24D-243 (6) INSURANCE COVERAGE:
I have a current Jiahility insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes❑ No❑
If you have checked Yes,indicate t ype 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 limas not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waivpsthis requirement.
Check One Only
Owner ❑ Agent El
Signature of Owner 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
Prngrpcs IncpectiOnS
Tate fnmments
Find Incpection.
Date Comments
Typ of License:
By Master
Title Master-Restricted Yb f.^)
City/Town ❑Journeyperson
Signature of Licensee
Permit#
❑Journeyperson-Restricted License Number: SO
Fee$
❑ Check at www macs anv/dp(
Inspector Signature of Permit Approval
Commonwealth of Massachuset s RECEIVED
City Of Northampton ` 1 32013
t*-N oFSUr�or
Date: G/ • /' 3 ' /3 Sheet Metal Permit Permit ° N°r�rHgMProN' ,EC .
m 1 'a-F.°
Estimated Job Cost: $ 2j DCt) Permit Fee: $ 3 ti 30 r ,16
Plans Submitted: YES / NO Plans Reviewed: YES i NO
Business License# Applicant License#
Business Information: /� Property Owner
r/Job Location Information:
Name: O BRAS• 4 2 Name: 1'f'z/6" 7 ec•• ,. �
6
1 8 H/ / C S
Street: .114,71 r /7 41 3ii. Street: 7/ - %'1/t cl 7-
City/Town:CO/VW/7 1 A o/3`1/ City/Town: #1, ' r,,/4")17-7-214-)
Telephone: AS',fay -I-03 Z ' Telephone: y/3 23o " b 3/ 7 <544466/ FdC 6&LAW
Photo I.D. required/Copy of Photo I.D. attached: YES NO
Staff Initial
J-1 /Ounrestricted license
J-2/M-2-restricted to dwellin s 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less
Res i de ntial: 1-2 family Multi-famil y Condo/Townhouses Other
Commercial: Office Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. V over 10,000 sq. ft Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC V Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
A '/ J i?Z /411_, Jivz/!/ AN c av).drAsyviii-y
v,v,7- ,t$' i/,/ .3,C
oit. ,440,/- qo ,:m9 7 A✓/ ) Le).)`;e4/142
—Mt //1(5)/,9T ) F /cam o l / C45.‘• PV Afiso
/ETA'//E,3 .
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-2013-0065
APPLICANT/CONTACT PERSON POWERS AIR
ADDRESS/PHONE 68 HAMILTON DR (413)539-7032
PROPERTY LOCATION 71 PINE ST
MAP 23A PARCEL 165 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY: 5/#1 PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 2
Fee Paid u 1;;IffiA T ypeof Construction: WARM AIR FURN/AIR CONDITIONING UNIT,ALSO ERV �New Construction ��l/
Non Structural interior renovations ,-� ae j
Addition to Existing
Accessory Structure II
Building Plans Included: I n Owner/Statement or License 504 /
3 sets of Plans/Plot Plan
THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION D O 2
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
iiii 'Y ii't from Elm Street ommission Permit DPW Storm Water Management
Sig 1 of:uil•ing '1 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.
61 CRESCENT ST UNIT 8 SM-2013-0064
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
PGIS#: 11666 oa-i"
Map: 124D 47s0.4)24 �
;Block: 243 ;J SHEETME TAI. PERMIT
Lot 000
[Permit: SHEETMETAL rfecENTEHPR�
Category: SHEETMETAL
Permit# SM-2013-0064 PERMISSION IS HEREBY GRANTED TO:
------#
Project# JS-2013-001766
Est. Cost: $300.00 Contractor: License: Expires:
Fee Charged:$25.00 POWERS AIR Sheetmetal-504 02/28/2014
Balance Due:$.00 Owner: LUCENTINI ERIC&SANDRA
j#of Fixtures: Applicant: POWERS AIR
'DigSafe# AT: 61 CRESCENT ST UNIT 8
UseGroup
ConstClass
ISSUED ON: 17-Jun-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
DRYER VENT,BATH EXHAUSTS,FAN
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-2013-006669 13-Jun-13 3430 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.