Loading...
107 HIGHLAND AVENUE - BUILDING JACKET llp �ijl �. IoI Commonwealth of Massachnsett tEGI?iV g R�10ES INSPEGTtONAI Sheet Metal Permit I�, pa � i� 1114 OCi 31 A Date: I© -� I e 1 Permit 1/ r Estimated Job Cost: SQ 1 0,9 a Permit Pee_S ---- _ Pl:ms Submitted: YES _ NO _ Plans Rey icwcd. YES NO Business License tL Applicant License # �2 19 Business Intbrinaattion: / Property Owner/IJob Location Information: NUme: / 17'F Ind T Cia, - �� b c�T W , 71 +,Z,r�j s Name: Street: 2 J O fJ( r.J J Z Street: 16 / �t n�✓/ 4r r City/Town: -f -l r m City/Town: S I c "1 ,rciephone: 171 ? ?I 11 y Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO_ surn�dm�m J-1 A1-1- nrestricted license J-2 / dM-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. 11. / 2-stories or less Residential: 1-2 family_ Multi-tamily_ , Condo/ Townhouses Other Commercial: Office_ Retail_ Industrial _ Educational Institutional Other_ Square Footage: under 10,000 sq. ft. _ over 10,000 sq. tt. _ Number of Stories: 3 Sheet metal work to be completed: New Work: Renovation: IIVAC_ Metal Watershed Rooting _ Kitchen E.ehaUst System Metal Chimney/ Vents_ Air Balancing Provide detailed description of work to be done: -IiTJ,/1d TJ T be In )T. der Ih e V.,r7l Jyjrernj — i INSURANCE COVERAGE: il' .rr I s r..- . 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 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❑,1 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 Proeress Inspections Date Comments Final Inspection Date Comments Type of ense: ©y-_ Master nne ❑ Master-Restricted Cilpicwn ❑JOUrneyperson *Snature of Licensee Pennd x. / 9 t7 ❑Journeyperson-Restricted License Number: O� I°oa 5 ---- -�-- F-1 — Check at w.r.v.m.c;,.rlOvAfltl Inspector signature of Permit Approval