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0046 PINEVIEW DRIVE
�i/✓E✓i£h/ �� pe- P i . �. 7,0 cob 5 Town of Barnstable *Permit# Regulatory Services Expires 6 monflts front issue tiale� Fee ss►�vsr►suE. 16 4-$ �� Thomas F. Geiler, Director Building Division' Tom Perry, CBO, Building Commissioner ®� 200 Main-Street, Hyannis, MA 02601 www,town.barnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid lvithoul Red X-Press Imprint Map/parcel Number. ba3 Property Address Residential Value of Work / 0 C 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address r7C:.�C �: � G1 cll�lif Contractor's Narne Telephone Number Home Improvement Contractor License #(if applicable). Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance `" R Check one: ❑ I am a sole proprietor OCT ` r [; am the Homeowner ❑ I have Worker's Compensation Insurance, TOWN OF BARNSTABLE Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(hurricarie nailed) (stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed) (not stripping. Going over existing layers of roofl Re-side #of doors 0 Replacement Windows/doors/sliders. U-Value (maximum .35) # 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 requir L.GNATUIZE: RMSIbiiilding permi onnslEXPRESS.doc 0 r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations { a 600 Washington Street., Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaiis/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 114-c-5 � chn, LAG✓ ��jlec # Address: City/State/Zip: C %(;< </ YAA- c/126 3'S Phone:# Are you an employer? Check the`appropriaie box: Type of project(required)'. 1.❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time). Have hired the stab-contractors 6. 0 New construction'. ` 2: I am a sole proprietor or.partner listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have g. Q'Demolition workingfor in an capacity. employees and have workers' Y P t1' 9:- E]Building addition [No workers'comp.insurance comp. insurance.$ 10. Electrical repairs or additions re iued.] 5. Q We area corporation and its ❑ P 3amu a homeowner doing all work officers have exercised their - 11.�'Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0',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 infoimation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy'and job site - information. Insurance Company Name: Policy#or Self ins.Lic. #: Expiration Dater Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).' Failure to secure coverage.as required.under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties_of.a; fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a,fine of up to$250.00 a day against the violator., Be advised that a copy of this"statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby certify unde a pains and penalties ofperjury that the information provided,above is true and correct Simafore: / Date: Phone#: U 3 U 6 CJ t� 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#: R Informatroff-an-d 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 includin the le acre resentatives of a-ileceased em Io er--or the-- - " g gJ rP g g P P Y , 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 confirrnation 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(hcense.