24B-077 (6) INSURANCE COVERAGE:
I have a current liahility insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes1g 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 El
OWNER'S INSURANCE WAIVER:I am aware that the licensee dnpc not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waivAsthis requirement.
Check One Only
� Owner ❑ Agent k
Sig a Owner or Owner's Agent
By checking this boO,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
PrngreCs Incrections
Date comments
Final linernrtiop
nate Comments
Type of License:
By UU Master
Title ❑ Master-Restricted
City/Town ❑Journeyperson
(/1ignature of Licensee
Permit# q
❑Journeyperson-Restricted
License Number:
Fee$ ❑
Check at StILIMILY-MBSS-gallkiPii
Inspector Signature of Permit Approval
L31....---- Commonwealth of Massachusetts
City Of Northampton
SEPT.OF BUILDING INSPECTIONS
NORTHAMPTON MA01060
Date: ir 6 3 Sheet Metal Permit Permit# 510 i 3'51..
019
3c` ,
Estimated Job Cost: $ ^.:01 Permit Fee: S b uC)
Plans Submitted: YES NO Plans Reviewed: YES i NO
Business License# Applicant License# 1 q SJ
Business Information: L Property Owner/Job Location Information:
//
Name: 1 `bra S tl; Name: Pe'c,pit.5 Ea ,,
Street: 13`1 64 / `06-*1 s+k- Street: SCi5 Kiv) 33 (
City/Town: CI'vv'Z4 P LE-- I') C fty/Town: Ajdr-ki`�'"Y)
l S- ,S -Ob S ��\ Tele hone:
Telephone: p
Photo I.D.required/Copy of Photo I.D. attached: YES X 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 Multi-family Condo/Townhouses Other
Commercial: Office Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. k over 10,000 sq. ft. Number of Stories: 1
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:
..I s-ktl c�Ltwz (\f■ null Eiw Zkc ()bait (341k.
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-2013-0056
APPLICANT/CONTACT PERSON MORAN SHEETMETAL
ADDRESS/PHONE 139 EAST MEADOW ST (413) 592-0031 0
PROPERTY LOCATION 300 KING ST
MAP 24B PARCEL 077 001 ZONE HB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out /fife. T)
Fee Paid d
Typeof Construction: DUCTWORK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 1053
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO TION 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
die �:.r.••.E Street Commission Permit DPW Storm Water Management
j„,. f=/8 - 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.
300 KING ST SM-2013-0056
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 9235 loaS"TN,p ti
Map 124B ��''
Block: 1077 ,-, 4 . SHEETMETAL, PERMIT
Lot. 001
Permit: ,SHEETMETAL ss r >�h
Category: SHEETMETAL
Permit# SM 2013 0056
PERMISSION IS HEREBY GRANTED TO:
Project#
Est. Cost: JS-2012-001663
- " - Contractor: License:
$30,000.00 0 Expires:
Fee Charged:i$50.0
- —$50.00 MORAN SHEETMETAL Sheetmetal- 1053 11/28/2013
Balance Due:$.00 Owner: PEOPLES BANK
#of Fixtures:', Applicant: MORAN SHEETMETAL
DigSafe# AT: 300 KING ST
IUseGroup
1ConstClass
ISSUED ON: 14-May-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
DUCTWORK
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-2013-006230 13-May-13 186 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.