148 MARLBOROUGH RD - BUILDING INSPECTION (3) Commonwealth of Massachusetts
Sheet Metal Permit
Date: I Y a(j, I t(. 201(- Permit P
Estimated Job Cost: S Permit Pee: S
Plans Submitted: YES NO Plans Reviewed: YES NO_
Business License # 6q,3 q( o(O6S Applicant License # L
Business Information: Property Owner/Job Location information:
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Name: "� "� l� ��tJC_ Name: f' � � `0u( � IS � 1�
Street: E-'� VQA.LS�� �(�- � Street: 1 a t au y j2cS
City/Town: City/Town: ��w
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elephone: L ) S 5 t �l 1 Telephone: 3 I r] Q?c D.S—
Photo I.D. required/Copy of Photo I.D. attached: YES NO_
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J-1 D,I-1- nrestricted license
J-2 / NI-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. / 2-stories or less
Residential: 1-2 family i L Multi-family— Condo/ Townhouses Other
Commercial: Office Retail Industrial Educational
Institutional Other_
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories: 2
Sheet metal work to be completed: New Work: Renovation:
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IIVAC Metal Watershed Rooting_ Kitchen Exhaust System _ Vam
Metal Chimney/ Vents_ Air Balancing_ s zm
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Provide detailed description of work to be done: D me
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Cam/ l J i J el;—(
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes)No❑
If you have checked Yes, indicate th type of coverage by checking the appropriate box below:
A liability insurance policy Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box ,1 hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and
accurate to the best of y knowledge and that all sheet metalwork and installations performed under the permit Issued for this application will be
In compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct.inspection required prior to insulation Installation: YES_NO_
ProaressInspections
Date Comments
Final Inspection
Date Comments
K1;
ati
T h
r. ,1 Type of License:
1
By Master
Title ❑ Master-Restricted `
City/Town
❑Journeyperson Signature of Licensee
Permit# ❑ Ll
(( Q
Journeyperson-Restricted License Number: � Ik
Fee 5 ❑
Check at wavw.mass.<IovMpl
Inspector Signature of Permit Approval
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Please visit our web site at http://www.mass.gov/dpl/boards/SM
ERIK M.TIMMONS
16R PINEWOOD RD (SM)
WILMINGTON,MA 01887-1930
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Fold,Then Detach Along All Perforations
COMMONWEALTH OF MASSACHI)S-E
BOARD f1F
SHEET METALWORKER •'
aISSUES THE,FOLLOWING LICENSEVAS A W
,MASTER-U RESTRICTE ` ; •"
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ERIKM,TIMMONS } ,
,1GR PINEWOOD RR f j
WILMINGTON MA 01887 1830
1989
429 09/28/2017;_ '