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�oFt►+E Ta,,� Town of Barnstable *Permit# Y � �
Expires 6 months from issue date
Regulatory Services Fee
• BARNS?ABLE, Y
MAC Thomas F.Geller,Director
t63g•. `0�
Building Division �+
Tom Perry, Building Commissioner RESS PERMIT
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 - AUG.,3 O.Z002 9-
Fax: 508-790-6230 �p� ��.���
EXPRESS PERIVIIT APPLICATION - RESIDEN�TALL
RAR
Not Valid without Red X-Press Imprint
Map/parcel Number, �
Property Address
Residential RCS T�''"'1 Value of Work �®
Owner's Name&Address ����� l�ld A,^ AAJ
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
CD
Construction Supervisor''s License#(if applicable)
-) C71
❑Workman's Compensation Insurance < W ;
Check one: in
❑ I am a sole proprietor p
I am the Homeowner �` =
c�>
I have Worker's Compensation Insurance
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Insurance Company Name
Workman's Comp.Policy#
Permit Request(check box) V'6,-(T (?Oro or �SSf.=�AF�L y C'a od Sic , 3b 3- G,9• /. I
Re-roof(stripping old shingles) All construction debris will be taken to "/A 2 M U l� LA•Nz Fl u—
❑'Re-roof(not stripping. Going over existing layers of roof)
Re-side
Replacement Windows. U-Value , (maximum.44)
❑ Other(specify) x
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc! , ip�OAZ
Signature
Q:Forms:expmtrg
Revised121901