B-19-147 - 0114 BRIDGE STREET - Building Permit i
C!)tlilllom1'ealth of ctilassachusetts
Sheet Metal Permit
Date:
Permit it
Intimated Job Cost: .S_AD_jJQ(� -v F ---- -- _.
— -- Permit I:ee: S 11-{'®
Sulyrnftted: 1`.ES NO , ~-
I Tans Reviewed: YES NO
Business 1-icertse#
Applicant [Acense#J 4A 7�
Business [nti�r,natian:Name ��(/ Property Uwner/Job Location Information:
Name: !V i- O: C `t—r� -
----: ✓�� I
Street: 1// T('eA1�>�6*P�y Stei: i e ,e-fi
City/Town: /(,(Q�,� �/�} City/Town:
Telephone:
Telephone:
I'hoto l.D. ret uired/Copy of Photo I.D. attached: YES ✓ NO -------------
J-1 / Jl-i-unrestricted license Staf W111a1
J-2/M-2-restricted to dwellings 3-stories or less and ommerc'al up to 10,000 sq. It./2-stories unless
Residential: 1-2 Family Multi-taini!
y Condo/ Townhouses Other
Commercial: Office Retail Industrial
Educational
Institutional Other
Square Footage: under 10,000 sq. tt. over 10,000 sq. it. /11' Number of Stories:
Sheet metal work to he completed: New Work:
/ Renovation:
I IVAC' ✓ i�ietal Watershed Ruuiin ► Kitchen b n Exhaust System
Metal Chimncy/ Vents ,fir Balancing
t'ruVitle detailed d scripti()n of work to be done:
00,45 alid ToN004 4en e _Ash
INSURANCE COVERAGE: i
I have a current liabilityinsurance policy or its equivalent which meets the requirements of M.G.L.Ch. c12 Yes No❑
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 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 chocking this box/,Ireby certify that all of the details and Information 1 have submitted(or entered)regarding this r his atloo are true ill de
accurate to the best of my knowledge undo all
shoot
oo metal work
setts BuildinganInstallations Code Chapter 1e12 of under
the permit
Issued
ed for thl;application
In compliance with all Pertinent provision
prior to Insulation Installation: YES NO
Duct inspection required p .
Progress tnsarctions
Comments
'Date
Final lusgection
Comments
I)ttw
1
Type License:
By
Master
i
t�;1e C]1 aster-Restricted I
r
1 C&j,,T;;vn_ _._ — ❑icurneyperson Signature of Licensee
❑Jaurneyparson-Restricted License Number: t
Foe S ....__.__._ ❑ Check at