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Compan'y,Name Cape Cod Insulation Inc. Phone Number 508-775-1214
Applicator Names Installation Date
Jobsite Address ,.,,,187-CoiUit-Ba-y-Dr.-Cotult-Ma.."-- - ,- A. Side Lot #'s
Permit Number B-Slde, Lot #'S `12455502919
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Town of Barnstable Building
_ Post TMMSTABM his Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
M A RK Posted Until Final Inspection Has Been Made. Permit
.asp.���
�t Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.
Permit No. B-19-2903 Applicant Name: Roland Langevin Approvals
Date Issued: 09/17/2019 Current Use: Structure
Permit Type: Building-Insulation-Residential Expiration Date: 03/17/2020 Foundation:
Location: 187 COTUIT BAY DRIVE,COTUIT Map/Lot: 056-036 Zoning District: RF Sheathing:
Owner on Record: MCGEE,TODD HUDSON& KAREN Contractor Name: INSULATE 2 SAVE INC. Framing: 1
Address: 35 NEWBURY PARK Contractor License: 180747 2
NEEDHAM, MA 02492 Est. Project} Cost: $7,362.00 Chimney:
Description: damming, R-37 cellulose to attic flat,install 2" rigid board to Permit Fee: $87.55
kneewall area,install 1 new attic space access hatch, install 1 new Insulation:
i ]• Fee Paid:. S 87.55
access hatch kneewall space hatch,two temporary accesses to an Final:
attic area,ventilation chutes,install 3 insulated hoses and roof Date: 9/17/2019
mounted vents to exhaust existing bathroom ans,install soffit Plumbing/Gas
vents, R-19 unfaced fiberglass to kneewall slope,air sealing,
(l Rough Plumbing:
Project Review Req:
Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within'six months after`issuance.
All work authorized by this permit shall conform to the approved application and the+approved construction documents for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same.
Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,permit.
Minimum of Five Call Inspections Required for All Construction Work: Service:
1.Foundation or Footing
Rough:
2.Sheathing Inspection
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6.Insulation
7.Final Inspection before Occupancy Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
I- Fire Department
Building plans are to be available on site
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT p� Final:
°4` ' to4 Town of Barnstable _ _ Building
? Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
Posted Until Final Inspection Has Been Made.
° Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit
Permit No. B-19-1940 Applicant Name: FRANK DONOVON Approvals
Date Issued: 07/12/2019 Current Use: Structure
Permit Type: Building-Addition/Alteration- Residential Expiration Date: 01/12/2020 Foundation:
Location: 187 COTUIT BAY DRIVE,COTUIT _ Map/Lot: 056-036 _ _ Zoning District: RF Sheathing:
Owner on Record: MCGEE,TODD HUDSON& KAREN ! Contractor Name: FRANK DONOVON Framing: 1
Address: 35 NEWBURY PARK Contractor License: 164521 2
NEEDHAM, MA 02492 +- " X
' Est. Project Cost: $ 17,000.00 Chimney:
Description: Adding 13x10 Dormer adding bedroom ` Permit Fee: $ 136.70
I Insulation:
Project Review Req: Fee Paid:" $ 136.70 4 r ,/ Final:
Date: � 7/12/2019
Plumbing/Gas
i Rough Plumbing:
i— ;Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within'six months after`issuance.
All work authorized by this permit shall conform to the approved application and the�approved construction documents for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas:
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. i
Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,permit.
Minimum of Five Call Inspections Required for All Construction Work: Service:
1.Foundation or Footing /`/ Rough:
2.Sheathing Inspection - .-
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6.Insulation
7.Final Inspection before Occupancy Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in M G L c.142A).
Fire Department
Building plans are to be available on site �q4 Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
S'
. .... .. .. .... . . . . ............. .... .......... .. . ... .
Wilt Va.
IKE (A
%plication Number.......—......`.�....I..�..�.....................
r ,� • BA�uvsr •
' MASEL .......................................Other Fee........................
039.
�1Fee Paid..................
V��O\ 9
TOWN OF B E 4PProval ..............on.... �.II��....
WELDING PERMIT ff�� (n
P............. ....................Parcei........" 1�'........................
