207 HIGHLAND AVE - BUILDING INSPECTION (4) Commonwealth of Massachut4ttLslyU
�NSPIECTVGtNAL SERVIu,.-
Sheet Metal Permit
' (:5-- Date. �_ �+ t to 101b JUN 14 A 8- 31
Permit #
0 Estimated Job Cost: S -7-3t460 Permit Fee: $_-7(3 �2i
9 Plans Submitted: YES NO Plans Reviewed: YES NO
Business License # 00 n
� Applicant License #
Business hiformation: c Property Owner/Job Location Information:
Name: lcoy\yo\ f ,, r �YCS�2`^ Name:
Street. tl \`a� ( J( e (�A Street. 4v / W e
City/town: Wes\«t � 1-`A City/Town: \�4�
'Telephone: 70t- 3(o5-y-092 `x 1 3 Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES NO
.Starr Initial
J-1 / M-I unrestricted license
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-family_ Condo/ Townhouses Other
Commercial: Office Retail_ Industrial T Educational _
Instiftnional Other
Square Footage: under 10,000 sq. ft. _ over 10,000 s ft. Number of Stories:
Sheet metal wor to be completed: New Work: _ Renovation:
HVAC Metal Watershed Rooting _ Kitchen Exhaust System_
Metal Chimney/ Vents_ Air Balancing_
Provide detailed description of work to be done:
rn A,t_ -t-o C . L.
m,zt,,L—(EXD R, h l z t
a
r
INSURANCE COVERAGE: �//
I have a current liabilityinsurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes l� No❑ k
If you have checked Yes, indicate t e 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 checking this box❑,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 f License:
By Master ^
Title ❑ Master-Restricted2 � �,L)'�/
City/Town
❑Journeyperson Signature of Licensee
Permit# ISSN Io
❑Journeyperson-Restricted License Number:
Fee$ ❑
�
C / Check at www mass clovldpl
v
Inspector Signature of Permit Approval