HomeMy WebLinkAbout1720 SOUTH COUNTY ROAD �7o?0
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oFIME Town of Barnstable *Permit#
Expires 6 months from issue date
snxtvsrnete Regulatory Services Fee ` 3
9cb MASS, . �0� Thomas F.Geiler,Director
A'ED f A°r p Building Division
Peter F.DiMatteo, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
G ! Not Valid without Red X-Press Imprint
Map/parcel Number Q 7b Q 1
Property Address V 0Ao Coo h +q �U
Residential Value of Work
Owner's Name&Address, eir
f'sontractor's Name ' , `b O VA C D Y1CJ Telephone Numb/ecr
Z
Home Improvement Contractor License#(if applicable) I q
c
Construction Supervisor's License#(if applicable) 0(o Z r)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
[_I have Worker's Compensation Insurance
Insurance Company Name 0�c Gz.VI C— CO 0 A m e, r( C
Workman's Comp.Policy# W C. 5 S -7 S S S 3 0
Permit Request(check box)
Re-roof(stripping old shingles) Too�
❑Re-roof(not stripping. Going over existing layers of roof)
Re-side
ok
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature g
Q:Forms:expmtrg
Revised121901