APPLICATION
Section 1 — Owner's Information and Project Location
Project Address villagej�
i
Owners Name_
Owners Legal Address
City JState Zip
Owners Cell# - E-mail
l Section 2 —Use of Structure
Use Group ❑ Commercial Structure over 35,000 cubic feet
❑ Commercial Structure under 35,000 cubic feet
}' Single/Two Family Dwelling
Section 3 - Type of Permit
❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use
❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm
Rebuild ❑ Deck Apartment El Sprinkler System
Addition ❑ Retaining wall ❑ . Solar
❑ Renovation ❑ Pool ❑ Insulation
Other-Specify
Section 4 - Work Description
i
t
Last undated: 11/15/2018
Application Number....................................................
Section 5—Detail
Cost of Proposed Construction /- OoO'Square Footage of Project
s
-Age of Structure Dig Safe Number
#Of Bedrooms Existing f?� Total#Of Bedrooms (proposed)
110 MPH Wind Zone Compliance Method ❑ MA,Checklist ❑ WFCM Checklist ❑ Design
Section 6—Project Specifics
J
❑ Wiring Oil Tank Storage ❑ Smoke Detectors
❑ Plumbing ❑ Gas ❑ Fire Suppression
I
❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom
_ ❑ Private 'Water Supply Public
Sewage Disposal ❑ Municipal ❑ On Site
Historic District ❑ Hyannis Historic District ❑ Old Kings Highway
a
Debris Disposal Facility: ffr,ry%, !LQA r S-f q�,d I am using a crane ❑ Yes 5-No
Section 7—Flood Zone {
Flood Zone Designation
Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑
Section 8—Zoning Information
Zoning District Proposed Use Lot Area Sq. Ft.
Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site)
Setbacks Front Yard Required Proposed
Rear Yard Required Proposed
Side Yard Required Proposed
Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No
Last updated. 11/15/2018
Application Number...........................................
Section 9- Construction Supervisor
Name fi4AA 6"3 L c A_ Telephone Number e loc
s
Address 1051 du-'o++-q tf(/rCity State At,9' r Zip p��e
License NumberC'S 0'9/.391 License Type Expiration Date /o - Xt',
Contractors Email 6a00_6:1>Cje.V2:;,f` 5wean C)/`co Cell # _2>4?' O,�3-
I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation reqold by 780 CMR and the Town of Barnstable.Attach a copy of your license.
Signatur Date
BHoe "mprovement Uontrac or
Telephone Number
Address n)� �lJd�p ig AEI City State x_t, _Zip OAC 6
Registration Number/6 Expiration Date ,/G
I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation re d by 780 CMR and the Town of Barnstable.Attach a copy of your H I.C...
Date 6 l-
ction 11 —Home Owner - -' zemption
Home Owners Name:
Telephone Number Cell or Work Number
I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation required by 780 CMR and the Town of Barnstable.
Signature Date
APPLICANT SIGNATURE
Signature c � Date
Print Name -f 1/- VU K D6lllo(MAJ Telephone Number'
E-mail permit to: n are-eo4
Last updated: 11/15/2018
Section 12—Department Sign-Offs
Health Department ❑ Zoning Board(if required) ❑
Historic District ❑ Site Plan Review(if required) ❑
Fire Department ❑
Conservation ❑
For commercial work,please take your plans directly to the fire department for approval
Section 13— Owner's Authorization
I, as Owner of the subject property hereby
authorize to act on my behalf, in all
matters relative to k au work orized by this wilding perm2tpplication f
llt7 ah;� �
(Address of job) IN
w
Signature of Owner date
7
Print Name
f
G
Last updated: 11/15/2018
The Commonwealth of Massachusetts
Department of IndustrialAccidents
Office of Investigations
IF 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
N2I71e (Business/Organization/Individual):
Address: iyO .1;)C(0V 4 R-D
City/State/Zip: Phone#:
Are you an employer?Check the appropriate bog: Type of project(required):
1.(rI am a employer with 4. ffI am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7.`remodeling
ship and have no employees These sub-contractors have g, ❑Demolition
working for mein any capacity. employees and have workers'
comp.insurance.: 9. ❑Building addition
[No workers comp.insurance p•
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152,§1(4),and we have no
employees. [No workers' 13.❑Other
comp.insurance required.]
*Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
=Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp,policy number.
I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site
information. 1 nn \ _
Insurance Company Name: !S `I �' V_+gUtld+Nee !*QPwCte 4
11
Policy#or Self-ins.Lic.#: f�rr� SQL Expiration Date:
Job Site Address: I e t a ,� lie. City/State/Zip: l ,
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$1,560.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby ce nder the pains and penalties of perjury that the information provided above is true and correct
Signafore: Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall 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 permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would bike 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
Revised 4-24-07 Fax#617-727-7749
www.mass.gov/dia
DATE
Ago CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY)
06/14/2019
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: Cris Webster
SULLIVAN GARRITY&DONNELLY INSURANCE AGENCY INC ac°NN Ell: (508)453-2529 Fa No):
ADDRESS: VIP@sgdins.com
10INSTITUTE RD INSURERS AFFORDING COVERAGE NAIC#
WORCESTER MA 01609 INSURERA: TRAVELERS INDEMNITY CO OF AMERICA 25666
INSURED INSURER B:
SILVA PROPERTY IMPROVEMENT INC INSURERC:
INSURER D:
40 INDUSTRY ROAD UNIT 4 INSURERE:
MARSTONS MILLS MA 02648 1 INSURER F:
COVERAGES CERTIFICATE NUMBER: 414571 REVISION NUMBER:
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 EFF POLICY EXP LIMITS
LTR POLICY NUMBER MMIDDIYYYY MM/DD/YYYY
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
CLAIMS-MADE OCCUR AM -
PREMISES Ea occurrence) 1$
MED EXP(Any one person) S
N/A PERSONAL&ADV INJURY .$
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S
POLICY �
PRO-
JECT LOC PRODUCTS-COMP/OP AGG S
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S
Ea acc dent
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $
HIRED AUTOS NON-OWNED PROPERTY DAMAGE $
AUTOS Per accident
UMBRELLA LIAB HOCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION X STATUTE EORH
AND EMPLOYERS'LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000
A OFFICER/MEMBEREXCLUDED? WA NIA WA 6HUB1K54479618 08/15/2018 08/15/2019
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under
DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000
N/A
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay
claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts.
This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the
issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification
Search tool at www.mass.gov/lwd/workers-compensation/investigations/.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED''IN
Karen & Todd McGee ACCORDANCE WITH THE POLICY PROVISIONS.
187 Contuit Bay Drive
AUTHORIZED/1 EREPRESENTATIVE
�{�.
Cotuit MA 02635 (�
Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA
@ 1988-2014.ACORD CORPORATION. All rights reserved._
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
The Commonwealth of Massachusetts
Department of IndustrialAccidents
Office of Investigations
IF 600 Washington Street
Boston,MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): C't --�
Address:
City/State/Zip: Phone#:
Are you an employer?Check the appropriate bo • Type of project(required):
l.[II am a employer with- 4. am a general contractor and I 6. ❑New construction
mployees(full and/or part-time).* have hired the sub-contractors
am a sole proprietor or partner- listed on the attached sheet. 7. O-Remodeling
ship and have no employees These sub-contractors have g, ❑Demolition
working for mein any capacity.acit3'• employees and have workers'
9. El Building addition
[No workers' comp.insurance comp'insurance.: 10. Electrical repairs or additions
required.] 5. ❑ We are a corporation and its ❑ rep
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance t c. 152,§1(4),and we have no
required.] 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 hue 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 worker;'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: C4<,-, Q!f t--fA —
Policy#or Self-ins.Lic. j70 Expiration Date: /^/9--/ 9
Job Site Address: /[� 'Y City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify nafer pa q*mtKdpenalties of perjury than the information provided above is true and correct
Si g re• Date: �^
Phone#:
Official use only. Do not write in this area,to be completed by city or town officiaL
City or Town: Permit(License#
issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall 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 conformation 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 munber listed below. Self-insured companies should enter their
self-insurance license number on the appropriate lime.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel.#617-727-4900 ext 406 or 1-877-MASSAFE
Revised 4-24-07 Fax#617-727-7749
www.mass.gov/dia
W
N .
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J
V/JLS `.�.�1�lLO011ll6ld�!!G 0��:�� �C/l1�QPi� t` �:l 4 q r•si �,
Otfice of Consumer Affairs it 3ustriess RegulAtion
'H6Mj:-WPAOVEMENT.CC3NTRAATOii
TYPE:i�►rti<hdueJ before tht;.ex}iira>"o�
t i Gn Oftice of tonsur:±st` ffaot�and 8tt�"stkt
rieaiszret�o.
