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0135 WEST MAIN STREET (15)
Ley, aFTHE ros, Town of Barnstable *Permit Expires 6 months fro ►Issue date ■ARNSCABLE, : Regulatory Services Fe 7' MASS. w cb ieg9. .0 Thomas F. Geiler,Director N' er� Building Division I" s Tom Perry, Building Commissioner QC 200 Main Street, Hyarmis,MA 02601 j 8 Office: 508-862-4038 NOF �QQ4? Fax: 508-790-6230 eq EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid►vitlrout Red X-Press Imprint L� vlap/parcel Number 1:7770 10.2 ©O A ?roperty Address J / a- residential' Value of Work . Dwner's Name&Address / 4 Q.L a(- contractor's NameCa a/Zzl 14O Doe '::1:4T f:)ye-M e-A4 Telephone Number 915-/ Some Improvement Contractor License#(if applicable) 100 7'y0 construction Supervisor's License#(if applicable) CL� 05 7 03") orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner have Worker's Compensation Insurance Insurance Company Name /► la k 'a d— I�L� Workman's Comp.Policy# C 1 L0C— aL5-0a c 7 Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U-Value ► r1 (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i e.Historic,Conservation,etc. ,Signature ` Q:Forms:expmtrg Reviscd121901