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Town of Barnstable
RECEIPT
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t SS 1 200 Main Street, Hyannis MA 02601 508-862-4038
Application for.Building Permit
Application No: B-17-3887 Date Recieved; 11/8/2017
Job Location: 55 HIGHLAND DRIVE,CENTERVILLE
Permit For: Building-Siding/Windows/Roof/Doors
Contractor's Name: PAUL J. CAZEAULT & SONS, INC. State Lic. No: 103714
Address: 1031 MAIN ST, OSTERVILLE, MA 02658 Applicant Phone: (508) 428-1177
(Home)Owner's Name: KADUNC,WILHELM& ROBERT Phone: (508)775-8748
(Home)Owner's Address: 55 HIGHLAND DRIVE, CENTERVILLE, MA 02632
Work Description: Remove existing shingle roof on the whole house and install new GAF asphalt shingles. ,
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Total Value Of Work To Be Performed: $13,500.00 ,
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Structure Size: 0.00 0.00 0.00
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). -
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject'of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a.permit is issued, it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and.belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: Russell Cazeault 11/8/2017 (508)428-1177
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Lota ,eost : $13,500.00 Date Paid Amount Paid Check#or CC#. i Pay Type
........
ee: $68.85 11/8/2017 $68.85 ��XXXX- Credit Card
......... 0985............. .......... ..... ......... _.............. .ee Paid: $68.85