164�24 - --_,10118i2019 10 PatkPta ,-Suite.5174' i
MA, 6
FRANK DONOVON!
RANK J.DONOVA.ti
,. _ i
1tz4 CAFiLOTTAAI/e: `` lsf llal Wit4 t✓_Ss
yy11 �•, .
l.`S'.:V'L[.7 F z i R
HY�ctt' uS,,, :�: _. 'U iderseiiretrai} _
Commonwealth of Massachusetts
Division of Professional Licensure
V Board of Building Regulations and Standards
ConstrV01611'Supervisor
CS-091391 Spires: 10/28/2020
FRANK DONOVAN ,
104 CARLOTTA AVENUE -:
i..
HYANNIS MA
Commissioner /4
d'or-
ermit: 387.
TO ,, � �; ,,Rt4STA8 gown of Barnstable
fME Tod ?�
Regulatory Services ate: 1012II6 3
�F
yP` H3 OCI 21 Thomas F.Geiler,Director'
ee:
BARNSTABLE, 'r Building Division
v MASS.
s639• .0 _____..__..r--- — om erry, Building Commissioner
�prED MP'�p (11V ISION 200 Main Street, Hyannis,MA 02601
Fax: 508-790-6230
Office: 508-862-4038
TOWN OF BARNSTABLE
SOLID FUEL STOVE PERMIT
Owner:
Phone: ��'��
Install at: �D'�/� Village: CA>nz./
Map/Parcel: (' (✓ ."l Date:
Sto
A New/Use
B ype: Radi /Circulating
C. Manufacturer: �, �� Lab. No. (,1!f�f y
D. Model No.:
Chimney
lease note date o last cleaning)
A. New/ xisting f existing,p f
B. Flue Size
C. Are other appliances attached to Flue? Z�
D. Pre-fab Type and Manufacturer N
E. Masonry: Line nlined
Hearth
A. Materials: b
B. Sub Floor Construction:
Installer f 0 �oX sAi .
Address:
Name:
Phone:
Location of Installation: 6&ft4 e„W ko&/6•c�
APPROVED BY: °�---
Please make checks payable to the Town of Barnstable
*This constitutes an official stove permit after inspection,photographed, and approved by the
Building Inspector
Q:forms^stove
o � �
1
t
n
Flop _
✓ 'r r.
Now
p
1
F
ni
r
_ 61
�y
Y
4
i I
�TME> Town of Barnstable
*Permit#
1AMSTABLE. : Regulatory. F.zpires 6 monthsJrom issue'dale
g ill ry.Services Fee
Thomas F.Geiler,Director
rF0 MAy� �
Building Division
Tom Perry, Building Commissioner ®PRE 8 PERMIT
200 Main Street, Hyannis;MA 02601
:.e: 508-862-4038 m
508-790-6230 MAY . 2045 �
EXPRESS PERMIT APPLICATION - RESIDENTIAT F BARNSTABLE
Not.Valid without Rcd X-Press Imprint
gel Number 0.3 C
Address p p
iential. Value of Work —. Minimum fee of•$25.00 for work under$6000.00
Name&Address j N e4
4 n2f 422
tor's Name_
Telephone Number__
mprovement Contractor License#(if applicable) /0 `' y
.ction Supervisor's License#(if applicable)
lsman'3 Compensation Insurance
Check one:,
[] I atsi a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
tee Company Name
can's Comp.Policy#_J P U 13 —®�9 �' I3 �e�1.4-� `►
Df Insurance Compliance Certificate must be on file.
Request(check box)
12YRe-roof(stripping old shingles) All construction debris will betaken to e {
[]Rc-roof(not stripping. Going over existing layers of roof)
[] Re-side
Replacement Windows. U Value (maximum.44)
•Where required: Issuance of this permit does not exempt eompfiahee with other town department regulations,i.e.Historic,Comery
***Note: ProperEyati on,etc.
Owner must sign Property'Owuer Letter of Permission. .Home Improvement Contractors License is required.
t e
nt:expmtrg
;063004
The Commonwealth of Massachusetts
Department of Industrial Accidents
Oilice ofinyeS11917 M
600 Washington Street
ems ,:;•.- Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
A is n o r m"ation� .leased .R� t .e t I �.:
�1' I
name: Nd SI JP'Aice.
t-�a�ati�n: / Lt
city
❑ I am a homeowner performing all work myself.
