17A-299 (2) INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 YesX No ❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy tyk Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee rinc.c. net have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws, and that my signature on this permit application waivecthis requirement.
.<_.... „.1 V
Check One Only
Owner K Agent ❑
Signature of r or ner's Agent
By checking this box 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
Progress Incpertion%
Hate Comments
Final In cpprtinn
Date Comments
Type of License:
By N E Master i (-,
Title ❑ Master - Restricted
City/Town ❑Journeyperson
Signature • " icensee
Permit # y
❑Joumeyperson- Restricted
License Number: 1a
Fee $ ❑
Check at govi dpi
Inspector Signature of Permit Approval
Qt
Commonwealth of Massachusetts
I JUL 1 8 2012 City Of Northampton
,E , t ,,,, Sheet Metal Permit Permit # ‘- 5)1')-- ii,
gi
Estimated Job Cost: $ D�'i ®D . Permit Fee: $ 616 i
3
Plans Submitted: YES NO ' Plans Reviewed: YES NO
Business License # \ act Applicant License # ‘aci
Business Information: Property Owner / Job Location Information:
Name: (\\ &f '» s 'c . - 6 - J t f Name: c� cNIcht.k. M 1 C P Il
@ Q ex) \ko.)..-.
,. ,N C�
Street: c C \y--. �rt Street: \5 �(l S - Mc r
City /Town: 11 p . A City/Town: • P it 0
Telephone: lit A %fit l 9 Esc Telephone: (0z4 - ctoc
Photo I.D. required / Copy of Photo I.D. attached: YES NO '(
Staff Initial
J -1 41 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. X over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC X Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney / Vents Air Balancing
Provide detailed description of work to be done:
\ -U. eX ‘ 54 1 I1.At Z 0 C\ S`el S ^ � K)c kcaLi
" h,
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, $100.00 Commercial
File # SM- 2013 -0006
APPLICANT /CONTACT PERSON ALL SEASONS HEATING AIR
ADDRESS/PHONE 93 ELM ST (413) 247 -9842
PROPERTY LOCATION 157 HILLCREST DR
MAP 17A PARCEL 299 001 ZONE URA(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �j¢ -7 -�
Fee Paid (��11 �+ t$O"6
Tvpeof Construction: REPAIR DUCT SYSTEM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 129
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO,RMATION PRESENTED:
roved 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
%• `�
f
Z.
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.
157 HILLCREST DR SM- 2013 -0006
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS #: 1604
Map: 17A
.Block: 299 ____ -__- � �
Lot -_- 001 W .1 SHEETMETAL PERMIT
Permit: SHEETMETAL r�£T
'Category: SHEETMETAL
Permit # SM- 2013 -0006 PERMISSION IS HEREBY GRANTED TO:
Project # JS- 2012 - 001860
-- - - - - -- - - - - - -- ---- - - - - --
C License:
Est. Cost: $2,800.00 Expires:
- ged Fee Charged: $25.00 ALL SEASONS HEATING AIR Sheetmetal - 129
Balance Due: $.00 Owner: RACHELLE MARLENE
C# of Fixtures: Applicant: ALL SEASONS HEATING AIR
DigSafe # AT: 157 HILLCREST DR
UseGroup
ConstClass
ISSUED ON: 20 -Jul -2012 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
REPAIR DUCT SYSTEM
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fixtures:
Floor: Type: # of Fixtures Floor: Type: # of Fixtures
Fee Type: Receipt No: Date Paid: Check No: Amount:
Sheetmetal REC- 2013- 000201 18- Jul -12 3888 $25.00
212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :lhasbrouck @northamptonma.gov
GeoTMS® 2012 Des Lauriers Municipal Solutions, Inc.