22B-041 (9) File#SM-2014-0062
APPLICANT/CONTACT PERSON PUN FAMILY LLC
ADDRESS/PHONE 191 SOUTHWICK RD
PROPERTY LOCATION 176 PINE ST
MAP 22B PARCEL 041 001 ZONE NB000)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: INSTALL DUCTWORK FOR ROOFTOP UNIT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 1641
3 sets of Plans/Plot Plan
THE FOLL 1N4G ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
Approved 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
ermit y
fr_W Elm Street Commission Permit DPW Storm Water Management
Signature of Bui n Official 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.
INSURANCE COVERAGE:
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 Z Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER:I am aware that the licensee rimes not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waims, this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this boXA,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
Prnvrncc TnenPrtionc
Date r nmmentc
Final Tncnnrtinn
r
Date cnmmentc
Type of License: (,L N M11 '
BY ❑Master x(a OQ 1
' v 1
Title ❑Master-Restricted /
City/Town ❑Journeyperson
Signature of Licensee
Permit# ❑Journeyperson-Restricted
License Number: Is l
Fee$
Check at wwau macs gnv/rip_I
nspector Signature of Permit Approval
Commonwealth of Massachusetts
City Of Northam p ton
V JUN - 5 2014
Sheet Metal Permit permit#
Electric, Plumng bi -a_
Northampton. MA 61066
Estimated Job Cost: $ CJ Cif} Permit Fee: $U041
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License# SJ4 Applicant License# 11G y
Business Information: Pyperty Owner/Job Location Information:
Name: Name: oL
Street: 3,) Street:
City/Town: FA 14 City/Town:
Telephone: 9 13- a G`s ?l y'Q Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES NO
Staff Initial
J-1 /M-1-unrestricted license
-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 J
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC J Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
v
Fees with Building Permit: $25.00 Residential, $50.00 Commercial. Fees for jobs without a Building Permit$6.00 per$1000
Minimum fees forjobs without Building Permit$50.00 Residential, $100.00 Commercial
176 PINE ST SM-2014-0062
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 8976
Map: 22B — - --
Lot: o01 001
Lot. -- - SHEETMETAL PERMIT
Permit: SHEETMETAL N` '`�
Category: SHEETMETAL _
Permit# S -2014- 0127 PERMISSION IS HEREBY GRANTED TO:
Project# JS-20I4-0Q 1273 �
Est.Cost: $2,000,00 Contractor: License: Expires:
Fee Charged:$50.00 KC MECHANICAL LLC Sheetmetal- 1641 12/28/2015
Balance Due:$.00 Owner: PUN FAMILY LLC
#of Fixtures +A licant: PUN FAMILY LLC
176 PINE ST
UseGroup
Co nstClass
ISSUED ON.' 06-Jun-2014 AMENDED ON.• EXPIRES ON.
TO PERFORM THE FOLLOWING WORK:
INSTALL DUCTWORK FOR ROOFTOP UNIT
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-2014-00701 I 06-Jun-14 1255 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMSO 2014 Des Lauriers Municipal Solutions,Inc.