HomeMy WebLinkAbout0187 GREENWOOD AVENUE ,�
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R rJ Town of Barnstable *Permit#
Expires 6 months from issue"date
Regulatory Services Fee ��
Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us -
Office: 508-862-4038 [;Faux: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 4 2005
Not Valid without Red X-Press Imprint .r® N OF BT
ABLE
Map/parcel Number '7M DG-7
Property Address
Residential Value of Work J Minimum fee of$25.00 for'work under$6000.00
Owner's Name&Address
YNA44-195 a
Contractor's Name LTelephone Number 3 Q
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
y_
DgWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's.Compensation Insurance
Insurance Company Name
Workman's Comp.Policy# ��. �O o
1/
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
Re-roof(stripping old shingles) All construction debris will be taken to l +Ck6,3 h,C. wkk�
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
,per -7�
❑ Replacement Windows. U-Value (maximum.44) �\ Board of Building Regulations and Standards
�.
*Where regpired: Issuance of this permit does not exempt compliance with other town departrr HOME IM� VEMENT CONTRACTOR
i! Registrati n� T32282
***Note: Property Owner must sign Property Owner Letter of Pei� r — / /2006
Home Improvement Co c ors License is required.
_ -
SIGNATURE: K.P.REMODELI T `
KENNETH PERRI� = - I
Q:Forms:expmtrg 1.9 GUILDFORD RD.
Revise071405 i
j Centerville,MA 02632 ;administrator
°FSMiE A Town of Barnstable
°^ Regulatory Services
BAMSUBLE. ' Thomas F:Geiler,Director
9 MAN. 0a
16.79. 6. Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.b arnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
/ ub' ct e
as Owner of the property
s )� P P riY
hereby authorize to act on my behalf,
in all matters relative to work authorized b4is building permit application for.
as
(Address of Job) /
iignature of ner Dat
�5 4 r
Print Name
Q:FORMS:OwNERPERMISSION
THE FOLLOWING
IS/ARE THE BEST
IMAGES- FROM POOR
QUALITY ORIGINALS)
I m
DATA
Town of Barnstable *Permit# '�B6"
Expires 6 months from issue date
.Regulatory Services Fee °�
Thomas F.Geiler,Director
Building Division
Toni Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us ®PRESS PERMIT
Office: 508-862-4038 ((;;Fau�x: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL OA�-'Y`- 4 2005
Not Valid without Red X-Press Imprint .r® N OF BARNSTA
KE
Map/parcel Number rR 06-7
Property Address �_7
�f Residential Value of Work 36n Minimum fee of$25.00 for*work under$6000.00
Owner's Name&Address TS lam- �18 2S�-��- o'er-"
yv�1a5 �e 4
Contractor's NameTu Telephone Number
Home Improvement Contractor License#(if applicable) '
Construction Supervisor's License#(if applicable) —
V
DgWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy# W ac 11:�"O oS0:5_0d I ok4O5--,
Copy of Insurance Compliance Certificate must he on file.
Permit Request(check box) 11
Re-roof(stripping old shingles) All construction debris will be taken to A+J k h C 0�
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
- c Ire �.mvmo�uuea o�,i�aeaaclu�art
❑ Replacement Windows. U-Value (maximum.44) Board of Building Regulations and Standards
*Where regpired: Issuance of this permit does not exempt compliance with other town dep HOME IM OVEMENT CONTRACTOR
Re str 2282
***Note: Property Owner must sign Property Owner Letter of Pe / /2006.
Home Improvement Co c rs License is required.
���� d
SIGNATURE: ,� E K.P.REMODELI
KENNETH PERR _
Q:Forms:expmtrg 1.9 Gi11LDFORD RD.'�N
Revise071405
Centerville,MA 02632 Administrator