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 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# fi 17-127-7749 Revised 11-22-06 www.mass.gov/dia t. } P�01HEiO�L Town of Barnstable Regulatory Services iaAI�STABLE, Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town,barnsta ble.ma.,us Office: 98-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: I() 6 r V/ 2"Cn/ ��4// C1 number street �J village- "FOMEOWNER" names home phone# work phone# CURRENT MAILNG ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occu ied 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 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 nd requirements and that he/she will comply with said procedures and requirements. Signature o 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:L 1 -Licensing ofconstruction 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:IWPFILESIFORMSIbuilding'perm it to rmslEXPRESS.doc_ Revised 072110 of Try ram, s . • HARNSTABI,E, q "E%. Town of]Barnstable �rFp Mp'f A Regulatory Services Thomas F. Geiler, Director 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 Property Owner Must Complete and Sign This Section If Using A Builder ---- - . . - r, , 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' n the reverse side. QAWPFILESIFORMSIbuilding permit forms EXPRESS.doc Revised 072110 f °FTME Town of Barnstable ° Regulatory Services * BARNSTABLE. v MASS. Thomas F. Geiler,Director qjA 039. ♦� lEo►9+" 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 March 8, 2007 Mr. Hugh Oldham 46 Pine View Drive Cotuit, MA 02635 Re: Illegal Apartment: 46 Pine View Drive, Cotuit, MA 02635 Map: 040 Parcel: 083 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. Sincerel L'. dson Amnesty Zoning Enforcement Officer Building Department gforms:zoning3 Parcel Detail Page 1 of 3 Y' i ZOO iA i, $ ti i y `�' ag a oaf ✓p�'r�a.�� .� �<< t Logged In As: Parcel IV _... Thursday, Ma Parcel Lookup Parcel Info ......... ...... Parcel ID 040-083 Developer LOT 15 Lot ., _ _...., _.. ... .., Location A6 PINE VIEW DRIVE Pri Frontage 125 Sec Road Sec Frontage ......... __.... _ _.__.. ......... Village COTUIT Fire District'COTUIT ...... _ ......... ......... ......... ......... Sewer Acct.. Road Index.1269 Interactive W^' qti Map Owner Info . . ....... ....... owner`OLDHAM, HUGH N Co-owner .. ......... ......... .... .............. ......... Streets 46 PINE VIEW DR Street2 city COTUIT State'MA Zip 02635 Country Land Info _._ .- .. .... ..._.. .... ..... Acres 10.46j Use;Single Fam MDL-01 Zoning E RF Nghbd 0105 Topography'Above Street Road ,Paved ...___ _.... Utilities I.PubVic Water,Gas,Septic Location € Construction Info Building of I Year 1984 Roof?Gable/Hi p Ext Wood Shingle Built= Struct' Wall Effect=,,,,.._._._._.._ Roof AC , __ _. _ ..-------_. Area 11424 1 Cover�Asph/F GIs/Cmp Type,None _. Int Bed E.. __ ... _..... Style=Ranch D wall 14 Bedrooms Wall' rY Rooms .. •._....... _,�__�_ Int „_.. ,._. Bath Model =Res idential 1 Full + 1 H Floor= Rooms; ...........:_...,,,,,, ..... . Total I Grade=Average Type£Hot Water Rooms http://issql/intranet/propdata/ParcelDetail.aspx?ID=2674 3/8/2007 Parcel Detail Page 2 of 3 ��w©x ....._....... % �y HeatFound- y stories!1 Sto Gas Poured Conc. ' Fuel ation t� Af 3r Permit History_.. Issue Date Purpose Permit# Amount Insp Date Comrr 10/3/2002 Out Building 64222 $2,300 2/27/2003 12:00:00 AM SGED 1/1/1983 B24695 $0 1/15/1984 12:00:00 AM CO 1 Visit History ......... _. ......... ......... ......... ......... ......... ........... Date Who Purpose 12/14/2005 12:00:00 AM Gary Brennan Data Mailer 11/15/2005 12:00:00 AM Jason Streebel Mea + Corrected Listing 7/11/2005 12:00:00 AM Paul Talbot Meas/Est 2/27/2003 12:00:00 AM Martin Flynn Mea./List Bldg Permit Only 3/16/1999 12:00:00 AM Frederick Stepanis Meas/Listed 5/15/1985 12:00:00 AM FR Sales History Line Sale Date Owner