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0040 GORHAM LANE
r , �a �� � _ � � �� o o O - � c r �wluil� � <2 -17 Ql� Town of Barnstable - THE � Regulatory Services o� Richard V.Scali,Director MAM 'g Building Division 16 9. .�� Paul Roma,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 BUILDING DSPT Fax: 508-790-6230 PERMIT# 062017 FEE: $35.00 TOWN OF BARNS-D,si_t SHED REGISTRATION RESIDENTIAL ONLY .200 square feet or less Vz5 0 2 /sfk12? L,4/V e- e 0-nu TeP_ Location of shed(address) Village Property owner's nam Telephone number to ` X Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission ju,isdiction? You must file with Old King's Highway `' Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMIYIISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:0620116 r oo NZ LOT /3 0 AT &X0. `A `0, OF THOMAS G I KELLEY Ire— EQ oP CERTI FLED PLOT PLAN 13 �0 S u Ft LOCAt10N SCALE.. Z . :410. : . DATE THONiAS E KELLEY CO. PLAN RjEMENCCE .4457. ENGINEERS- SURVEYORS 346 LONG POND DRIVE SOUTH Y ARNIOUTH, MASS. p / 07.664 I CERTIFY THAT THE i�fr T/.!.. .. ...... SH.OWK-ON THIS PLAN.IS LOCATED ON.THE GROUND AS SHOIN��I:'NEREON AND THAT'I�'CONFORMS TO THE C�.rJ TF,�d�/G��� �IJ.�SS • SET Qt�I i THE.TOWN OF WHEN CONSTRUCTED. PETITIONER: ., ;{STERED -LAND SURVE. OR TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �Qc Permit# �s 3 L} - — - Health Division I—S Its14 tuff gar o. Date Issued Conservation Division ^ Fee Tax Collector f 4: 0 7 Application Fee Treasurer Pl anning t4>Ie1 Chec 9 Dept. umn Date Definitive Plan Approved by Planning Board Approvedlp,� OFBWROOMS Historic-OKH Preservation/Hyannis Project Street Address N A t-(e Village Owner & G V N Address 0-V V Ar M -2. Telephone <-G, - D .. f3 Permit Requester ° X �°� �I`.M�-�(' S o�' Square feet: 1 st floor: existing proposed proposed \ '�2nd floor: existing C' proposed <=1 Total new_\0_X_'a Valuation Zoning District Flood Plain Groundwater Overlay Construction Type WCX>)iS "V\t A-"\Lot Size �. ��� Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure CO Historic House: ❑Yes )�,No On Old King's Highway: ❑Yes No Basement Type: lYkFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 4t) 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: )Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes VNo Fireplaces: Existing New� Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size C 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 JNo if yes, s; plan ev'ew# Current Use t, eJY1 Proposed Use �-- BUILDER INFORMATION Name �42A%,k _ '2. Telephone Number Address�^�.'� QVA � License# 0 � Q 0 J" TT Home Improvement Contractor# t "l Worker's Compensation# P a ( ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE' ATE C� FOR OFFICIAL USE ONLY r PERMIT NO., DATE ISSUED `MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' FRAME O K 2 3z- ' INSULATION ` FIREPLACE t ELECTRICAL: ROUGH FINAL- - Rt PLUMBING: ROUGH L FINAL I - GAS: ROUGH R FINAL FINAL BUILDING 1 "- r Tr DATE CLOSED OUT m ; ASSOCIATION PLAN NO. F, l �pSHETp�, Town of Barnstable Regulatory Services vABM Thomas F.Geiler,Director MAM Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date F 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 with other requirements. Type of WorC: ,Nk > hl M�Q Q�� ���� Estimated Cost O Cj Address of W ork: 4-6 d T `�y A�M h&TS. - Owner's Name: \()d A-- �- y Date of Application: J J" 0 I hereby certify that: - Registration is not required for the following reason(s): MWork 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 PENALTIE E Y I hereby apply for a permit as the agent caner: V 1 A Date Contractor 14arne Registration No.. OR Date Owner's Name Q:forms:homeaffidav The Commonwealth of Massachusetts x •_ Department of Industrial Accidents Office of Investigations 600 Washington Street; 7`h Floor Boston,Mass. 02111 Workers'Com ensation Insurance.Affidavit:Building/Plumbing/Electrical Contractors. name: address: city state: zip: phone.# work site location(full address): ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel I am a sole proprietor and have no one worldn in capacity. ❑Buil& Addition +, ' r} �:!, yF Akrbtvre t-�"ry'++'x '�y 1. 'c�','4',�yayt %°?"+ +.'+ '}.�'r. v.� q•.�j .s �°`.J�+vlS'.- .l..•r_•s yr..''•'p�''•„�,'a��r.Li'i, ��?5.'Wo ...19."'' t{�'X•F•F+1E:�dr,�,Y..