6 MANNING ST - BPA (jacket info) � �7Octe�i2ac�
Conunoinvealth of Imass.1gipi gERVNi'[z, k .
Sheet Metal PermltHlb MAY 2l A D 4b
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. � Inane: �la��IIQ—
fermi[ N.
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t Fstimated Job Cost: S Permit Fee: S—10
Plans Submitted: YES NO ✓ Pleats Recicwcd: }'F.S _ NO
13usiness C.icensc k p4�j-t}9— s_cjc� Applicant License tt 2904 ---
I1311siness lntormation: Property Owner/Job Location Information:
Name: Sale, l(9fxJ-tvn andL lli' �inr�Nanne: SK6U, lb�t -. (e-c�
J
StIect: Ia (AatEL& _ Street:
CitylTown: �:1 Txk6a. nnA ualsc, City/Town: S (g-W, , YVIR N`ljo
Telephone: n)W-ZX- L4114 Telephone: 0-In S59 -19 or]
Photo I.D. required/Copy of Photo I.D. attached: YES _
_ NO
J-I NI-1-unrestricted license Staff Initial
J-2 / M-2-restricted to dwellings 3-stories or less and commercial up to I 0,000 Sq. ft. /2-stories ur less
Resideotial: 1-2 family ✓ Multi-ramily_ Condo/ Townhouses
Other_
Commercial: Office_ Retail Industrial
— Educational _
Institutional _ Other_
Square Footage: under 10,000 sq. tt. ✓ over 10,000 sq. tt. _ Number of Stories:
Shcet metal work to he completed: New Work:
— I Renovation: _
IIVAC INIetal Watershed Rooting_ Kitchen Exhaust Syslctn
Metal Chimney/ Vents_ Air Balancing
Provide detailed description of work to be done:
ynSi 4 lls�ilcm e� �� — - _
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-_k o o r-S -(
.0
Mai ms - (0 IT Tb GC .
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INSURANCE COVERAGE: '
I have a current Iiabili insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes ER L7"No❑
If you have checked Yes, indicate the type of coverage b checking the appropriate box below:
Y
- nit Bond El
policy Lv7 Other type of Indemnity ❑
A liability wired b Chapter 112 of the
e re Y
coverage q
OWNER'S INSURANCE WAIVER: I am aware that the Ilcensee does not have the Insurance c 9
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent [�
ASignaturener or Owner's Agent
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
By checking this box❑,I hereby certify that all of the details and Information 1 have submitted(or entered)regarding this application are true an
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
Proar:ess 111sgectiOns
Comments
Date
Final Il�tion
Comments
D atu
Type of License:
By _ ❑ Master
rla
rile ❑ Master-Restricted r`7N`—
i
�I�y,ro•.vn___.--_._ ourneyperson Signaturet� icensee
pert z ❑Journeyperson-Restricted License Number: S1 1
as i ---
❑ _-------- Check at m.r;s;lov!�1LX,
I
I
Inspvclor signature of Permit Approval