❑ 1 am a sole proprietor and have no one working in any capacity
CV,I am an employer providing workers' compensation for my employees working on this job.
company name: � � 1L AZA(L
address: Id. /J A17V S
city: M A O Z(—o 5—C phone 9: �� t
insurance co. p �y I
policy# l ()o—/
❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the acontract ors listed below who
have
the following workers' compensation polices:
r17
company name
address:
city:
insurance co. k w
lolicy#
company name: r
address
city:
hone#:
insurance co.-, DOliCV#
01
Failure to secure coverage as required under Section 25A of NICL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against tile. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
du hereby cerr' rder the pains an enn/fits ojperjury thnlnjuonped above is true and correct.
Signature
Date
Print name Phone# �k8--1 1-7-
official use only do not write in this area to be completed by city or town official
st
l city or town: permit/license#
f (1Building Department
check if immediate response is required ❑Licensing Board
*. ❑Selectmen's Office
❑health Department
P. contact person: phone#;
I—IOtltcr
Property Owner Must Complete & Sign This Form
If Using a Roofer / Builder.
(Please return this form with your signed contract, thank you)
(pant) J O/M) H, A0Ao LL/9Nl9 , as Owner of the
subject property hereby authorizes Paul J. Cazeault & Sons Roofing
Inc. To act on my behalf, in all matters relative to work authorized by
this building permit.application for:
(Address of Job) Ca�v,r Dj2 1VZ
Signature of Owner
Date Tel# SZ T- y1,o- �2)17y
i
�> -P0
Board of Building Regulat'ons an tan a�s �
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home lmprovement`:Contractor Registration
Registration: 103714
Type: Private Corporation
Expiration:. 7/9/2006
PAUL J. CAZEAULT & SONS,
Paul Cazeault
1031 MAIN ST
OSTERVILLE, MA 02658
Update Address and return card.Mark reason for chang
Address 0 Renewal C3 Employment Lost Card
OP8-CAI Q SOM-04M-GIM16
/. -eOOINIK nwca&1,. O
Board or Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR License or registration valid for indivillrll use onl}
Rogistratlon:- 103714 before llle expiration dale. If found rcluru to:
U19, Expiration::1037106 Board of liuildinl;Itcy;ulalions and SLoitLirtls
Uuc \sllburUm Place Itn► 1301
;';,Type:`:Private Corporation 13oslou,NLI.02108
PAUL J.CAZEAULT;$,SONS,.INC:'
Paul Cazeault
1031 MAIN ST
OSTERVILLE,MA 02656 Administrator
Nu BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 026325
Bi rthdate: 10/20/1959
Expires: 10/20/2005 Tr.no: 8603.0
Restricted: 00
PAUL J CAZEAULT
1031 MAIN ST
OSTERVILLE, MA 02655 Administrator
Board of Buildingg egulations
One'Ashburton Place, Rm 1301
Boston, Ma 02108-1.618
License: CONSTRUCTION SUPERVISOR'LICENSE Birthdate: 10/20/1959
Number: CS 026325 Expires: 10/20/2005 . . Restricted TO: 00
PAUL1 CAZEAULT
1031 MAIN ST
OSTERVILLE, MA 02655
I Tr.no: 8603.0 -
} Keep top for receipt and change of address notification_
CERTIFICATE OF LIABILITY INSURANCE . lEfM/DDJYY)
PPODUCER-, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Mc Shea Insurance Agency, Inc. ONLY AND CONFERS Nb RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Osterville, Ma. 02655 INSURERS AFFORDING COVERAGE
508-420-9011
INSURED Paul J Cazeault & Sons INSURERA: LloVdIS
Roofing Inc. INSURER B: TraVelervS Insurance
1031 Main Street INSURERC: ,
Osterville, Ma 02655 INSURERD:
INSURER E:
COVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR DATE MMIDD/YY DATE(MMIDDIYYI LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL-GENERAL LIABILITY FIRE DAMAGE(Any one fire) $
CLAIMS MADE ®OCCUR MED EXP(Any one person) $
ti LGL034776 04/30/04 04/30/05 PERSONAL&ADV INJURY $1 ,000 ,000
GENERAL AGGREGATE $21,000,000
GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $
1 ,000 ,000
POLICY PRO LOC -
JECT
