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�s J Town of Barnstable *Permit#0)00
Expires 6 months from'slue date I
muwsrAniz Regulatory Services Fee /
PE Thomas F.Geiler,Director
163 RWl ilding Division
NOV ? 2006 Tom Perry, CBO, Building Commissioner
-�� 200 Main Street,Hyannis,MA 02601
' oiz BqRNSTgg '.town.barnstable.ma.us
Office: 508-862-4038 F : 508-790- 230
EXPRESS PERMIT APPLICATION - RESIDENT NLY
rr_� j Not Valid without Red X-Press Imprint
,\
.p/parcel Number G'Ll b t�q I
,perty Address
-Residential Value of Work �3 I D ` PD Minimum fee o 5.0 fo work er$6000.00
tner's Name&Address
ntractor's Name ��� e���'� Telepho umber �� 0-1
,me Improvement Contractor License#(if applicable)
nstruction Supervisor's License#(if applicable)
Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner r
anave Worker's Compensation Insurance
;urance Company Name `rn rn J�J�
orkman's Comp.Policy# '� 6,9 k
ipy of Insurance Compliance Certificate must be on file.
rmit Request(check box)
Ef Re-roof(stripping old shingles) All construction debris will be ken to
❑Re-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 compliance with other town dep ent gulati '.e.Historic, onservation, c.
'Note: Property ner ust sig P rty Owner Letter of rmissi
Ho I r e nt Co c License is required.
GNATURE:
Forms:expmtrg
vise071405
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TParcel,Detail Page 1 of 3
07,
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Logged In As: Parcel Detail Thursday, Novem
Parcel Lookup
Parcellnfo
e-------,_ __ Developer
� � _ per
Parcel ID#246-071 I Lot�A, B
Location 1528 CRAIGVILLE BEACH ROAD I Pri Frontage 490
Sec Road STRAWBERRY HILL ROAD sec 283
Frontage
villageCENTERVILLE I Fire District C-O-MM
Sewer Acct I Road Index 0369
InteracMave ;
Owner Info
Owner�RRIFIELD, EVERETT B I Co-owner jC/O THOMAS W SANFORD, JR- EX
Streets139 VANCOUVER AVE I Street2
City WARWICK I State RI zip 02886 Country US
Land Info
Acres 13.08 Use Single Fam�f'JIDL-01�I zoning 1�B Nghbd 10107
Topography Level Road Paved
Utilities Public Water,Gas,SepticI Location
Construction Info
Building 1 of 1
Year 11930 I Roof Gable/Hip Ext Vinyl Siding I
Built Roof
Wall
Effect 1994 1 Roof f sph/F GIs/Cmp AC I Nonr- -_e — I
Area ! Coverl�� Type
nt
Wall
Style Cape Cod I Ill Rooms Plastered Bed 2 Bedrooms
I
Model Residential I Floor I Rooms I ' Full + 1 H I
Total
Grade Average ^ I Type Hot Air I Rooms I Rooms I
http://issql/intranet/propdata/ParcelDetail.aspx?ID=17145 11/9/2006
.4Parcet Detail Page 2 of 3
IT
Heat Found- k ,- t
stories 1 1/2 Stories Oil nc. Block
Fuel ation Co aI��`
A 11 4�- .
Permit History
Issue Date Purpose Permit# Amount Insp Date Comments
- Visit History-_______
Date Who Purpose
7/29/2003 12:00:00 AM Paul Talbot Meas/Est
12/4/2001 12:00:00 AM Paul Talbot Meas/Listed
10/15/1991 12:00:00 AM ML
Sales History
Line Sale Date Owner . Book/Page Sale P
1 12/13/1999 MERRIFIELD, EVERETT B 12719/056
2 3/27/1998 KEANE, ROBERT E ESQ 98P-0099-EP-
3 MERRIFIELD, MARY C
Assessment History
Save# Year Building Value XF Value OB Value Land Value Total Parcf
1 2006 $135,900 $2,400 $0 $309,900
2 2005 $118,900 $2,300 $0 $276,700
3 2004 $96,800 $2,300 $0 $276,700 ;
4 2003 $84,800 $2,300 $0 $147,600
5 2002 $90,400 $2,400 $0 $147,600
6 2001 $90,400 $2,600 $0 $147,600 ;
7 2000 $77,000 $2,500 $0 $99,300
8 1999 $77,000 $2,500 $0 $99,300
9 1998 $77,000 $2,500 $0 $99,300
10 1997 $79,500 $0 $0 $77,300 ;
11 1996 $79,500 $0 $0 $77,300
12 1995 $79,500 $0 $0 $77,300 ;
13 1994 $81,100 $0 $0 $99,300 ;
14 1993 $81,100 $0 $0 $100,400
http://issql/intranet/propdata/ParcelDetail.aspx?ID=17145 11/9/2006
Parcel Detail Page 3 of 3
15 1992 $91,600 $0 $0 $110,400
16 1991 $92,500 $0 $0 $198,700
17 1990 $92,500 $0 $0 $198,700
18 1989 $92,500 $0 $0 $198,700
19 1988 $60,300 $0 $0 $82,300
20 1987 $60,300 $0 $0 $82,300
21 1986 $60,300 $0 $0 $82,300 ;
Photos
http://issql/intranet/propdata/ParcelDetail.aspx?ID=17145 11/9/2006
x
SINE 'Town of Barnstable *Permit#d000
-sY Expires 6 months from's ue date
Regulatory Services Fee
ass*'
16; Thomas F..Geiler,Director
�.
