an=wM$ie insurance
rerpz¢e�eamsofPluscbapfeshaveTietnpresemedinfileamtactingM: h0:dtY:'
AppI�caats .
COMP eusafion affidavit completely,by d=kmg the boxes ffiat apply to Your sifnafion and,if
Please flI oixt tile;worms mp n� s es and phonennmber(s)alongwith fheir cert��(s)of
necessary,supply sul-contractor s) e(), ( ) otTher�th0
insurance. Lioaited I-rab�giE,Comp=es(LLG)or Lmlit$d Liab�ity Parise uFs(LLP)w n° e�pl°yees
members or pm aexs,are not rbqil'--d to carry wm'm e compensation msc ce If an L C or r I13 does have
employees,&policy is BeadvisedthetthisafddayitmaybesabmY�dt°theDeparmentofThdasirial
Accid�for confmmahnn of insnraa ce coverage Also be sore to sign and date the af2tdavii: The affidavit should
beretomed to ib e city or tnwnf3iat the application for ffie peratit or license is being regw--&ed,not fhe Department of
te- dyou ate,4 ®s regag f3ie law or ifyoa are
rTA regr�ed fn ob�m awozitcrs'
lease call the D artm—t at flu-,number listed.below=
elf-fi mmce license Se1f ios��d OO�anies sTionId enema fjieir
compe�sationpofiey,P �
s giber on the approlniafia line.
City or Towa Officials
t
Please be sure that tfie affidavit is complete:audprioted.legibl-.f. The Department has provided a space at ffie bottom
of the affidavit for Put[)frll orrf iathe event the Office oflnvmffgatinnc has to contactyotlrega gi -m applicant
P lease be sure to fill in the pe�itllicense number which vM be used as a r 5f=ce [amber. In ad dition,an applicant
that must sobmil n>_ul*le pe=1llic=s;o apph in any gw=year,need-only sabmit one affidavit indicating cm1wt
policy in fouuaiioa(rf n 5')and under"lob 55e t 2&csd-tie applicaat Should wrif-"aU l ocafi.:ns is ( Y or
;own)»A copy of the.aff davitf3iat has bey officially s'taaiped or maimed by�e�Y or town may be provided to fine '
applicant as prooff3zat a valid affidavit is on file for ft�e•pemi►s O1 licenses A new aff davit�st be f Med oin each
year.Where a home owner or citizen is obtaining a license or pew not related in any business or�mmMcial v
tntaM
(ie.a dog license orpmmit to branleaves e#c.)said pegson is MOT to��Iete this affidavit
The Office of TnVeSdgaffi=wouldBlom-fothankyouin.a&mcofor yourcoopmadon and shouldyouhaveanygao ons-
please do nothw ate to� a C�z
The.Depaxtn-mf's addressy telephone and fax number -
-Tila Co=M Bata of ma=ch
Degazimmtof1-& AmUauts
`Fed.4 61 I-T27-49W mt 4€6 or 14 MA M
Fax#617 72'-'749
Bevised¢24-07 - m 9trIER-
Town of Barnstable
Regulatory Services
�� of Richard V.Scali,Director
Building Division
`MASS. ` Paul Roma,Building Commissioner
1 200 Main Street, Hyannis,MA 02601
EO www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
DATE: 27 1 7 Please Print
JOB LOCATION:_ Yq
number street / c village
"HOMEOWNER": V�Q Pam" k�fl(�1 TCA&(SSA 1O�d 7 p O 3 L
name ,,QQ` home phone# work phone#
CURRENT MAILING ADDRESS: VyAl�4lJ�'r
l�vA N6_2 r 5
:ity/town state. zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings'of six units or less and to allow
homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. .
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or.is intended to be,a one or two-
family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one
home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be responsible for all such-work performed under the buil i permit (Section
109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
procedures and requirements he/she will comply with said procedures and requirements.
Sign of Homeowner
Approval of Building Official
Note: Three-family dwellings.containing 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt
from the provisions of this section(Section 109.1.1 Licensing of construction Supervisors);provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often
results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot
proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is
ultimately responsible.
To ensure that the homeowner,is fully aware of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page
this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in
your community.
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
06/20/16
• M
Town of Barnstable
$ Regulatory Services
Richard V.Scali,Director
ELAM
,�„ • Building Division.
Paul Roma,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 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)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date
Q:FORMS:OWNMPERMISSIONPOOIS
STv
Tow -of Barnstable
Expires 6 months from issue
Regulatory Services Fee
1e39. �e�: Thomas F. Geiler;Director .
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601. '
www.towmbarnstable.ma us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
f� of Vaffd without Red X-Press Lnprint
Map/parcel Number 1. V 0 '
oP y.Address l T YLA106j i`,\ ! 67ZL-01
V /
Residential Value of Work C>r'�, (� Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address j A"[
11,J11LA,* 1s . l-�.AA�v� I�1A C zn
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑workman's Compensation Insurance -PRESS PERMIT
Check one:
❑ I am a sole proprietor SEP 2 20�2
I am the Homeowner ._
.. ❑ I have Worker's Compensation Insurance
Insurance Company Name TOWN OF BARNSTABLE
Woriman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑,Re-roof(hurricane nailed)(not stripping. Going over exist ing'layers of root) .
Re-side
#of doors I
replacement Windows/doors/sliders.U-Value (maximum 35)#of windows
❑ Smoke/Carbon-Monoxide detectors 4 floor plans marked with red S and inspections required. .
Separate.Electrical&Fire Permits required.
*Where required- Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&'Constru
required, ction Supervisors License is
. i
SIGNATURE:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
+ d 600 Washington Street
Boston,MA 02111
`�N ,• �� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): yrj 1iA,T ah i1,lL
Address: lmI 11u —
City/State/Zip: NAVUtW / hone.#: A
Are you an employer?Check the appropriate box: Type of project(required):.
1.❑ I am a employer.with 4. ❑ I am a general contractor and I
employees(full and/or.part-time).
1. * have hired the sub-contractors 6. New construction . .
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor me in an capacity. employees and have workers'
Y ]? tY• $ . 9. ❑Building addition
[No workers' comp.insurance comp.insurance.
