32A-201 (13) l
File H SM-2013-0OI4 4�4 Si,
APPLICANT/CONTACT PERSON SWIFT RIVER HVAC INC
ADDRESS/PHONE 221 N LIBERTY ST (413)323-4123
1411, 41/3
PROPERTY LOCATIONPHILLIPS C �( � i
MAP 32A PARCEL 201 000 1 ZONE URC(I(10)/ l .,f'_�, `,`,t/-y"
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid jU6ttQ liJJd`
Building Permit Filled out
Fee Paid
Tyoofconstructigm HVAC SYSTEM giniS- -
q a
New Construction
Non Structural interior renovations
Addition to Existing
_ Accessory Structure
Building Plans Included:
Owner/Statement or License 220
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
iApproved 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 Requital:
_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
Permit from 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.
Commonwealth of Massachusetts
4 %7 Sheet Metal Permit
/ Peutit# 5N7 'I5-1
Estimated Job Cost: $_..—.. Permit Fee: $ lb1 Wa a'5
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License #_ Applicant License#
Business Information: Property Owner /Job Location Information: ,�7
Name: J&JIf ,'ef )/ V 4.( . Name: // " �(: '. / eurlL'-
Street: 0242/ N 1 t her& ,St• ._ Street: 5/ Ph 14,5 // ' _._
City/Town: Br-le &( 4 C/V City/Town: J')tr pOaf i J/
Telephone: / - , - Telephone: �/5"0 i5 -.695
Photo LD. required/Copy of Photo LD. attached: YES _ NO _,_
_._
.-� - - Sian trial
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
Sgaare Footage: under 10.000 sq. ft. over 10,000 sq. ft. Number of Stories:
Skeet 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:
f V.A.0 ,Sy,3 ,.n 0Sic%fin l/ /%in .
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes Eine❑
If you have checked Yes,indicate the type of coverage by checking the appropriate box below:
A liability insurance policy LQj Other type of indemnity ❑ Bond 0
OWNER'S INSURANCE WAIVER:lam 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 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 air 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
°.--... T of License- --
By Mader
The— - 0 Master-Restricted
Cfty/Town QJoumeyperson
>'gnature of Licensee
Pemilt a
aJoumeypersan-RestnIX1a,)
ed License Number:_ :.a� L/
Fee a
Check at www.mass,Govldet
Inspector Signature of Permit Approval