0036 FELT STREET BPA 17-126 09/29/2011 13:05 9787409846 CITYOF SALEM PAGE 01/02
Commonwealth of Nlassachusetj#A -
1017 FEB
Sheet Metal Perinit it q Ck 06
Perm
1.stimmted Jab Cost: Ss- Permit tee: $ 2—'--D CE 5�b�
Plans 5ubmittud: YES NO Plans Rcviewed: YES NO
Business License # [�t � Applicant License; #
�(1 Business Information: Property Owner/Job Location Information,
Nanw,;. sjamp�bif W4-aaz,4�'1 Nan1c:
i -
5trecr. iCQ3L Street:
- -- -- --
City/'['own: A Q Cityr('o1Wn:
Telephone: -7/VI '� Z I-1 1 Telephone: — C� t - Hug —
phut r uir /copy uFPhoto 1.D.attached: YES_ y�NO
s,�rr inut:i
J-1 I b•1-1-unrestricted license
J-Z/ M-2-restricted to dwellings 3-stories or less and commercial tip to 10,000 sq, Ft. / 2-stories or less
Residentlal: 1-2 Family vngMulti-family Condo;/Townhouses Other
Commercial:maercial: Office Retail Industrial Educational
Institutional Other
Square Footage: undar 10.000 sq. R. ✓ over 10,000 sq. l2. Number of Stories: �r
Sheet metal work to he completed: New Work: Renovation:
I IVAC ✓ klctal Watershed Rooling_ Kitchen Fxhaust System
`ictal Chimney/Vents Air Baltincing
P►'Ok-ide detailed dc,crilrtion ()t•work to be Mone:
AUL-C-4 Lk a�-Cq V, G LAA ak,C-\ 31—d
09/29/2011 13:05 9787409846 CITYOF SALEM PAGE 02/02
INSURANCE COVERAGE: ---�
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.R.Ch. 112 Yes i✓7'No[:1
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 haws,and that my signature on this permit application waive this requirement.
Check One Only
Owner ❑ Agent ❑
LSignature of Owner or Owner's Agent
By checking this boxD,I hereby certify that ail of the detalls and information I have submitted(or entered)regarding this application are true and
accurate to the bestiof my knowledge and that all shoot metal work and installation$performed ander 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
Protrress Inspectiony
Date Comments
Final_tnmpcetion
Uate Continents
Xaster
License:
By
Mile
0 Master.Restricted
City/Town
❑Journeyperson
Pennit# Signature of Licensee
[3.1ourneyperson-RestrNFees cumberf t
Check at r�ww.�n,zss,nav/dpi
Inapcctor 3lonaturo of Permit Approval
` J