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3 I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t . c. 152, §1(4),and we have no
employees. [No workers' 13.❑ Other
comp.insurance required.] .
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.M Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Simafore: Date: Z /
Phone#: i U
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#:
L
}
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of.the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced 1 acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority.".
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office,of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone-and fax number:
The CommQnweaith of Massachusetts
Departrnent of Industrial Accidents
Office Of IRV.estlgat ons
600 Washington Street
Boston, MA 0.2111
Tel. #t`617--727-4900 ext 406 or 1-877-MASSAFE
Revised 11-22-06 Fax#617-727-7749
www.mass.gov/dia
THE r° Town of Barnstable }
Regulatory Services
�s�ttvszeac.E Thomas F.Geiler,Director
p ,J�A Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstabl&.ma.us
Office: 508-862-403 8. Fax: 508-790-623 0
Property Owner Must
Complete and Sign This Section
If Using A Builder
h , as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized.by this building permit:
(Address of Job)_.
**Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date
Q:FORM&OWNERPERMISSIONPOOLS 6/2012
Town. of Barnstable
Regulatory Sendees
. )3A�ST,mIX « Thomas F.Geiler,Director
Mass.
9`bp s639• ..� Building Division
rFC MPS A '
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.b arnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: 77 (,,-)A /l J(> !J Y �,J WI A
number street village
"HOMEOWNER": IUAT IA6,IQ WOgc
name home phone# work phone#
CURRENT MAILING ADDRESS: S q L.L—,,fq L
VF�ryly l 5 . in A
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to xeside,on which there is, or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other-
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Si re of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is.required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use.this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot p-oceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
_ Town of Barnstable ��� ��
Op1HE tpk *Permit#
j' _4�11 ti� Expires 6 month issue to -
Re ulato Services Pee
g rY
►I i3ARNSTABIX, +'
y etAss.
c� 039, � Thomas F. Geiler,Director 1
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstab le.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number b cm
\
Property Address VVA I--i'LiU`l - 0\
Residential Value of Work 2 6- 00 Minimum fee of$35.00 for work under$6000.00
((Owner's Name& Address co t`I A-T)a A N �(���,C=QsA
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
ITConstruction Supervisor's License#(if applicable) v
❑Workman's Compensation Insurance in, 2011
Check one: - .a
❑ I am a sole proprietor -
®` I am the Homeowner 'TOWN OF SARNSTABLt.
❑ I'have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roof)
[p Re-side
#of doors 2
�] Replacement Windows/doors/sliders. U-Value ftj '.Z OI J(maximum .44)#of windows /
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign h'
ProP er Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
• Q:\WHILES\FORMS\buil g permit forms\EXPRESS.doc
Revised 070110
IL
I -
, , The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
y f 600 Washington Street
' Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individue): 30 FN
Address: W/,�7UQ Lr rt j L
`/AreCity/State/Zip: a iv i f� Phone#: rODemolition
you an employer?Check the appropriate box:
1.❑ Iam a employer with 4. ❑ I am a general contractor and I . ject(required):employees(full and/or part-time).* have hired the sub-contractorsconstruction
2.❑ I am a sole proprietor or parrtneer- listed on the attached sheet. deling
ship and have no employees These sub-contractors have lition
working for me in any capacity. employees and have workers'[No workers' co .in��nce c .hmzance•l ng addition
mp omPrequired.] 5. [] We are a corporation and its . cal repairs or additions
3• I am a homeowner doing all work officers have exercised their 1 I. Plumbin
mysely [No workers' comp. right of exemption per MGL g repairs or additions
insurance required]t c. 152, §1(4), and we have no 12•❑Roof repairs
employees. [No workers' 13.0 Other
comp• insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew afridavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and static whether or not those entities have
employees If the sub-contractors have employees,they must provide their workers'co Policy manber,COMP,P cY
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(shouting the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c..152 can lead to the imposition of criminal penalties of a
fine up to$1,500..00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains andpenalkes ofpv jury that the information provided above is true and correct
.Signature:one Date: 2
Ph #: —A
F[6. Other
only. Do not write in this area, to be completed by city or town official
Town: PermitUcease#
hority(circle one):
Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
son: Phone#:
of ZFIE Town of Barnstable
_
Regulatory Services
BMWSTABLE, : Thomas F.Geiler,Director
MASS.
9�p 039. ••�a g Buildin Division
rFo Ntp�
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: /11
JOB LOCATION: j <� /7Z�/v �ac r 1
number street village
.HOMEOWNER":_ ZlWfVi)A AyV
name home phone# ,v* work phone#
CURRENT MAILING ADDRESS:
YVAAJAsj MA 112(W
Eity/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit (Section l09.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Sign a of Homeowner _
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
�IK Town of Barnstable
Regulatory Services
BARNSTABLE,
MA & Thomas F.Geiler,Director
t659. �� Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-623 0
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.
(Address of job)
Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled before fence is installed and pools are not to be
utilized until all final inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date
Q:FORM&O W NERPERMIS SIONPOOLS
- / T
Town of Barnstable *Permit#
,per 'b Expires 6 months from issue date
Regulatory Services Fee
BARNSTABM
9� b 9 A`0� Thomas F. Geiler.,Director /L�
Building Division . -PRESS PERMIT
Tom Perry,CBO, Building Commissioner LIAR 2 3 '2010
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us TOWN OF SARNSTABl E
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 3/o Property Address 5 t W At IV U I J- L'V A A 2 AJ ( 5" 1^��`' l A
(]Residential Value of Work r L�C� .00 Minimum fee of$2S.00 for work under$6060.00
Owner's Name&Address A,1 VA A C%.� ` 1 tz,Ac, o A
4 A
Contractor's Name 0;A /, t" f)L.t0 rU F?n Telephone Number e-f
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
Re-roof(stripping old shingles) All construction debris will be to l'yid S
❑Re-roof(not stripping. Going over existing layers of roof)
'� Re-side
#of doors n�
rM Replacement Windows/doors/sliders.U-Value (maximum .44)#of windows
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
req r
SIGNATURE: '
1�-- _..._......._
Q:\WPFILES\FORMS\building ermit forms\EXPRESS.doc
Revised 090809
The Commonwealth of Massachusetts
Department of Industrial Accidents
{ Office of Investigations
600 Washington Street
Boston, MA 02111
f www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): 7nos)Aa t4 A"1V (ZA6:60T
Address: tTJ WA L_fU UT ` T V lV ty
City/State/Zip: Ivl'Vi ,01 Phone #: Q —
Are you an employer? Check the appropriate box: Type of project(required):
4. I am a general contractor and I yp p J
1.❑ I am a employer with ❑ g 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
require
d.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
q ] officers have exercised their l 1. Plumbing repairs or additions
� 3.� I am a homeowner doing all work ❑ g P
myself._[No workers'comp. ..right of exemption per MGL
P _ , —T __.r: __12.K..Roof_repairs
insurance required.] t c. 152,§1(4),and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins. Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the.Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certi under the pains andpenalties ofperjury that the information provided above is true and correct.
