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p�' '0 Expires 6 months froth issue=" e
Reaulator Services Fee d
9 MAsa Thomas F.Geiler,Director
1659• ♦�
'�Eo"�►�' Building Division
Elbert C Ulshoeffer,Jr. Building Commissioner
367 Main,Street, Hyannis,MA 02601 w
Office: 508-862-4038 X-PRESS PERMIT
Fax: 508-790-6230 AUG 2 6 2002
EXPRESS PERNUT APPLICATION
J Not Valid without Red X•PrewImprint TOWN OF BARNSTABLE.
Mapiparcel Number O C 7 ` 7-14
Property Address 4 `
Residential OR ❑Commercial Value of Work _
Owner's Name&Address
Contractor's Name Telephone Number 2 2�� 15 3
Horne Improvement Contractor License#(if applicable) o 40 /.2 Y
Construction Supervisor's License#(if applicable) 3 3.2 a
Workman's Compensation Insurance
Check one:
Lath a sole proprietor '
I am the Homeowner
U-I have Worker's Compensation Insurance
Insurance Company NamegA
WoFkmau's Comp.Policy# V c (/ 0 O /S%2 y
Permit Request(check box) 0 X L1.M10091-L .
R roof(stripping old shingles) 1�,�K T �o-o1a to X21W,0-y a e4� I&o 3,
g
❑ Re-roof(not stripping. Going over existing layers of roof)
Re-side
f7 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
expmtrg