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)'
GARAGE LIABILITY
AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE
RETENTION $ $
WORKERS COMPENSATION AND W A - H-
EMPLOYERS'LIABILITY
TDRY LIMITS ER
7PJUB-0095664A04 08/13/04 08/10/05 E.L.EACH ACCIDENT $
B E.L.DISEASE-EA EMPLOYEE $
E.L.DISEASE-POLICY LIMIT $ 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1D� DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED RE jf�A I
J/ /
ACORD 25- (7197) 0 ACORD CORPORATION 1988
10 77- ZV+"�
..� + .. � • `y-� Sys• � ��" �9t � � � ' �-
..LOTGG
A>4 QT F� .�N. `!?.�" 44`N�J
lNo. 31309
�`' C�E.�E'T/ Y :►-, �-•cOt/.uv.4'�'/ov .$�.4/oy✓ /�'�' S•'�,,.' i!t�
7"•s✓Ja� �G�`i1,� !S' r4~v^ !7" �"`X1.� 7�.5' /9NQ •�.'"./�/N 7"' /T'
G.'<.'/�lFc��✓.'�?.S 7'4 .Z'O�iV/���" �'�-G'�J��.`�' �`:'cJN�5`- �a O'4�^'E•• �is`r'Y1�/ .,^C���•'f /~'�6.d
E
,�� "'S• FROM
TOWN OF BARNSTABLE
Mr. Francis Lahteine BUILDING DEPARTMENT
Town Clerk '367 MAIN STREET HYANNIS, MA , 02MI
Phone: 775-1120
SUBJECT: 1
FOLD HERE -
DATE - -
February 28, l9 MESSAGE
Work has been :completed under Building Pemit #225255 (John McShane).
Please. release Band. '
SIGNED
,DATE f
REPLY
$I GNED
Ne7.RMI RECIPIENT:RETAIN WHITE COPY,RETURN PINK.COPY.
PRINTED IN U.S.A.
SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE-AND PINK COPIES WITH•CARBON INTACT.-
TOWN OF BARNSTABLE Permit No. 251.55
------------------------------
Building Inspector
aAUSTA , Cash
------------------------- -
°o
OCCUPANCY PERMIT Bond --
Issued to John McShane Address `
. r
lot: 467 ' 1,87 cotilit BAV wive. Cotuit;
.t
Wiring Inspector r� Inspection date
Plumbing Inspector// Inspection date
Gas Inspector Inspection date
+'lEngineering Department r � Inspection date
,:Board of Health b - , Inspection date
THIS PERMIT WILL ;NOT BE VALID, AND THE BUILDING SHALL NOT RE OCCUPIED 13NTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0,,Og` THE MASSACHUSETTS STATE
BUILDING CODE.
..................................................... 19............ ..........................•-.... ..................
Building-spector
Assessor's map and lot number ......... .rf-......
.. �.......... iTHE T
G, ..Sewage Permit number .......... ............... ... .............:. d
i BAUST"LE, i
House number .............................../R-7.....................:......... ro NAM
O i639• 6�
O/A�, �fOYPYa\
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION ......... ............1V19:0-.zk............ ...................................................................
..................... .........,9
TO THE INSPECTOR OF BUILDINGS:
The undersigned/hereby applies for a permit according to the following information:
Location ...........� ........ ............................................................
Proposed Use ......... .............T_ �........ ....................'...
Zoning District ..............................Fire District ...
Name of Owner ..<�d..til!t!1.....11i .f ..............................Address ..�.. lN........ ............ lJr JGJ
f Name -of Builder .......... .... Q.................................Address ...................................�1..............................................
Nameof Architect ......../............................:............................Address ....................................................................................
((0.
Numberof Rooms .......:....... .............................................Foundation ...........I t...C. ..................................................
..............................Roofing ............. . .......... ....................................
Floors ......>...:.. ....6i`-.d......................................Interior ................t .�!.... .......... ....................
Heating ... .....:.: _ .�.L........d.�.. ....................:.......Plumbing ...................7.....!sue. ........
