HomeMy WebLinkAbout0030 DUNN'S POND ROAD Pad �.
s/� /V/Y
oFtHE rq,,, Town of Barnstable *Permit# ZC e,53
Expires 61nontlis from i e date
,, ,STABIE, : Regulatory Services Fee -
v� asps• �
i6gp. Thomas F.Geiler,Director
1m
Building Division X PRESS PER
MIT
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601 �A
eU 2004
Office: 508-862-4038
Fax_ 508-79.0-6230 TOWN OF BARNSTABLE
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY _
Not.Valid witltout Red X-Press Imprint
Map/parcel Number
Prop a Address
rt3' -
VResidential Value of Work
- Owner''-s Name-&Address
• ..-Dun.r1S KV
Contractor's Name " Telephone Number
v«
Home Improvement Contractor License#(if-applicable) �-
Construction-Supervisor's License#(if applicable)
❑W orkman's-Compensation-Insurance
Check one: -
❑ I..am a.sole proprietor: _
- gq I;am the Homeowner_
Q`I have-Worker's.:Compensation Insurance.
_ �...
Insurance Company Name — -
Worlailan's_Comp.Policy#
Copy of Insurance Compliance Certificate must be on file. _
Permit Request(checkbox)
E Re-roof(stnpping old shingles) All construction debris will be taken to
x _
-
❑Re-roof(not stripping. Going over existing layers of roof)
Re side.. . :. . -• _. ^'
3ai
-
keplad6inehtWind6Ws. U-Value (maximum.44)
*Where required:!Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic Conservation,etc tl r
***Note: Property Owner must sign Property Owner Letter of Permission.
Home I ovement Contractors License is required.
Signature
Q:Forms:expmtrg
Revise053003