� r. .? Z:!•4"2 +'•.bStY", .�' wh.;�.�r.`c.•. �' y 7�.�e„!'�iN.:7�G 84 rn.�eey I am an emplo er providing wor _ s'comp sation for my employee w• rlcing on this job. com an name• `Qd address:' hone Insurance co. olicy i�"'i4ta�d't�S�7+it�Er���s:�i4t+?ii3'',fE kt�.y3.":��?kwb'r"c�irsR:gr'.f''�.'t^.:�r •• ".'>'"r�;aati~�s'`�'.'3s:%aie��r�r�i'a��l:�°it_':s"Yes)ask'�:.=:,r:'�uurk.:?c;�:�.`i':t�i:AG:+�S•.'S.'.r:�•"�`'''"9fi"k^:� . .. . a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following worlters' compensation polices: comoanv name: address cites shone#• Insurance co. olic # a*; •`y>f1".;�'•�'r, -uirl Kr ~� R 4� : tTYtAi'�Yil��.:ili �.i�. •i'L'•%S.LSICi(.'rt+R..."f'::7a.>.•.%�.:�1.�'`:�'a lr .g yy.,,�ppgg u'''N rr �'�tlV`�� �{.i!'•Y'�i•+ 'comoanv name: address, city phone#•. insurance co. 13011cy Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition-of criminal penalties of a tine up to S1;500.00 and/or one years'imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a f ne df$100.00 a day against me. I understand that a- copy of this ata ent may be forwa to he Ofri of investigations of the DIA for coverage verification. ' do hereby c i under the p Iti of perjury that the information provided above is a aId "ect, MM Signature c Date 4i Print name 1-� v Phone# S 6 "Zk tZ.-F'�( b'O official use only do not write in this area to be completed by city or town official city or town: permitnicense# ❑Building D:�opard ment check if immediate res onse is required ❑Licensing p q ❑Selectmence❑Health Deent contact person: phone#; ❑Other. (revised Sept 2003) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all-employers to providevorkers' 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. br 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 r 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. x i• . ' '•.s•'�"�, t 'K. ., d :d3�Fdt�i ^;r� �hx«il�U�lY...� , 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 listedbelow. w� � � r" s.�+�!.: ...�s�.J!"�'t�tt�^°'��„' i-0'y,3•�-,^K 4r rt ` OEM .6 s Yi s .l A r•.Yi sJ6+�lv�e#�" '�i�Li` i} 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 dumber 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. a "d = m _'.,� i'a+ � SERUM .The Department's address,telephone and fax number: The Commonwealth Of Massachusetts- Department of Industrial Accidents Office of Investigations 600 Washington Street,7 h Floor Boston,Ma, 02111 fax#:(617)727-7749 phone#: (617)727-4900 ext. 406 . OF WE A Town of Barnstable Regulatory Services • snxwnai.E Thomas F.Geiler,Director . Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I as Owner of the subject property hereby authorize %6�6-".e-- to act on my behalf, in all matters relative to work authorized by this buil ' g permit application for. LA (Address of Job) of Owner %ate Print Name QTORMS:OWNERPERMISSION .. _ �1ze�oormrw,u�alt� ��aaa I BOARD OF SUILMING F-.E'lULATIOMS License: G NSTRUC—ON SUPERVISOR Niwm!be 035037 gem 9 I 6 Tr.no: 13079 Re�im, -4 i DEAN F STANLEY, '� In 1- 0 359 APTAIN LIJA G F� a x 5 l CtNTE•RMILLE, MA Administrator. t i Board of Buildin g Regulations and Standards HOMEIM VEMENT.CON.TRACTOR Re istratron. 32149 12006 lug idual DEAN F.STANLp _ °r j DEAN STANLEY c Cam ; ntN yy O�tl s-6 359 CAPT•LIJAH R A 02632 Administrator CENTERVILLE,M ` e .. i /I r` * The Town of Barnstable �« Department of Health Safety and.Environmental Services 039. Building Division 367 Main Street,Hyannis,MA 02601 office: 508-9624038 Fax: 508-790.6230 - AN aEY Owner 1� N) Map/Parcel:, A U Z Project Address: �ia�ti -- Builder: The following items were noted on reviewing: Reviewed by: Date: LOT /3 2D, 88 0 ` 3z lzi : O Of M_ �a TH�AS yC", KPEdtEY CERTIF ED ' PLOT PLAN T � @ 4�o svftv�° LocATION .� 7� CMG :✓1� ,1'S•.. SCALE . DATE.— . THO.MAS E.KELLEY CO. PLAN RarEERENCE .4-P,T. �,.•? C' ENGINEERS—SURVEYORS 346L04NO POND DRIVE A Q rA�.�'�(��8010� SOUTH XARMOuTH,MASS. 03664 I I CERTIFY THAT THE SHOWN,ON THIS PLAN IS LOCATED ON THE GROUND �igA'/tJ L/'7?q',1'f kvl, v + AS SHOWN-HEREON AND THAT IT CONFORMS'TO THE SET R I THE-TOWN OF WHEN CONSTRUCTED. GPo ✓ DATE PETITIONER: / f ROISTERED LAND SURVE OR '� SyEE 1►— 2 0�Z CC \ TOP OF FOUNDATION / CONCRETE COVER CONCRETE COVERS I e; 4'�CAST IRON 4'MAX. PIPE (OR 12"MAX. ' 4"ORANGEBURG(OR EQUIV.) EQUIV.)