31A-076 (5) INSURANCE COVERAGE:
i have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 YesIt No❑
If you have checked Y,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 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 of License:
By Master
Title ❑Master-Restricted 4.1 �,-71 10774
City/Town ❑Journeyperson
Signature of Licensee
Permit#
❑Journeyperson-Restricted License Number:
Fee$ ❑
Cheek,at www.mass.gov/dpi
Inspector Signature of Permit Approval
-- '' Commonwealth of Massachusetts
, ' 111
0 0C-1- 2 3 2013 +
Sheet Metal Permit
{ _Date ID a. Permit Permit# 90 1 q 2 6
Elecir a Piun ina n� �c -- - - -
r!c Estimated Job Cost: $ Permit Fee: $ 100---/06t.
Plans Submitted: YES NO X Plans Reviewed: YES ` NO
Business License# 9 a Applicant License#
Business Information: Property Owner I Job Location Information:
Name:H uC k() n -It vl , -l.G Name: 1 0-
0 1'
Street: 9 C) k ut_ —.� Street: ein Si,
City/Town:S )` \( 14) MA City/Town: )JOfCYI
C
Telephone: "t tS- ) d�.-3l ig Telephone: l/3 J (:,~ 3--,--
Photo I.D.required/Copy of Photo I.D. attached: YES X NO
Staff Initial
J-1 /04 estricted 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 Educational
Institutional Other
Square Footage: under 10,000 sq. ft. ). over 10,000 sq. ft. Number of Stories: a
Sheet metal work to be completed: New Work: Renovation:_>(,,_
HVACX Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
'/. � '��� 1.File for sheet metal and gas permits with the City of Northampton.
2. Disconnect,remove and dispose of one rooftop units and one split system.
3.Provide high efficiency replacement equipment of equivalent capacity
4. Provide connections to existing gas and ductwork systems.
5.Provide allowance for sub-contract of crane rigging and electrical systems.
6.Check,test and start up system operation.....).ti,itn.e."t(7 ..)/a e e.1113111011'
G
File#SM-2014-0025
APPLICANT/CONTACT PERSON HURLEY&DAVID INC
ADDRESS/PHONE 90 Fisk Ave (413)732-3141
PROPERTY LOCATION 264 ELM ST I
MAP 31A PARCEL 076 000 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 3'7 161 fr7
Fee Paid
Typeof Construction: DUCTWORK FOR NEW ROOF TOP UNITS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 824
3 sets of Plans/Plot Plan 7c..7s,jJ(- C'_'
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
"Approved Additional pet nuts required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Z-vt‘he,
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan .
Major Project: Site Plan AND/OR Special Permit with Site Plan
011(Au,
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
o 1 S t Co ssion Permit DPW Storm Water Management
/ '//
Signature of Building fficial Date
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.
264 ELM ST I SM-2014-0025
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 111473
,Map: 31A . �1''
Block: 076 KIWI" SHEETMETAL PERMIT
Lot 000 �
Permit: 'SHEETMETAL £RCENTENPR
r
Category:
Permit# SM-2014-0025 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2014-000730
Est. Cost: $21,442.00 Contractor: License: Expires:
— - –Fee Charged:$100.00 HURLEY&DAVID INC Sheetmetal-824
(Balance Due:$.00 Owner: DEMAIO AARON A
I#of Fixtures: Applicant: HURLEY&DAVID INC
1DigSafe# AT: 264 ELM ST I
UseGroup
ConstClass
ISSUED ON: 04-Nov-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
DUCTWORK FOR NEW ROOF TOP UNITS
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Sheetmetal REC-2014-001852 23-Oct-13 10037 $100.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.