HomeMy WebLinkAbout0072 GLEN ROAD
of rati Town of Barnstable *Permit#
Expires 6 months from issue date
l RAMSDO = IC
Regulatory Services Fe w-s'KAM
039.
Thomas F.Geiler,Director Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
EXPRESS PERNIIT APPLICATION - RESIDENTUL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 6 (01 .
Property Address
(�Residential Value of Work �S
Owner's Name&Address A. ,.tiw►PVS
Contractor
I l 1h7� +Rt 1(�►'�i✓ A914 Telephone Number � S 'T o�7�(
s Name
'
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor XPRLSS PE® 1T
❑ I am the Homeowner I``�� 6
I have Worker's Compensation Insurance AUG,,3 0..2002
Insurance Company Name gall Cr.1 jeyI l _YLlw,4-e �°1111i1�t n,—
- I' 13ARNSTAI LE
Workman's comp.Policy# Cm 12 q 1 3 8 OF
Permit Request(check box)
❑ Re-roof(stripping old shingles)
❑Re-roof(not stripping. Going aver existing layers of roof)
❑ Re-side
(� Replacement Windows. U-Value �' (maximum.44) �o`L
❑ Other(specify)
*Where required: Iss ce of this permit does exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature
Q:Forms:expmtrg
Revised121901