Si nattue: Date: `,3 / 6
Phone#: ((, p — 63H
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall nWt because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, 25C 7 states"Neither the commonwealth nor an of its political subdivisions shall
P § ( ) Y
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been.presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s) along with their certificate(s)of
insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,-are not required to cai=ry worke s'compensation-nsuiance. If an LLC or-LL:P does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below, Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 4-24-07
www.inass.gov/dia
�JHE roh Town of Barnstable
Regulatory Services
BARNSTABLE'$ Thomas F. Geiler,Director
16.39. Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Pax: 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.
Town of Barnstable
F�riE T�
Regulatory Services
Thomas F. Geiler,Director
sAarlsrABr.e,
9� Building Division
plfD "�a Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barDstable.ma.us
Gffice: 508-862-4038 Fax: 508-790-6230
nomEOWNER LICENSE EXEMPTION
2 Please Print
DATE: J1-2-1110
JOB LOCATION: 6- WALO ' A�IUA."Is
number street Village
Lq
„HOMEOWNER �nNA 1 Y�IV t�L ��-C��trt ✓�0 ��I b' bay I �-�O`��d�
name / home phone# work phone tl
CURRENT MAILING ADDRESS: J 1 "At'vLrr 6
InA
city state zip code
-- -----
The current exemption for"homeowners"was extended to include owner-occupied-dwellings-of-six-uni.ts_or_less_and ___
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to
be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
require e
Sig re of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages.a person(s)for hire to dQ such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when.the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a fomi/certification for use in your community.
Q:\WPF.ILES\FOR\4S\homeexrmpLDOC
�tKKE► Town of Barnstable
Regulatory Services
• s,►xi RMBLE,
9 �. Thomas F. Geiler, Director
0 9.�AlFOMplA 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
February 26, 2008
Mr. and Mrs. Jonathan D. Fragosa
54 Walnut Street
Hyannis, MA 02601
Re: Amnesty Apartment
54 Walnut Street
Dear Mr. and Mrs. Fragosa:
Enclosed is the Certificate of Occupancy for your Amnesty apartment.
We have prepared the Amnesty Certificate of Compliance and forwarded it to the
Amnesty Program Coordinator.
Sincerely,
Lois Barry
Division Assistant
Enclosure
amnco
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�THETn..� Town of Barnstable
Building Department - 200 Main Street
BARNSTABLE, = Hyannis, MA 02601
9� MASS. (508)
i63q. 862-4038
Certificate of Occupancy
Application Number: 200800841 CO Number: 20080039
Parcel ID: 310045 CO Issue Date: 02/25108
Location: 54 WALNUT STREET (HYANNIS) Zoning Classification: RESIDENCE B DISTRICT
Village: HYANNIS
Gen Contractor: PROPERTY OWNER Permit Type: RC00
CERTIFICATE OF OCCUPANCY RES
Comments: AMNESTY APARTMENT ISSUED TO JONATHAN D. & JENNY E. FRAGOSA
0
Building Department Signature Date Signed
�INEr TOWN OF BARNSTABLE Building
Application Ref: 200800841 BARNSTABLE, Issue Date: 02/14/08 Permit
9 MASS.
�A i639• Applicant: FRAGOSA JONATHAN D&JENNY E
rFG MAC A Permit Number: B 20080299
Proposed Use: SINGLE FAMILY HOME Expiration Date: 08/13/08
[Location 54 WALNUT STREET (HYANNIS)oning District RB Permit Type: AMNESTY APT NO CONSTRUCT RES
Map Parcel 310045 Permit Fee$ 25.00 Contractor PROPERTY OWNER
Village HYANNIS App Fee$ License Num
Est Construction Cost$ 0
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
EXISTING STUDIO,LOWER LEVEL THIS CARD MUST BE KEPT POSTED UNTIL FINAL
INSPECTION HAS BEEN MADE. WHERE A
CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH
Owner on Record: FRAGOSA,JONATHAN D 8r JENNY E BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL
Address: 54 WALNUT ST INSPECTION HA7BE MADE.
Q.,".
HYANNIS, MA 02601
Application Entered by: LB Building Permit Issued By:
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK ORANY PART,THEREOF,EITHER TEMPORARI 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 MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.
THE ISSUANCE OFTHIS 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).
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BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
2 2 2 .
` 3 1 Heating Inspection Approvals Engineering Dept
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Fire Dept 2 Board of Health
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t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel Application
Health Division
Conservation Division Permit#
Tax Collector Date Issued
Treasurer Application Fee
Planning Dept. Permit Feed
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address
Village o
Owner Address
Telephone ' 03
Permit Request '(,�3So1
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Square feet: 1st floor:existing 1 b52 proposed 2nd floor:existing 5�''� proposed 0 Total new
Zoning District Flood Plain Groundwater Overlay W
Project Valuation Construction Type
Lot Size 0 i 214 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes L/No On Old King's Highway: ❑Yes L"No
Basement Type: /Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) 10 Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing 1— new ® Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths):existing new_ First Floor Room Count
Heat Type and Fuel: ❑Gas 00il ❑ Electric ❑Other 1Z AD I Al A KS
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Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes XNo
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existp ❑nqw, size
Attached garage:❑existing ❑new size Shed: existing ❑new sizeqaftO,her:
Zoning Board of Appeals Authorization C Appeal# 24- M Recorded❑
Commercial ❑Yes U(No If yes,site plan review#
Current Use rl U�L�� ��� Proposed Use
BUILDER INFORMATION
Name 6W A)e_, Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE Z 1151 ®
FOR OFFICIAL USE ONLY
PERMIT NO. -
DATE ISSUED
3 MAP/PARCEL NO.
3 ..
