HomeMy WebLinkAbout1029 IYANNOUGH ROAD/RTE132 (42) o 9 zy a-%I V-,o
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Op THE Tp� 5�: Town of Barnstable *Permit
Expires 6 months from issue date
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* BARNSTABLE, Regulatory Services Fee
9 MASS. Thomas F.Geiler,Director
�p 1639. X-PRESS PERMIT
TFDMA�e Building Division
Tom Perry, Building Commissioner SEP 13 2005 vs
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 TOWN OF BARNSTABLE
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL, ONLY
Not Valid without Red X-Press Imprint ` �( ut"(\,1
Map/parcel Number — - — A / v V
Pro erty Address 109A I
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Residential Value of Work t • X Minimum fee of$25.00 for work under.$6000.00
Owner's Name&Address Joh Nd
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Contractor's Name + V/ Telephone Number p 1-0 "l
Home Improvement Contractor License#(if applicable) Q
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Construction Supervisor's License#(if applicable)
VWorkman's Compensation Insurance
Check one: `` '
❑ I am a sole proprietor a.
VI am the Homeowner
I have Worker's Compe ation Insurance J'
Insurance Company Name
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 ��
Re lacement Windows. U-Value a (maxim a.44) (A,
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*Where required: Issuance of this permit does not exempt compliance with other town department regu eol' W.t. c.
***Note: Property Owner must sign Property Owner Letter of Permission.
�n nnHome Impprrovement Contractors License is required.
Signature I / lWJ
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CAPIZZI HOME IMPROVEMENT INC . ID 6 9
SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6
STATE OF MASSACHUSETTS
LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT
I,
OWN THE PROPERTY LOCATED AT
IN MASSACHUSETTS.
I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT
TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,
THE MASSACHUSETTS STATE BUILDING CODE.
I GIVE MY PERMISSION TO
LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE
MASSACHUSETTS STATE BUILDING CODE.
SIGNATURE OF OWNER:
OWNER'S ADDRESS:
OWNER'S TELEPHONE:
LESSEE'S SIGNATURE:
LESSEE'S ADDRESS: '
LESSEE'S TELEPHONE:
APLLICANT'S SIGNATURE: I
APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUTT, MA 02635
APPLICANT'S TELEPHONE: 508/428-9518
RESPONSIBLE OFFICER: '
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' RESPONSIBLE OFFICER ADDRESS: t
RESPONSIBLE OFFICER TELEPHONE:
ACCEPTED BY DATE
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THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL #
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„o'TM"'• TOWN OF BARNSTABLE Permit No. ------23258
i »nAc Building Inspector Cash -__-�--
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OCCUPANCY PERMIT Bond _ I2/3 /
"No.building nor structure shall be erected, and no land, building or structure shall be
used fora new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued ,#o—R belt Shields &'Douglas ipebelAddress
Buildinm 10 ih1.3 ti D 1029 Route 132. ardis
Wiring Inspector ,�� ' -�- Inspection date
Plumbing Inspector� � �� Inspection date
Gas Inspector � � Inspection date
Engineering Department Inspection date
THIS PERMIT WILL NOT BE •VALID„AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
............. 19..?� / 11 ,4 ........... .
!Building Inspector F