39-041 SHEET METAL 1 1
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Commonwealth of Massachusetts
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City Of Northampton
1 7_olSheet Metal Permit5�,,.Z� gate: it 1, 2020 Permit# Ro 7
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n `4sti rt c IJob Cost: $38,000 Permit Fee: $ 7S G� ��a
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� Plans Submitted: YES ✓ NO X Plans Reviewed: YES NO
Tr Business License#508 Applicant License# 5644
Business Information: Property Owner/Job Location Information:
Name: RK Solutions Name: Northwood Development
Street: P.O Box 262 Street: 15 Atwood Drive
City/Town: Agawam City/Town: Northampton
Telephone: 413-374-8500 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 X Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. X Number of Stories: 3
Sheet metal work to be completed: New Work: Renovation:
HVAC X Metal Watershed Roofing v"' Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
HVAC supply, return and exhaust duct systems.
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,$100.00 Commercial
INSURANCE COVERAGE:
1 have a current liah�insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes R] N(VI
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy Other type of indemnity❑ Bond❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee mops, not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws, and that my signature on this permit application waivethisrequirement.
Check One Only
____ - __ Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this boxy, I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation: YES _____ NO
Proarrcc incnrrfionc
Date
F111`dl IilypeC.tio u
Date ("nmmr>ntc
Type of License:
By X Master
Title Master-Restricted
City/Town ❑Journeyperson
Signature of Licensee
Permit#
❑Journeyperson-Restricted
License Number: 5644
Fee$
Check at
Inspector Signature of Permit Approval