The URL can be used to link to this page

Home My WebLink About0072 OXFORD DRIVE � (� n �. 0 el -—� Assessor's office(1st Floor): Assessor's map and lot"umb Oa I § c� THE To`i Conservation ,.c�Board of Health(3rd floor): j 11 II � g (� • Sewage Permit number �� '� ON 7J1 Arlo Z seanr�ntt: : Engineering Department(3rd floor): �� House number o at'r Definitive Plan Approved by Planning Board 19 SEPTIC SYSTEM 6"AUST aE APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-00 P.M.only i STALLED IN COMPLIANCE TOWN OF BARN6i'T .. '. � ' ®DE AN BUILDING INSPEG� �� °�� APPLICATION FOR PERMIT TO CC- OY-U C l CtAk (JA—AfTYU^ TYPE OF CONSTRUCTION VVoc� �M1 1 19 Z- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 11 0 X fpy-& �� Qq UT1— Proposed Use .W lio'r9 Q L� /yc"a ` MryV\ Zoning District Fire District Name of Owner f JW d , ��{Q Address Z � �l cU� T� Name of Builder !�i�L,)�C A)7Mr �V '�k S Address � Z"8 Name of Architect Address Number of Rooms ' Foundation Exterior ce-C S ro Roofing Floors Interior Heating Plumbing Fireplaces Approximate Cost 60 aG,' Area ®� f Diagram of Lot and Building with Dimensions Fee �. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnst re ar i th bove construction. Name Construction Supervisor's License i TOBOJKA, RICHARD Y e - No 35067 Permit For ADDITION - Single Family Dwelling Location 72 Oxford Drive Cotuit Owner, ., Richard Tobojka t - Type of Construction Frame F' , i Plot Lot , 4 Permit Granted May 19 , 19 92 -• Date of Inspection 19 _ •' Date Completed 19 , .f t = COMMONWEALTH OF MASSACHUSETTS I EXPIRATION DATE RESTRICTIONS .; y SS 0,22-42-5640 PHOTO (BLASTING OPR ONLY) FEE: _ f}p Of- HEIGHT.- DOB: THIS DOCUMENT MUST BE CARRIED ON THE PERSON OF THE HOLDER WHEN ENGAG- OTHERS - RIGHT THUMB PRINT ED IN THIS OCCUPATION. L20OM-2-87-81429 �3ieo�6SR^►f�� I 33SN3011 30 38n-LVNOIS H3NOISSIWWO 3 30 VNOIS 3dVIVIS A11M0I330 ONV 3 3011 AS 03NJIS 1 011VA ION I >{ •:.".�t}vI7(StS:� yfXP `a'{t, '� -i;f . . !!!!iVW H11 . E f"4C t1M3,N -P i]Z AbIll z i -ON-DIl 31V0 3AII03333 of i _SN-.3.,:x j SVZZO 'SSVW 'NO1SOS '3AV HllV3MNOWWO3 O1OL ? A.133VS onand 30 1N3WlHVd3a s t REGISTRATION AND CERTIFICATION FORM FOR FORECLOSINGNORECLOSED PROPERTY y . Thank you for registering in accordance with Town of Barnstable Code chap ler 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure(Xl " (section 224-3) or already foreclosed for which possession has been taken(section 224- ). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law,please state the reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its _ - records: , Section 1 —Propelly Information Property Address:72 OXFORD DRIVE COTUIT MA 02635 Assessors Map#: N/A Parcel#: 021-065 Land area and description SINGLE FAMILY Building(s)description and contents S I N G LE FAM I LY Occupied: Y Occupant(s)(if borrowers so state and include name(s)) BORROWER: JOHN ROJEE JR Phone: N/A email: N/A other: N/A Vacant: N Date: N/A Anticipated Length of Vacancy: N/A Last occupant(s))(if borrowers so state and include name(s)) Phone: N/A email: N/A other: N/A Has possession been taken NO If so,please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing PaM Information Foreclosing Parry (full name/title) WELLS FARGO HOME MORTGAGE Foreclosure Case Court: N/A Docket# N/A ill Date filed: 04/10/2015 r Current Status: FORECLOSURE FILED Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name,title,): WELLS FARGO HOME MORTGAGE Company (if different from foreclosing parry): N/A Address: ONE HOME CAMPUS, DES MOINES, IA, 50328 X9400-034 Phone: 8776175274 email: codeviolations@wellsfargo.com other: N/A If an exemption is claimed,please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i. e. "none" or"see above")). Name,title, other: NONE Company (if different from foreclosing party): Address: Phone(s): email(s): other: Name,title, other: Company(if different from foreclosing party): Address: Phone: email: other: Attorney representing foreclosing party N/A Firm name (if different from attorney's name): N/A Address: Phone(s): email(s): :other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. 1 onathan.mosier@nwellst1 jonat llysig sier@ l t DN han.mosian.mosier go.com 04/30/2015 argo.com DN :2015.04.3009:15:56-OVfzrpo.com Date: > Date:2015.04.30 09:15:56-05'00' Name: Title: I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable MAINTENANCE AND SECURITY PLAN FORM FOR FORECLOSING/FORECLOSED PROPERTY Town of Barnstable General Ordinances, Code section 224-4, requires a mortgagee taking possession of a property before or during foreclosure, or after foreclosure if the mortgagee becomes the owner,to bring the property into compliance with the maintenance and security standards contained in Code subsection 224-4(B)within thirty (30) days of a notice from the Building Commissioner. Please either complete and file this form or another containing the same information with the Building Commissioner , within thirty (30) days of the notice. If a mortgagee claims an exemption from the provisions of Code sections 224-3 and 224- 4,please explain, leave the remainder blank, sign at the end and file this form or letter of explanation and also.complete and file the applicable sections of the registration form for foreclosing/foreclosed property NIA Town of Barnstable, 367 Main Street, Hvannis, MA 02601 (1) Registration date: NIA If not registered,please complete the registration form and state date of filing or anticipated filing 04/30/2015 (2) If commercial property,describe space utilization floor plans required by the Fire Chief and filing date (actual or anticipated)NIA (if in possession or ownership must be certified as accurate twice annually in January and July). (3)Describe any hazardous materials on the property as that term is defined in MGL c.2 1 K and the date(s)and method(s)for removal as approved by the Fire Chief UNKNOWN (4)Method(s) and date(s) all windows and door openings secured(or will be secured) Property is owner occupied. If left secured, name, address,and contact information of security personnel providing twenty-four-hour on-site security personnel on the property WELLS FARGO HOME MORTGAGE 101 Federal St Boston, MA 02110 8776175274 cod eviolationsp_wellsfara . (5)Location(s) and date(s) "No Trespassing" signs posted or to be posted on the property IF PROPERTY BECOMES VACANT (6)Name(s), address(es) and contact information of person(s)responsible for maintaining: structures, lawns and shrubs in sound condition free from excessive growth and the property generally in accordance with the Barnstable Zoning Ordinances the definition of"maintenance" in this Ordinance; any other provision of this Ordinance; and for disposing of trash, debris and pools of stagnant water as provided in Chapter 54 of the Town of Barnstable General Ordinances WELLS FARGO HOME MORTGAGE 101 Federal St Boston, MA 02110 8776175274 cod eviolations(ED-we I Isfam (7) If the Fire Chief of the Fire District in which the property is located has approved turning off the water or electricity,please state: Date of approval UNKNOWN Date(s)electricity turned off on if applicable ; Date(s)water turned off on if applicable (8)Name(s), address(es) and contact information pf person(s)responsible for maintaining all existing fences around swimming pools and spas or installing fences as required by Chapter 210 of the Town of Barnstable General Ordinances WELLS FARGO HOME MORTGAGE 101 Federal St Boston,MA 02110 8776175274 codeviolations@wellsfargo.com (9)Name, address, telephone number and email address of person who can be contacted in case of emergency if different from the person named above or in the registration `under section 224-3(A) (name and contact number to be posted on the front of the property if required by the Fire Chief or Building Commissioner WELLS FARGO HOME MORTGAGE 101 Federal St Boston,MA 02110 8776175274 codeviolations@wellsfargo.com (10)Date(s)certificate of liability insurance on the property filed with the Building Commissioner N/A (11)Date(s)cash or surety bond of at least$10,000.00 filed with Building Commissioner to remunerate the Town for any expenses incurred in inspecting, securing and making the premises comply and continue to comply, a portion of which shall be retained by the Town as an administrative fee N/A:OWNER OCCUPIED (12)Date(s) scheduled for inspections with the Building Commissioner and Health Director,who may at his or her discretion include the Fire Chief, in order to confirm that the land and structures comply with the provisions of this Ordinance N/A or to identify the provisions with which the property does not comply and establish a program to bring the property into full compliance N/A (13)Date(s) when the property was sold, or is anticipated to be sold,to the foreclosing party. If neither,please explain, N/A I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. jonathan.mosier@wellsfargo Digitatly signed byjanathan.mosler@wellsfargo.mm ,.DN:rnyanathan.=sien@_11sfaW mm Corn 'Dade:2015.04.30 09:14:34.oso' Date: 04/30/2015 Name: JONATHAN MOSIER Title: RESEARCH AND REMEDIATIONm I hereby certify that the above-named foreclosing,party is in compliance with the provisions of section 224-4 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable 21174 ® DATE YYY)A(l`.-„(/,JQ,R CERTIFICATE OF LIABILITY INSURANCE 3/25/2025/20IY15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT NAME: Wells Fargo Certificate Service Center Wells Fargo Insurance Services USA,Inc. PHONE 404-923-3719 FAX 1-877-362-9069 IC A/C No 3475 Piedmont Rd E-MAIL vvfis.certificaterequest@welisfargo.com ADDRESS: re o.com q �% g Suite 800 INSURERS AFFORDING COVERAGE NAIC q Atlanta,GA 30305 INSURER A: Old Republic Insurance Company 24147 INSURED INSURER B: Wells Fargo Home Mortgage INSURER C: a division of Wells Fargo Bank,N.A. INSURER D: 90 South 7th Street,14th Floor INSURER E: Minneapolis,MN 55402 INSURER F: COVERAGES CERTIFICATE NUMBER: 8901677 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED*BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM POLICY EFF POLICY EXP LTR IDDfYYYY MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY 304056 04/01/2015 04/01/2020 EACH OCCURRENCE $ - 10,000,000 CLAIMS-MADE �OCCUR _PR EM SES DAMAGEOEaEoccuence $ 10,000,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY PRO ❑ JECT LOC PRODUCTS-COMP/OP AGG $ 10,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION MWC302638 04/01/2015 04/01/2020 X STATUTE �RPER H AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N - E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) - Proof of Insurance CERTIFICATE HOLDER CANCELLATION Wells Fargo Home Mortgage, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN a division of Wells Fargo Bank,N.A. ACCORDANCE WITH THE POLICY PROVISIONS. 90 South 7th Street,14th Floor Minneapolis,MN 55402. AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) N ton /J4 jlgq 5V ICY` IKET TOWN OF BARNSTABLE Building Application Ref: 20064439* BARNSTABLE, Issue Date: 11/07/06 Permit' 9 MASS. i639• �� Applicant: ROJEE JOHN JR pp Permit Number: B 20061697 Proposed Use: RESIDENTIAL Expiration Date: 05/07/07 Location 72 OXFORD DRIVE Zoning District RF Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 021065 Permit Fee$ 85.00 Contractor PROPERTY OWNER Village COTUIT App Fee$ 50.00 License Num OWNER Est Construction Cost$ 2,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND PORCH ENCLOSURE ON EXISTING DECK THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: ROJEE,JOHN JR BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 72 OXFORD DR INSPECTION HAS BEEN MADE. COTUIT,MA 02635 Application Entered by: RM B g Permit sued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY'STRE OR SIDE JALK OR ANY PART'THEREOF,EITHER TEMPORARILY OR PERMANENTLY ENCROACHEMENTS ON PUBLIC,PROPERTY,NOT SPECIFI Y P ITTED ,DERe THE,BUILDING,CODE,MUST BE APPROVED BY.THE JURISDICTION. STREET OR ALLYGRADES AS WELL AS DEPTH AND-LOC ON, F LIC WERSIMAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC'WORKS THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE`T APP AN THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS RE UIRED F L CO f TRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED T T T T L L BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS T EC PL R TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL ME ER . READ LATH). 5. INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMIT A IRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL I PEC HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION„ PERMIT WILL BECOME N D IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS IS D AS T ABOVE. PERSONS CONTRACTING W UNREGIS RED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). ;gj �050�1� A WIND 1,07MM BUILDING EC LS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t r Map j Parcel 0 .=1 Application# Health Division Conservation Division Permit# Tax Collector Date Issued Q_ Treasurer Application Fee Planning Dept. Permit Fee co Date Definitive Plan Approved by Planning Board i r Historic-OKH Preservation/Hyannis Project Street Address 7?o O 1C Fo r4 Dr. Village ►V Owner �,1 0�ul Address SA M t Telephone SOV" 4,X0-Mcf Permit Request Po r& FO C.I®Svr c ® Xt S r f k.)q t�e—c—N I O k 1 O ? -TeA-S Av F Y�e Square feet: 1st floor:existing proposed 2nd floor:existing proposed S To new- Zoning District Flood Plain Groundwater Overlay V J Project Valuation Dco Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting locumenuion. ,1 Dwelling Type: Single Family LI Two Family ❑ Multi-Family(#units) Age of Existing Structure_ 015 yrs. Historic House: ❑Yes C4 On Old King's Highway: ❑ 'o Yes 0Q Basement Type: ®Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Al Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing 7 new First Floor Room Count Heat Type and Fuel: ❑Gas VOil ❑Electric ❑Other Central Air: dYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,'site plan review# Current Use Proposed Use BUILDER INFORMATION w Name ,7Z,�24::4 Telephone Number Address License# Home Improvement Contractor# I Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i SIGNATURE DATE %l11e7tOG 1 9 FOR OFFICIAL USE ONLY i PERMIT NO. DATE ISSUED MAP/PARCEL NO. 4; f I I ADDRESS� VILLAGE x r. OWNER x 4 DATE OF INSPECTION: F' FOUNDATION FRAME 3 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO,. r r r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street � N Boston, ALL 02111 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): `Ip�%V\ Ralf e_ r Address: 7a. OX'Fvt� _D(' City/State/Zip.Qo1V 1 M k Phone#: YdO,1 I�'cf Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hiredthe'sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t. 