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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, j f 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. t