ADDRESS- VILLAGE
OWNER
1
DATE OF INSPECTION: E _
FOUNDATION
FRAME
INSULATION
FIREPLACE `
ELECTRICAL: ROUGH FINALy
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
i FINAL BUILDING e-=
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DATE CLOSED OUT
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ASSOCIATION PLAN NO. - f
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&AMSTASM 907 OCT 11 P 4 '2
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Town of Barnstable
Zoning Board of Appeals
Comprehensive Permit Decision and Notice
Appeal 2007-088-Fragosa
Decision-Chapter 40B Comprehensive Permit
Applicants: Jonathan D. Fragosa&Jenny E. Fragosa
Property Address: 54 Walnut Street,Hyannis, MA
Assessor's Map/Parcel: Map 310,Parcel 045
Residential B Zoning g District
Applicants:
The applicants are Jonathan Fragosa and Jenny Fragosa,who reside at 54 Walnut Street, Hyannis,MA.
Mr. & Mrs. Fragosa were granted title to the property by deed recorded in the Barnstable County
Registry of Deeds on April 13, 2005 as recorded in Book 19719, Page 224.
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 within a single-family owner-
occupied residential dwelling. The issuance of this Comprehensive Permit would allow for an accessory
affordable apartment unit in the lower level of the principal residence.
Locus and Background:
The property at issue is a 0.24-acre lot located at 54 Walnut Street, Hyannis,MA. The lot was developed
in 1941 with a single-family conventional style home. The effective living area of the main residence is
1,834 square feet. The accessory apartment is a studio unit located in the lower level of the principal
residence. The square footage of the rental area is approximately 550 square feet.
The lot is served by public water and sewer, and is located within a Wellhead Protection Overlay
District. The town of Barnstable's Public Health Division reviewed the application, and on July 9, 2007,
approved a total of four(4)bedrooms at the property.
Procedural Summary:
A site approval letter was issued for the property by Town Manager John Klimm on August 7, 2007, 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 August 31, 2007 and September 7, 2007, and notices were sent to all abutters in
accordance with MGL Chapter 40B.
On September 26, 2007 Hearing Officer Gail Nightingale presided over the public hearing. The
applicants, Jonathan D. Fragosa and Jenny E. Fragosa, were present at the hearing. Madeline Taylor of
the Growth Management Department was also present. Ms.Nightingale reviewed the file with the
applicants to ensure compliance with all of the program requirements.
Findings of Fact on the Comprehensive Permit:
At the hearing on September 26, 2007 the Hearing Officer made the following findings of fact:
1. The applicants are Jonathan and Jenny Fragosa who reside at 54 Walnut Street, Hyannis, MA. They
are requesting a Comprehensive Permit to convert an existing studio apartment located in the lower
level of the principal residence into an accessory affordable apartment. The conversion of the unit to
an accessory affordable unit within a single-family owner-occupied residential dwelling qualifies for
the "Accessory Affordable Apartment Program."
2. Jonathan and Jenny Fragosa were granted title to the property by deed recorded in the Barnstable
County Registry of Deeds on April 13, 2005 as recorded in Book 19719, Page 224.
3. On August 7, 2007 a site approval letter was issued for the property by Town Manager John
Klimm, 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 550 square feet, and is located in the
lower level of the principal dwelling.
5. The applicants are 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 sewer and is in an identified Wellhead Protection Overlay
District. The proposal has been reviewed by Thomas McKean, Health Director, and he has approved a
total of four(4)bedrooms at the property.
7. On July 9, 2007 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 applicants understand 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
September 26, 2007 6.63%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.
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Finding Summary:
:
Based upon the findings, the Hearing Officer ruled that the applicants have standing to apply for a
Comprehensive Permit under MGL Chapter 40B and the Town of Barnstable's Accessory Affordable
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, Jonathan and Jenny Fragosa. It is issued to allow for a studio accessory
affordable apartment unit in accordance with the following conditions:
1. Occupancy of the affordable unit shall not exceed one person.
2. The total number of bedrooms on the property shall not exceed four(4).
3. The property owner 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 and no lodgers shall
be permitted for the duration of the comprehensive permit.
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 applicants 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
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the affidavit. Upon any report from the town that the terms and conditions of this permit are not
being upheld,the Zoning Board of Appeals or it's Hearing Officer shall have the ability to hold a
hearing to show cause as to why this permit should not be revoked.
12. This Comprehensive Permit shall not be transferable to any other person or entity without the
prior approval�of the Hearing Officer or Zoning Board of Appeals. This decision,the Regulatory
Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed
at the Barnstable County Registry of Deeds. If the ownership of the property is transferred,the
Growth Management Department of the town of Barnstable shall be notified within 60 days of the
name and address of the new owner.
13. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its
issuance or it shall expire.
Ordered:
Comprehensive Permit 2007-088 has been granted with conditions. A written copy of this decision shall
be forwarded to the Zoning Board of Appeal as required by the Town of Barnstable Administrative Code
Chapter 241, section 11. If after fourteen (14) days from that transmittal the Members of the Zoning
Board of Appeals takes no action to reverse the decision,this decision shall become final and a copy
shall be the filed in the office of the Town Clerk.
Appeals of the final decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL
Chapter 40A, Section 17,within twenty(20)days after the date of the filing of this decision in the office
of the Town Clerk. The applicants have the right to appeal this decision as outlined in MGL Chapter
40B,Section 22.
