HomeMy WebLinkAbout0301 PINE STREET (HY �-�� � �
�-
. � .
_�
,_ , .
L
..
c ..
!r
!�
�OFIKE�� Town of Barnstable *Permit#
Expires 6 months from issue date
STAB = Regulatory Services Fee 00
9� 1 MASS.. �A Thomas F.Geiler,Director
a A
T
A
ED N10` Building Division
Tom Perry, Building Commissioner I�
200 Main Street, Hyannis,MA 02601 MAY
Office: 508-862-4038 . 2 92003
1O
Fax: 508-790-6230 wN or
BAR/VS-r
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY HALE
Not Valid without Red X-Press Imprint
Map/parcel Number G 61.
Property Address .) 6 t YL e- Y\.e fZ 1 ! ��
esidential Value of Work Q 4)
�.Owner's Name&Address rCnp� .
n �
DQ c 0 1 3�
Contractor's Name Telephone Number
Horne Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) k)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
121 am the Homeowner
I have Worker's Compensation Insurance }
Insurance Company Name C
Workman's Comp.Policy#
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)
Pl<e-side
❑ Replacement Windows. U-Value (maximum-.44) w
` ❑ Other(specify)
*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 Permissions.
Signature
Q:Forms:expmtrg
Revised121901