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp;insurance. 9. Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its ,,� officers have exercised their 10.❑Electrical repairs or additions 3.LY I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions . myself. [No workers' comp. c. 152, §1(4),and we have no 12.[]Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of'the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: c • 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 Investi ations of the DIA for insurance coverage verification. I do h e y certify nder the pains andpenalties ofperjury that the information provided above is true and correct �Jl atur Date: l lo(p Phone#: Offs 'al use only. Do not write in this area,.to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual;partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s),of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance, If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy.information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 6.00 Washington Street Boston,M-A 02111 Tel. #€617-727-4900 ext 406 or 1-877-MASWE Fax 617-727-7749 Revised 5-26-05 www.mass.gov/dia �fVE p� 1 V YY11 V1 Lalu►7�t11✓tar h' ~°� Regulatory Services sAuvsrae , ' Thomas F.Geiler,Director 9 1"ss. Building Division Tom.Perry,Building Commissioner .200 Main Street, Hyannis,MA 02601 www.towiq.barnstable.mz.us Rce: 508-862-4038 Fax: 508-790-6230 Permit no. Date - AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units.or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along will- other requirements. , i `Type of Work: Estimated Cost 0?00 0. Address of Work: 7a O XFi�h� f ©? uj_ Owner's Name l Oil✓1 �O�l C� Date of Application: (!1 b 1 D I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []•Job Under$1,000 ❑Bull ' g not owner-occupied Qe<mer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A, SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ate Contractor Signature Registration No. OR 1� D to Owner's Signature fnes.for=homeaffidav v: 060606 f ' Town of Barnstable yP��FTHE Tp��O� ; Regulatory Services * Thomas F.Geiler,Director snaxsTnatE 0s.039• Building Division 9� �� .. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Dffice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 0 o X rO rl b r. CO ul number street village ,,HOMEOWNER': �� of e t- Sod'-YAo-l tC6 44-Irc y7 .name home phone# work phone# CURRENT MAII NGADDRESS:SAM 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 of 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 un ersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department mmunqqa inspection procedures and requirements and that he/she will comply with said procedures and requiretts. ' signatur of omeowner Appr pal 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 �c f ��.Ss-tip d O 4_ t O (10 �♦ �iWd�M9v =4X�m�r�' �Y,'A' .Y.i hnhW�;-et�oGR SLsya�4N .e...-wgy.p�y6.��cA'Y4yiu;.W ik.SEY�Si42'"a� 'I FILE':# B3403 CENSUS TRACT # F ENT: Prescott, Bullard & McLeod DEED BOOK 2202 PAGE 250 ER : Glen T. & Virginia M. Sizemore PLA BOOK 271 PAGE 56 L 75 PLICANT : Richard B. Tobojka ASSESSORS PLAN PLOT MORTGAGE PLOT PLAN OF LAND I N B A R N S T A B L E SCALE : 1"= 50 MARCH 81 ..984 LOT 76 199. 58� LOT 75 LOT 77 DECK 31 ,009 S , F , ± 2 STORY #72 LOT :74 54:00, "i � 00 � X c. U Rp � RI I CERTIFY TO FAIRHAVEN SAVINGS BANK AND ITS TITLE' INSURANCE COMPANY , THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOW;I AND THAT THIS PLAN WAS :PREPARED UNDER MY IMMEDIATE SUPERVISION , THE ,"LOCATION OF THE DWELL I NG AS SHOWNt '�� OF I.,•i�'��. HEREON IS I N ..COMPLIANCE WITH THE LOCAL XPr-- APPL''I CABLE ZONING BY-LAWS WITH RESPECT o`' KENNETH TO HORIZONTAL DIMENSIONAL REQUIREMENTS , R. o ERREIRA `a No.28716 THE � ;DWELLING SHOWN HERE DOES NOT FALL W I TH I.N A SPECIAL FLOOD HAZARD ZONE AS -9,yoo ✓vv DELINEATED ON A MAP OF COMMUNITY #250001 SJR DATED 10/1/83 BY ' THE F . I . A . Land Surveyors Civil Engineers • V, f®l�E �II�tIIn �1Mn� �4ur'.tE� �LIIq �nG z61 �ttiatt �Ketr �tbfora, cyy�' 12740 GENERAL NOTES: (1) The declarations made above are on the basis of my knowledge, information, and belief as the result of a, mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing in Massachusetts. (2) Declarations are made to the above named client oily as of this date ,(3) This plan was not made for recording purposes, for use in preparing deed descriptions or for con— structions. (4) Verifications of property line dimensions, building offsets, fences, or lot configuration may be accomplished only by an accurate instrument survey. FFORSIIIOOMS� i _:'=" ;. r_: f aches State` n>Idin Coe ..8WX f en echo - L :z3a1 w. The Massachusetts State Building Code (780 CAM) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental .CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructinglinstalling a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to,an existing house (780.CMR, Appendix J, Section J1.1.23.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size,configuration,orientation,form'of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings lY create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and constructionlinstallation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that .a homeowner may 'wish to consider before actually constructing/installing a"sunroom".It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential-.energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading - • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/.seal durability and/or weather tightness of the sunroom • Adequate ventilation Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.123.1,..requires that the actual property owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential buil mg. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read th ormation in this document concerning sunroom comfort and energy conservation. Si lure of Actual Building Owner Date St%tic e Print Name Address of Permitted Project r r)a ©Xforj d_�F o�'t� t l S©� Ya c 119� Owner Address(if different than project location) Owner's telephone number } TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map _Parcel , . ' _ Permit# Ll F81 Health Division s 60 31— 3 1wh,� F } "'��q ^�r Date Issuedol Conservation Division < �� 5;?