B-17-1212 - 0051 AURORA LANE - Building Permit 09/29/2011 13:05 9787409846 CITYOF SALEM PAGE_ 01/02
Commonwealth of-iMassachusetks�,
Sheet Nletal Permit 2011 DEC I U {P 2: 4 01.
NDate; _ � / _ Permit i# --_—_--
l Estimated Jab Cost: ��. t�d"r'� PcrlttiC f ec: 'h ��: 00
flans Submitted: YES NO ✓ Plans Reviewed: YES NO
13usiness License # , � I_ . _ . Applicant License # �}! .-
I3usiness Property Owner/Job Location Information-
Name: Name: -nhaj'leS
Street: �1
City/Town: _A n LI cL. I90c-- Cityrrown: <—SCf &
Telephone: �--��j�p�1S�I q "telephone:
Photo I.D. required/Copy of Photo I.D.attached: YES NO
�� Muff Inillal
J-1 I iti't-I-unrestricted license
J-Z/ M-2-restricted to dwclling;s 3-stories or less and commercial tip to 10,00t>sq, ft. /2-stories or less
Residential: 1-2 family Multi-family Condo/Townhouses ✓ Other
Commercial: OMCC Retail Industrial Educational
Institutional Other
Square Footage: under 10,600 sq. ft. ✓ over 10,000 sq. 1'1. Number of Stories.-
Sheet meti►I Nvork to be completed: New Work: Renovation:
l IVAC ✓ kletal Watershed Rooting; Kitchen > xhaust System
`fetal chimney/Vents Air Balhncing
I'l-OVidC&Wile:d descrilstiun of work to be done:
_ "4`ermile- -f dc�' e er-r eKkSTlltic� 'Rr �n u L-t
IA P t L tD co p-1pAcT-cp —
I
09/29/2011 13:05 9787409846 CITYOF SALEM PAGE 02/02
INSURANCE COVERAGE:
I have a current flabiliN 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 E Other type of indemnity ❑ 8ond ❑
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 permlt application waive 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 bestiof my knowledge and that all shoot metal work and installations performed under the permit Issued for this application will be
In compliance with a;ll panInent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to Insulation Installation:YES NO
I'rotress Inspccti0n9
Date Comments
Finstl rttspection
Date Cclntlxicnts
Type of License:
By ----�- ®Master
rise
❑Master.Restricted
City/Town
❑Journeyperson
Pennil#
Signature of Licensee
_
❑Journeyperson-Restricted Fee 5 ense Number:
Check atwww,1miss.<lov/dpl
Inspector Signaturo of permit Approval