Book/Page Sale P 1 9/21/2005 OLDHAM, HUGH N 20279/212 2 10/2/2000 THOMPSON, RONALD P & & DEBORAH J 13275/102 3 11/15/1984 AVGIS, JAMES W&ATHENA M 4313/309 4 DENNIS STAR CONST CO 1822/144 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2007 $141,100 $11,300 $1,100 $152,100 ; 2 2006 $124,800 $3,400 $1,100 $157,200 3 2005 $118,100 $3,400 $1,100 $142,800 ; 4 2004 $95,800 $3,400 $1,100 $142,800 5 2003 $86,800 $2,700 $0 $47,700 6 2002 $86,800 $2,700 $0 $47,700 7 2001 $86,800 $2,700 $0 $47,700 8 2000 $68,700 $2,700 $0 $29,100 http://issql/intranet/propdata/ParcelDetail.aspx?ID=2674 3/8/2007 Parcel Detail Page 3 of 3 9 1999 $67,100 $2,600 $0 $29,100 10 1998 $67,100 $2,600 $0 $29,100 11 1997 $73,700 $0 $0 $21,800 12 1996 $73,700 $0 $0 $21,800 13 1995 $73,700 $0 $0 $21,800 14 1994 $71,400 $0 $0 $26,200 15 1993 $71,400 $0 $0 $26,200 16 1992 $81,200 $0 $0 $29,100 17 1991 $79,900 $0 $0 $47,200 18 1990 $79,900 $0 $0 $47,200 19 1989 $79,900 $0 $0 $47,200 20 1988 $60,600 $0 $0 $20,100 21 1987 $60,600 $0 $0 $20,100 22 1986 $60,600 $0 $0 $20,100 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=2674 3/8/2007 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Q Map ® Parcel U Permit# Health Division ! Ci"` Date Issued 3 Ze 2 0 Z0� Conservation Division � Application Fee Tax Collector 2, Permit Fee TreasurerZ!i07� Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 416 Dr/I'-e (// �• �alO � Village Owner ' I f'1�I�'Yr' c�C 11- Address Telephone tloa 9 5_ Permit Request �yi f �x � s �G Ska rC e i Square feet: 1 st floor: existing proposed 0 2nd floor: existing proposed Total new l a 0 Zoning District Flood Plain Groundwater Overlay Project Valuation 3 0 0 ' r Construction Type WOOD Lot Size 125 X ((o Grandfathered: Yes ❑No If yes, attach supporting documentation. -, J 71 t� n [)welling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes No On Old King's Highway: O=Yes ANo 14 / 2 Basement Type: ❑Full ❑Crawl Walkout ❑Other f Basement Finished Area(sq.ft.) 10 X 1,5- Basement Unfinished Area(sq.ft) o Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas I ❑Oil ❑ Electric ❑Other U wit/ Central Air: ❑Yes 4110 Fireplaces: Existing ( New Existing wood/coal stove: O Yes 1&N0 Detached garage:❑existing ❑new size Pool:0 existing ❑new size Barn:0 existing ❑new size Attached garage existing ❑new size Shed:❑existing 0 new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes A No If ye ,site plan review# Current Use �J' b Ca' per,a� �W�� 1 Proposed Use BUILDER INFORMATION Name �' ` M/I Telephone Number ���� Address ��9 �(� ��! ��� ` ,�--� License# fi�o )► �, � Home Improvement Contractor# Worker's Compensation# C. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1h w S'" SIGNATURE JepL DATE 0 FOR OFFICIAL USE ONLY PERMIT NO. ' DATE ISSUED MAP/PARCEL NO. f it ADDRESS •-�^ VILLAGE _ OWNER - - DATE OF INSPECTION: { - - FOUNDATION ; FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. a w _ - .. e; .: '. a-3.. r,,Id `.i . M`a..w w w.r. _ .Y - • ... r" � oF�HIT°�o The Town of Barnstable. aAR YMAssSSA.LE. '• Department of Health Safety and Environmental Services x 9Qpiy.639.`0 sa � rE°Maya, Building'Division 367 Main Street, Hyannis, MA 02601 Office: 508-862-4038 x5 Fax: 508-790-6230 PLAN REVIEW 41 Owner: Map/Parcel: Project Address: L16 V1/= `C611, Builder: The following items were noted on reviewing: y Chi'l'FA Igo x'�z u i rL s09 Cyr- Reviewed by: Date: q:building:forms:review I 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 HOMEOWNER LICENSE EXEMPTION Please Print s r.