30A-035 (2) INSURANCE COVERAGE:
I have a current lianility insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes tl[1 No ❑
If you have checked Yes, indicate type of coverage by checking the appropriate box below:
A liability insurance policy Other type of indemnity ❑ Bond ❑
ty r cep icY YP Y
OWNER'S INSURANCE WAIVER: I am aware that the licensee arum not limns the insurance coverage required by Chapter 112 of the
Massachusetts General Laws, and that my signature on this permit application maims 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 Geneyel Laws.
Duct inspection required prior to insulation installation: YES ✓/ NO
Progrnec ingrvetions,
lgte Corprnents
Fin pi In Tertian
Date j''nmmPntq
Ty _�_ of License:
Master
!rJ aster
Title ❑ Master - Restricted
City /Town OJoumeyperson
Signature of Licensee
Permit #
DJoumeyperson- Restricted
License Number:
Fee $ ❑
Check at
Inspector Signature of Permit Approval
k Commonwealth of Massachusetts
JUL 6 2012 i City Of Northampton
/ 42 Sheet Metal Permit
Permit #
Estimated Job Cost: $ 6 b0 - Permit Fee: $3C 3 a--5
Plans Submitted: YES NO f/ Plans Reviewed: YES NO
Business License # Applicant License #
Business Information:
�f Property Owner / Job Location Information:
Name: ` vV S , 4A tt. Name: d4GA✓ ?y4 AI, Ok
Street: 6e 14/4„),,4-a,„ ;2 Street: 7 , 1445 l ( Av /4 3
City /Town: Lv /t/ / 'i4 o/l$i' City /Town: /W"2 r,4'*70 °' '
Telephone: 72'i — 5 3 7 — 703 Telephone: ' ('3 5 7V5 7
Photo I.D. required / Copy of Photo I.D. attached: YES NO
Staff Initial
J -1 nrestricted 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 7 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:
S'' /' 4/r 4- 2g/✓o,/q TON , 13/4/- G7 4/e Pt/ 2c(
-, - ij % 7i 4 / ' /f,4U -7 �/Z/1 t sxA4 5 ' A94/, z/ti
v. / - cc ag o- ('Sr,., 7 -n4 /4v1&# C'£l4
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 -0005
APPLICANT /CONTACT PERSON POWERS AIR
ADDRESS/PHONE 68 HAMILTON DR (413) 539 -7032
PROPERTY LOCATION 327 RIVERSIDE DR
MAP 30A PARCEL 035 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out tot 2 3 �j
Fee Paid `� ✓�
Typeof Construction: NEW DUCT WORK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 504
3 sets of Plans / Plot Plan
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN 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
Permit from Elm Street Commission Permit DPW Storm Water Management
6:::/ 7. - .----'-'.('-/ 7/ 77i 2_
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.
327 RIVERSIDE DR SM- 2013 -0005
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
IGIS #: 5355
Map: 30A: - i mo o, s — " �\
Block. oo� W A, SH EETMETAL PERMIT
Lot: 's s\ OZ i �`�
[ Permit: SHEETMETAL
Category: renovation
Permit # sM- 2013 -0005 PERMISSION IS HEREBY GRANTED TO:
Project # JS- 2012- 001726
s - — _ C License:
Est. Cost: $600.00 Expires:
Fee Charged: $25.00 POWERS AIR Sheetmetal - 504 02/28/2014
Balance Due: $.00 Owner: CHON BYONGOK
[# of Fixtures: Applicant: POWERS AIR
IDigSafe # AT: 327 RIVERSIDE DR
jUseGroup
[ ConstClass
ISSUED ON: 20 -Jul -2012 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
NEW DUCT WORK
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- 000185 17- Jul -12 3273 $25.00
212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :lhasbrouck@northamptonma.gov
GeoTMS® 2012 Des Lauriers Municipal Solutions, Inc.