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Town of Barnstable *Permit# 7 3 ? l
�pQ Tpyt� Expires 6 months from issue date
Regulatory Services Fee r
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v tares. 0� Thomas F.Geiler,Director
�Ar 1 39. &1 Building Division
Tom Perry, Building Commissioner PERMIT
200 Main Street, Hyannis,MA 02601 -PRESS
Office: 508-862-4038 L 17 2003
Fax: 508-790-6230
EXPRESS PE M'f APPLICATION - RESIDENTIAL ONLY OF SARNSTABLE
Not Valid without Red X-Press Imprint
Map/parcel Number J O
Property Address
Value of Work
[c�tesidential ,
Owner's Name&Address
Telephone Number
Contractor's Name //D
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check e:
am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
workman's Comp.Policy#
Permit Request(check box)
[,/Re-roof(stripping old shingles) All construction debris will be taken
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ 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 Letter of Permission.
ome Impr vement Contractors License is required.
Signature
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`�tHETpy,_O� The Town of Barnstable
BARE. Department of Health Safety and Environmental Services
9 MASS. ell. P
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prFo �a, Building Division
367 Main Street,Hyannis,MA 02601
Office: 508-790-6227 ,. Ralph Crossen
Fax: 508-790-6230 '+ Building Commissioner
Inspection Correction Notice
Type of Inspection , .�; „9, s,
Location / _ �. _ ��, +—Permit Number
Owner Builder
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
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Please call: 508-790-6227 for re-inspection.
Inspected by
Date r�
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