�DATE: JOB LOCATION: t% V�10 Ir r O e Vv vz, number ' e/e�t villa "HOMEOWNER": xoplald (/ name /�/ • home -ph e# work phone# CURRENT MAIIING ADDRESS: �/ l% flne V 1 Cam" �r 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 Depa t minimum inspection procedures and requirements and that he/she will comply with said pr _A, es an re eme Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any 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 personas 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 fomiJcertification for use in your community. O:FORMS:EXEMPTN °FINE Town of Barnstable Regulatory Services '* BARNSTABLE, Thomas F.Geiler,Director 9`bA S. 1639' Building Division lfD MP'�A 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: /✓U, / + QrU Estimated Cos 3-1 63-5— Address of Work: �/ � 2 V Owner's Name: ko va I—I, d�Y' U v Date of Application: 17 7 / (1 00 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied (Owner pulling own permit Notice is hereby given thhat:_ OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name QIorms:bomeaffidav r o F, � _ _•___, The Commonwealth of Massachusetts. M _ Department of Industrial Accidents • r ��_- - � Olfice ollnyestigadans . �a -' 600 Washington Street --'- -- �, Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name, d �� ��✓� e ✓ifs r p location ,*///� n ) �`' �o ci a�V/ °/ry V aZ toJ✓ hone I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one worm in ca ac�ty %%%%/G%%/%%%%%/lzll,/%//%ompe ' co ensation for my em loyees working on ravidJn workers mP .....................:::::.��::::::.:::.:;;.:;.}:�::::::::::::::::::::;.};:.:::.::::::.::::::.:::}::::::::.:::::?.}:::::::;.>.�.�::::.�::.;.}:.:.::�:':::::::;::.?:: ........:..::.... .T III ............... ..:::...:................ .........:.,.:::::....�:::::.:.... .. ....,....... ........::: ��OII iR `v$ ..:......................... ..::.....:.. ..... 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'. '. .... .r:f.•}tin: ..::: ............. .. ....v;{. r FaIIm a to secore coverage as required Adenhies in the f rm of a STOP WORKtORDER and s Sne ofc S10 00 a day agfai�ut m�I mtderstu�d fbat a one years,imprisonment as well as civil p copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby eerti under the pains and penald of perjury that the information provided above is ttrv.and /correct. Date q - Sig'oature Print name �b�Gt- � � �. � 0 iM p.S 0 B✓ Phone#!C � Y ofndal use only do not write in this area to be completed by city or town official germit/license# ❑B��g Department city or town: ❑Licensing Board ❑sdecb►teWs Office ❑checkif immediate response is required ❑Health Department contact person: phone#; Mother (revi+ed 9I95 PJA) 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 conract 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 checldng the box that applies to your situation and supplying company names, 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 s to fill in the pe'rmit/license number which will be used as a reference number. The affidavits maybe retrimed to ure 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 amce of InYestlgatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 tv:t a'. S ;'�"� LOT 2530 5 00 6' � � �6 12 13 SOT 16 0 � 5 1 1 0 _____=6 = __--- -- o �Q. ___-iis- _46 CW_ a 3'05 , 0 62 5 00 .0 12 o 1� YY i RES. ZONE.- RF' This MORTGAGE INSPECTION Bank Useoonly FLOOD ZONE.* 'C" THE DISTANCES AND MEASUREMENTS ON THIS PLAN SHOULD BE VERIFIED BY AN INSTRUMENT SURVEY. TOWN: _E REGISTRY OWNER: JAMES _W.