HomeMy WebLinkAbout0096 MAPLE STREET / f
III
Town of Barnstable *Permit#Z
Expires 6 months fr
oa issue date
/oo:5?5
BAMSTABIA Regulatory Services Fee
r +ss.eb ,bs9. .0 Thomas F.Geiler,Director
A'FD 11°r Building Division
Tom Perry, Building Commissioner X-PRESS PERMIT
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 AUG 0 4 2003
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIALLM OF BARNSTABLE
Not Valid without Red X-Press Imprint
Map/parcel Number �� �� 3
Property Address �/�4
esidential Value of Work
Owner's Name&Address Gc%."00
<
Contractor's Name_r jg .,tom c jr,,� Telephone Numberj't-�� —�
Home Improvement Contractor License#(if applicable) �Z 2F.
r
Construction Supervisor's License#(if applicable)
❑Workman's C pensation Insurance
Cl one:
I am a sole proprietor
❑ I am the Homeowner
❑ T have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Permit Request(check box)
a-Ke�-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 Lettep of Permission.
o e Improvement Con4acte License is ed.
Signature
Q:Forms:expmtrg
Revise053003
6
Town of Barnstable
Regulatory Services
anxxsTaai,s,
y Mnss. g Thomas F.Geiler,Director
�'iOrEc r'u9. 6. Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
.W4 / ,as Owner of the subject property
hereby authorize�t 6 /f� ,�,�%! to act on my behalf,
in all matters relative to work authorized by this building permit''application for:
Address of Job)
l
Signature of Owner Date
Y}] •
Print Name
ti
Q:FORMS:OWNERPERIvUSSION 'i•.'
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ula o►►�wi Stan,
Mar of Bmfot'-
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