HomeMy WebLinkAbout0249 SEA VIEW AVENUE Liq `j �
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Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workmen's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be
❑Re-roof(not stripping. Going over existing layers of roof
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (r
•Where required: Issuance of this permit does not exempt compliance with other told
***Note: Property Owner must sign Property Owner Lette
A copy of the Home Improvement Contractors Lice
;IGNATURE:
!•Forms:expmtrg
.evise061306
U:S. Postal Service-r.
CERTIFIED MAIL. RECEIPT
(Domestic Mail Only;No Insurance Coverage Provided)
For delivery information visit our website at www.usps.coma
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PS Form 3800,June 2002 See Reverse for Instructions
Certified Mail Provides:■ A mailing receipt (asi-a d)tool eunr ugg uuod sd
• A unique Identifier for your mallpiece
• A record of delivery kept by the Postal Service for two years
Important Reminders:
• Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail&
• Certified Mail is not available for any class of intemallonal mail.
• NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
• For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Rece( t(PS Form 3e11)to the article and add applicable postage to cover the
fee.Endorse mailpieoe'Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS®postmark on your Certified Mail receipt.is
required.
in For an additional fee, delivery may be restricted to the addressee or
addressee's authorized a ant.Advise the clerk or mark the.mailpiece with the
endorsement"Restrfciedgelivery'.
a If a postmark on the Certified Mail receipt-is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt Is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present It when making an inquiry.
Internet access to delivery information Is not available on mail
addressed to APOs and Ms.
COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Sign / E�
item 4 if Restricted Delivery Is desired. ( // ant
■ Print your name and address on the reverse X"�, ressee
so that we can return the card to you. B. Re ved by(Printed " ate of livery
■ Attach this card to the back of the mailpiece, II
or on the front if space permits.
D. Is delivery address�iffe A 1? ❑ s
�Si t
1. Article Addressed to: If YES,enter delivery adl
2nd NOT P.5
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RETURN
IFERTY
21'. 021I03512 1906 02 '?0�4%12/07
Y SENDER OF NEW,ADDRESS
& FINNERTY ❑Expo Mail
MAIN.S T S TE., 2
MA 02655-2053 etum Receipt for Merchandise
{IZVIL'LE " '
❑C.O.D.
(Extra Fee) ❑Yes
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(Transfer fitim service lab i : f❑U-b ❑01 D` UUUU'7 c j;7 3 9 0 , r
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UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
I USPS
Permit No.G-10
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• Sender:'Please print your name, address, and ZIP+4 in this box •
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TOWN OF BARNSTABLE
--BUILfiDIN-DMSION
wy 151vc tl��P rT3�
200 MAIN ST. NOTI
HYANNIS N!A 02601 • =FIr
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