& ATHENA AVGIS DEED REF: _431�309 ____ _________BUYER: R01VAL17 _P._DEBORAFI_J._ THOMPSON__________. DATE: 9�22/00_ ________ PLAN REF: 282/27 _ ____SCALE:1"= 30___FT. I HEREBY CERTIFY TO CEIVDAIVT CORP t� OF YANKEE SURVEY ___THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS CONSULTANTS SHOWN AND THAT ITS POSITION DOES _ _ CONFORM PAlA.& 40B (SUITE 1) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE WMINMEW v. INDUSTRY ROAD TOWN OF ___BARNSTABLE_____________AND THAT N4 sm IT DOES_NOT_ LIE WITHIN THE SPECIAL FLOOD HAZARD v MARSTONS MILLS, MA. 02648 ARETEL: 428-0055 Cor ASntySHOWN ON TH�5O001 0018D ATED_ 2�92__ <q� slims I FAX 420-5553 • _ _______ THIS PLAN NOT MADE FROM AN SURVEY 29526 PA MERITHEW PLS NOT TO BE USED FOR FENCES BUILDING PERMITS ETC. 6 • •I y '�. Z� � �i��'� R'F` THE%OSTONIAN STYLE . � ' fig T } cream -s 4-6 T� 4 f 1y� F x arYC "�/, /' U� �� A/J� V �V v• '✓`i Vl�'�V' — ,` J/l y y A� _ �� C �.' L / I/'! � � � r�' � (tt!// IINN✓✓"__" 111 L I prof vN'e-;V i �Standard�Features & Materials extended peak or gambre • 1/2"plywood • 2"x4"construction,24"on center , Self-sealing shingles with 20-year warrant available in black,white/gray or brown Peak V • 6'wide sheds available in peak roof only witk(I �j Roof Heights • 6' wide eak=8' • 8' wide gambrel= ' p g � Extended Peak �• 8' wide peak=8'3" • 10' wide gambrel=9'5" • 10' wide peak=8' 11" • 12' wide gambrel=9' 10" • 12' wide peak=9'6" Walls • 2"x4"construction,24"on center • Shed Panel: pre-primed sheathing(vertical) Gambrel • Pine:6"tongue&groove(horizontal) • Cedar:6"or 8"tongue&groove(horizontal) 1 • Wall height=71" • Vinyl siding applied over 1/2"plywood Floo'r."Ofoor6im are.approximate) k • 5/8"plywood • 2"x4"construction,16"on center for 6'&8'wide units *-'2:x6'construction,-16'=on center-for-10'&-12'wide units Concrete block supports-4 comers,front& i back center of outside frame Heavy Duty PT 2x4 or If preparing your own foundation/footing,pleuse call M Floor Construction Sheds USA for exact outside floor dimensionsow • All windows come with flower boxes and shutters o 6x6,6x8,8x8,8x10 and 1Ox10 units include " sf one window—all others include two _ wj D L '+-� [`(� • Wooden sheds come standard with functional windows. > > \,�1i� • Vinyl sheds come standard with non-functional windows Window(optional screen) J�'►/ (functional windows available as an option) tJl t • 40'double door standard -' i' (6x6 sheds come with 26"single door standard) L4 Standard 40 Double Door i J t i 1 # ' 4 j 1 Standard Features & Materials ��o��`� .� ..:. amt►.?el ��R � • 1/2"plywood • 2"x4"construction,24"on center • Self-sealing shingles with 20-year warranty available in black,white/gray or brown Peak i • 6 wide sheds availablein peak roof only lg • 6' wide peak=8' • 8' wide gambrel=9' Extended Peak • 8' wide peak=8'2" • 10'wide gambrel=9'S" �• 10'wide peak=8'11" • 12'wide gambrel=9'10" a • 12 wide peak=9 6" • 2'x4"construction,24"on center ; • Shed Panel: pre-primed sheathing(vertical) Gambrel • Pine:6"tongue&grove(horizontal) • Cedar:6"or 8"tongue&groove(horizontal) • Wall height=71" • Vinyl siding applied over 1/2"plywood • 5/8"plywood • 2"x4"construction,16"on center for 6'&8'wide units • 2"x6"construction,16"on center for 10'&12'wide units • Concrete block supports-4 comers,front& back center of outside frame Heavy Duty PT 2x4 or If preparing your own foundation/footing,please call 2x6 Floor Construction Sheds USA for exact outside floor dimensions. Nam MEN= • All windows come with flower boxes and shutters • 6x6,6x8,8x8,8x10 and 1Ox10 units include one window— all others include two • Wooden sheds come standard with functional windows. Window(optional