/ ® ® r Application Fee Tax Collector 4 Permit Fee Treasurer xpq Jy _�['____ •-..._._,SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address 7�_ )(FO rd J e Village C Oft)i � Owner TD`t.0 R D , f e e Address 5 AM;6 Telephone 50 W- q e-Q 11 q 9 Permit Request Poo Square feet: 1st floor: existing 13,00 proposed 2nd floor: existing proposed Total news Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size 060 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure_ 215 'yeaO Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: 4 Full ❑Crawl ❑Walkout CI Other Basement Finished Area(sq.ft.) JVn Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 1 new Half:existing l new Number of Bedrooms: existing_? new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas C-Oil ❑ Electric ❑Other Central Air: 16es ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site.plan review# Current Use Proposed Use BUILDER INFORMATION Name S 15 tq n a rZo , Telephone Number !Mo`a S Address a rs f o ` if S License# 2 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTI N DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE r , R ' FOR OFFICIAL USE ONLY V � R U PERMIT NO. j DATE ISSUED r a MAP/PARCEL NO. Y -d • ADDRESS VILLAGE " OWNER • r � DATE OF INSPECTION: ` FOUNDATION FRAME f INSULATION r t FIREPLACE ELECTRICAL: ROU(fA'm > FINAL Kk Q PLUMBING: Roudn- q Z. 5 FINAL OZ > GAS: ROUC S - 5 n FINAL /e FINAL BUILDING C►iK � �`��ay t� J co u O _ r h <CD Ire m DATE CLOSED OUT ASSOCIATION PLAN NO. 1 The Commonwealth of Massachusetts u�) �= (�(n: Department��0/o�f(Industrial Accidents r _J MO//��o AMMZFP#M 600 Washington Street ?' Boston,Mass. 02111 1 ' Workers' Com ensation Insurance Affidavit-General Businesses YX address' 2(� o.xfW ✓ r city state: - ziy:Qdb phone# 120 work site location(full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑Sales(including Real Estate,Autos etc.) ❑I am an em loyer with em loy%e%e%s�(/Ofu�ll&�ar%t�ti%m%e O�t�he%r %%%�%%/G�%/�17/%//%� % [5 I am an employer providing workers' compensation for my employees worldng on this job. company name: address: city: phone#:._ ... .lnSurance.co:- TI am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: com finV name: address: city:.. phone 0- insurance co. olic # comoanv name: address city.. . insurance so. olicv# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this s ment may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby a ify under thepains and penalties of perjury that the information provided above is true and correct Signature n Date f7-oZ0"0 Print name� I CCU sf"� Phone# Yd o�i y official use only do not write in this area to be completed by city or town official city or town: permittlicense# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office i ❑Health Department . contact person: phone#; ❑Other e (7evsed Sept 7A03) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents WIN of Inl 8119atlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 f IHEr 'Town of Barnstable F , 0 Regulatory Services 9a at,E,$ Thomas F.Geller,Director 4'pl16 3�A�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 • Fax: 508-790-6230 Office: 508-862-4038 . Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements, y�l' 00 Type of Work: OD Estimated Cost- /v1,000 • Address of Work a X r CoT ln`A - Owner's Name• O.Te� - Date of Application• 9- ,RD-d`_ I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OARS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owzLer: Date Contractor Name Registration No. - OR a-ao 10 Date Owner's Name Town of Barnstable �oFzr�rOwti o„ Regulatory Services anrwszasrE, : Thomas F.Geiler,Director MASS. 0 9• A.O� Building Division rED MA'1 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: -ao-0 if JOB LOCATION: �c�. t x&' 00Zl/ number street village "HOMEOWNER": \Ok A PC;j-C-e sog- ya o -1!Y y yd�-yy/7 name home phone# work phone# CURRENT MAILING ADDRESS: t- • 13D X 75 y C11)TL lT MA. oar3s city/town kstate 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. e undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department "imurn inspection procedures and requirements and that he/she will comply with said procedures and l uirements. . hk_�_ gnature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building 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 I L C%j 2'LT 51 12'-011 6„RC 4' 8' 6"RC 41-011 12'-0" , 1 81 � 81 2' 21 6' DEEP 8' PLASTIC 41.011 STAIR I , :4 81 8' 1011 8' 9 ii N , 1 12'-0" 10 .91-011 1-011 121 p I. 18" 1811 ,moo --- - 11------------- 8' STEEL tiO ' I STAIR ' 1 8' 81 'p11 81 I � , 40" FINISH Date: 12/99 Pool De a Number One in Quality Title: Rectangle 12'x 24' 6" RC Forbes Road Newmarket Industri Newmarket,NH Oc t Drafter: JLC PHONE(603)6594 FAX (800)595-( NO DIVING IN Ell L ME] SHALLOW END File Name: tpd/RECT1224-6 of Pool Area: 288 sq.ft. DIVING MAY CAUSE PERMANENT INJURY,PARALYSIS OR DEATH Perimeter: 72' -NOTE-These dig dimensions DO NOT MEET the Ne6onel Spa and Pool Institute suggested Template#: 21085 minimum stands for residential NOT pock.Weminq-DO NOT DIVE INTO THIS POOL NSPI Type 0 Mon-Dlvl Diving boards or slides ARE NOT TO SE USED with this pool.For information eoncemm' I NSPI minimum standards,write:National S and Pool Institute,2111 Eisenhower Avenue, ` s._Alexandria VA 22314(/03)838-0083 's! Q�J!E sPD gat AS EJ4 S rat i "a"ll M t7972 =19bi OE-7--BRACII+NI3 cnfroll,l0 o11 dMon wafer b ibo t' 424:I� i j� WATER DEPTH OFTEN 1'-(r DEPTH -OF EXCAVATION FOR POQL" WATER I;59DE X 24" CONCRETESLAB AROUND THE SIDE BASE. OF THE POLL WALL. I POOL DIMENSION ASSUMED 0 16' X 32' ' �0 MATERIAU 14 GA. uLyANr2ED 'STEEL s'3 WALL PANEL F. = 47 K.S,I, i pur 10 y POINT "kV P. WATER PRESSURE AT RASE or STEEL WALL PANEL .IS 218.4 /T'T, THE .RESULTANT .'WATER PRESSURE ACTING 1/3 FROM THE RASE IS, AT 3a32.2 I/pT 016:4 /f-T) (3�50') (1/2)7 i NEGLECT THE EFFIMT OF THE EARTH PRESSURE DETERMINE IF THE POOL IS STABLE WITH 3'-611, t3EPTN4 4F WATER INSIDE THE POOL. TRY ANCHORS AT $'a-i}" MAXIiA.IlN. T+ MOMENTS AT INNER FACE OF THE 'WALL 0 .POINT "A (6)(100) - 14,400.00 X I l = 1 x2,3DD.00 a4( )(tea) = 21.600.00 x 12 = 259,2GO.00 361382,20 •42.6,64 0 A > I9/3 S.DEf .b/2 1 " g4 x_24) — 6(?i.7269) 30-�0 � 11,619 PSF/FT. (24) 3s.+ 2.2D (24 _ .'t THE POOL IS STABLE AND TH'E. FOUNDATIOt4 PRESSURE IS ok The Town of Barnstable Deparbnent of HebLlth Safety and Environinental.Services Building'Division 367 Main Street,Hyannis,MA 02601 S-862-4038 8490.6230 PLAN REVIEW jam" p 21 b� S ►wner. Ol^ ��• Ma /Parcel: roject Addy.ss' Builder:, Octi►�-P r. Che following items were noted on reviewing: (,v of Cc s e- C 12?j0LI 'F I LE`.# 0-3403 CENSUS TRACT # CLIENT : Prescott, Bullard & McLeod 1DEED BOOK 2202 PAGE 250 OWNER : Glen T. & Virginia M. Sizemore PLA BOOK 271 PAGE 56 L 75 I APPLICANT : Richard B. Tobojka ASSESSORS PLAN PLOT MORTGAGE PLOT PLAN of LAIND I N BARNSTABLE SCALE : 1"= 50 ' MARCH 8, 984 LOT 76 h. 199, 581 LOT 75 LOT 77 DECK K 100 S , F , ± 2 STORY �� ibx3D 37 #72 t 9 LOT 74 54.00, 00 0 � c I CERTIFY TO FAIRHAVEN SAVINGS BANK AND ITS TITLE INSURANCE COMPANY, THAT .THERE ARE.- NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOW11 AND THAT THIS. PLAN WAS ,PREPARED UNDER MY IMMEDIATE . SUPERVISION , THE L`OCAT I ON OF THE DWELLING AS SHOWN HEREON IS IN .:.COMPLIANCE WITH THE LOCAL �P��H °F'"'le:; . APPLICABLE ZONING BY-LAWS WITH RESPECT o`' . KENNETH ' r, TO HORIZONTAL DIMENSIONAL REQUIREMENTS , R. E ERREIRA - :: No.28716 THE {DW LING SHOWN HERE DOES NOT FALL.