HomeMy WebLinkAbout0279 HINCKLEY ROAD _ _ a�9 /�:,�� �
- _ - - - - —
Town of
Barnstable *Permit# 2 '
E Tres 6 months om issue date
Regulatory Services Fee a 5
'+ IAnNWAMYL
MAsa. Thomas F.Geiler,Director
off" Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address o -E{I Vr1C��eu t�C�C� , }UCI �m i1 , OZ ool
Residential Value of Work Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address I„ {�c, &Wcr
a19 41vAoLv u kd 4juCm RI's, N 14 uz obi
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor X-PRESS PERMIT
0 lam the Homeowner
❑ I have Worker's Compensation Insurance JUL 17 2007
Insurance Company Name TOWN L)F BARNSTABLE
Workman'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 taken 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 department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
Hope Improveme t Contractors License is required.
SIGNATURE:
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Fa>Joe to sec u"coverage as'rnl�made Season 25A of MGL a 152 cad lessl m the imposition
oaf as well as civil penalties im farm of a STOP WORK ORDER and a fine
fine up to$115W.00 amd/or one-yeao<i� of tLis sbtem�t»Y be Sorwatdd ID Bm Office of
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