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32C-182 (17) INSURANCE COVERAGE: I have a current Iiahility insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes ❑ No ❑ If you have checked Yes, indicate e the type of coverage by checking the appropriate box below: A liability insurance policy C1 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee sI nc+a not have the insurance coverage required by Chapter 112 of the Massachusetts Gener I Laws, and that my signature on this permit application waivacthis requirement. C heck One Only Owner W Agent ❑ Signature o wn or Owner'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 �^�*+^� Prngrose tnerertinns Date Commeuts Final Inepprtinn Date Cnmments Type of License: By ❑ Master Title ❑ Master - Restricted City/Town DJourneyperson Signature of Licensee Permit # ❑Jou rneyperson- Restricted License Number: Fee $ ❑ Check at lelawa. mass ronvtrlpl Inspector Signature of Permit Approval ECEIVED Commonwealth of Massachuset s = o City Of Northampton BPI OF BUILDING INS >; T •r n„ NORTHAMPTON, MA O6 1 Sheet Metal Permit Date: [/�J �, Permit # 61?2—/3 Estimated Job Cost: s \� 00 a Permit Fee: S 60 Plans Submitted: YES NO Plans Reviewed: NO Business License ,. \ *a\ Applicant License fi \ amt Business Information: Property Owner Job Location information: Name: t1k'p� A N5� -- Name: F y �� ►.� 4c o cc I Street: t^ V �� t— �� 5�:�' street: "awl_(a._ �yo� City/Town: \\(s C itvt I own: 1 ■)'001 °,K) D QI O6. Telephone: i k3—at y 7'-P9' 9 a. Telephone: yU3— (zk@`) — CF1 l6 E " cam- - 4 bay -Limo Photo I.D. required / Copy of Photo I.D. attached: YES NO s t'.f � 11_1 _ i ntieor elo i I M-2-restricted to dwellings 3- stories or less and commercial lip to 10.000 su. ft. / 2- stories or less Residential: 1-2 family Condo Townhouses Other Commercial: Office Retail industrial Educational Institutional Other Square Footage: under 10.000 sq. ft. over 10.000 so. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: Metal Watershed Roofing Kitchen Exhaust System lvletai Chimney ''ents Air Balancing Provide detailed description of work to be done: i �t C. 1P®,c o �• - - Fees with Building Permit: $25.00 Residential, $50.00 Commercial. Fees for lobs without a Building Permit $6.00 per $1000 Minimum fees for jobs without Building Permit $50.00 Residential, $100.00 Commercial File # SM- 2013 -0024 APPLICANT /CONTACT PERSON ALL SEASONS HEATING AIR ADDRESS/PHONE 93 ELM ST (413) 247 -9842 PROPERTY LOCATION 376 PLEASANT ST MAP 32C PARCEL 182 001 ZONE GB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out *97 /y � Fee Paid 0 `� Typeof Construction: NEW HEATING DUCTS 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 FOLL ING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO 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 Co sion Permit DPW Storm Water Management ■•/ //-45 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. 376 PLEASANT ST SM- 2013 -0024 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS #: 10236 _ z o Map: 32C Oki Bonk: ooi = � SHEETMETAL PERMIT Permit_ SHEETMETAL reR�EN1E Category: SHEETMETAL Permit # SM -20 13 -0024 PERMISSION IS HEREBY GRANTED TO: Project # JS- 2012 - 000715 Est. Cost: $11,000.00 Contractor: License: Expires: Fee Charged: $50.00 ALL SEASONS HEATING AIR Sheetmetal - 129 Balance Due: $.00 Owner: SZLOSEK STEFFIE AND OTHERS C/O 6 CRAFTS AVENUE LLC # of Fixtures: Applicant: ALL SEASONS HEATING AIR DigSafe # AT: 376 PLEASANT ST UseGroup ConstClass ISSUED ON: 05- Nov -2012 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK: NEW HEATING DUCTS 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 - 001772 02- Nov -12 4097 $50.00 212 Main Street, Phone:(413) 587 -1240, Fax:(413) 587 -1272, Email :lhasbrouck @northamptonma.gov GeoTMS® 2012 Des Lauriers Municipal Solutions, Inc.