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HomeMy WebLinkAbout0045 NATHAN ROAD „ M, x , s - , , a y. t ` =w , r,G r ' , Ir t , s. ;i r f 1 p p Ry ' t r ..r�---� I ,I f ' �. - ,. � ... ., � _ .. �, R j rr ,R Town of Barnstable *Permit# P p� Expires 6 months fro n u'sue date MIME , : Regulatory Services Fee s639. � Thomas F.Geller Director �p ��m rFo1 Building Division Tom Perry, Building CommissionerX-PRESS PV& 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 � �; 1 $ 2003 Fax: 508-790-6230 AR�g�Agt.E EXPRESS PERA UT APPLICATION - RESIDENjUV6�Ig Not Valid without Red Z Press Imprint Map/parcel Number 1,26 663 Property Address 41vr�/IiTIMAI A? [Residential Value of Work Owner's Name&Address 42/1/2l?L,Q V Contractor's Name_4:�9�7Telephone Number.Se'J'-26/Z-2Z?2, 1� Home Improvement Contractor License#(if applic le) ✓�� t` Construction Supervisor's License#(if applicable) 61 OWorkman's Compensation Insurance Check one: I am a sole proprietor [� I am the Homeowner [ 'I have Worker's Compensation Insurance Insurance Company Name 44.r - C,, X ZZZ�� //9 n C 0 Workman's Comp.Policy# 06, °°o 2 3 Permit Request(check box) �C OF T �-✓o r t C G L o U?Re-roof(stripping old shingles) All construction debris will be taken to rl 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 Letter of Permission. Home Improvement Contractors License is required. Signature ' Q:Forms:expmtrg �F T Town of Barnstable h Regulatory Services 3 seatvsr ELL ' Thomas F.Geiler,Director KAM 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 I _ r._.:::.......__..;as.•Ocvner..ofthe.subjectpropertr- ._.._..._.. .. 36. hereby authorize ... .:. .to,act ongay.behalf,. in all matters zelative to work authoiized.hy this building.permit•application for: (Address of Job) /2 ®� $ attire of Ownez ate Print Name Massachusetts 'C3 Casualty ® Insurance Company 155 Federal Street,7th Floor 1� y Boston,MA 02110 Incorporated 1926 (617)728-8000 PREMIUM NOTICE DISABILITY INCOME POLICY STEPHEN WHITNEY HAZARD PO BOX 526 BARNSTABLE, MA 02630-0526 . Notice Printed: Agency: 03/21/02 MC007 Policy Number Mode of Payment Amount Due Due Date 0600023 TA# 16920 QUARTERLY $ 218.85 20 APR 02 "OUR BILLING NOTICE HAS ANEW LOOK." OUR MAILING ADDRESS FOR PAYMENTS HAS CHANGED. PLEASE MAIL THE BILLING STUB IN THE RETURN ENVELOPE TO ENSURE PROMPT AND PROPER CREDIT. ALL OTHER INQUIRIES SHOULD BE SENT TO THE ADDRESS ON THE TOP OF THE BILL. THANK YOU. PROMPT PAYMENT PROTECTS YOUR FINANCIAL SECURITY PLEASE RETURN BOTTOM PORTION OF PREMIUM NOTICE WITH YOUR PAYMENT - T,.ea ..lad�✓G�� Board of Building Regulations and Standards BOARD OF BUILDING REGULATIONS HOME IMPROVEMENT CONTRACTOR License: COWSTRUCTION SUPERVISOR Registration: 107529 Number Gi 026361 Expiration. 8/4/2004 _ BI, 04/Q61938 •P' Type: Individual E>ffiW 04!©612004 Jr.no: 20381 ANDRE G.DUPREY _..._:..__ R •.DO. Andre Duprey ANDRE G DUPR@Y 24 Fraser CUPO Box 373 FRASER CT � BARNSTABLE, MA 0263a Barnstable,MA 02630 — Administrator � 4dtni.nistrator