HomeMy WebLinkAbout0353 SANDY NECK ROAD i
I
• doff res Town of Barnstable
*Per t#�i ' r Pe_'
Expir o issu to
.,i :. .. .. Services .:..
. .*1 - �-5=�,r_...-7R •a gul atory S ...
acesa .. F G .
�m . . ,,....,.z-... .Thomas: . eiler,Director
•9`�� '1 ---• ••••-. .. . . -'.. ..._.-ceding Division- . .. . _.
• - . -• ••-• --• ToniPerry, Blinding Commissioner ..
• -.200 MainStreet,.Hyannis,MA 02601-.•.• •• .
Office: 508-862-4038 . . . . . .. .. .
Fax:'S08-790-6230' . .. :;s ••.....::. . ...._• .. .-RESIDRI�T'I'IAY, . ... . 2005 . . .• .
..-EXPRESS PER14T"T AP1?LICATT.ON -
Not Valid without Red X Press Imprint
TOWN OF BARNSTABLE
•
dap/parcel Number 33 eoI o .
'ropertyAddress 3 3 -C 1 10"tL
Residential Value of Work A gboe) Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address •C
Contractor's Name 1-at Telephone Number 50.k;.36 Z-79/9 '
Home Improvement Contractor License#(if applicable) /,)--5 -7 7 / `
Construction Supervisor's License#(if applicable) (`_S C»--S•S -S
yorlmnan's Compensation Insurance '
Check one: •
IV I am a sole proprietor
74 :,.the Homeowner •
ye'have Worker's Compensation1nsurance,� . .
Insurance Company Name t--t f 1�_ Y/'`U 1U 44.(._
Workman's Comp.Policy# /4.) C- 3/S i /(D D % — O/ V
Copy of Insurance Compliance Certificate'must be on file.
Permit Request(check box)
Rite-roof(stripping old shingles) All construction debris will be taken to 7 00 I
0 Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
0 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 0 t sign Property Owner Letter of Permission.
Home r t Contractors License is required.
Signature
Q:Forms:expmtrg .
1 Revise063004
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