�' �� 111ding Division
NOV D 7 2006 Tom Perry,CBO, Building Commissioner
- 200 Main Street,Hyannis,MA 02601
OF SAR'VSTAB town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
p/parcel Number
)perty Address ��
'Residential Value of Work �39 D D ` PD Minimum fee of$25.00 for work under$6000.00
iner's Name&Address
� I
c5 at l cx\f xx NJ 1 `C
ntractor's Name ��` t'C�4 ' Telephone Number �! 0
)me Improvement Contractor License#(if applicable) (p
nstruction Supervisor's License#(if applicable)
Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
[5--nave Worker's Compensation Insurance
:urance Company Name
orkman's Comp.Policy# '� b(9 r 1 rs nE5 Co
ipy of Insurance Compliance Certificate must be on file.
rmit Request(check box)
Re-roof(stripping old shingles) All construction debris will be taken to C t�
❑Re-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 compliance with other town department regulations,i.e.Historic,Conservation,.etc.
***Note: Property ner ust Sig P rty Owner Letter of Permission.
Ho I r e nt Cc c License is required.
GNATURE:
Forms:expmtrg
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MARK HERBST
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35 Peep Toad Rd.
I Centerville MA 02632 '
(508)420-6216
t Celt phone 774-238-2938
a,x
x PROPOSAL SUBNIITTED TOi WORK PERFORMED AT:
h:
t Tom Sanford '
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5 _�a.
139 hancover Ave 528>Crargvtlle Beach Rd
" Warwick RI 02886 Cneterville 11�IA 02632 { �
- r � j
i = 401-739-4634
r, t We herby propose to furnish the materials and perform the labor necessary or the
Completion of the following;,:
ss=
New Roo
L� Remove 1 layer o existing shingles
h Install 8"drip edge
rJs ; Install ice &water shield dt edge and in valley areas
1`af Install 15 lb.felt paper
,T Install certainteed algae resistant shingles of choice sfi
F Cut ridge &install cobra vent T „
P Replace all plumbing boots
Storm nail all shin Zees
Certainteed XT 25 r. al ae resistant 3 600.00
Certainteed Woodscape 3 r algae resistant 3 900 00¢
i 4 Price includes material labor&duMp fees x
*Please check&;initial choice above. Thank You'
All material is guaranteed to be as specified, and above work to performed in 'a
. accordance with specifications submitted'for above, and completed in a substantial i
f � workmanlike ipanner for the sum of, as'specified above&verified w/your initials
Y� ^ DollarskL )with:payments as follow;full'amount due upon completion
5 , .
Any alterations)from abov 'nvol 'ng"eactra costs will be added under wratten y
agreement,, and becom n e ra` ge.over.and above signed estimate/agreement
J : RESPECTFU
Signature 10/24/06. *j
p . P ACCEPTANCE OF PROPOSAL.
