31A-133 INSURANCE COVERAGE:
I have a current liability,insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes i4o❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy LrJ 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 CJ,I hereby certify that all of the details and information 1 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 Insaection
Late Comments
Type of License:
By Master
Title
❑ Master-Restricted ��( ..
City/Town
❑Journeyperson
Signature of Licensee
Permit#
Fee$ ❑Journeyperson-Restricted License Number: } 53�.
Check at www.mass.gov/dpi
Inspector Signature of Permit Approval
Commonwealth of Massachusetts
0 Sheet Metal Permit
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e: RP , 14
0.11 4 Permit#
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an
mated Job Cost: $ 3��c Permit Fee: $ 5,3q
N
s Submitted: YES NO Plans Reviewed: YES NO
Business License # Applicant License #
Gxp,uc�
Business Information: Property Owner/Job Location Information:
Name: R,1CN►Ei � P)klzS () •.Name: C,rN CGa'f iSawt Qz� )UDW x44-:
Strcct: k Gzz,( 4O'7 Street: UYT
01 A
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City/Town: A fA, M-R . Qll'!Jj- )�70ty/Town: btG4L�P{�cCtf''�CQ� IYl -
Telephone: Lill IC- [aL44 Telephone: 413 -71W%
Photo I.D. required/ Copy of Photo I.D. attached: YES NO'/
OR MlC Staff Initial
J-1 /M-1-unrestricted license
3-2 /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. V over 10,000 sq. ft. Number of Stories: ot+
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:
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1A C-.yo14 Q TA Fha Ay�i—s. %gTQAGA F?�a
FRGSh Ai o. w4iT RENT„
File#SM-2014-0055
APPLICANT/CONTACT PERSON RICHIES AIR CONDITIONING&HEATING INC
ADDRESS/PHONE P O BOX 407 (413)789-1244 Q
PROPERTY LOCATION 90 MOSER ST-LOT A2
MAP 38A PARCEL 133 ZONE PV
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out , /��y �►
Fee Paid
Typeof Construction: INSTALL COMPLET AIR DUCT SYSA +w (�
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 273
3 sets of Plans/Plot Plan
THE FOLLOWJNG ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOR ION PRESENTED:
proved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan
Major Project:_ Site Plan AND/OR Special Permit with Site Plan
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
from Elm Street C mmission Permit DPW Storm Water Management
Signature of it mg Of tcial 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.
90 MOSER ST - LOT A2 SM-2014-0055
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
IGIS#: 12,105
-- -
IMap: 38A
:Black, - 133` T - SHEETMETAL PERMIT
Lot:... _ ��..•
Permit: SHEETMETAL
Category: New Single Family House
Permit# sM-2014-0055 PERMISSION IS HEREBY GRANTED TO:
Project# 75-2013-001987 w
Cost: $8,000A0 Contractor: License: Expires:
Est 8000 RICHIES AIR CONDITIONING& Sheetmetal-273 03/15/2014
Fee Charged:$2
Balance Due:$.00 Owner: KENT PECOY&SONS CONSTRUCTION INC
�#of Fixtures
—Applicant. RICHIES AIR CONDITIONING&HEATING INC
DigSafe# _ AT. 90 MOSER ST-LOT A2
�UseGroup
CGonstClass
ISSUED ON. 06-May-2014 AMENDED ON: EXPIRES ON.
TO PERFORM THE FOLLOWING WORK.
INSTALL COMPLET AIR DUCT SYS BEDROOM OVER GARAGE
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-2014-006319 30-Apr-14 16534 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS9 2014 Des Lauriers Municipal Solutions,Inc.