In accordance with Chapter 241, section 11.of the Town of Barnstable Administrative Code, the hearing
officer transmitted a written copy of the Comprehensive Permit decision to the Zoning Board of Appeals
on September 26, 2007. Fourteen (14) days have elapsed since the transmittal to the Board, and no
Board Member has taken action to reverse the decision.
la167
Ga' Nightingale, earingAffilcer Date Signed `-` +
I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, MassachusjtK hereiy,c ffy
that twenty20 days have elapsed since the Zoning Board of Appeals filed this decisiprt-n d th
( ) Y P g PP � tu
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appeal of the decision has ban filed in the office of the Town Clerk.
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Signed and sealed this —day Of under the pains and peiiyj l)its.o �u :f,w
Linda Hutchenrider, Town Clerk
I
BARNSTABLE REGISTRY of DEEa2 4
22539 F 9291
REGULATORY AGREEMENT
AND DECLARATION OF RESTRICTIVE COVENANTS DEC 0 � 2007
GRO TH M GEMENT THIS REGULA Y AGREEMENT and DECLARATION OF RESTRICTIVE COVE ,
this day of f A-Or 2007,by and between Jonathan and Jenny Fragosa of 54 Walnut
Str eta ,Hyannis,MA and its successors and assigns (hereinafter the "Owner',and the TOWN OF
BARNSTABLE (the"Municipality"),a political subdivision of the Commonwealth; '
WHEREAS the Owner has been granted a Comprehensive Permit under Massachusetts General Law Chapter
40B and local regulations by the Zoning Board of Appeals to permit the creation of an accessory apartment in
an owner occupied dwelling which will be rented to a Low or Moderate Income Person/ Family(hereinafter
"Designated Affordable Unit");and
NOW THEREFORE,in mutual consideration of the agreements and covenants contained herein, and other
good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties agree
as follows:
I. PROJECT SCOPE AND DESIGN:
A. The terms of this Agreement and Covenant regulate the property located at 54 Walnut Street,
Hyannis, MA as further described in deed recorded herewith as Barnstable County Registry of Deeds
Book 19719, Page 224.
B. The Project located at 54 Walnut Street,Hyannis 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. 2007-088 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 2-7-5 39
Page'11-1:61r[
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:
1 In receiving the comprehensive permit to create the Designated Affordable unit, the Owner agreed that
the Designated Affordable Unit shall be set aside in perpetuity for the public purpose of providing safe and
decent housing to persons earning at or below 80% of the area median income of Barnstable Metropolitan
Statistical Area (MSA) and that the Designated Affordable Unit shall be deemed to be impressed with a public
trust.
2. The Designated Affordable Unit shall be rented in perpetuity to a household with a maximum income
of 80%of the Area Median Income (AMI) of Barnstable MSA and that rent(including utilities) shall not exceed
an amount that is affordable to a household whose income is 80% of the median income of Barnstable MSA. In
the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority
shall be deducted from the rent level.
3. The Designated Affordable Unit will be retained as a permanent,year round rental dwelling unit with at
least a one-year lease.
4. The Owner has the full legal right,power and authority to execute and deliver this Agreement.
5. The execution and performance of this Agreement by the Owner will not violate or,as applicable,has
not violated any provision of law,rule or regulation,or any order of any court or other agency or governmental
body,and will not violate or, as applicable,has not violated any provision of any indenture,agreement,mortgage,
I
mortgage note,or other instrument to which the Owner is a party or by which it or the Owner is bound,will not
result in the creation or imposition of any prohibited encumbrance of any nature.
6. The Owner, at the time of execution and delivery of this Agreement,has good,clear marketable title to
the premises.
7. There is no action,suit or proceeding at law or in equity or by or before any governmental
instrumentality or other agency now pending,or,to the knowledge of the Owner,threatened against or affecting
it, or any of its properties or rights,which,if adversely determined,would materially impair its right to carry on
business substantially as now conducted(and as now contemplated by this Agreement) or would materially
adversely affect its financial condition.
B. COMPLIANCE
The Owner hereby agrees that any and all requirements of the laws of the Commonwealth of
Massachusetts to be satisfied in order for the provisions of this Agreement to constitute restrictions and
covenants running with the land shall be deemed to be satisfied in full and that any requirements of privileges of
estate are also deemed to be satisfied in full.
C. LIMITATION ON PROFITS
1. The Owner agrees to limit his/her profit by renting the Designated Affordable Unit in perpetuity to a
household with a maximum income of 80%or less of the Area Median Income (AMI) of Barnstable
Metropolitan Statistical Area (MSA) and that rent(including utilities) shall not exceed an amount that is
affordable to a household whose income is 80% of the median income of Barnstable MSA. In the event that
utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be
deducted from the rent.
2. The Owner shall annually deliver to the Municipality and to the Monitoring Agent,as designated by the
Town Manager,proof that the Designated Affordable Unit is rented,the tenant's income verification,a copy of
the lease agreement and the rent charged for the unit or units. Such information shall also be forwarded to the
Monitoring Agent within 30 days of the occupation of the dwelling unit or units by a new tenant. The Owner
shall notify the Monitoring Agent, as designated by the Town Manager,within thirty(30) days of the date that a
tenant has vacated the Designated Affordable Unit.
III. MUNICIPALITY COVENANTS AND RESPONSIBILITIES
1. The MUNICIPALITY,through the monitoring agent designated by the Town Manager agrees to
perform the duties of verifying that the Designated Affordable Unit is being rented in perpetuity to a household
with a maximum income of 80%or less of the Area Median Income(AMI) of Barnstable MSA and that rent
(including utilities) shall not exceed an amount that is affordable to a household whose income is 80%of the
median income of Barnstable MSA. In the evert that utilities are separately metered,a utility allowance
established by the Barnstable Housing Authority shall be deducted from the rent.
IV. RECORDING OF AGREEMENT:
Upon execution,the OWNER shall immediately cause this Agreement and any amendments hereto to
be recorded with the Registry of Deeds for Barnstable County or,if the Project consists in whole or in part of
registered land, file this Agreement and any amendments hereto with the Registry District of the Barnstable
Land Court(collectively hereinafter the"Registry of Deeds"),and the Owner shall pay all fees and charges
incurred in connection therewith. Upon recording or filling,as applicable,the Owner shall immediately transmit
to the Municipality evidence of such recording or filing including the date and instrument,book and page or
registration number of the Agreement.
