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9 WEST TER - BUILDING INSPECTION Commonwealth of Massachusetts fF,l —all-, i, Sheet Metal Permit ' RECEIVED "sSPFCTIONAL SE4RYiCc;a Date: y/� / Permit# a a 2016 APR 28 A & 18 Estimated Job Cost: $ /(e ate• Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO Business License # {/ Applicant License# d k 76 Business Information: Property Owner/Job Location Information: Name k <llAa-mvZec)ft- �ee d u�Y4 PU 1 Name: ?u c.,J ha it yi l k� Street: IUL3 Street: L3 i eS+ 'Tcrrar e� G City/Town: L ith 0(90a- City/Town: t C� 1.-_p-1 IMcz 6174c) Telephone: -7kl 6q;9 /S/,7 Telephone: q2k - 7 q'' - L3 77 7 Photo I.D. required/ Copy of Photo I.D. attached: YES ✓ NO Staff Initial-1 /M-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 ✓ 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: Sheet metal work to be completed: New Work: —%Z Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: l n3- 4( ✓bw f '�vz. -r•5 P � oNw t,s � s W•,�n�.��rz. � G>'SS P tMQ_M .'t N C> 6t_O Cz PirR ryi�A sv IY10 t L�p IV on f INSURANCE COVERAGE: 1 I have a current liabili insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes 11?4o ❑ If you have checked Yes, indicate,the type of coverage by checking the appropriate box below: A liability insurance policy DIhe 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 PCo$ress Inspections Date Comments Final Inspection Date Comments Type of License: By ❑ Master Title ❑ Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ ❑ Check at www.mass.gov/dpl 4 Inspector Signature of Permit Approval 4 sC1 ey$ Nr 2� � '� '� haw §'�a"t'N'+Y�J y��,� � g• �*�{x< .a �?4 _NOR"k (a'�iH'skY'„`I _ 'lease visit our web site at http://www.mass.gov/dpi/boards/SM (/ I JAMES V CARONE SWAMPSCOTT REFRIGERATION (SM) 163 ESSEX ST LYNN,MA 01902-1796 Fold,Then Detach Along All Perforations 3sCOMIVI©N1AYEk►LTI F INI 5 prCkiwiT 3 .�� ISSUES`T ��'Qf�4O�lIQ�1C��EN��CSFA `�v s`�. JAM#" A t.f SY1fA101P�COTz��J�)� s MASS �HiJS�TTS DRIVERS :. LICENSE Ql9aEND .�„ ee..HER. S609925z5_ 11>1Z 195 as Sam rsRo,SiT;r 54 1l •• s WAMPSCOn, iul>lesz MA 01907.1044 •. . 5 OO IIgSPp11 Rq 0>.ISppOy