21 1-2 BROAD ST - BUILDING INSPECTION (2) f6-1'-4-135f GK 3 Lj
Commonwealth of Massachusetts $ 4-7
Sheet Metal Permit RECEIVED
Date: / INSPECTIONAL SERVICES
Permit#
Estimated Job Cost: $ Permit FeN AUG 15 A 11: 5 q
Plans Submitted: YES_ NO Plans Reviewed: YES NO X
Business License# 5a Applicant License#.. q 6 q
Business Information: Property Owner/Job Location Information:
Name: C'enkal Cool i na+la cA+;n�,Tic. Name: �5�bP_I J-z S k Ka j
Street: q Ne A a d l p S-Ir v o�- Street: Q I& B paa y
City/Town: _W6hur,,,, MA alam/ City/Town: SL-kf m , H W 01570
Telephone: 7?f-q31- $ 8,p Telephone: q 7k- J�o- y j > j
Photo I.D. required/Copy of Photo I.D. attached: YES_X NO
J-+ -1/ unrestricted license swrrwdw
J-24+4-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less
Residential: 1-2 family-L Multi-family— Condo/Townhouses Other
Commercial: Office— Retail— Industrial Educational
Institutional_ Other_
Square Footage: under 10,000 sq. ft.F — over 10,000 sq. ft._ Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC � Metal Watershed Roofing— Kitchen Exhaust System
Metal Chimney/Vents— Air Balancing
Provide detailed description of work to be done:
i
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Ye No❑
If you have checked Yes,indicate the type of coverage by checking the appropriate box below:
-
A liability insurance policDd— 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 checking this boxy 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 &blaster L
Title ❑Master-Restricted
City/Town
❑Joumeyperson Signature of Licensee
Permit#
❑Journeyperson-Restricted
o� License Number:
Fee$
Check at wrww.mass.00vldof
Inspector Signature of Permit roval