16 ORCHARD ST - BUILDING INSPECTION Commonwealth of Massachusetts
Sheet Metal Permit
Date: Co Permit#
'mated Job Cost: d� Permit Fee: $
Estimated S
Plans Submitted: YES_ NO Plans Reviewed: YES_ NO
Business License# Applicant License#
Business Information: Property Owner/Job Location Information:
Name: �Cz fi1k //y e- Name:
Street: y(o I �c 77a!1)6�r �t3 Street: 16 Q X CA A-0 1) 57-
City/Town: Cyj t! /� M� O C13 j City/Town:C Xa /,P444�d�
Telephone: �71� 7L�o-�a�o? Telephone: 971�'��y—c3/7�
Photo I.D. required/Copy of Photo I.D. attached: YES_ NO_
` Staff Initial
J-1 / I�- unrestricted license
J-2 /M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less
Residential: 1-2 family-Z Multi-family_ Condo/Townhouses_ Other
Commercial: Office_ Retail_ Industrial_ Educational
Institutional_ Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. A Number of Stories:
Sheet metal work t be completed: New Work: _ Renovation:
HVAC Metal Watershed Roofing _ Kitchen Exhaust System
Metal Chimney/Vents , Air Balancing
P ovide detailed description of work to be done:
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 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 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
Proeress Inspections
Date 'Comments
Final Inspection
Date Comments
Type of License:
By ❑Master
Tits Master-Restricted
Cityrrown ❑Journeyperson
Signature of Licensee
Permit to
❑Joumeyperson-Restricted License Number.
Fee$'
❑ Check at www.mass.gov/dpi
7..= - Inspector Signature of Permit Approval
Fold Then Detach Along All Perforations
COMMONWEALTH OF MASSACHUSETTS '
BOARD
SM ASrA BUSINESS
ISSUES THE ABOVE LICENSE TO.
TYPE THOMAS B FAVAZZA
PREFERRED AIR INC
—B 461 BOSTON ST
NO A3
TOPSFIEL'D MA 01983-0000
129535 493 01/24/14 129535
LICENSE NO. EXPIRATION DATE SERIAL NO.
Fold,Then Detach Along All Perorations �
Fold.Then Detach Along All Perorations
CONTROL# . H324680
IMPORTANT
If this license is lost or destroyed, notify your Board at the:
Division of Professional Licensure, 1000 Washington St.,
Suite 710,Boston,MA 02118-6100. _
If your name or address shown is changed, notify your board
of correct name or address to insure proper mailing of next
Renewal Application. Always refer to your license number.
This license is subject to the provisions of the General Laws
as amended. it is a personal privilege,and must not be loaned
or assigned to any other person. Keep this license on your
person or posted as required by law.
Fold.Than Detach Along All Perorations r
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