- 0 WITHIN A SPECIAL FLOOD HAZARD ZONE AS 9�yc . �1` ' DELINEATED ON A MAP OF COMMUNITY#250001 S J 0 ' DATEI: 10/1/83 BY ' THE F , I . A . Land Surveyors Civil Engineers AN poston X21 b *zr.rev (90.;�lnc 261 �ninn �4t. Ndu �rbfora, 1 12740 GENERAL NOTES: (1) The declarations made above are on the basis of my knowledge, information, an ] belief as the result of a. mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing in Massachusetts. (2) Declarations are made to the above named client o1:ly as of this dater (3) This plan was not made for recording purposes, for use in preparing deed descriptions or for con— Lstruc`ti_ons. (4) Verifications of property line dimensions, building offsets, fences, or lot cor.Figuration may be.accioi*mplished only by an accurate instrument survey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map CPa I '' Parcel Permit# "B d � berg \ a,0.ii? 0. AST,; :� �' Health DivisionS7' PDate Issued Conservation Division ��J63 20 'L . 6 j g:Application Fee Tax Collector C20 0 k — /NL 1,Q/03 Permit Fee 00 Treasurer 0 - - (� r lu%3 P4 c--w=°T1C SYSTEMU1 IST BE INSTALLED IN COMPLIANCE Planning Dept. VWTH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AM T001 REGULPTIONS Historic-OKH Preservation/Hyannis Project Street Address Village 0-o,;%1 (Y\A Owner SRM- 1a QcaPCf_ Address Telephone S08- 4010__11`0 Permit Request Pore, 3y � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation asso-CO Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) , Age of Existing Structure Historic House: ❑Yes U(No On Old King's Highway: ❑Yes ❑No Basement Type: u(Full ❑Crawl 0 Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: .Full: existing new. Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel 0 Gas VOil 0 Electric 0 Other Central Air: ❑Yes ilk No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:0 existing ❑new size 4Attached garage:Vexisting ❑new size Shed:❑existing ❑new size Other: ' Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0 Commercial 0 Yes ❑ No If yes, site plan.review# Current Use Proposed Use BUILDER INFORMATION Name J o\,%A Qofef— Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE • DATE `6"D r - I FOR OFFICIAL USE ONLY ' PERMIT NO. , DAT&ISSUED '3 MAP/PARCEL NO: _ f r� ADDRESS— -• � � ` � .j VILLAGE »< OWNER DATE OF'INSPECTION: FOUNDATION ' FRAME .y INSULATION _ �1 FIREPLACE '. ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL GAS: ROUGH : t : ' FINAL FINAL BUILDING ___�°�f?alas SC-• DATE CLOSED OUT. ' s z A_SSO•CIATION PLAN NO. I r , �OFZHE�p Town of Barnstable yWP O� Regulatory Services sexxsrAM4 ' Thomas F.Geller,Director NAM 1639. a•�� Building Division D MA Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date • AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four,dwelling units or to structures which_are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Work: PoC tx Estimated Cost Address of Work: ®XFor CoTuP 1 Owner's Name: -Tot,V1 Date of Application: �o•-(a 0� I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c, 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner:. e Date� Contractor Name R gistration No. OR fL l T, .e Owner's Name f _ The Commonwealth of Massachusetts . ��. - Department of Industrial Accidents Office 011HIMMOMONs _ 600 Washington Street -= Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit name: , location hone# ci I am a homeowner performing all work myself. ❑ I am a sole netor and have no one workin in ca achy ro� ////%a %%///G////%%/��%%%///%%%/%/%%/%�%/�i,. 1 rovidin workers' compensation for my employees working on this job.:::: }:Y:.};:.;}:.}:.}:?•>:.}:;.J}::J:;{:>::>.<:>:}.<::<:>:>.<:;:}:::><:::};::;> = I am an em s2?>5''' i '<' 5i:' s }"� ? � f < ''��!i?%''''`�>` �`? �3i�<`s�ii� ?'`i' <��'% i?ir ?;<::%`�>? `%ii%? :;:;:::;ia;::`:_:;:z;;;: `:i:::�i:?:::E: :cow an n . t { }: y� .......:.v:::w::n:::::::•::.v:::::::.•:.v:::n:::::{:•iY.}}'.;•}::;}:•Y:y:{;{.}:?;J:{;:;i:v}}•::::n}•..v::{{x. • ;:�`':}Ji:•iss}iiY�iiiii`'}i:^ii:tij;}:;:;:;:?{}�i:v}isi}:•}ti{i::,>.:v.•.:•":{:,:.i:.:ii: Yu � ..:•::,.:::.:;:note}'.:v:;::.... - c i .•::•#<$:<}?:;';'i?:":yt<:......v,:4:':+'';?:.'•';i;,;>';:;,}>}y •'+••'oli iiisuiast ❑ I am a sole proprietor,general contractor,or homeowner(circle one and have hired the contractors listed below who have orl=' compensation polices: :...........:...::.::..........:...:.:.:::.:::>:::.:.-...,;}};:;,>•,:•:n:»::.}:::; following w P .. .. ,... 4n..h..... the g :::::::.::::.:::..............::.:::::.:::.:::.::.:................... <> :> :........::::..::::..::::.:...::::.::............. . ...: .....:.:.:..:...;....:.. ........... :` < . > .... ........::..::::.::.: ;:;:<:.}::;:;::':.::::.:'.:.: •:.:::.:.... ...... ......:..........:....:...::....:::'......:......'::i:.;i;}:v:gJ:i}}:;q:::::::•};::v.?:?+.is i:::::•Y}.v:i::.v:w: ,� ......... .......... ....n... ............. }}i:•:ji;{l'riJ:?^Yii}:?4};::::::>M1?�:?;?{{•}rvv}:.'fix:i't+L... ......... .......r.... .......reeve..• ............... ...................................... .....................n•.v,v:..::. ..n.........• .................. ..........r......... .........r..........................::.....................:w:::.v:::.v.,r .::::::::.v:::.v:.w:n.....................;...... w:}Y:??v.vv:Yv:..}v:fir.;}::{.a;:/.•^<T:iiii:•ii v:..........:.:::•..................:Y.v:...............••:••:v.................• ........... . ......................... .................... ... n•4:^.�::.. :k?{+.. }t�—.•��::;:�':;isis��ii:{?jt;:;i;L:tisj:,'.;i:,+.;:,:�::`>.>{:'r,::Y:;`.::.}}: i;•:{;............................................ ;:::?.}iFi;iYi• .s tie. ...................,..:....................::..::......................::::.................................::.................:•.:�:.r...:,n............. :.....rev. ',.vn;.r�. .{ ::'.' ........ ....... ......... ............. .........:.:v::.v........ .........n. ........ . :rev:{:;:Y.{4:•}:.w::n.v:.v....;}.. ::.jnnY 4 ........ .......... ........... .............. v..................r.......n...........:::...............:...... :::...w........ .. ........n ...,..... .w:::v:::•......... }:r::::i'�ii?i i::i•'tiii>:i:ti'y}y$";:�;:j:��?::.v:..r....:::.:•::::::::r.....r...,::::?•::!:•:..........•.:.v,••,?:•.v.::x:?w:nv:,v...v; v:::::n.:•::.4::vJ;.:.v.:............. ......... ..... ......................:..::{?ny}:;;•}:•}:vr;{•}:•i'.Yw;:?:r•?::L}::v:•}:•i:o:•i$:i::?:ii$ii:;:.: :...........,.:,rn.. ...................:............ .............................:.......:....:.......::env:•w:::;:::?:......;:••iJ=}::•}:•::::::::;i}}{n•i:::?:�:i:::;:;::•:;:::.vr.v:•:.}rvvy.:,'•}}YY}Yoh ............ ......................::}.�:::.v:::::::•;, 4}:4:?;.{.;;:;,x......v:n{,,fit ........... ...... .......... ..r..:................................w........v.................:.::ti•:.v..........err:::.:::::::.....:.... +••w:n:n...• :: y.... ...... ..... ....... ..n..... .......... ..:...........r..... ...r:•::v:..4::::::.v::v::::.vJwx w.v::Y.::^:+.{.}}:i}:i:•J:?!.}, ...C.