HomeMy WebLinkAbout0285 RIVERVIEW LANE •
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Town of Barnstable *Permit# ;2o'o 6� S
Expires 6 months from issue date
Regulatory Services. Fee !915'09
Thomas F.Geiler,Director �jgl�,
Building Division �.
Tom Perry,CBO, Building Commissioner X-PRESS.PERMIT
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us S E P 1 9. 2006
Office- 508-862-4038 -�- 08-79230
EXPRESS PERMIT APPLICATION. - RESIDENTIA��S RNSTA0=6KE
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/ Not Valid without Red X--Press Imprint
Map/parcel Number 7, d cY Z
Prope Address n CZp �� �t1� � il� � V l r;° �j ®2-� 3 Z-
esidential Value of Work Minimum fee of$25.00 for'work under$6000.00
Owner's Name&Address c75 9°MD GO
Contractor's Name L o&.) ► V L11� Telephone Number —?-5`7=3M
HomejImprovement Contractor License#(if applicable) 7j f .
Construction Supervisor's License#(if applicable) �� 1
❑Workman's Compensation Insurance
Che one:
a sole proprietor
❑ lam the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name '"EfN t-jCrie IL7 0- C • 1,li'1 A1P.1 i_1 ry)
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-ro f(not stripping. Going over existing layers of roof)
Re-side
❑ Replacement Windows/doors/sliders. 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.
A copy.of the Home Improvement Contractors License is required.
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SIGNATURE:
Q:Forms:expmtrg
Revise061306
SENT BY: ; 7777777; SEP-19-06 8:21AM; PAGE 1/1
Sep 19 06 07 40a Cullotte Painting OW'M"I is N '
Sep to OB 09:50P Mullen Building 6 Remod. 5087904107 p• 1
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Town of Barnstable
Regulatory Services
Tbomw IF Gdors.1weew,
Budding DiviSiton
To=rury Bsn"6 Camokwomer
200 Mafia SMO. ]IV= ►o.MA 01601
pax: 508-79a4230
OE6cr 508.862-4433
Property OVMCT Must
Complete and Sign'This Section
If Using A Builder
44 ek c c! ,s6 Owne:of the subject pxopeaty
I
to act on my behSA
heavy suthcsite
' iu sll mattes=da
tcve to aosk sutharb eA by this budding pit VPb= lbn fog
(Address of job)
* Date
Of Oovices
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