screen) • Pmyl sheds come standard with non-functional windows (functional windows available as an option) • 40"double door standard (6x6 sheds come with 26"single door standard) Standard 40"Double Door k 4 r4 t Standard Features & Materials NE • 1/2"plywood • 2"x4"construction,24"on center • Self-sealing shingles with 20-year warranty available in black,white/gray or brown Peak • 6'wide sheds available in peak roof only • 6' wide peak=8' • 8' wide gambrel=9' Extended Peak • 8' wide peak=8'3" • 10'wide gambrel=9'5" �• 10'wide peak=8'11" • 12'wide gambrel=9'10" • 12 wide peak=9'6" h , Walls p = � } •� 2"x4"construction,24"on center � �• Shed Panel: pre-primed sheathing(vertical) Gambrel • Pine:6"tongue&groove(horizontal) • Cedar:6"or 8"tongue&groove(horizontal) • Wall height=71" • Vinyl siding applied over 1/2"plywood • 5/8"plywood r • 2"x4"construction,16"on center for 6'&8'wide units • 2"x6"construction,16"on center for 10'&12'wide units • Concrete block supports comers,front& i back center of outside frame Heavy Duty Pr 2x4 or 9 preparing your own foundation/footing,please call 2x6 floor Construction - Sheds USA for exact outside floor dimensions. j. • All windows come with flower boxes and shutters • 6x6,6x8,8x8,8x10 and 10x10 units include one window—all others include two • Wooden sheds come standard with functional windows. • Vinyl sheds come standard with non-functional windows Window(optional screen) (functional windows available as an option) s • 40"double door standard Blom (6x6 sheds come with 26"single door standard) Standard 40"Double Door f Standard Features & Materials • 1/2"plywood • 2"x4"constn�ctioin 24"on center • Self-sealing shingles with 20-year warranty available in black,whitelgray or brown Peak • 6'wide sheds available in peak roof only too ie�gt�ts: b • 6' wide peak=8' • 8' wide gambrel=9' Extended Peak �• 8' wide peak=8'3" • 10'wide gambrel=9'5" • 10'wide peak=8' 11" • 12'wide gambrel=9'10" • 12 wide peak=9 6" • 2"x4"construction,24"on center • Shed Panel: pre-primed sheathing(vertical) Gambrel • Pine:6"tongue&groove(horizontal) • Cedar:6"or 8"tongue&groove(horizontal) • Wall height=71" • Vinyl siding applied over 1/2"plywood • 5/8"plywood m i • 2"x4"construction,16"on center for 6'&8'wide units ' `� • 2"x6"construction,16"on center for 10'&12'wide units • Concrete block supports-4 comers,front& back center of outside frame Heavy Duty PT 2x4 or If preparing your own foundation/footing,please call 2x6 Floor Construction Sheds USA for exact outside floor dimensions. • All windows come with flower boxes and shutters ` • 6x6,6x8,8x8,8x10 and 10x10 units include one window—all others include two • Wooden sheds come standard with functional windows. • Vinyl sheds come standard with non-functional windows Window(optional saeen) (functional windows available as an option) • 40"double door standard (6x6 sheds come with 26"single door standard) Standard 40"Double Door 3 i _Qk � t��O-Q1 5'c� S Coy N � 1 I I i t � J� 1--� 0 k 1) AssessoqL, map:and lot number, ..... a.......8.3 •g.. TxE r gyp% Tp� ®E? Sewage Permit' number . // tBARNS ABLE, i Mouse number .......:...... .......lR'!9 ........................................... so TOWN O F B ARI � i ►°B yE coTirk w IA a e BUILDING INS , E APPLICATION' FOR PERMIT TO ........................ ;.;..................................................................................... TYPE OF CONSTRUCTION ..... Cr��% . ... -���....................... .......................19.... ?. 