HomeMy WebLinkAbout0012 STEVENS STREET,� a S +e„�s st
-- - _ _— -
I
OFTME 1p,�, Town of Barnstable *Perinit#
yvP O� Expires 6 mouths from issue dal
BARNSTABLE, : Regulatory Services Feea S
v� MASS.9. ,0� Thomas F.Geiler,Director
plfDN1°'`A Building Division
Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 X.PRESS PERMIT
Office: 508-862-4038
Fax: 508-790-6230 OCT 1 0 2002
EXPRESS PERMIT APPLICATION - RE,SIug,Ij;L j,& ..ONLY,
TABLE
Not Valid without Red X-Press Imprint
✓lap/parcel Number
v
'roperty Address
Residential Value of Work
)wner's Name&Address bu
;ontractor's Name �
�� �lzl I4 Telephone Number
come Improvement Contractor License#(if applicable) J Z/Q
;onstruction Supervisor's License#(if applicable)
orkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ Ijarn the Homeowner
have Worker's Compensation Insurance
a
nsurance Company Name /1 1C.(��/ �Gl% 0 n G /?e- l7`r 7. .4D o
! �_¢Vorkman's Comp.Policy# V C 0a_ aL OC7 ;�-' C C �
C)
ernut Request(check box) a 7
Re-roof(stripping old shingles)
co
❑Re-roof(not stripping. Going over existing layers of roof) `4 rat
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
signature
):Forms:expmtrg
Levised121901