HomeMy WebLinkAbout0000 SANDY NECK ROAD �39 one ��c
� � �
�� �
e � � ::
a e;
_ t
,, _ f r n
q,;
_;
� v
Town of Barnstable *Permit# ' /
Expires 6 monthsfrom issue date
Regulatory Services Fee 4 co
Thomas F.Geiler,Director )sPRLZ
Building Division �� /7-
Tom Perry,CBO, Building Commissioner OCT 2
200 Main Street,Hyannis,MA 02601 7 ��0�
www.town.barnstable.ma.us TQw��F B,q� �v
Office: 508-862-4038 Fax.AT%tf230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
y Not Valid without Red X Press Imprint
viap/parcel Numberr .
?roperty Address Gl*✓'r rlc7 e
Residential Value of Workl�dM- Minimum fee of$25.00 for work under$6000.00
Dwner's Name&Address L.
C,4_/,,
Contractor's Name ,7 Ct . Telephone Number ��
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor P
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
MRe-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side /
. to
❑ 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 Lett r of Permission.
Home Improvement Contract icense is re ed.
CGNATURE: rl�6a5�FS4__
Q:Forms:expmtrg
Revise071405