•::::;YOY:•'•.v.•... A'^•K.......;t.. .....:..... .............. ...n.:.v:. ...........n..• .........................+........x:::::::::v.::::{•}:{;!::^i::i:•}::. �'M.:.::•.:•.:::•:::::•::::::,:v:, ....•.v:;.r.•;::;:.?4ii:.};.}:;::•::r::::•:.�::::n.....•:........ XX '�•'i:::::.:'•5:;�::;:::^�:::: ;;;>:;.^:.::::`i::?":t::•`::"r:}�:�5:;;:;::{:;Y;`.i.:?:<:;':;::::::::';::±i:%;'�:;:�>:�r?%.::�i'i'f`:::::::i;:'�'.?%:'2i:;:`.:;:c::}:::;:;:;>:.>::%:�>:}`?�'k;�:::;:;::`%;:':•}.`.}::::'{>::i,:y:;;•}w:}}:?;{•J}J;.}•:.:.;;:_?:..>•:::::.:::•:: ::::::::•.:.... Fwhwe to secure coverage as required wider Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$I M.00 and/or one yam,,imprisonment as well a,dvII penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do here ertify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print ram ° D i, ��•� Phone# S®Sn Ya0'!t official use only do not write in this area to be completed by city or town official city or town: permdt/license# ❑Buiiding Department ❑Licensing Board ❑ ❑ check if immrediate response is required nea'a Office ❑Heapealth Department contact person: phone#; ❑Other Ocviud 9195 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. ration or other legal entity, or an two or more of association corporation �Y, Y fined as an individual partnership, rp g - An employer is de , P 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 section 25 also states that every state or local licensing agency shall withhold the issuance or'renewal of a license or permit to operate a business or to construct.buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with'the insurance requirements ofthis chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and company names, address and phone numbers along with a certificate of insurance as all affidavits may e supplying mP y .. submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and &d- 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 on policy,please call the Department at the number listed below. are required to obtain a workers' compensati City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tr the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to.give us a call. now The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEO VMR LICENSE EXElYIPTION Please Print DATE: Ca-6 0,3 JOB LOCATION: �� Eyx F Dlt Q Jr•. Cb 1 V I number street village "HOMEOWNER!': J0�1V� RQ(E'er �S� �d�o �►C� / name 1k). 13OX home phone# •work phone# CURRENT MAILING ADDRESS: I till CoT-iT A � �d[�35•. 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 e artment minimum inspection procedures and requirements and that he/she will comply with said o edures anA requirements. Si tare 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 .03/10/04 23:02 FAX 17813351895 [a 02 PEDA Inc. CONSULTING ENGINEERS March 10,2004 Mr.John M. Rojee 72 Oxford Drive Cotuit,MA 02635 Re: 72 Oxford Drive,Cotuit, MA Structural Inspection,March 10,2004 Dear Mr.Rojee: In accordance with your request,Mr. Paul E_ Donahue,P.E.of this office,visited the above referenced site on March 10,2004,The purpose of this visit was to inspect and assess the condition of the concrete that supports the wall and bracing of the swimming pool. The concrete in question is the slab beneath the vertical sidewalls that is utilized as a working surface for the installation of the wall panels.The concrete slab provides an anchorage for the bottom of the wall panel and as a support point for the diagonal braces. These diagonal braces along the side walls slope from the top of the wall outward to the slab_These braces maintain the top of the wall vertically from horizontal movement inward. Based upon a conversation with the Owner,the pool installer placed approximately five(5)cubic yards of 2,500 psi concrete on Monday morning March 8,2004.The concrete supplier was South Eastern Concrete_ There is a concern that the low temperatures have comprised the strength of the concrete. Placement of concrete during the winter months is always a concern.Due to the normally low ambient temperatures,curing of the concrete to reach design strength usually requires special consideration and steps taken to prevent freezing. In this particular instance,the placement of the concrete occurred mid-morning, with ambient temperature in the low forties.It is our opinion that the concrete should have reached a minimum strength to prevent freezing. While the concrete in all likelihood has stopped curing,once the ground temperature reaches above 40 degrees F,curing will resume until full strength is achieved. It is our opinion that construction may continue with the pool construction_It is not recommended that the final pool deck surfacing be installed until temperatures above freezing have occurred consistently for several weeks. If there are any questions concerning the above,please do not hesitate to call. ate. Very trulv yours, Paul E.Donahue,P.E. ` NAL E�1� 549 COLUIV B AN STREET WEYMOUTH MA 02190 781.335,1890 a-mall pedaloa*aoLcom fax781.335,1895 i i JOB Peda, Inc. 549 Columbian Street SHEET NO. ® �' OF SOUTH WEYMOUTH, MA 02190 CALCULATED BY DATE (781) 335-1880 FAX (781) 335-1895 CHECKED BY DAT E-MAIL pedalo@aol.com SCALE 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 .o :. i...... .. i.. : ... ._.. g a .. t s 3 i 10 m - _. 5 a o- _..... ,....i ..l... ..:. a. _ C : .... ...t. .. ...... t 1 } � t fi Y a _ ... .. 7 LJ `D 6 ... ... _ ._. ... 7�4G' i , m GOB/ � ? y 5 F i i 2 , 1 d r • i i . 4 a 2 ... 6 : : : : : : 1 . . . . . . . . . . . . . . . .. . . . . . : .. . .. . . . . : ; .............:....:. , : D PRODUCT207 F I LE # B3403 CENSUS TRACT # CLIENT : Prescott, Bullard & McLeod DEED BOOK 2202 PAGE 250 OWNER : Glen T. & Virginia M. 'Sizemore PLAN BOOK 271 PAGE 56 L 75 APPLICANT: Richard B. Tobojka ASSESSORS PLAN PLOT MORTGAGE PLOT PLAN of LAND I N B "ARNSTABLE SCALE: 1"= 50 '. MARCH 8, ..984 LOT 76 199, 58 � w� LOT 75 LOT 77 DECK 31 , 009 S , F , ± 2 STORY #72 0,rG LOT 74 ' 54.00, Q �1 00' RIV E I CERTIFY TO FAIRHAVEN SAVINGS BANK AND ITS TITLE INSURANCE COMPANY , THAT .THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOW'I AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION THE', L`0CAT ION OF THE- DWELLING AS SHOWN .- , HEREON IS IN COMPLIANCE WITH THE ' LOCAL APPL'I'CABLE ZONING BY-LAWS WITH RESPECT o` (EN NETH TO HORIZONTAL DIMENSIONAL_ REDU_IREMENTS , . R• =^14— o ERREfRA No.28716 THE ",DWELLING SHOWN- HERE DOES NOT FALL W I TH I N A SPEC I AL FLOOD HAZARD ZONE AS DELINEATED ON A MAP OF COMMUNITY .#250001 S DATED.. 10/1783 BY THE F . I . A . Land Surveyors Civil Engineers (ffilbi 39uston Xa b �$nr-ieg (go., �nr. 261 �niun �4t. Ntfu �tbfarb, 1 -12740 GENERAL NOTES: (1) The declarations made above are on the basis of my knowledge, information, and belief as the result. of a mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing in Massachusetts. (2) Declarations are made to the above named client of-ly as of this date °.,(3) This plan was not made for recording purposes, for use in preparing deed descriptirns or for con— structions. (4) Verifications of property line dimensions, building offsets, fences, or lot coy:figuration may be accomplished only by an accurate instrument survey. ' rrla t 4' a . y� .3 a r 1 ) X 1 p �r -am pis Poo tv �j„/A _,r l-f/ t2T 13e�2...,O> � i 7 Aoope Ave, 7 S � - _. _- _ _ N 19 9 --- -T ON- : : F T z�)/R/y : T-- Wit'_5l1ci t..cayri'�Is_ 7'a �IvA Of G '.