— MIN. PIPE- MIN. LEACH ° PITCH 1/4"PER.FT PITCH I/4�PER.FT PIT 6 ° PRECAST 1� -� LEACH I N G o' `—INV�gT o a ..:. EL.�t<R� O INV T INVE T o . c :' PIT OR SEPTIC TANK ,/3 DIST. EQUIV. a INV T EL. BOX EL4. .7 . >_ �-►- o; EL. ...r.�9. 'Q. ., GAL. INVERZZ INVE T ; ' ww Q' 3/4"TO II& E L4S o e EL! .S U_0 O. WASHED o / W STONE —6 D I A. PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED. BY : DATE .5��/79... TIME//�, . . . �- 'T. . BOARD OF HEALTH TEST HOLE I TEST HOLE 2 ENGINEER ELEV. . . . . . . . . . . ELEV. .. .. . . . . . . IsDESIGN DATA ' NUMBER OF BEDROOMS . .TH!� . . . SUa-�n(L TOTAL ESTIMATED FLOW 3©©Q . . GALLONS/DAY BOTTOM LEACHING AREA /ppa�.SD . SQ.FT. /PIT SIDE LEACHING ARE,,A//. .�CJ�•.Sd. SQ.FT./ PIT Fs�/ GARBAGE DISPOSALNO/4U. (50% AREA INCREASE) TOTAL LEACHING AREA . 1o.. /. -.0(P . SQ.FT /�.i PERCOLATION RATE����T���IJ .e. MIN/INCH LEACHING AREA PER PERCOLATION RATE SQ.FT. !y.�. .WATER ENCOUNTERED NUMBER OF LEACHING PITS � .� APPROVED . . . . . . . . . . . BOARD OF HEALTH 6AJ j;' DATE . . . . . . . . . . . . . . . . . . . . . . . . . . AGENT OR INSPECTOR Z-0 j00, ell •THO E.KELLr_ro. Y '�//��r�� ,�TT �} ••,,�� f 346 LOiX l<'OND TTha'"11- C SOUTH YA-R1A33DUT_ H,11AS& PETITIONER . • •�� ��• • V3664 11 S� BE Asse sor's ma and lot'number ....1. :, :'. .. . .... ... • `Sewage Permit.number• .......................................................... YlOWKWULATIONS VINE T / 0-TOWN` OF BARNS_ TABLE 9AHHSTADLE. NAM 9 BUILDING INSPECTOR APPLICATION FOR:PERMIT TO :........� �........:....� �............................................:. TYPE OF CONSTRUCTION ........:...........:... 4�r�� '.... z................ .19.7, ..'� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fo�r2a permit according to the following information: Location ..... . �r/ ....f ... it-?. ...........................C!� �...."-..... ..... ......r..... ........................................... ProposedUse ...........l .................................................................. .................................................................. Zoning District ........................... .............................................Fire'District ..«(.............. ' Nameof Owner ... V,,....:! ...................................Address r.. ................. .. //....... ............................ f/ Nameof Builder ....................................................................Address .................................................................................... Name of Architect .......Address Number of Rooms ...... ......................................................Foundation ....... �..... ..?- . Exterior .......... /PD�... .:.......c.... Roofing ......... ... Floor s Interior L -�Cri�-�V ... ./ 7...................... .....j ..... ... ;.. j ........... ............:...................... �� Heating .... Plumbing Fireplace .................... ............................. .........Approximate Cost .... Definitive Plan Approved by Planning Board --------------------------------19________; Area , /..r�.S. ........... Diagram of Lot and Building with Dimensions Fee 1?6 SUBJECT TO APPROVAL OF BOARD OF HEALTH �Qtilo• I hereby agree to conform to.all the Rules and Regulations of the Town of Barnstable regarding the above construction. * Name ......:`.":....e6 . Stanley, C. F. A=193-102 N� 2-1334.......P rmiflor J stoxy..dwelling Location #13• •40:"Corham•R.d•.. .� ......................> b1 �`2'�z3� 8. .............................. r + . T_ OWne(C'....F,--S.tan1ey......................................... Type of Constructionwood.-., YP ............................................................ `Plot ........................ Lot .......... ` Permit Granted .................Jun .......19 79 ,Date of Inspection 19 ✓ ! / Date Completed ..•.:.. .....J� 19 ... ..... , PERMIT REFUSED .r I n. . .............................................. .......... Aft ....................................................... .�Y........ .................................................. ...... t. ............ ............................................ . Approved ............................................ 19 . h 7 ...................................................... •� s Assessor's map and lot- number ... l �. Sewage Permit number ................................:.........:............... O�THE?