06-039 (4) INSURANCE COVERAGE:
I have a current liahility insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes❑ 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 rinec not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waivecthis requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this boxkhereby 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 increctinns
Date Cnmments
Final Incrertinn
Date f nmments
Type of License:
By ❑Master
Title ❑Master-Restricted �/� ►
City/Town nJourneyperson
Signature of Licensee
Permit# .y-�
Fee$
DJourneyperson-Restricted ��
License Number:
Check at www macs gnvldp(
Inspector Signature of Permit Approval
\E) ---' ,_ii 1,
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I
a"'i NOV - 5 2013 iJ Commonwealth of Massachusetts
I s City Of Northampton
Northampton,MA 01060 y,� �f 2
Date: gal/ -°i 20/3 Sheet Metal Permit permit# �/� `/ ' 30
Estimated Job Cost: $ /b5) 63'4-9C7• Dr" Permit Fee: $ /f6 ' %5
Plans Submitted: YES NO Plans Reviewed: YES I NO
Business License# Oto l(3.3(:)3610 Applicant License# 0,25-1 13 J
Business Information: ff Property Owner/Job Location Information:
Name: ,!�v l�l 1 ,i Name: giNcy
Street: �55- t l (ley._ Sr Street:3(--)7 \� / A P f O\ I ` 1° A.
• City/Town: -r • A C Cp I J City/Town:)04. --kk *rfrL.l? 0 •
Telephone: 0,k3— ;3(--)._5-bl c1 Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES NO
Staff Initial
J-1 /M-1-unrestricte. ic- -
J-2/M-2-restricteo to ow- ' : -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 }{ 900,1- I,L' ' '` 5
Square Footage: under 10,000 sq. ft. "71- over 10,000 sq. ft. Number of Stories:
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: .
d,.,,,,,i„.5 0 .--:: '---?,_ ,Azt____%. (--00,f.".. Ve A \---S A v v A__ 6
c jec s \5c ,S,,vvi- Av►no --\ o'\ £c T-
v o 0 0 TS c,-vim, 0 U S M✓v■,e-te— S vJ: ,-e A_ ` 'V AC
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-2014-0030
APPLICANT/CONTACT PERSON COPPER VALLEY HEATING&COOLING LLC
ADDRESS/PHONE 78 C GOLDEN ST (203)237-5019
PROPERTY LOCATION 345 HAYDENVILLE RD
MAP 06 PARCEL 039 001 ZONE SR(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT i jl 5-e3
Fee Paid (0 0
7 U�'
Building Permit Filled out
Fee Paid_
Typeof Construction: BATHROOM VENTS,DRYERS&P-TAC UNITS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 25137
3 sets of Plans/Plot Plan
THE FO 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
p e, •., m S eet Commission Permit DPW Storm Water Management
//..—S a.1.-•—/E
Signa H - of Building G ' "ial
ate
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.
345 HAYDENVILLE RD SM-2014-0030
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS# 207
HA
4� M T aMap 06 :
Block: 039 t-4)14
�
/
SHEETMETAT, PERMIT
0 � s .��
Permit: �SHEETMETAL T£RCENTEN
rY:
g
Cate o �SHEETMETAL
Permit# SM-2014-0030 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2012-000244
- --- Expires:
Est.Cost: $165,000.00 Contractor: License:
Fee Charged:$50.00
COPPER VALLEY HEATING&COSheetmetal 25137 08/28/2014
Balance Due:$.00 Owner: CHAKALOS INVESTMENTS INC
#of Fixtures:, Applicant: COPPER VALLEY HEATING&COOLING LLC
DigSafe# AT: 345 HAYDENVILLE RD
UseGroup
1ConstClass [
ISSUED ON: 07-Nov-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
BATHROOM VENTS,DRYERS&P-TAC UNITS
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-2014-002068 05-Nov-13 1564 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.
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