<l7 . ALA canisu�Tr !G f kV NE -i �jdr ��• 76 r,Assessor's map and IotC`% :r..:.......... A SEPTIC €YSTESP INSTALLED IN COMPLIANCE Sewage Permit number ............. X.�..f..7....._. ... .._ ... ....... WITH ARTICLE Ii STATE �oFTHETo�♦ TOWN OF BAIN" S TABLE Z EAE39TSDLE, i "bq. BUILDING INSPECTOR f�MPY a. I�,Z APPLICATIONFOR PERMIT TO .................9:...... ....................................................................... TYPE OF CONSTRUCTION ............Ll!..Q.I. .J)., .......................................................................................... ............ .0 ... ............l 9. .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appliiees for a per/m�iit according to the following information: y r j�p Location .........�eC.0.yl ,7..t?......... ,IU6..!5.....S.��/�)......... +�f. ..............��/..�.1...0),P.... ..!L./V�J ProposedUse .........../.b. SS.1. - ......................................................................................................................... Zoning District Fire District ...... Name of Owner ...... D��...........Address ..!.. .... Name of Builder I ,II .Address .J......�✓1. .4s"! 'K..N � . Nameof Architect ..................................................................Address .............................p.............................. .......�................. Number of Rooms ..............7................................................Foundation ...............�.v....✓�..�..�...... ./.•�.4, ../............. Exterior ....... .....................................................Roofing ......19. 1./ .1............................................... Floors !lr. ,/� ... � .:.d. /9..... Interior ............. . ,��yl�!./� L'.................................. Heating ......./ .. .......4�1.k...............................................Plumbing ................ L. e c.................................... Fireplace .............6 )CA1,...............................................Approximate Cost .......... .. ........................................ Definitive Plan Approved by Planning Board ........ . ..______________19 ________ . Area 'v �, i ........................ Diagram of Lot and Building with Dimensions C . .. 7S Fee ......... .. .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 'ell �i I hereby agree to conform to all the Rules and Regulations of tai4 of Barnstable regarding the above construction. Name . .... .Z./..�..... ..................... Sizemore, Glen No .....17821. Permit for ...,.1 1/2 story, single family dwelling ............................................................................... Location / ford Drive ........... ................................................. Cotuit ............................................................................... Owner e ................Gl.........n..Si.....zemore.................................. Type of Construction .....................frame ..................... ................................................................................ Plot ............................ Lot ...........#-?.5.............. Permit Granted July 16 75 . ......... Date of Inspection Date Completed � d 19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... � 'ess ris wmap and' lot numE�er w y� .�...:....'t... !...�`�S , •i� „'��.,Y ��".��d �`- �s�._ �`��, • .! � ,�a_ � "7 1�D" Jr,. J,.�,�}i�j n tt 7 �:] J` •r{' 'y - • Y a Sewage Permit number ..... .... ! ,�. P�'Of THE ropy TOW Nu O Fc B A R N Z EAHHSTAIILE, 1639. a t .�.�i� u'�• :5.::. Wit.-:a 9 0 ,r i DUIL�DIN.G - INSRECTOR f .� r. �. ; - APPLICATION FOR PERMIT- TO `.. ^ ...................................... ...... TYPE OF.CONSTRUCTION .............. 1. X6/Fit� t.� r +��.:............. ..:..... ......... '.:: �........]� i # .1 r . . L TO THE INSPECTOR OF BUILDINGS: Y The undersigned hereby applies for�a,�_permit according to the following information:_ Location ��".. .. .. !► �.t.' it � I A,r r� �� t•� �P .. . .....� ..Y Proposed Use ...:.. .......................................i". J l �. ....... ....: _ .....* g ............... K I Zoning District .... .... .....'�' ......................................................_ Fire'District .t. . ` �'i+�f /...... ............................... y� r � Name of Owner ...... a �'• .,.r 3" tt?, � *^... ..Address ..y..: r s �.s3 ..k �,.J ?' � .A�.I N!X l iY."r' 7(1' I� �:►tr`t i .. .ir!.." - Name of Builder Address ..........rram�' t x-,• J•is-t'T_t�f 4.•r c Name of Architect 'Address Number of Rooms ....................................................� . Foundation .. . :..... . .. ........ .. , Exterior' .... ,� r' !t 11 :......Roofing ........ .... ...... ....... r +f; °T M 1.7�N J1 h..... 7. ?+ Tyr.. j .Interior .......: .. �' Floors ...... ... . Heating ..!- 4�, ......................................Plumbing ...... raj `1 ' a , Fireplace ..... pp' .............j-.�,l{�/..........................:........:...:..::: A roximate Cost-,,�............................................. r Definitive Plan Approved by Planning Board ________________ " . .. ... ---------------1 9 -----. Area . ,.�,..� , Diagram of Lot and Building with Dimensions Fee . SUBJECT TO APPROVAL OF BOARD OF HEALTH • '+�c, " c2,• �'i _ ""s K 5 .`' 'a' a •r r •�� i .L i • r st A� I hereby agree to 'conform to all the Rules and Regulations of the�Town ,of Barnstable regarding the above' construction. Name . . ..............................' ...... .. .. . - , ,„ , Y � ~ Sizemore, Glen A=21-65 .14.....s.ing 1 e...f.am.i.ly..dwe.l.l.in.g........./........... kill Location Drive Cotuit ^^-= ---- ----_-- � Type of Construction � _ ~ vu/e of Inspection uore Completed /.........................19 - | ERMIT REFUSED - l lV .................. ........................ � � ................ ............................................................. ............ ...-----...—.—.---..—.—~.~-- . � ----.-----.-- ..-----.—... (? T ////;?� Approved ................................................ lg ' ----------------------..--- � , -----------'---------'—^—'^—^' � | | � �� f 7 YYYY j I : " �7 40/ /9o`lb� �- �LICr{'-�-CUh/�f i'•�lS -�� - -- �IA OF ALAI W-1 I r _ P 'crust �,� Town of Barnstable *Permit# Expires 6 months from issue date y7 snarrerasiA Regulatory Services Fee , d� eras 16 Thomas F.Geiler,Director Building Division Elbert C Ulshoeffer,Jr. Building Commissioner X P R �e 367 Main Street, Hyannis,MA 02601w !