2
V. GOVERNING OF AGREEMENT:
This Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any
amendments to this Agreement must be in writing and executed by all of the parties hereto. The invalidity of
any clause,part or provision of this Agreement shall not affect the validity of the remaining portions hereof.
VI. NOTICE:
All notices to be given pursuant to this Agreement shall be in writing and shall be deemed given when
delivered by hand or when mailed by certified or registered mail,postage prepaid,return receipt requested,to the
parties hereto at the addresses set forth below, or to such other place as a party may from time to time designate
by written notice.
VII. HOLD HARMLESS:
The Owner hereby agrees to indemnify and hold harmless the Municipality and/or its delegate from any
and all actions or inactions by the Owner,its agents, servants or employees which result in claims made against
Municipality and/or its delegate,including but not limited to awards,judgments,out-of-pocket expenses and
attorney's fees necessitated by such actions.
VIII. ENTIRE UNDERSTANDING:
A. This Agreement shall constitute the entire understanding between the parties and any amendments or
changes hereto must be in writing,executed by the parties,and appended to this document.
B. This Agreement and all of the covenants, agreements and restrictions contained herein shall be deemed
to be for the public purpose of providing safe affordable housing and shall be deemed to be, and by these
presents are,granted by the Owner to run in perpetuity in favor of and be held by the Municipality as any other
permanent restriction held by a governmental body as that term is used in MGL Ch. 184, Section 26 which shall
run with the land described in deed recorded herewith as Barnstable County Registry of Deeds Book
19719, Page 224 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 19719, Page 224.
IX. TERM OF AGREEMENT:
The term of this Agreement shall be perpetual,provided,however,that the Owner of a Designated
Affordable Unit or Units may voluntarily cancel the granted Comprehensive Permit and the terms and
restrictions imposed herein. Such cancellation shall only take effect after: 1) expiration of the lease terms
entered into between the Owner and Tenant occupying said unit and 2) notification by the Owner of said
dwelling to the Zoning Board of Appeals of his/her desire to cancel the Comprehensive permit upon a date
certain and the recording of said notice at the Barnstable County Registry of Deeds or Barnstable County
Registry of the Land Court as the case may be,thus rendering said Comprehensive Permit void. Upon the
cancellation of the comprehensive permit,the property which is the subject matter of this restrictive covenant
shall revert to the use permitted under zoning and the restrictive covenant shall be rendered void.
X. SUCCESSORS AND ASSIGNS:
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A. The Parties to this Agreement intend,declare,and covenant on behalf of themselves and any successors
and assigns their rights and duties as defined in this Regulatory Agreement and the attached comprehensive
permit.
B. The Owner intends,declares,and covenants on behalf of itself and its successors and assigns (i) that this
Agreement and the covenants,agreements and restrictions contained herein shall be and are covenants running
with the land,encumbering the Project for the term of this Agreement,and are binding upon the Owner's
successors in title, (ii) are not 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 alien 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
Court for Barnstable County. A purchaser of the Project or any portion thereof will be liable for the payment of
any unpaid costs and expenses that were the subject of a perfected lien prior to the purchaser's acquisition of the
Project or portion thereof.
XII. MORTGAGEE CONSENT:
The Owner represents and warrants that it has obtained the consent of all existing mortgagees of the Project to
the execution and recording of this Agreement and to the terms and conditions hereof and that all such
mortgagees have executed consent to this Agreement.
IN WITNESS WHEREOF,we hereunto set our hands and seals this day of�D&_P!'1'1r 2007.
OWNER OWNER
BY: BY: —
Signature Signature
Vo
Printed:Jonathan D. Fragosa Printed:Jenn . Fragosa
COMMONWEALTH OF MASSACHUSETTS
County of Barnstab e,ss:
On this day of 6 07 before me,the undersigned notary public,personally appeared
( n QM �C'r'Q1 1j{��{cLG&the Owner(s),proved to me through satisfactory evidence
of identification,which were N A -1)[ , to be the person(s)whose
name(s)is signed on the precedin or attached document and acknowledged to be that he/she signed it
voluntarily for the stated purpo es.
Not
ary ary Public DORINDA A. TOLLIOS
�v0�l sgsed �, My Commission Expires Notary Public
tQ y r Commonwealth of Massachusetts
My Commission Expires
August,22, 2$14
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TOWN OF BARNSTABLE
BY: l
TO MANAGER
COMMONWEALTH OF MASSACHUSETTS
County of Barnstable,ss:
On this day o tC 2007 before me, the undersigned notary public,personally appeared
the Town Manager for the Town of Barnstable,proved to me through satisfactory
evidence of identification,which were,DPr piyiilu kilruh ,to be the person whose name is signed on
the.preceding or attached document at�d acknowledged to be that he/she signed it voluntarily for the stated
purposes.
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Notary Public
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BAMSrABLE, : Regulatory Services
9�b039. .�� Thomas F. Geiler, Director
QED MA'1 A
Building Division
Tom Perry Building Commissioner
200 Main Street, Hyannis, MA 02601
Office: 508-862-4038 Fax: 508-790-6230
January 28, 2008
Mr. & Mrs. Jonathan Fragosa
54 Walnut Street
Hyannis, MA 02601
Re: Proposed Accessory Affordable Apartment
Dear Mr. & Mrs. Fragosa:
We have received the recorded Regulatory Agreement and Comprehensive Permit for the
accessory affordable apartment 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
Barry, Lois
To: Dillen, Elizabeth
Subject: 54 Walnut Street, Hyannis
Beth,
I received 2 copies of the Fragosa's Comprehensive Permit but did not get the Regulatory Agreement.
Lois
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12-14-2007
B�RNSTIa,BLE
T ,
BARNSTABM '07 QCT 11 P 4 .28
Town of Barnstable
Zoning Board of Appeals
Comprehensive Permit Decision and Notice
Appeal 2007-088-Fragosa
Decision-Chapter 40B Comprehensive Permit
Applicants: Jonathan D. Fragosa&Jenny E. Fragosa
Property Address: 54 Walnut Street,Hyannis, MA
Assessor's Map/Parcel: Map 310, Parcel 045
Zoning: Residential B Zoning District
Applicants:
The applicants are Jonathan Fragosa and Jenny Fragosa,who reside at 54 Walnut Street, Hyannis, MA.