Fireplace .. .. `..fl.!lf -,� �. ................../.....Approximate Cost ................. .,(..0 ..O"�' ..............
Definitive Plon Approved by Planning Board -----------_______-----------19_______. Area ...... l�✓...........
Diagram of Lot and. Building with Dimensions Fee 7 �
SUBJECT TO APPRfOVAL OF' BOARD OF HEALTH n ��
�00
I �
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS , E
I hereby agree to conform to all the Rules and Regulations of the Town of Born-stable regarding the above
construction.
ig-&
Name . YY.:. .................. ....................
Construction Supervisor's License ..! . w........
McS.HANZ, JOHN A=56-36
25155 1�-, story .
No ................. Permit for .............;......................
..............
Location ...............................Lot 67. 187...........Cot...u..i.,..t.....B.ay........Dr.
Cotuit
...............................................................................
John McShane
Owner ................;............................. ...................
Type of Construction ..F.r.ame...........................
.. .. .......
.................................................................................
Plot ............................ Lot ............................
7,
Permit Granted ....June.....................................19 83
'Date of Inspection ....................................19
Date Completed ............................. ........19
00c�L
L-17
ZjrjA&��
�6
/ �-l essor s map and lot number .........'�,o .......... ,..y.......... 0*T14E To
Sewage Permit number ..... 3....
House number ...............................L7 :..... . .:... "-~��C SY1,63;Et��. SVl���I v= 90�SAM B"
B..
1 'STALLED IN C YA
TOWN OF BA039.
RS" 13lb-T 11
ot , 9o�� 01SI
TOWN RE�a�J�►`�+a`;s
BUILDING INSPECTOR -
APPLICATION FOR PERMIT TO ........> .......k ...... ............................... ,
TYPE OF CONSTRUCTION .......... :....... . ......... ....... ...............................................................
....................g.`..�y........19..�3.—.? '
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ...........Z ..L9.....1..........ra./ /-„•`.-"�!.......
.. T.7............................ ...................................
ProposedUse ........... ....:w....... 4.......................................:.:.................
f
Zoning District ........................................`..............................Fire District Oo.Tal
r
Name of Owner .J.0..4.6k.....!IV...lJ..............................Address ./..: ......:"r?'.
Nameof Builder ........... `......................................................Address .................................:�/...............................................
Nameof Architect ..........................................................:.......Address ....................................................................................
Number of Rooms ..................................................................Foundation ............A...�....................................................
Exterior ........... .C..,. ..............................Roofing ...............X15 ........................................................
Floors ................ ..
/Ck:.......W.a!/........................................Interior ................�,-�.. ... .......... .... �
Heating //��,, '^ ........................Plumbin ................... ...... �": 'i
g ........... .�.W........ �........:. g
• !1
Fireplace / -.� Approximate Cost .................. ............................... .......
Definitive Plan .Approved by Planning Board -------------------_-------------19_______. Area ......gg.���r�................
Diagram of Lot and Building with Dimensions Fee ........... ..........
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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.
Name .
Construction Supervisor's License .. .. v.. .
1
HANE, JOHN
25155 13-2 Story
............. Permit for ....................................
Single Family Dwelling
...............................................................................
Location ...Lot....6.7.........1.8.7...Cotuit Bay Dr.
Cotuit
...............................................................................
Owner .John McShane
.... ............................................................
Type of Construction .....Fr.ame............................. .......
...................... .........................................................
Plot ............................ Lot ................................
Permit Granted ...June 7.1........ ..........19 83
Date of Inspection .,,,.................................119
Date Com pleted ...19
-------------- ---------------- ----------------- ------------------------------------
McGee Plans
7 Cotuit Ba Drive BASEMENT
e tu it,
-
-----------------------
------------------------------------------------------------------- ----------- -------------- -----
Window
window
33H- '%'J%33 H- Sun-Rmom
-
22W 22W 70 79 Slider
S Slider
--------------- --- -------------------
Full Bath
Stoca
15-6 / 13-6 Finished Basement
- —- ------------- --
14.6 / 25--
ell
4
--- --------I-------------- - - `�' - - - ,
StairsII
U inished
-----------
•
ire
r � �
-Ftoor-Pta 27
Karen &Todd McGee -- --- ---- -- --- - - - - - -
1.87 Cotuit Ba Dr QOtult, A --
I_ I r Y2 Bath.
