B-17-683 - 0014 BEACH AVENUE - Building Permit Commonwealth of Niassai�
Sheet iNletal Pern Il JUL Zq P 12 0Ll
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I)ate:
Permit t�
l� Iatimated Job Cost: S ( [ _ , —
Permit Fee:
ego Phil's Submitted: YFS NO (/ —'-- ---
a� Plans Reviewed: YES NO ---
� Business License# '��� � �(���
�?J ApplicantLicenset# 7 �� P '
13usiness (ntbrnuttiun: ,
An l romty Owner/Job Location Information:
��` � Name: _ �� �'`i5 ��y�L Name: � at.� ��
:street: Ga
Street: /4/ ��C Q c`r1 v--e
City/1'own City/Town: �—
Celephune: _ ���3 `E 6a 7-?j3� o c:) Telephone: `763 �( a
Photo [.D. required/Copy of Photo I.D. attached: YES NO_
J-1 /,N1-1-unrestricted license Staff totrta1
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-lamil
Y Condo/Townhouses Other
Commercial: Office Retail Industrial
Educational
Institutional Other
Square Footage: under 10,000 sq. ft.�er 10,000 sq. tl:. Number ofStories:
Sheet metal work t c completed: New Work: t/
Renovation:
IiVAC' iMetal Watershed Roofing Kitchen Exhaust System
Metal ('hinuicy/Vents Air Balancing
Provide detailed description of work to be done:
bvN
rnl�Lc. g � �
INSURANCE COVERAGE:
t have a current liabilityinsurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes No❑
If you have checked Yes,indicate the pe of coverage by checking the appropriate box below:
A liability insurance policy
Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIV
ER: am aware that the licensee does not have the insurance coverage
quired by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit appiicatlon waive this requ remen
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
application will '
By chocking this boxO.I hereby certify that
thatiaof the details and ll sheet metal work ao dd Intstallations performed funder the permit issu dlforthis appor entered)regarding ths li are true and
accurate to the best of my knowledge a
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
Progrea 111SOCCtiO11S
Comments
Date
Final inslMetinn
Comments
[)ate
Type of Li nse:
By aster �
rit1e C]blaster-Restricted
❑Journeyperson Sig, tune of Licensee
' Penrot x.__._ ❑Journey person-Restricted �
Li nse Number: i
Fad J - ❑ Check------ at y'V'y to l:i:i.?lw �lt]l
I
Inspector Signature of Permit Approval
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