Mr. & Mrs. Fragosa were granted title to the property by deed recorded in the Barnstable County
Registry of Deeds on April 13, 2005 as recorded in Book 19719, Page 224.
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 within a single-family owner-
occupied residential dwelling. The issuance of this Comprehensive Permit would allow for an accessory
affordable apartment unit in the lower level of the principal residence.
Locus and Background:
The property at issue is a 0.24-acre lot located at 54 Walnut Street, Hyannis, MA. The lot was developed
in 1941 with,a single-family conventional style home. The effective living area of the main residence is
1,834 square feet. The accessory apartment is a studio unit located in the lower level of the principal
residence. The square footage of the rental area is approximately 550 square feet.
The lot is served by public water and sewer, and is located within a Wellhead Protection Overlay
District. The town of Barnstable's Public Health Division reviewed the application, and on July 9, 2007,
approved'a total of four(4)bedrooms at the property.
Procedural Summary:
A site approval letter was issued for the property by Town Manager John Klimm on August 7, 2007, 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.
f
A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the
Barnstable Patriot on August 31, 2007 and September 7, 2007, and notices were sent to all abutters in
accordance with MGL Chapter 40B.
On September 26, 2007 Hearing Officer Gail Nightingale presided over the public hearing. The
applicants,Jonathan D. Fragosa and Jenny E. Fragosa, were present at the hearing. Madeline Taylor of
the Growth Management Department was also present. Ms.Nightingale reviewed the file with the
applicants to ensure compliance with all of the program requirements.
Findings of Fact on the Comprehensive Permit:
At the hearing on September 26, 2007 the Hearing Officer made the following findings of fact:
1. The applicants are Jonathan and Jenny Fragosa who reside at 54 Walnut Street, Hyannis, MA. They
are requesting a Comprehensive Permit to convert an existing studio apartment located in the lower
level of the principal residence into an accessory affordable apartment. The conversion of the unit to
an accessory affordable unit within a single-family owner-occupied residential dwelling qualifies for
the "Accessory Affordable Apartment Program."
2. Jonathan and Jenny Fragosa were granted title to the property by deed recorded in the Barnstable
County Registry of Deeds on April 13, 2005 as recorded in Book 19719, Page 224.
3. On August 7, 2007 a site approval letter was issued for the property by Town Manager John
Klimm, 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 550 square feet, and is located in the
lower level of the principal dwelling.
5. The applicants are 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 sewer and is in an identified Wellhead Protection Overlay
District. The proposal has been reviewed by Thomas McKean, Health Director, and he has approved a
total of four(4) bedrooms at the property.
7. On July 9, 2007 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 applicants understand 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
stock qualifies as affordable housing
2 2007 6.63/o of the towns year round housing s q g
September 6, y g
p
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
i
Finding Summary:
Based upon the findings, the Hearing Officer ruled that the applicants have standing to apply for a
Comprehensive Permit under MGL Chapter 40B and the Town of Barnstable's Accessory Affordable
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, Jonathan and Jenny Fragosa. It is issued to allow for a studio accessory
affordable apartment unit in accordance with the following conditions:
1. Occupancy of the affordable unit shall not exceed one person.
2. The total number of bedrooms on the property shall not exceed four(4).
3. The property owner 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 and no lodgers shall
be permitted for the duration of the comprehensive permit.
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 applicants 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
3
the affidavit. Upon any report from the town that the terms and conditions of this permit are not
being upheld, the Zoning Board of Appeals or it's Hearing Officer shall have the ability to hold a
hearing to show cause as to why this permit should not be revoked.
12. This Comprehensive Permit shall not be transferable to any other person or entity without the
prior approval of the Hearing Officer or Zoning Board of Appeals. This decision,the Regulatory
Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed
at the Barnstable County Registry of Deeds. If the ownership of the property is transferred,the
Growth Management Department of the town of Barnstable shall be notified within 60 days of the
name and address of the new owner.
13. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its
issuance or it shall expire.
Ordered:
Comprehensive Permit 2007-088 has been granted with conditions. A written copy of this decision shall
be forwarded to the Zoning Board of Appeal as required by the Town of Barnstable Administrative Code
Chapter 241, section 11. If after fourteen (14) days from that transmittal the Members of the Zoning
Board of Appeals takes no action to reverse the decision,this decision shall become final and a copy
shall be the filed in the'office of the Town Clerk.
Appeals of the final decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL
Chapter 40A, Section 17, within twenty(20)days after the date of the filing of this decision in the office
of the Town Clerk. The applicants have the right to appeal this decision as outlined in MGL Chapter
40B, Section 22.
In accordance with Chapter 241, section 11 of the Town of Barnstable Administrative Code,the hearing
officer transmitted a written copy of the Comprehensive Permit decision to the Zoning Board of Appeals
on September 26, 2007. Fourteen (14)days have elapsed since the transmittal to the Board, and no
Board Member has taken action to reverse the decision.
�l la/// 167
Ga' Nightingale, Baring fficer Date Signed
O s. d 6_/
I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusitey ljer-1—c` ;
that twenty(20)days have elapsed since the Zoning Board of Appeals filed this decisipriai d th 4 c�
appeal of the decision has be(,n filed in the office of the Town Clerk. : vy% so
Signed and sealed this day of under the pains and peiiiy)js.o buy
Linda Hutchenrider, Town Clerk
BARNSTABLE REGISTRY OF DEED81 4
i
�oFTHe r�� Town of Barnstable
Regulatory Services
Y �
* BARNSCABLE,
9 MASS. g Thomas F. Geiler,Director
�prEDMA�pe Building Division
Thomas Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ina.us
Office: 508-862-4038 Fax: 508-790-6230
AMNESTY APARTMENT ELIGIBILITY VERIFICATION
Re: nJt eel D
Date hl
After reviewing the street file of the above named property, I verify, to the best of my
knowledge, that the apartment was in existence before January 1, 2000. This property
is now eligible to apply for the Amnesty Program.
