31B-004 (36) 40-42 ROUND HILL RD - AJ BAMS HOUSE SM-2019-0012
,1OMMONWEALTH OF MASSACHUSETTS
CITY OF' NORTHAMPTON
GIS#: 9474
Aff
Map: 31B
Block: 004 1 �: SHEETMETAL PERMIT
--- 0
Lot: 001 ,..�
Permit: SHEETMETAL
Category: SHEETMETAL
Permit# M-2019-0012
9-0012 _
,Protect# CJS 2018_000638 PERMISSION IS HEREBY GRANTED TO:
�
,Est.Cost: 1$6,000.00 ;Contractor: License: Expires:
BalanCharged:ce Due:$0000 ---�M J MORAN Sheetmetal-267 10/28/2019
Owner: 1924 LLC
{
1#of Fixtures:j ';Applicant. M J MORAN,
DigSafe# AT: 40-42 ROUND HI11,RD-ADAMS HOUSE
�------- --- -- ----- —--I
UseGroup
ConstClass�
ISSUED ON. 06-Sep-2018 AMENDED ON. EXPIRES ON:
TO PERFORM THE FOLLOWING WORK: .
BATH AND DRYER VENTS
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
i.
Signature:
Fee Type: Receipt No: Dail Paid:, Check No: Amount:
Sheetmetal REC-2019-000791 05-Sep-18 26175 $25.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck@northamptonma.gov
GeoTMS®2018 Des Lauriers Municipal Solutions,Inc.
File#SM-2019-0012
APPLICANT/CONTACT PERSON M J MORAN
ADDRESS/PHONE P O BOX 278 (413)268-7251
PROPERTY LOCATION 40-42 ROUND HILL RD-ADAMS HOUSE
MAP 31 B PARCEL 004 001 ZONE URCO 00)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCL D REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
lypeof Construction: BATH AND DRYER VEN
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 267
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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
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.
i
3/ 6 - 00q
Commonwealth Of Massachusetts 090LOW �NOIL,7,vHLtoN - --
SNOIlo3dSNI JNIQ iinj do ldic,
Sheet Metal Permit
8,OZ b - d3S
Date: l� (y Permit#
Estimated Job Cost: $ 000 Permit Fee: $
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License# Applicant License# -7
Business Information: Property Owner/Job Location Information:y
Name: Z�'!G Name: ' ( 2 Y L L 4,,'--
Street:
Street: y SyUr�h St Street:4 b I(.OW, 4i l� ��
City/Town: L")_1160 City/Town: 19� �_
Telephone: W 36) 6f-' IcZ57 Telephone: 917— F�b — 50)q
Photo I.D. required/Copy of Photo I.D. attached: YES NO
Staff Initial
J-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. �J_ over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC Metal Watershed Roofing Kitchen Exhaust System �J
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
' 13a�'k Ulm rS
✓� f5
�._
e
_ . ..
�:�,.
. ,
INSURANCE COVERAGE:
I have a.current liabii1'i insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes 9 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 doe,;not ha. the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application wail+esthis requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this b.ZW 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
1pm��mnce 1(nenpTfii�itac
?ate Colts
Unai Ynsyection
Date Comments
Type of License:
By Master
Title El Master-Restricted
City/Town ❑iourne erson
YP- Signature of Licensee
Permit# ❑Journeyperson-Restricted 7
License Number; v'`?e
Fee$
Check at omy9 mass-gaa� pI
Inspector Signature of Permit Approval
i