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32C-260 (21) INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes jg 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 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 box0,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 Progress Inspections Date Comments Final Inspection Date Comments Type of License: By ❑Master Title ❑Master-Restricted Citylrown ❑Journeyperson Signature of Licensee Permit DJoumeyperson-Restricted 1/ 9 6 Fee$ 0 License Number. Check at www.mass.pov/dai Inspector Signature of Permit Approval Commonwealth of Massachusetts Sheet Metal Permit 9° l 13 S!��'��� _ ` Date: Permit# - Estimated Job Cost$ R-$?-049 Permit Fee: $ eP# � (f) Plans Submitted: YES NO t)( Plans Reviewed: YES NO Business License# Applicant License# I I �( Business Information: Property Owner/Job Location Information: Name: r,c.., 'TZ Name: 1 i..J '�,Ve r t Street: 11 e. rG I'd C i Street: go d'o i,e r o y "T'e c-r v + 6 City/Town: S pc(d i"; 01/2-R City/Town: r, r L.- Telephone: y/3 -'7 r2 s y C 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: .SZ Renovation: HVAC 0( Metal Watershed Roofing Kitchen Exhaust System i( Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: s e�L, � e�. , (-.1 -.6) 4k Sys •,-, IJ +IN v S "1-1 ev, s41),r,€ i /cog f l File ft SM-2014-0012 \04,l APPLICANT/CONTACT PERSON BRIAN TATRO J� S S ADDRESS/PHONE 4 BERARD CIR I7 -A99 o fLa ' e PROPERTY LOCATION 90 POMEROY TERR /4 MAP 32C PARCEL 260 000 ZONE flv'f THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out j 35 10-6- Fee Paid Typeof Construction:_INSTALL NEW HEATING/AC SYS,BATH VENT&KITCH H OOD New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 11990 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON =RN-PRESENTED: d 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 'ermit fro is 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. 90 POMEROY TERR SM-2014-0012 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS# 12070 6a1HAMPTOti Ma 32C Blopk:— 260 -,a-, :: . SHEETMETAL, PERMIT Lot 000 ����`� Permit_ SHEETMETAL rERCENt j . 5 Category: SHEETMETAL Permit# SM-2014-0012 PERMISSION IS HEREBY GRANTED TO: Project# JS-2013-000729 Est Cost: $8,800.00 Contractor: License: Expires: BRIAN TATRO Sheetmetal- 11990 Fee e Charged:$25.00 12/28/2014 Balance Due:$.00 Owner: MUERLE LINDA #of Fixtures: Applicant: BRIAN TATRO D1gSafe# AT: 90 POMEROY TERR UseGroup [ConstClass ISSUED ON: 01-Nov-2013 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK: INSTALL NEW HEATING/AC SYS,BATH VENT&KITCH HOOD 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-2014-001105 11-Sep-13 155 $25.00 Inspection Type: Inspector: Date Inspected: Date Signed Off: Status: ROUGH Charles Miller 30-Oct-13 FULL COMPLY 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck®northamptonma.gov GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.