2 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora ermit according to the following information: Location . .. .... . �-'trc��-�✓..... F/.v.e..... ) 'L�.!�� �........ ProposedUse .....ao_-�JaztA�........................................................ ..................... ............................................ Zoning District .....................Fire District ... C7../... ............................................. .... . ................. . Name of Owner ... . --�i:Li,Rv�....�..'t�atlt_J.............................Address ��•...�!:.�9.`1�..... ..���X... ..UJ./.::..�.... .��...�4.�?UT�. Nameof Builder ... Address .. .................................�.,R '.......... ......... ............................ ................ Nameof Architect ............1....................................................Address .................................................................................... Number of Rooms ..............(..............................................:.Foundation .....0 ................................I............ t 4 4� Exterior :.� ... Roofing � 3L p .......... Floors ......................................................Interior .... .� �T`../ :4� ................................ ` .. Hea tin ... .....•.g � . ... . . . ..�..............................Plumbing. � I �- ................................. a Fireplace ..... ... .................................................................Approximate Cost ......aC�./. s�............................ . ...... Definitive Plan Approved by Planning Board ------19__9 Area �./.. ........................ Diagram of Lot and Building with Dimensions �' Fee 32' SUBJECT TO APPROVAL OF BOARD OF HEALTH. . 4 i 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. Z/ h �O Name �... ...................... DENNIS STAR CONSTRUCTION Cr` NoJ'L469.5... Permit for One...s. 9..y............ E � Single..Fam ly..Awe.7,j.j Xg. Location Lot #15, 46 Pinevie��•••Dr2.ve ' . Cotuit -, ............... . ennis Owner .... tar Constrction ...D ... .................................. u ... .. .......... y Type of Construction Frame. ... .. ....... .......... ........................................... Plot ............................ Lot ................................ Permit Granted January 5, 19 3 3' Date of Inspection 19 # Q DatA C m leted ���F ` t , r . Au�soo�o mo��on6`| 6e �[��.]U:�,___.. ' � SovvoQe Permit number ......... ............................................... � | ,,House number ----���z..���^�� -----------'_'` ' \ / r���-���'7l�T �lu�7 ��� � l0� l�T�� rN� � ������ TOWN�� |� �� �]� �� /� N� |� �� �� A& ������ �- . . �� � N �� �� INSPECTOR �� �� �� ' - ��� NN � N � Nm N �'��� N� 0 NN �� �� �~ � ���� mmm�� � w� ��m- ���� � �� mm ~ APPLICATION FOR PERMIT . ------.---.�---,..—_—.--~_.--`-,-^, TYPE OF CONSTRUCTION ..... ............................................................. ^/(�' c��} ' �~�,��:��—x.�.. .......................l6... �^�� | TO THE INSPECTOR OF BUILDINGS: | The undersigned hova6v applies for it according to the following information: Location /^�-_, .. _.. � �! __.. ��.!�7---_,_.____________.. Proposed` Use ' -------.--'--------------...----.------------ � Zoning District — —,----------------.—Rva District — ..................................................... � � Name of Owner 'P — ---------�A66re» ��.4/.. ~. —. ..J)�.. U ' . / / Nome of Boilder' . ---------------A66res --------.—..-----..---.—.—...--. / Nome of Architect ---�� � ../,/--.--------------A66res ------------------------____ ~ / Number of Rooms ----.�z----------------Foundation ............................................. � Exterior .1,yA"M�'' -----------'Roofing -- --------.