�� TOWN OF BARNSTABLE, 33AWSTSDLE, "6 . DUL.DING INSPECTOR .1 �:.•.............................................. APPLICATION FOR PERMIT TO .....,............................................................ .... .� TYPEOF CONSTRUCTION ................................:.........:......�:................................................................................... ... \sT, ;....o..... ..................19./� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... , /�;t•� -!y?... r'. ( t?�,- i . .......................................... ........ ............Y ...... .. ....... .................. ...... ProposedUse ........... .....�............................................................................................................................................. Zoning District ..................Fire District ..�:�.?..... ................................................................ C� +.. ............................, .i..............!...... , Name of Owner ... .�........ Address ( ��. ?' c.�/ r` , ft r?J:.. ... ...-........ ........................... ............ ....................�.................. .. Nameof Builder ...............................<........I...........................Address ...............:.................................................................... Nameof Architect ..................................................................Address .......................................:............................................ Number of Rooms ' .........................................................f • a. / .....::........... ....... .....( .....................................Foundation ... �i...v�+ Exterior ..........��...... .. ..�`'::...................n..................................Roofing ............:,.:.... .................................... f' r!fJc rZ C'L� :� Gf �Q at7 Interior ...........:�f`................................/z . Floors ......................................... ............ ..... ............................... r f ` .r Heating ...........: ............... ...: : .....................fir`^' . .Plumbing .............. . ..:..:..............: .................................. Fireplace ............................Approximate Coster °� ................................... ` Definitive Plan Approved by Planning Board __________________________ ���. ..!....`...... -----19--------, Area ................ Diagram of Lot and Building with Dimensions Fee 176. ........................1...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Q M { I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. _ Name ........::.Q... ........................................................... . . . . . . . . � , N-2-=33- 4....... . .... ... ~ = ' ' ^"^.."" . ----^ ' \ /-' ^ L� ' ' —.~~,~-~°.°°^^=`^---.------------.. - . Owner ....... ^ ',p= of Construction ' . . Plot ............................. Permit Granted�� bate of Inspection. uo/a Competed ' . . . . . . | ----' ' ^..........................� �^ / ' � . —.—. .~--^- -`--.----. ' ' ........................................ ................... � ^ ' _----'�^;�.����—.�ux�r�vs�—................... ' , . .. Approved ................................................. lQ ' ' . ^ ' ----------------^--~—^—'''—'—r ------------.—.-----~--.....— u �r W T :. - w .Fivy - I H ii i I /` 7 .. � NEW PORGN L <C y FRONT ELEVATION i SCALE: 1/4" _, V-O" r2 tS z-� u LU Z M kj 6z 4 p =T�r uj O 1 c LU LU Z crrr �. J o LU JJyy 7-r J SHEET 1 OF 2 / �s _-_ RIGWT ELEVATION SCALE: 114" V-O" = • _XJB: 0507 • DRAWN BY: KW DATE: 5/29/05 k; i i y I 13'-0° EXISTING FOOTPRINT w u z -V -kEDCER BaQW c FLAS4ED) iu! w TW W-BOLT TO EXISTING RIM.JOIST { / GAIN. METAL WANGEiS TTP: ul z IL 12 Q 2-2P RIM.JOIST � 4x4 P.T. P057- 3!_3e' 5�_7• T-6° 7"-6° 7"_6° aALV. METAL POST ANdRL aO . - �. .10° °SONO-TUBER PIER TYP.' 12 J ' -0e ASPI"LT SWINQ.W 4 n ;) Lul >' ADDITION '-COX'SWEATANG eye w �. Z MATOW EXISTING TRIM (], z - ALUM, GUTTERS'/ ON. SPOUTS SEA!?E9II LU )'zow , W U 0 axa PT'POST }- )CRAP K/ PINE U.1 Z EXISTING RAIL a FIRST FLOOR J V I q. .� 4� - b,.0p. f; EXISTING O j BASEMENT � v SWEET 2 OF 2 a _ PORCP SECTION J05: o5a, SCALE: I/4" = V-O" DRAWN BY: KW DATE: 5/29/05