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1-15 TRADERS WAY - HVAC PERMIT APP 2 Commonwealth of Massachusetts Sheet Metal Permit — S (�tq�ZS� Datc: Permit t# 00 listimatcd Job ('ust: '$ �o��fL� Permit I•'ee-'$ — - Plaus Submitted: YES -!I NO Plans Reviewed: YES _ NO --_— Business License J# 5/l Applicant License t# 4T01e� Business Intiirmation: / Property Owner/Job Location Information: Name: q / Ila - N:une: , d Street: �/ r� d�r Jtr��;'.__ 1 City/"Town: d2 �//l/P/L //q, City/Town: Telephone: Telephone: Photo I.D. required/Copy of Photo LD. attached: YES— NO_ Staff Initial1 / M-f-unreslric 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 Multi-tamily C'ondo/lbwnhouseS Other_ Commercial: Office_ Retail f/ Industrial _ Educational Institutional Other Square Footage: under 10,000 sq. ft. over 10,000 sq, tt. _ Number of Stories: _ Sheet metal work to be completed: New Work: _ Renovation: V I IVAC✓ iMetal Watershed Routing_ Kitchen Exhaust System `fetal Chimney / Vents- Air Balancing PRA iLIC 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 ItlspeCN011S Date Continents Final Inspection Date Comments Type of License: By _ eat,aster fine_ ❑ Master-Restricted u`i/Toum ❑Journeyperson Signature of Licensee Permit x _ ❑Journeyperson-Restricted License Number. J If Fee s ----- ----- ❑ -- Check at:r;r.v.m.lss,,levhgrl UU Inspector signature of Permit Approval `1 COMMONWEALTH OF MASSACHUSETTS ~ SHEET METALWORKERS AS A BUSINESS ISSUES THE ABOVE LICENSE TO: i i JOHN C REI.1 REID MECHAf� 7CAL CORP 27 CHARLES ST y NORTH_ ANDOVE,I? MA 01845-00 0 511 'i':./29/14 160766 EXPIRATIONLICENSE NO. Fold,Then Detach Along All Peft ations ~ COMMONWEALTH OF MASSACHUSETT SHEET METAL WORKERS AS A MASTER-UNRESTRICTED ISSUES THE ABOVE LICENSE TO: JOHN C REID �v 1500 SALEM ST m u, NORTH ANDOVER MA 01845-491 1111 5806 11/28/14 28008 ' Fold,Then Detach Along All Perforations 3 4