22D-101 89 BLISS ST (wrong map block on card) (2) 89 BLISS ST SM-2017-0063
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 11909 _ o�
Map 35 t t
Lot: °' ° i SHEETMETAL PERMIT
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Permit (SHEETMETAL
Category: SHEETMETAL
Permit a SM-eon 0063 _ PERMISSION IS HEREBY GRANTED TO:
Project# CJS-2017-002311
Est.Cost: $5,000.00 ',Contractor: License: Expires:
Fee Charged:$25.00 iIPETER MOSIJCHUK-M&M COPvSheetmetal-5445
Balance Due:$.00 Owner: COYLE DANIEL
#of Fixtures: lApplicant: PETER MOSIJCHUK-M& M COMFORT ZONE
DigSafe# _ AT: 89 BLISS ST
UseGroup
ConstClass I
ISSUED ON: I6-Jun-2017 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
REPLACING WARM AIR FURNACE,INSTALLING AC
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-2017-006793 14-Jun-17 3989 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:Ihasbroucluknorthamptonma.gov
Gaol MS®2017 Des Lauriers Municipal Solutions,Inc.
File#SM-2017-0063 '-
APPLICANT/CONTACT PERSON PETER MOSIJCHUK-M&M COMFORT ZONE
ADDRESS/PHONE 19 OAKDALE ST (413)231-7164
PROPERTY LOCATION 89 BLISS ST
MAP 35 PARCEL 040 ZONE SR/WSPII
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
LOSED REQUIRED DATE
ZONING FORM FILLED OUT ��
Fee Paid 5
Building Permit Filled out
Fee Paid - / h. S
Typeof Construction: REPLACING WARM AIR FURNACE, INSTALLING AC q
New Construction p£2IM \
Non Structural interior renovations
Addition to Existing
Accessory Structure y\. ���
Building Plans Included: J% ->
Owner/Statement or License 5445 ' ,
3 sets of Plans/Plot Plan c�n'LLr,'V\
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOIjMATION 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
Permit fromm Elm Street Commission Permit DPW Storm Water Management
611(I
Signature of Buil mg 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.
Commonwealth of Massachusetts
City Of Northampton
Date: 6 —/c/— /72 Sheet Metal Permit Permit;#'j—/ 7• G 3
Estimated Job Cost: $ CV/ v c'rirD Permit Fee: $ o 0
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License# 5t/ c{5 Applicant License# -S V 67-
Business Information: Property Owner/Job Location Information:
Name: Ldi; OrT COC.99-2-4:14-f f?aNP Name: J�!>rc%-E-L 6y(2
/G 67.4x—o3/29 6
Street: 7 -23-,g/15-4— Street: 5 9 3 4 SS sr .
_ Gd
City/Town: - City/Town: - /<
Telephone: o2 — g 3r" 7/6,y Telephone: 23 ? — 1/4.2 (7✓
Photo I.D. required/Copy of Photo LD. attached: YES NO
Staff Initial
J-1 /M-1-unrestricted 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:
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:
C--29 c<'aro- tc11,L6ti 4/i[
<ir( A /7/ ,t/ - /I /✓ .
Fees with Building Permit:$25.00 Residential,$50.00 Commercial. Fees for jobs without a Building Permit$6.00 per$1000
Minimum fees for jobs without Building Permit$50.00 Residential, $100.00 Commercial
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes El No❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER:I am aware that the licensee Aaec nnf ha.'e the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application u.aive this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this boxD,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation:YES NO
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Final Incperfnn,
Darn Comm-tits
Type of License:
By 2Mpeaster
nne4J1❑ Master-Restricted
City/ own ❑Journeyperson
Signature of Licensee
Permit#
- - ❑Journeyperson-Restricted
License Number: LS- VY,S
Fee$ ❑
Check atwwlni matt gnvldpl
Inspector Signature of Permit Approval