108 BOSTON ST - BPA-13-343 HVAC \ Commonwealth of Massachusetts W l
Sheet Metal Permit
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Fstimated lob Cost: .y_ �j�jzj7�_ Permit Pee: `5
Plans Submitted: YES I�N'O_ Plans Reviewed: YES NO
Business License t/ — Applicant License tt 11125
Business Inli,rmation: Property Owner/Job Location Information:
Name: Nante:
Street. �9 �/ Co 2eF-T $ r Street: 0 �
City/Town: �p �r,/� �C��� City/Town:
Telephone: --on Telephone:
Photo I.D. required/ Copy of Photo I.D. attached: YES— NO
J-1 / :�(- mrestrictcd license Staff nimtan
J-2 / :M-2-restricted to dwellings J-stories or less and commercial up to 10,000 sq. It. / 2-stories or less
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Residential: 1-2 Family_ Nlulti-Rumily_ Condo/ "Townhouses_ Other_
Commercial: OFtice_ Retail_ Industrial _ Educational
Institutional) Other Ll__� —
Square Footage: Under 10,000 sq. tt. ✓ over 10,000 sq. tt. _ Number orStorles:
Shect metal work to he completed: New Work: _// Renovation:
1IVAC_ Metal Watershed Roofing_ Kitchen Exhaust Systen,
`fetal Chinnney/ Vents_ Air Balancing
I'rovidc detailed description of%%ork to be done:
P��1CLtiSl� 75-0
INSURANCE COVERAGE:
I have a current liability insurance 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:
Other type of indemnity El Bond El
A liability Insurance policy Yp
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(],I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and
Iaccurate to the best n compliance with all pertinent my knowlede and that pertinent provision of the ll shoot metal work and Installations perfored Massachusetts Building Code and Chapter 112 of lder the prit he Generaln Issued for this application will be
Laws.
Duct Inspection required prior to insulation Installation: YES_ NO
Provress Inspections
Date Comments
Final 111SPectif111
D:uc Comments
Type of License:
By ❑ Master
nne ._ ❑ blaster-Restricted
ra.�n ❑Journeypersan Signature of Licensee j
❑Journeyperson-Restricted ?
License Number.
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In spactor hrto ol\ ii Approval
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