32C-260 (21) INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes jg 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 ❑
OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner'_ Agent ❑
Signature of Owner or Owners Agent
By checking this box0,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
Progress Inspections
Date Comments
Final Inspection
Date Comments
Type of License:
By ❑Master
Title
❑Master-Restricted
Citylrown
❑Journeyperson Signature of Licensee
Permit
DJoumeyperson-Restricted 1/ 9 6
Fee$ 0
License Number.
Check at www.mass.pov/dai
Inspector Signature of Permit Approval
Commonwealth of Massachusetts
Sheet Metal Permit
9° l 13 S!��'���
_ ` Date: Permit#
- Estimated Job Cost$ R-$?-049 Permit Fee: $ eP#
�
(f) Plans Submitted: YES NO t)( Plans Reviewed: YES NO
Business License# Applicant License# I I �(
Business Information: Property Owner/Job Location Information:
Name: r,c.., 'TZ Name: 1 i..J '�,Ve r t
Street: 11 e. rG I'd C i Street: go d'o i,e r o y "T'e c-r v + 6
City/Town: S pc(d i"; 01/2-R City/Town: r, r L.-
Telephone: y/3 -'7 r2 s y C Telephone:
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: .SZ Renovation:
HVAC 0( Metal Watershed Roofing Kitchen Exhaust System i(
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
s e�L, � e�. , (-.1 -.6) 4k Sys •,-,
IJ +IN v S "1-1 ev, s41),r,€ i /cog
f l
File ft SM-2014-0012 \04,l
APPLICANT/CONTACT PERSON BRIAN TATRO J� S S
ADDRESS/PHONE 4 BERARD CIR I7 -A99 o fLa '
e
PROPERTY LOCATION 90 POMEROY TERR /4
MAP 32C PARCEL 260 000 ZONE
flv'f
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out j 35 10-6-
Fee Paid
Typeof Construction:_INSTALL NEW HEATING/AC SYS,BATH VENT&KITCH H OOD
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 11990
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
=RN-PRESENTED:
d 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
'ermit fro is Elm Street Commission Permit DPW Storm Water Management
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.
90 POMEROY TERR SM-2014-0012
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS# 12070 6a1HAMPTOti
Ma 32C
Blopk:— 260 -,a-, :: . SHEETMETAL, PERMIT
Lot 000 ����`�
Permit_ SHEETMETAL rERCENt j . 5
Category: SHEETMETAL
Permit# SM-2014-0012 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2013-000729
Est Cost: $8,800.00 Contractor: License: Expires:
BRIAN TATRO Sheetmetal- 11990
Fee e Charged:$25.00 12/28/2014
Balance Due:$.00 Owner: MUERLE LINDA
#of Fixtures: Applicant: BRIAN TATRO
D1gSafe# AT: 90 POMEROY TERR
UseGroup
[ConstClass
ISSUED ON: 01-Nov-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
INSTALL NEW HEATING/AC SYS,BATH VENT&KITCH HOOD
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-2014-001105 11-Sep-13 155 $25.00
Inspection Type: Inspector: Date Inspected: Date Signed Off: Status:
ROUGH Charles Miller 30-Oct-13 FULL COMPLY
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck®northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.