Tom Perry
Building Commissioner
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Expires 6 months from issue
Regulatory Services Fee_
Thomas F. Geiler,Director
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.tov.,n.barnstzble.m&.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
ip/parcel Number :3 1 o _ (O "1 S
operty Address 0—t La -C� lx�k7 (s 0 2—&d
Residential Value of Work �D/000 Minimum fee of$25.00 for work under S.6000.00
vner's Name&-Address l )�V1S4 's
mtractor'sName Telephone Number •
ome Improvement Contractor License#(if applicable)
Lzcer ( aPPheable) _..
]Workman's Compensation Insurance.
Check one: - S PERMIT
❑ I sole proprietor
1-1 am the Homeovmer MAY - 4 2007
❑ 3 have Worker's Compensation Insurance
surance Company Name TOWN OF BARNSTABLE_
_orkman's Comp-Policy#
opy of Insurance Compliance Certificate must be on file.
,rmit Request(check box)
Re-roof(stripping old shingles) All construction debris will be taken to Do ,,, OtJ /O'Pe.--4Z
❑Re-roof(not stripping. Going over existing layers of roof)
��e-side
'Replacement Windows/doors/sliders. U-Value �' (maximum.44)
"Where required: Issuance of this permit does not exempt compliance with o 'Miff
artment regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission,
of the Home Improvement Contractors License is required.
Na �- AVW LODZ
GNATURE:
Forms:expmtrg
vise061306
r
fi The Commonwealth of Massachusetts
' Department of Industrial Accidents
Office of Investigations
600 Washington Street
< Boston,MA 02111'
wttiw.mass.gov/dia '
Workers}Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
_AUplicant Information .Please Print Le�fbly
Name(Business/Orgauization/individual): PJVI Vl �10S
Adclress _5`� ' AA . in 0 1 a, Gr
City/State/Zip: Phone.#'
Are you an employer?Check the appropriate box: :Type of project(required)-.
1:❑ I am a employer with 4. ❑ I am a general contractor and I 5 ❑New construction .
employees (full and/or part-time),* • have hiredthesub-contractors
listed on the'attached sheet. 7. ❑Remodeling
2,❑ I am a'sole proprietor or partner- These sub-contractors have g, ❑Demolition
ship and have no employees employeeg and have workers'
itorking fax me in any capacity. t. 9. ❑Building addition
[No workers' comp,insurance comp•insurance.
5. ❑ We are a corporation and its 10.❑Electricalrepairs or additions
required.] officers have exercised their 11.0 Plumbing repairs or additions '
I am a homeowner doing ill-work .
myself,[No workers, comp right of exemption per MGL 12,❑Roof repairs
insurance.required.]t c. 152, §1(4),and we have no 13 ❑ Other
employees, [No workers'
comp,insurance required.]
,Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such.
#Contractors that check this box must attached an additional sheet showing the name of the oub-contractors and state whether or not those entities have ;
employees, Ythe sub-contractors have employees,they must provide their workers'comp•polidy number.
I ant 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:
lob 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 tip to$1,500.00 and/or one-year imprisonrnent,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'
TnVestilzations of the bIA for insurance coverage verification.
I do hereby certify un atns a penalties of perjury that the information provided above is true and correct:
Date: J ' .3 _
Si fora: -
Phone#:
Official use only. Do not write in this area,tb.be completed by.city ar town official
City or Town:' .Permit/License#
Issuing Authority(circle one):
:1,Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector
6.Other
Contact Person: .'Phone#:
information ana instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hiie,
express or implied, oral or written."
An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a-deceased employer,or the
receiver or trustee-of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of.the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house .
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.'
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any
applicant who has not produced�acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter_152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for,the perfommce of publiawork until acceptable evidence of conipli ea withtlie insurance-
requirements of this chapter have been presentedto 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-conti'actor(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. Alsoaffidavit.be sure to sign and date the The affidavit should
be returned to the-city or town that the application for the permit.or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law-or if you are required to obtain a workers.'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self insurance license number on the appropriate'line.
City or Town Officials
Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom
of the-affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city'or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant.as proof that a valid affidavit is on.file for future permits or licenses. A new affidaw must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture
(i.e.a dog license or permit to burn leaves-etc.)said person is NOT required to complete this affidavit
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call
The Department's address,telephone-and fax number:.
The CQmouw lth ofmmaduwtts
Dqa amt of l.dustdal Accidents
Of a of Inivatkaftolks
600 Washing S.tma
Basto�..,.l 1A 02111 • .
TO.#617-727-400 ext 406 or I- MAS•SAFE
Fax#61«-727-7749
Revised 11-22:06 WWW.M .8QVM8
k
T� Town of Barnstable
�oF '°wti
yP Regulatory Services
BARNKABLE, : Thomas F.Geiler,Director
9 MASS. g
i639• ,• Building Division
TFD MA't
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
y L� Please Print
DATE:
JOB LOCATION:
number �,�r street (� rc village
"HOMEOWNER': \1,Oy\VtU �u" IW(A �8 (a''1 6 V
name home phone# work phone#�r
CURRENT MAILING ADDRESS: � /S c4 6
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Signature of Homeown
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of construction Supervi ors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner.shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction-Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forrns:homeexempt
�FiNE ram, Town of Barnstable
�Pv ti�
* Regulatory Services
* BARNSfABLE,
9 MASS. g Thomas F: Geiler, Director
�A i6gg. ♦0
'En 39. 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 11, 2007
Mr. Johathan Fragosa
54 Walnut Street
Hyannis, MA 02601
Re: Illegal Apartment: 54 Walnut Street Hyannis, MA 02601
Map: 310 Parcel: 045
Our records indicate that your house at the above-referenced location is currently being
used as a multi-family home, which is contrary to Barnstable Zoning Ordinances.
Violation of zoning ordinances is a misdemeanor, conviction for which results in a
criminal record.
You must contact this office within 14 days to either:
Apply for a building permit to restore the property to a one-family home
• Apply to the Amnesty Program
• Prove that this is a legal multi-family home.
Please contact this office immediately to tell us what direction you wish to take.
Sincerely,
da Edson
Amnesty Zoning Enforcement Officer
Building Department
gfonns:zoning3