B-17-1149 - 0001 BROAD STREET - Building Permit Commonwealth of Massachusetts
Sheet Metal Permit
11/21/17
6� Date: Permit#
13,000
Estimated Job Cost: $ Permit Fee: $
1 Plans Submitted: YES NO ❑� Plans Reviewed: YES _ NO
Business License# 52 Applicant License# 469
i Business Information: Property Owner/Job Location Information:
Name: Name:.
Central Cooling and Heating,Inc. Constance Arlander
Street: Street:
9 North Maple St. 1 Broad St. #5
Woburn,MA 01801. Salem o
City/Town: City/Town: =•
(781) 933-8288 (978) 979-0037
Telephone: Telephone:
Photo I.D.required/Copy of Photo I.D.attached: YES X NO r ;�
Staff Initial
J-1 nrestricted license
J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stones.o,,less
Residential: 1-2 family •' Multi-family Condo/Townhouses Other
Commercial: Office Retail Industrial . Educational n_j
Institutional Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. .Number of Stories:3
Sheet metalwork to be completed: _ New Work: F Renovation: ✓V
HVAC n Metal Watershed Roofing II Kitchen Exhaust System
Metal Chimney/Vents F-1 Air Balancing
Provide detailed description of work to be done:
is 'n
04
INSURANCE COVERAGE:
have a current liabili insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes 0 No
If.you have checked Yes;indicateahe type of coverage by checking the appropriate box below:
A liability insurance policy Other type of indemnity 0 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
Ow ❑ Agent.❑
Signature of Owner or Owners Agent
By checking this boxE,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under 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
Progress Inspections
Date Comments
Final Inspection
Date Comments
Type of License;.
By 0 Master
Title
f
❑Master-Restricted.
C.
Cityrrown
❑Journeyperson.
Signature of Licensee
Permit#
OJourneyperson-Restricted
License Number:
. : Fee$ O
Check at www.mass.gov/dpl
Inspector Signature of Permit Approval