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EXPRESS SHED PERMIT APPLICATL C E I V E p
TOWN OF YARMOUTH -----
Yarmouth Building Department
1146 Route 28 APR 23 2025
South Yarmouth,MA 0266414
(508) 398-2231 Ext. 1261 .UILe e DEPARTMENT
BY
CONSTRUCTION ADDRESS: 47 Bayberry Rd, West Yarmouth MA 02673
OWNER: Christian Preus 47 Bayberry Rd. West Yarmouth MA 02673
NAME PRESENT ADDRESS TEL. #
CONTRACTOR: Pine Harbor 326 Yarmouth Rd Hyannis MA 02601 5CS La) ,a 0
NAME MAILING ADDRESS TEL.#
EmAIL:cppreus c@gmail.corn
Ik Residential IJ Commercials^ L Est.Cost of Construction$9,750.00
/vim
Home Improvement Contractor Lic.# 1,3 Construction Supervisor Lie.# C5 W " v 1 38 2
SHED INFORMATION
New X Size L! I x W 10 zit I Ia 7 " Corner Lot:Yes NoX
Per Town of Yarmouth Zoning By-Law Sec 203.5 Note E: •
Side and rear yard setbacks for accessory buildings containing one hundred fifty(150)square feet or less and single story,
shall be six(6)feet in all districts, but in no case shall said accessory buildings be built closer than twelve(12)feet to any
other building on an adjacent parcel. All sheds are required to be located thirty (30)feet from any front lot line
2"64" t tt
Replace existing* Size L 8. x W x H
*The debris will be disposed of at: Pine Harbor Removal Services
Location of Facility
I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s)
will be just cause for denial or revocation of my license and for prosecution under M.G.L.Ch.268,Section 1.
�/Applicant's Signature: > Date:
4-23-25
T Owners Signature(or attachment _ L ^'� Date:4-23-25
Approved By: Date:
Building Official(or designee)
Zoning District:
Historical District: D Yes D No
**Conservation review will be required if shed is placed within 100ft of
wetland,200ft from riverfront,or located within a flood zone**
6/24
•
__ The Commonwealth of Massachusetts
1 — ', Department of Industria1Accidents
__ M' - 1 Congress Street;Suite 106
`; -'7_= Boston,MA D2114-2017
,.., www.onaass govidia
Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plambers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information 4 e Print Leeibly
Name (Businessiorganizaiiodlndividual):Yi Wt.Ai0►YAD4Y \4 0\t 9 1k 1, 1. L C.
Address: 2S 9 Qhl gOn we.'
CitylState/Zip7q O,Y°W i V\k QiZ6hS Phone#: ED% - ct S 0 -Z S
Are as employer!Cheek tie appropriate hot Type of project(required):
i. I am s employe with ?S aaptoyees(MI and/or part-time).' . 7-laNew construction
2.0 lam a sok proprietor or parioership and have no employees working for me' ,, r` „ 8. 0 Remodeling
any capacity.[No workers'comp.insurance required.]
3 rain a homeownerall work9.,El Demolition
-D doing myself.[No wacicers'comp.insurance required]t
4 a 1 am a homeowner and will be hiring contractors to conduct all work ODmy property l will 10 D Building addition
ensure that all oontrai:bra either have workers'compensation insurance or are sole 1 I.0 Electrical repairs or additions
proprietors with no employees
12.[3 Plumbing repairs or additions
S a lama general Continaps and l have hired tine urecorttractan Bated on the attached sheet 13.DRoof repairs
These sub-contractors have employees and have workers'comp,insurance t
6.0 We area corporation and in officers have exercised their tight of exemption per MGL c. (4.[]Other
152,I1(4).and we have no employees.(No mittens'comp.insures=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 tech.
iComractaa that check this box must attached an additwnel street showing the name of the sub.contractrxs arid state whether or not those ethnics have
employees. If the subcontractors have employees,they must provide their workers'comp.policy number. ,
I am an a nployer that is providing workers'compensation insurance for n employees. Below Is the policy and job site
information.
• • • e•_
Insurance Company Name: �v/•ter
Policy#or Self-ins.Lic.#!:a.cc-Goo- 12 4 9 r'2azs Expinition Date:2. f Z ,2
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the porky number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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$250.00 a
day against the violator.A copy of this state •ent • forwarded to the Office of Investigations of the DIA for insurance
coverage verification. 1
I do hereby certify ;?, :7e frofpMrury drat the information provided above is true and corm
Signature: i gate. // c
Phone#: C D '3' - -I 3 0 " �.�Z T
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
. -
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tid/V'/ r yr!i/6.+�"�'tir�f�ilrft1 of v 1
. �J O f i of Consumer Affairs and u1inessaegulat1O» 'b
. 10 Park Plaa - Suite 5170
i ."
E
Boston, Mas e>�ts 021 16 .t.
Ho Improvement ".• , .-or ReZistration
Commonwealth of Massachusetts
. )R =7t — g at Division of Occupational Licensure
Board of Building R ulations and Standards
• - 7110ag
.. ac * .' ! f. .F 1:::C n ttit;C14 t? 1 r 3 r1) !/
ANNE RD.JAMES Mai:GRATH �` T. l_- • 1# CSFA-073865 j�� „ '. pires.03/14/202
8(AMEN �"� — �.� --
JAMES ft 'Rk$ i t'r ,, ., M t
�6ARWICH` tea• • : _ -
— - BREWSTER s 6 '
C S t
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affaifs and Business Regulation
1000 Washington Street-Suite 710
Bostoni_Massachusetts--D2118
Home Improvement E sacborRegistration
.4'..t --a. .dv
-r , �7,.:..... Type: Corporation
2935
MCGRATH POST&BEAM CORPORATION r k .;4 qn 1D 6
0/B/A PINE HARBOR WOOD PROD ion.
259 QUEEN ANNE R0. ,,w.
HARWICH,MA 02645 "i '^"" ".f
�:r.
�"",. .. w� Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Otlios of Consumer Affairs:4 Business Regulation Registration valid for Individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration dab. If found Mum to:
TYPE:Z;orpore4on Otfloa of Consumer A 9a1n s.Regutatten
B E M
4n 1000 Waingt Butte 710 \
132935 -- `: 1040/2026 Boston,MA 18
MCGRATH POST A BEAM CORPORATION
0/8/A PINE HARBOR WOODiPROD. .
JAMES R.MCGRATH lk
259 QUEEN ANNE RD. Pam"
HARWICH.MA 02645 r Undersecretary
•
PLOT PLAN
FOR LOT •
t#
Ihdicans location of garage or accessory building
Additions with dashed lines ----
sewerage disposal (cesspool)
Well 1g
(ltit ft. rear)
Abutter's l Abutter's
Name Name
Lot# + Lot#
If this is a REAR YARD If this is a
corner lot,
corner lot, write in
write in
name of street. name of street.
3.
8
t �
SIDE YARD HOUSESIDE YARD
(�------moo
SET BACK
(lot ft. frontage)
• �� 1 b61ni
(NAME OF STREET)
/ Infnrmaticn
/ Supplied ed by