22B-043 (18) INSURANCE COVERAGE: ��
I have a current Iiahility insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes C� No❑
If you have checked Yes,indicate the type of coverage by checking the appropriate box below:
A liability insurance policy t( Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee rinf. not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws, and that my signature on this permit application waivrcthis requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this boV. reby 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
Progrecc incnnrtinnc
Date Comments
Final Incpprtinn
DAP. Comments
Type of License: ca°°---
By OLI Master
Title ❑ Master-Restricted
W Ylitffr.
City/Town ❑Journeyperson
Signature of Licensee
Permit#
❑Journeyperson-Restricted License Number: 3P. 15- -
Fee$ ❑
Check at www matt rgnviripl
Inspector Signature of Permit Approval
if.,; i Commonwealth of Massachusetts
.; 2 2 201 City Of Northampton
Electric, Plumbs G_ -I---- t �����
Nortr,Frr ._ p Fo4-s Sheet Metal Permit Permit#
p`i1 w° O�IC °1
Estimated Job Cost: $ 5ve. Permit Fee: $ 670 31725-
Plans Submitted: YES' NO Plans Reviewed: YES ' NO
Business License# I 36qc Applicant License# 134'5
Business Information: Property Owner/Job Location Information:
` '
Name: C ngecLAI,/L,41 Name: 4-0r-BI1(I 4., ,LL I. Lc
Street: 3 ,el e A G e Street: 9.4 4,04-07 t/Ck
City/Town: A 41c.b4 Al ;City/Town:Voie Q I Pt A
Telephone: 'if 3` 107 1 ( 7 Telephone: ' 3-7 e th f
Photo I.D. required/ Copy of Photo I.D. attached: YES 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. (./ over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC G/- Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
f eel 111&14 ' Itfci:14-L 46 StAtoL w (ie L1L 607 `
9 .GtiP 'r9, p'1,Pock olt ik-G ;vila4(e .
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-2014-0023
APPLICANT/CONTACT PERSON JC MECHANICAL
ADDRESS/PHONE 53 RIDGE AVENUE (413)427-7497
PROPERTY LOCATION 296 NONOTUCK ST-BLISS ST BUILDING
MAP 22B PARCEL 043 001 ZONE SI(110)/WP(73)/URA(2)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
��� `�O
Fee Paid �ft7
Building Permit Filled out
Fee Paid
Typeof Construction: SHEETMETAL DUCTWORK FOR SUNDIAL BUILD OUT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOL WING 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
y'' Elm Street ssio Permit DPW Storm Water Management
400,
--■11"....411/' .Z.:,111.96''V a.Signature of Building •fficial 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.
296 NONOTUCK ST - BLISS ST BUILDING SM-2014-0023
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#: 8978
'Map: 22B 1
Block- 043 .�.�� :�) SHEETMETAL PERMIT
Lot. 001
L _ 5
s9 � i
Permit: SHEETMETAL -AR RCENTENP—
Category: SHEETMETAL
Permit# SM-2014-0023 _ PERMISSION IS HEREBY GRANTED TO:
Project# JS-2014-000388
1Est. Cost: $6,500.00 Contractor: License: Expires:
,Fee Charged:$50.00
JC MECHANICAL Sheetmetal- 13645
Balance Due:$.00 Owner: NONOTUCK MILL LLC
;#of Fixtures: _ Applicant: JC MECHANICAL
DigSafe# AT: 296 NONOTUCK ST-BLISS ST BUILDING
UseGroup
ConstClass
ISSUED ON: 22-Oct-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
SHEETMETAL DUCTWORK FOR SUNDIAL BUILD OUT
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-2014-001810 22-Oct-13 3925 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.