i
' ------- ----- - -----
I 1'
/
--
Farr ry Room
I
16.10128 II
i
I
i
I
Master Bedroom,
Two Car Ga'a
IC-ite�i
I �e
I �
13.8 /31 ,
13.4114
I
I I
----- ----
Ful) Bath -
-- - --
1 I�
I 9_� 9
i I
:-------- -- -
,
I I - -
♦I I
\\1
I ♦ , I I
n
I i
I ',
. I /
Living Room Dining Room
132/20 11.31 13.8 ----- -------------
------ ------ -- ------ ----- - ---- ;
Stairs
H allway— way
I ,
- ------- ------
- — -
I
F-ire
- - - --------------------- -- - - - - ----------- - --- - - - - - - - =- - ------ -- '
-- - --- -----------------•----------
----
--- ------ --------------------------
2nd-Floor Plan
i
M ee Flans I •---- ------ _ ___ - - T--- - ---_. - — - - --' - -
187 Cotum Bay Drive ', IA
ttiit-M�4
- — --
-- -- - - -- Be�roam ,
zi
_6! 1
- - �- - 6 - - -------- - - --;' edroam
----- - - —
-- - `1tJs�� 1J4
Unfinished Lott
Over Gara e
' ----- ------ ------ ------ FUII Bath
9.
i
{
I ; Bath J
` -- ------ - 11.919 5
Propos ----- - -------------
� -
6ed'ro ' ---- -- _ - - - ;
ed
------ - - - -- -- -
Stairs
L l�
Walk
Closet Lia
, ;Closet closet
Fire
I
- - - - ----- ---- ---- ------ - - -
----- --- ---- --- ---- ----':
C .
BUILDING DEPT.
JUN TO 2019
TOWN OF BARNSTABLE
{
-Ftoor-Rt 27
Karen k Todd McGee
- --- - ------ ----- ------- - `
187 C�tuit Ba Dr Gotuit MA j L _- _- - i
--1 -----I -----�------------- I -----1----- Y2 Bath- - -
--
Family Roam - - - -
16.10/28
i
I
Master Bedroom, Kitep Two Car G 'fie
13.8/ 31
I
13.4114
I
i Fu l Bath -
--- ----- - --- }
9.6 9
-- -- _ - -. - - -------
,
- - - ---- ------ ---- - - -
:: . - ----- -- Livin9R, 00m Dining Room
;
,
132/20 11.3113.8 - -- - - - - '
- - -- -
Stoirs
I
HdlIlwa —
Y N iilway
Ff'e
' - - - - - -----------
-- ------- ---- -- ------ ----------------------
------ ------- ------ ------- ------------------
oor Flan
mc+ Plan ------ -------
pee s I . 1, 1
187 Cotult Bay Drive
el
6.6/31
---------- roo
----- ------ ---- ----------- --------------
nfiffislied Loft
Over G arage
----------
------ ----- Ful.l ath
Full
-----------
Bath
11-9 1�.5
I L
Proposed ---------- --------------
--------------- --------
------------ - --
1TS :4 ------y-:
1
i lk lR '.Unen
,Closet Closet
Closet
Fire
ILI--
--------- - - ------------- ------ -----
J�I
------------------------ -------------------------- --------------------- -- -
------ ------ ------- ------- ------I--------
w
� d
LU rn -
NCD
z
o
m
Z -
� � z
m .�
McGee Plans
18' 7 C' otuit Bay Drive BASEMENT
C%tuft7
----------- --------Ue
------ ---------------- ---- -- ------- - ---------------- ---------------- --------- -------- --------
Window
Window
-33 33fl- Sun-Ream--
22W 22W 70 79 Slider
Lee
81 glider
------------ --- - -- ------------------
Full Bat
Fin-[Shed basement
15.6 1
14.8 / 25
-------------------
------------------------- ----------------
--------------- 7--------- -------------
/ 13-6
------ ---------------
St' Irs
Utffinisff ed
------------
Fj-
re
SMOKE DETECTORS REVIEWED
Barnstable Bldg: Dept.*
i
ABAgT�Ar' LDI G-DEPT. E Approved by:
FIRE DEPARTMEN DATE Permit ' t0( 4 C3
MOTH VGNATO _____�_..,..__.. . _...-,....... _.�..-t.
P:
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