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150 NORTH ST - BUILDING INSPECTION Commonwealth of Massachusetts Sheet Metal Permit Date: / / Permit # Estimated Job Cost: $ 101, boo Permit Fee: S C �� Plans Submitted: YES NO_ Plans Reviewed: YES NO Business License # Applicant License # Business Information: / Property Owner/I/Job Location Information: Name: �, 1 se�(L��r Name: /Vi t GIt j� e�?�� ©/V Street: 4,114W 1,1 e2 Street: /Dr2<�( S % City/Town: _2,ea /3Q /� �/ City/Town: 16�[ "a�l Telephone: q 7L BC--? ?a 6 Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO St if I II I I I:11 J-1 / 1 4l 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 ' Multi-family_ Condo/Townhouses- Other Commercial: Oft-ice_ Retail_ Industrial Educational_ Institutional Other Square Footage: under 10,000 sq. ft. -Yl— over 10,000 sq. ft. _ Number of Stories: Sheet metal work to be completed: New Work: _ Renovation: IlVAC- Metal Watershed Rooting_ Kitchen Exhaust System Metal Chimney/ Vents_ Air Balancing Provide detailed description of work to be done: KI S �Uletil2C� /✓r��j �� L�/S%G4�� l�/ NIL Zo/yt l#�Vo S2CD-✓l� }�/oo� z�/l/ 2 INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yesi)t No❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy Izf 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],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 of 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 Progress Inspections Date Comments Final Inspection Date Comments Ty of License: By aster t Title ❑ Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permil# �iQ 1 1 ❑Journeyperson-Restricted License Number ``t�S "l Fee$ ❑ Check at www.mass.govldpl Inspector Signature of Permit Approval ar v COMMONWEALTH OF MASSACHUSETFIS All . . ' AS fc -Us (ESTRICTEU ISSUES THE ABOVE LICENSE TO ERIC LIkinc: Hom "IT7 < Pi 8R00 ' I} PEABDDY f' °1A 01960-2001 8042 01/. /13 900056 r Y..