44-129 (6) 292 OLD WILSON RD SM-2019-0047
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
;GIS#: ..11389
Map: 144. i f
29
ca: 001 SHEETMETAL PERMIT
ot: ,. 001
Permit: SHEETMETAL
Cutegory SHEETMETAL
Permi[# ISM-2ot9-oo4� _ PERMISSION IS HEREB Y GRANTED TO.
Project# JS-2019-001541
Contractor: License:
Est.Cost $8,500.00 - Expires:
Fee Charged''$25 00 —IJOHN THOMAS PLUMBING&HE Sheetmetal- 1081 07/28/2019
Balance Due:$.00 'Owner: SIERROS KONSTANTINOS N&SUNITA B SIERROS
�#of Fixtures:- Applicant: JOHN THOMAS PLUMBING&HEATING
DigSafe# _ _ JAT: 292 OLD WILSON RD
UseGroup �
ConstClass
ISSUED ON: 03-Apr-2019 AMENDED ON: EXPIRES ON.
TO PERFORM THE FOLLOWING WORK:
INSTALL DUCTED MINI SPLIT AND HEAT PUMP IN HOME THEATER
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:
Sheclmctal UC-2019-003082 27-Mar-19 321 $25.00
212 Main Street,Phons(413)580-1240,Fax:(313)587-1272,Email:lhasbrouck!a&.northamptooma.gov
GeoTMSO 2019 Des Lauriers Municipal Solutions,Inc.
File#SM.2019-0047
APPLICANT/CONTACT PERSON JOHN THOMAS PLUMBING&HEATING
ADDRESS/PHONE P O BOX 614 (413)626-2976 O
PROPERTY LOCATION 292 OLD WILSON RD
MAP 44 PARCEL 129 001 ZONE
(5
THIS SECTION FOR OFFICIAL USE ONL
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypgofConstructiom INSTALL DUCTED MINI SPLIT AND HEAT PUMP IN HOME THEATER
New Construction
Non Suntan to,
l interior renovations
Addition to Existing
Accessory Structure
Building Plans Included
Owner/Statement or License 1081
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFgRMATION 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: 3
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
_ 3
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
Sheet Metal Permit
jj (( r-- t r c
Date: 3127 1 � RECEI V L Permit 0->rll "!Cf -q7
Estimated Job Cost: $ SU�'� MAR ?_ 7 2019 ermit Fee: $ a
Pians Submitted: YES NO e/ -iaos-Reviewed: YES-„_ NO_
._
Business License# rcant icense#_..,
Business Informatii�o{: Xf,710a M y Property Owner/Job Location Information:
Name: .�Doh lvwWtcT `� J-L1✓y 11'6+^1 Name: Ky'yy...5leVO-1
Street:S 30ai4. Street: 292 0(� tS6h /ld
City/Town- � City/Town: l�G _
Telephone:f{P7� 'telephone: _
Photo I.D. required/Copy of Photo I.D. attached: YES_ NO_
StaII Iaitim
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 familvc" Multi-family_ Condo/Townhouses._ Other_
Commercial: Office Retail _.._ Industrial — Educational —
Institutional—
ducational _Institutional— Other _
Square Footage: under 10,000 sq.ft. Z over 10,000 sq.ft. _ Number of Stories: 2
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:
1 vs t11 �5 otnz b,)Je Vw tKt Sal + +stIll �t ISA of
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 bo{y 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
CityFrowr Joumeyperson
❑ Signature of Licensee
Permltu
❑Joumeyperson-Restricted License Number:
Fee$
❑ Check at wwyy.mass.ciovldol
Inspector Signature of Permit Approval