B-19-134 - 0023 BARR STREET - Building Permit commonwealth of Massachusetts
Sheet Metal Permit
_ r
Date: o y!�� Permit#
Estimated Job Cost: $ Permit Fee: $
j q
Plans Submitted: YES NO Plans Reviewed:' YES NO
Business License#
� Applicant License#
L
Business Information:4V4
Property Owner/Job Location Information:
Name: C ffT n/r Name. N ^� �I 'T
Street:
- - n
Street:'
City/Town:10LAj elf �, �%��
m Ci /Town: `e7>1 wl e� p t7
'Telephone: 8J' Qom„ Telephone:
Photo I.D. required/Copy of Photo I.D.attached:. YES ✓ NO
OM-1-unrestricted license Staff Initial
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 jV 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: Renovation:
HVAC V' Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
�/G %war N
r
q
v
n
INSURANCE COVERAGE:
I have a current liability Insurance policy or.its:equtvalent Which:meets the requlrements:of M.G.L.Ch.'112 Yes❑ No
If you have checked Yes,Indicate the
ty of coverage.by.checking the appropriate box below:
A liability insurance policy Other type of indemnity
hr ❑ Bond ❑
OWNER'S INSURA
IVE •I am aware that the licensee does not have the
Massachusetts:Ge er insurance coverage required by Chapter.11:2 of the
id that my signature on this permit application wa_ 1_ves this requirement
- !Check One Only
er t .❑
Agen
to a of. er or Owner's Agent: ::
By checking this box[],i hereby certifY.thatall of the details and into I have submitted(or entered)regarding this application are true:accurate to the best of my knowledge and that: hset metal work and Installetlons performed under the permit Issued for this application will be
In compliance with all pertinent.provision of the Massachusetts Building 1.Code and:Chapter 112 of the.General Laws.
_.. _.
Duct inspection required prior to insulation inStallatiOn::YES
NO
Prog ess In
saections
.. Date
Comments
Final Inspection
Date.. .
Comtrients
TYPe of License: .
By
❑Master
. .. ....... .
Title*. .. . .. ....... .
El Master=Restricted
City/Town : :::
❑Journeypersorr .:
Permit# .. . O Licensee
yp. .
f. ur
- ❑Journe erson-Restricted. License e
Si
Fee$ Number:
Check at vrvv'mass dov/dole
. .. ....... .
Ins ector Signature of Po t approval: