16C-003 (9) INSURANCE COVERAGE:
I have a current liar insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes❑ No❑
If you have checked Yas,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 rines ant haves the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waive this requirement.
Check One Only
Owner ❑ Agent ❑
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
Progrecc TncpeCtionc
Date Comments
Final T�cpPrfinn
Date CnmmPntc
Type of License:
By ❑Master
Title ❑ Master-Restricted
City/Town ❑Journeyperson
Signature of Licensee
Permit#
❑Journeyperson-Restricted
Fee$ License Number:
Check at www mace gnu
/TI
Inspector Signature of Permit Approval
LD'ate_: r;"-�V'/�
6 Commonwealth of Massachusetts
��j4 City Of Northampton
&Gas
n, MA 0]nsP Sheet Metal Permit permit#
Estimated Job Cost: $ Permit Fee: $ tom"
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License# Applicant License#
Business Information: Property Owner/Job Location Information:
Name: �lK, 4-f7TG Name: /h
Street: P-6 303 Street: 3 ;{ 2 r.L- _S7
City/Town: Uti ✓ City/Town: �S
Telephone: � d' -6 2 � l 0 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: Renovation:
HVAC 1r Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done: /
IAQ
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-2015-0006
APPLICANT/CONTACT PERSON PAUL'S PLG&HTG
ADDRESS/PHONE P O BOX 303 (413)238-0303
PROPERTY LOCATION 334 SPRING ST
MAP 16C PARCEL 003 001 ZONE URA000)/WSP(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: REPLACE FURNACE DUCTWORK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 12283
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOR TION PRESENTED:
pproved 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 it from Elm Street Commission Permit DPW Storm Water Management
Signature o Buildin 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.
334 SPRING ST SM-2015-0006
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
IGIS#: 1253
rMw:-- 1'6C T +�
LLot °03 -- — : , SHEETMETAL PERMIT
:- 0 01 __
Permit, ..SHEETMETAL
Category: renovation
Permit# SM-2015 0006 it P
Project# Js-2o 14=00 1702 ERMISSION IS HEREBY GRANTED TO:
Est. Cost: Contractor: License: Expires:
PAUL'S PLG&HTG Sheetmetal- 12283
Fee Charged:$25.00._ _ _ 11/28/2014
(Balance Due:$.00 Owner: LANGMUIR JONATHAN
#of Fixtures Applicant: PAUL'S PLG&HTG
�DigSafe# 334 SPRING ST
�UseGroup _
�ConstClass
ISSUED ON.• 26-Aug-2014 AMENDED ON: EXPIRES ON.•
TO PERFORM THE FOLLOWING WORK:
REPLACE FURNACE DUCTWORK
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-2015-000897 26-Aug-14 9508 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouckgnorthamptonma.gov
GeoTMSO 2014 Des Lauriers Municipal Solutions,Inc.