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148 MARLBOROUGH RD - BUILDING INSPECTION (4) v I>yjtt u� e t Aso Commonwealth of Massachtlsgto E(J jSPECTIONAL SBVjCES Sheet N[etal Permit Date: 3` o�� ' �(o IOIb I�IR 2 # A 8:140 Estimated Job Cost: S ('e�Tec) Permit Fee: $ 67, 66 Plans Submitted: YES NO_ Plans Reviewed: YES _ NO 10 Business License # Applicant License # i Business information: Property Owner/Job Location Information: Name: ^�J6z-t�(P �n�C— Name: 1f D U��j I Street. / � �2 �j Street: I " (J �1 City/Town: Lto i \v\.A6 Cityrrown: P— Telephone: SC?T 65'7 V I ( / Telephone: —( ' /, 311-7 Photo I.D. required/Copy of Photo I.D. attached: YES� NO_ S[nfr l fliIN] J-t /01- -1,JAntestricted license J-2 / AI-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. / 2-stories or less Residential: 1-2 family DL Multi-family Condo/Townhouses_ Other Commercial: Office— Retail Industrial_ Educational Institutional_ Other —7 Square Footage: under 10,000 sq. ft.2�1,over 10,000 sq. ft. _ Number of Stories: G Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Rooting Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: �v\ S1�llt�E C-e 2A t lsY V<}t.2 Ct: � rnNtuwo 31 31 r a .t INSURANCE COVERAGE: ,,;G I have acurrent liability insurance policy Iriits equivalent which meets the requirements of M.G.L.Ch. 112 Yes jNo❑ 4 If you have checked Yes, indicate the 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 be I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and accurate to the best f my knowledge and that all sheet metal work 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 Prot<ress Inspections Date Comments Final Inspection Date Comments Type of License: By 'i aster \ Title ❑ Master-Restricted city/Town - ❑Journeyperson Signature of Licensee Permit x 2a ❑Journeyperson-Restricted License Number: Fee$ ❑ Check at www.tnass.govldIII Inspector Signature of Permit Approval i Fold,Then Detach Along All Perforations �� `C.�O,.M,..MONWEALTH OF MA'SACH.USETTS . •i , c, 1BOAR© F SHEET>METAL WORKERS s ��� � ISSUES THE ROLLOWING LICENSE AS'A IIMASTER-�INRESTR(CTE z r x S � ERIK M,,TIMMONS �WILMINGTON MA 01$87 1830 � 4, �a„ ,i� , i S 3 4