The above races s ecaficataon & conditions are satisfactory,we herby accept
You are authorized`to o the k,and payments will be as:specif ed above. k1
4
Signature(s)
r Date � ;p
d s'' *This pro 'osaI ma be withdrawn b said company if not accepted within 30 days tit
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Board of Bullding Regulations and Standards License or registration valid for individul ute.only
HOME IM VEMENT CONTRACTOR before the expiration date. If found return to:
Board of Building Regulations and Standards
Regi§trat rr 6480 One Ashburton Place Rm 1301
_ 08 Boston,Ma.02108
r dual
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MARK HERBST 6
MARK HERBST — 3'
' 35 PEEP TOAD RD. ��� 5•' ��.+CL�.r-`. —
dENTERViLLE,MA 02632 39eputy Administrator Not valid wttbo t nature
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CERTIFICATE OF INSURANCE
^PROAUCE:R
ISSUE DATE(MM/Dp/YY)
CA
CONFCEERAS p S N T T FICA gp blrR, TFi]S CERTIFICATE
Leonard Insurance Ag�ncy Inc RMATION ONLY AND
P O BOX 494 DOES NOT AMF,Np
POLICIES BELOW.'EXTEND OR ALTER THE COVERAGE AFFORDED X V THE
Ostervihe, MA 0265`�o COMPANIES AFFORDING COVERAGE
NSURED i
ark Ilerl)SI j
S Peep Toad Road I LETTERCOMP A A.I.M. Mutual Insurance Co
enterville, MA 021
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VERAGES i
TNDIC TO CERTIFY 7 HIAT DI POLTCiLS OF INSU1tANCE LISTED HELDW IIAVE BI3BN ISSUED TO THE INSURED NAMED ABOVE
CERTI CAb MAY 13E JSSU f NG ANY REQUJREMENT,TERM OR CONDITION pp pNY CONTP
CERTIFICATE MAY nli ISSUED OR MAY PERTAIN,THE INSURANIC ACT OR OTHER DOCUMENT WITH RN35PECTTO WHICH THIS
EXCLUSIONS AND CONhrr10NS OP SUCH poL1CIES. LIMITS SHOWN FOR THE POLICY PERIOD
A 'ORDIib BY THE POLICIMS DESCRIBED HEREIN IS SUBJECT TO ALL THE
MAY HAVE BEEN AHDUCED BY PAID CLAIM TERMS,
i TYIlUFINStR �N01s
)( POLICYNMII)III POLICY EFFECTIVE
DATE(MM/DD/YY) O UC EXPAtATIO
GMRAL L1,011,1TY I (MM/DD/YY) LIMITS
CUMMCRCIAL(iGNFI(AL LIARII,ITY GENERAL AGGREGATE
S
�C:LAIMSMAp r—]CL'UR PRODUCTS-COMP/OPAGG, S
OWNL•n'S&CON`rRAgTOR'S I'II PERSONAL
&ADV,1NIl1RY S '----�
FACH OCCURRENCE S -
PIKE DAMAGE(Any oft fire) S
AU1'0DI0h11.I:LIn11I1,iTr M6D.EXPENSEE A
( nY ofn;Ptrson) S .
ANY A UI.O I MIIINED SINGLE
All OWNLD AU'I'Oa f IMrr S
CHFDULEDAUTRC I
ODILY INJURY
HIIIAUTOS I (?"Per—) S
NON-UWNCD AUTOS BODILY INJURY
CARAGE LIABILITY I (Peraccidem) S
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'XCESS MAHILITY ROPERTY DAMAGE S
EACH OCCURRENCE S
TI IEK TITAN UMIN LfLA FORM - - - - - - - - OORGCRI Q - - - - - - -S
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AKTNGRS/FXr.CUTIVE INCL OI/IO/2007 S
FFICCRS Altt: }( X THl It .t L DIEA
_S_S,B-POLICY LIMIT f 5DO000
BL DI S&-EA EMPI YEE S
100 000
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U'f1UN O1'gl!li ltn'I'IONS/T,PICA'1'I(INSNEllICLIiti/SPEGIAL ITEMS
i
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71")CATE II OLD ON
I CANCELLATION .
i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED REPORE THE
EXPIRATION DATE TNIERZOF, T14E ISSUING COMPANY Wn i ENDEAVOR TO
MAIL 15 bAYSWItITrENNOTICEToTHECEATIFICATEHOLDERNAMED.TOTHE
LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
yn Of Barnstable; Bldg Dept. LIABNLiTY OF ANY KIND UPON THE COMPANY, rrs AGENTS OR
n St j REPRESENTATIVES.
Tubs, MA 02601I AUTHORIZED REpMENTATIVR
The Commonwealth of Massachusetts
l Department of Industrial Accidents
Office of Investigations
600 Washington Street
' Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
[dame(Business/organization/Individual):—
Address:—
City/State/Zip: Phone #: tJ O'D b c`A I to
Ire you an employer? Check the appropriate box: Type of project(required):
❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the-sub-contractors
❑ I am a sole proprietor or partner-
listed on the attached sheet. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp.insurance. 9. ❑Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its
required.]
officers have exercised their 10.❑Electrical repairs or additions
❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4), and we have no 12.�oof repairs
insurance required.]t employees. [No workers' 13.❑ Other
comp.insurance required.]
.ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
lomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such,
ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
zm an employer that is providing workers'compensation insurance for my employees. Below-is the policy and job site
formation. 1
surance Company Name:
)licy#or Self-ins.Lic.#: L`� ( (o c C7 D I -A. Expiration Date: '1
b Site Address: �r .�7 �1 City/State/Zip: 1.GI(l
ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
tilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
ie 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
up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
:vestigations of the DIA for insurance co rage verification.,
do hereby certify un the ains an en s ojperjury that the information provided above is true and correct.
ature: Date:
lone
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#:
a
Ile F, ..
. Town of Barnstable
SAMWASM
v MAss.
Regulatory Services
Thomas F. Geiler,Director
Building Division
Tom Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barustable.ma.us
office: 508-862-4038 Fax:. 508-790-6230
Property Owner Must .
Complete and Sign This Section
If Using A Builder
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
Q:Fomis:expmtrg
Revise071405