_ �.7s PE A r Office: 508-862-4038 e�T Fax: 508-790-6230 SUN 2 9 200, EXPRESS ERAUNot Valid without dAPPLress ICPATION, 7"OWN pF BARrintNSTq . Map/parcel Number of N � - BCE Property Address t M-Residential OR 0 Commercial Value of Worky�(% Owner's Name&Address 11 6 o P QC 8 OX 2-73 C6 Jt � Contractor's Name i 2 ZIf,W�WP044 Telephone Number 119 k J Yllf Home Improvement Contractor License#(if applicable) LUU 7 qC Construction Supervisor's License#(if applicable) C [Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner [.I'have Worker's Compensation Insurance Insurance Company Name ZJL�',C L�KJ JIM 4 L CG A Workman's Comp.Policy# b� Permit Request(check box) Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value (maximum.44) Mther(specify) 4� a�CG eQ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature expmtrg_ 1 , Assessor's offic'e ', (1st floor); �� `-, ,.. TNETG Assessor's map and lot number ... ..'.: ��.....:: ... • r �♦ .......... , a Board of Health (3rd floor): -► � l jsepne WQ ' Sewage 'Permit number .. .Vy.: ....:. � r 1t.k a'� ` N C r Engineering Department (3rd floor) l' j .L. House number ................. �. NV F30 y 6�0 s Si T aTL i63 N -. E �, . ENTAL N�a Definitive"Plan Approved by Planning Board :____:_________________________19 -_-___ . TOWN APPLICATIONS PROCESSED' 8:30'-9:30 AM. and 1:00-2:00 P.M. only' TOWN Of , BARNSTABLE BUILDING INSPECTOR ; APPLICATION FOR PERMIT,TO �.L� .. .!.�.�i�!.�`?.. . C.IC ........................................................ TYPE OF CONSTRUCTION �. . ...fi �S :SJ1Z4''. R ` ��•- ............... S?.;-. . _, pp ...:: TO. THE INSPECTOR 'OF BUILDINGS: The'undersigned hereby applies, for a permit` according to the following information: Location .L45 1. ....... .: .CQ:r� �� .\ . '...'... Q C�..C.. y..`:/..`......... ..��. ................. ..... Proposed Use .....r`Las.J.VCP.. 196.4 ........ ......... ............ :...... . .........::........ Zoning District. ...... ... .........Fire District. .... '. ;.... .. ...... Y Name of �L-.. .........Address •.72. -3� �w. .. Name of Builder(�Y .. .. �J..�tV � ..�.....Address rI� N�.��. ..``�G.. ..... :. Y:... . Nameof Architect ...................... ..................................`.......Address ...................................................... ... Number 'of Rooms ............................................ ..... ..........Foundation ' .... . .. 1 �� ^ Exlerior ... 1 �.. ...... ::.Roofing :::....:............ Floors ...................................................... .............. ....................Plumbin . .,..,.......:Heating ............................................:........r......... g J Fireplace ....Approximate Cost .....:.......3�.q'.. .© ....:...........:......... ..... Area 015.}:..+ 37( ).1`zS Diagram of Lot and Building with Dimensions Lo- —7.6, Fee ......... 61 i oar ,. OCCUPANCY PERMITS.REOUIRED FOR NEW DWELLINGS , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ; Name . ... ............ Construction Supervisor's License �./..... .... ..... 41 TOBOJKA, RICHARD .. fifi 31760, Remove/Reconstruct Deck No . Permit for .................................... ........ - r` Single family Dwelling - • _ Location Lot` #75, 72 Oxford Drive 7 _ "' �N, . I COtUit A •,;� , ......... ......... ................................. ,1• F •ti i - Owner Richard Tobojka ;• ......... �.. .".:Y. ..... ..... ... ....�......... k, Type of Construction ........Frame ........................... ? Plot ... .....j _�Lots ....... ....... ✓,. ; ..,. Nam•"' 1c 1�1 �s � ."� ��. �. •.— _. . '� _ a Marh 31 , 88 a Permit Granted ... ....... .... ..}19 �k �,• i ;� ,. s >• Date,of Irispection .. .... .' -19 : J. Date-Com pleted ........i .. 8' -n ).1.9 L, Y :• �` 96 !! 1 Ut AV F,+",, . ... r, t• k • � !�— Rd' r+1' � 1 i !, i/"'� - �� .- • F' P.�_+fir•^ } r } r _ ' JAssessdF�_offitt (1st floor): / THE Assessor's map and lot number ...� 1...'"... 5.......:.. i ..° o� Board of Health (3rd floor): 757.(115 �] � � U fO�P ♦� Sewage Permit number .......... /. ............../......... �-.../� O i Basa9TsnLE, i Engineering Department (3rd floor): rasa / o saga. House number 0 ...,.......................:............ D MAY Definitive Plan Approved by Planning Board ________________________________19-------- . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only k TOWN OF ' BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... ..................................5! ........ .. i� 'c..................................................... TYPE OF CONSTRUCTION L 5 .............................. r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /� - . _Location . 1.:► ....1.. t..."....�� .. -!. .� ... .M�.�4.a. . '...�.. �! ..�. - ...✓..:. !..A. ..5.......................... r ProposedUse ��"51T,71` .�A,a,U., .................................................................................................................... Zoning District .......................................................Fire District .................................................... ................ } ...................... J 'f , Name of Owner Address rr1? 1 ,.:..... .... ... .................. ........ — 1 Name of Builder .1�1�r'�" GGd? ........Address ....f.:e... .��'-''. . .......... p, ........� ti Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation .......................................... Exierior f cV! P ,,l,'[ .E=?.t '�. 4► Jf ..........Roofing .................................................................................... Floors ..... ................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ..............,a�a.-l.............................................. {t Area .� )r -T- � 5 Diagram of Lot and Building with Dimensions lrRo Fee ..................... 17 1 or 75' Y 2S 7Z rri-Ec-l-'. �r �' L "I L� F07,V T;)� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. l f � Name ./� .... .4.... Construction Supervisor's License TOBOJKA, RICHARD, A=021-65 X _ 021- 6� No ... 31160. .... Permit for ...Remove. . /Reconstruct. . . Deck .. ....... .......... .. ....... . .. ...... �'. Single Family Dwelling Lot..........................................................oxford Drive Location ................................................................ Cotuit ............................................................................... Owner ....Richard Tobojka ............................................................. Frame Type of Construction .......................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted March 31 , 88 .......................................19 Date of Inspection ....................................19 Date Completed ......................................19 , : q x- 9 i ' S �^ '1 IV i f _ - t _ i b76r f L S t \/ r , //. - - - - - TF� TAT--T� i &W //YlGYN off/-77{/s ! T- , ,/ r- • of - - - - - - ice' /LIB/1✓1�. I-Wb ,ZOf_1fMEs' - =�``P ss9c� - x �'S/ �A/�S .�4�sx1175. - �L1/l�'v�"i" �iT �"� 7C`. �aS�S�I` _AL1A r1NSGlGT/i`fC� _. - 119`/ - j2�'. N E ? 5! 0 : GIST a� 1. G / / 9 S 7� X Pb r � � 1' t GCE r. 4 IT 0 J Lt I �1 1 Aul RE4c�r�Pf 1-4•1�4 i) rr - I ANV, +*f'_` Cfl L 1— f mo. iyS 14-K i U J ' ` 1'a ' { N - f ( \\may, ��• �3.'� '- - �y 1 1, l SCALE I t 1 APPROVED BY DRAWN BY nATF ...' i I f k op a SCALE. II- _ �' `3" APPROVED BY DRAWN BY DATE r I i v � 1 1 l� , rr-5 ry- i '� � 'S'tb�1aE'Y3U_ �s.- ✓' ��, �SYE-tf1�..T 5H PVC�ts._ � � - "'j '-�-"_� " �, -- - I� ' MIN. �.'�`. Qit_W CARD, G .i tNSsJ�.r�-rani � 4- l0�-04 SCALE lI�M ' APPROVED BY DRAWN BY DATE