38B-291 (4) 284 SOUTH ST SM-2019-0035
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
PMap:GIS# i 7787 �
39B
Block:' 291
Wi ' SHEETMETAL PERMIT
t: 001 � � � .�. .
Permit: SHEETMETAL
'Category: 'FIREDAMAGE
Permit SM-2019-0035PERMISSION IS HEREBY GRANTED TO:
�Praject# IJS-2019-000740
[6t.Cost: $12, Contractor: License:
000,00 Expires:
Fee Charged:1 �$25.00 STEVEN GRAYDON DBA S&G HESheetmetal-3651 07/28/2020
Balance Due:SAO Owner: CAMPBELL CATHERINE
#of Fixtures: Applicant: STEVEN GRAYDON DBA S&G HEATING
�gSafe# '; AT: 284 SOUTH ST
UP —
L onstClass ;.
ISSUED ON: 29-Jan-2019 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK.•
NEW HVAC SYSTEM
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-2019-002499 28-Jan-19 1291 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouckgnorthamptonma.gov
GeoTMS®2019 Des Lauriers Municipal Solutions,Inc.
File#SM-2019-0035
APPLICANT/CONTACT PERSON STEVEN GRAYDON DBA S&G HEATING
ADDRESS/PHONE 14 LOWELL LANE (413)237-3747
PROPERTY LOCATION 284 SOUTH ST
MAP 38B PARCEL 291 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildina Permit Filled out
Fee Paid IT P
Typeof Construction: NEW HVAC SYSTEM
New Construction
Non Structural interior renovations
Addition to Existing_
Accessory Structure
Building Plans Included:
Owner/Statement or License 3651
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFqRMATION 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 from Elm Street Commission Permit DPW Storm Water Management
Signature of Building 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
S��t�[et��e�iit
Date: 2 Permit# ` !9' 6
--
Estimated Job Cost: $ 12-- JAN 2 8 2019 rmit Fee: $
DEPT.OF BUILDING INSPECTIONS
Plans Submitted: YES NO NORTHAMPTON,MAoloMans R viewed: YES NO
Business License# Applicant License# 2 �;S
Business Information: Property Owner/Job Location Information:
Name: �� (' - -Q�2_ l`'� Name:
Street: Lr�U�--�- I L I, Street:
City/Town: �-'��-'� «c Ta�-�_ City/Town: f'� ��u
Telephone: ,z 3� L� Telephone:
Photo I.D. required/ Copy of Photo I.D. 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 X 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:
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 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 boCl 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
City/Town
❑Journeyperson Signature of Licensee
Permit#
❑Joumeyperson-Restricted License Number: 3 ��
Fee$
❑ Check at www.mass.aov/dt)l
Inspector Signature of Permit Approval
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