— F|oom ... ��.�������=-----------------,.Interior —��� — ^�.______________. Heating —'�—...t�— —.. /Y�-......................................Plumbing --/ yr --------.~,,____,_____,.._ � � �� ) Fireplace —'`�------------------------App,oximo�* Coo -----������l-- . .__,_,. ' ` /�/�� � �� v� 4 V ^ / � �~ ' ' Dufnh�eP|on 6v Planning Board lQ-�~�. Area --------'-----. . � Diagram of Lot and Building with Dimensions Fee ___ ................... ] SUBJECT TO APPROVAL OF BOARD OF HEALTH ' � 1 ] �- w ] ] � ` OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above � construction. No ...... ..................... DENNIS STAR CONSTRUCTION A=40-83 f469 One Story No ..........5.... Permit for ........................ ......... Single Family Dwelling ............................................................................... Lot #15, 46 Pineview Drive Location .............................................................. Cotuit ............................................................................... Owner D.ennis. . ....Star. . ...Con struction. . . ... .... .. .... .... .. .. ....... ....... .... ....... . Type of Construction ....Frame ...................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...January 5. 19 83 Date of Inspection ....................................19 Date Completed ......................................19 dNI-fi 1 2 i 4 FROM _ - TOVVN OF BARNSTAB E- BUIL DING DEPARTMENT Mr. Francis Lahteiue 367 MAIN STREW r MYAMA#1S, MA Town Clerk Phone: 7 7,5-1120 SUBJECT: FOLD HERE _ DATE N vember 19, 198 WE S S A GE Work has been completed under Building Permit #24695 (Deninis Star ' Construction) Please-release Bond: DATE - REPLY , - -- • - SIGNED - - Ne7:Rmi. RECIPIENT,RETAIN WHITE COPY,RETURN PINK COPY • - PRINTED IN U.S.A. i.. -SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. • "' . TOWN OF BARNSTABLE Permit No. 1 Building Inspector cash 'g ,ego• OCCUPANCY PERMIT Bond _.---- Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .. ....................................................... ".... ................................................................ v.....:........................................... Building Inspector h . .{ . .') yam.. • j!. h }� .a1''."° r> _ 1, i'T x � i..., 'F 1 j �''�` r� 4+. h�4�'4.{ka• T? {r..�, L! *` � ��+. � tiY� i'�j yx.Sp 3 �� •R r t: ,.t. „ -r's< <i;yi 5 "Y 't 1 `;s"d •4, 4 4 �. •� .� h 't.' �. j F A:. (6•+ti�.74 r �: 7 �!S' �"'"t(t.��x` 4 ��h ��•t '-t'. C"P r�' �' . Ny, as v!•3 A � T•}h '' b. ti �i. w.. {,�,2} .1 t F >S • 1 .>'+tfi�� 2j T , IP yt, y ^s d +�,�. t R.I �t l . ti.r} 3...r Er tl� e.•k T .fir 3'�„',f Y, i v { rr • �1��j A ,, � �s±i•�'Tnrzo�I,s fy�T�",;K,;s•t•p �.a' `>. � { �.0�`�V � lA t� ° t :�' t '��.�� 4��j��„�Y�„r,,.�at: ,;t' ���,T r t . � t. ; L� 1 •• ,,•• ,�. •�-s { .+C.•- r sx.F ♦•!t � h. ! w�'. K r •; - 12S.-a4 •.�-.,,;5 wx s , PLAN SNOWING FOUNDATION LOCATION o lv�a TTSW { 3 GOTUI T, MASSACHUSE OWNED BY: h•XiV/VIS .S'7,XAZ eC,,41Sr4 Gd o v f Qa VA.P.•lacJTfi/• M/9,S'S_ r GnV SCALE : DATE: DE ryw . NORMA,N GROSSMAN—---•REGISTERED LAND SURVEYOR oC ,'r`W• , a(OZ �F t: h^ 'p x 'I HEREBY . CERTIFY THAT' THIS FOUNDATION IS .LOCATED !�qs ON TINE tOfi:AS SHOWN AND CONFORMS TO THE TOWN : a�� r tx�. ad + 4 time ' j, OF BARNSTABLE ZONING 'REGULATIONS REGARDING Ow,poot {'Ao '• 'r} G, . t k c> Ftt •3 :4) U 1t7 4 . AND `SOT LINES SETBACKS "FROM STREET LINES w KORMAN . GROSSMAN- R.L.S` DATE t h;, i t `' ... .. .�r it ..,• a a .. .. .,3 .. ll...i._Y kv ., ±G.«r�a< .ems�.._.:,'a r.�..L