HomeMy WebLinkAbout0063 WOLLEY ROAD 63 Wo/%yid .
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oFt r0 Town of Barnstable *Permit# 7
Expires 6 months from issue date
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Regulatory Services Fee
Thomas F.Geiler,Director
Building Division X-PRESS. PERMIT
Tom Perry, Building Commissioner u 1 5 2��4
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE
EXPRESS PERAM APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 2 7 ® 06
Property Address
(Residential Value of Work a�5'00.eta Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address g A-7'- Q VN #7 ZLI lz�
6
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
[� I am the Homeowner
❑ I have Worker's Compensation Insurance
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
,❑ Replacement Windows. U-Value (maximum.44)
"Where required: lssuance 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.
Home Improvement Contractors License is required.
Signature
Q:Forms:expmtrg