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39-060 (10) INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes® No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy R. Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee mac not have,the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waiuesthis requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this boxD,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 X NO Prngrecc 1ncrectinns Date Comments Final incppetinn nate C'nmmentc Type of License: By ❑ Master Title ❑Master-Restricted AP A AIL City/Town ❑Joumeyperson Signature of Licensee Permit# ❑Joumeyperson-Restricted ©8 License Number: L� Fee$ ❑ Check at www mass anvlripl Inspector Signature of Permit Approval i ,n ECEll ,.< , Nov - 7 2013 { Commonwealth of Massachusetts City Of Northampton irG lSC!C Inspections 0x30 L! / Date:Novem er 7, 2 01 3 Sheet Metal Permit Permit# 5)72/7 '3/ Estimated Job Cost: $2 5 0 0 0 .0 0 Permit Fee: $ 1/454)-6 3 0 Plans Submitted: YES NO X Plans Reviewed: YES NO Business License# 5 0 8 Applicant License# 5 6 4 4 Business Information: Property Owner/Job Location Information: Name: RK Solutions Name:Oxbow Professional Park, LLC Street: PO Box 262 ,i., Street: 22 Atwood Drive City/Town: Agawam b(bb City/Town:Northampton Telephone: 413-374-8500 Telephone:413-789-3720 Travis Ward Photo I.D. required/Copy of Photo I.D. attached: YES NO X 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:X Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Install partial supply and return air duct mains_ 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, $100.00 Commercial File#SM-2014-0031 APPLICANT/CONTACT PERSON RK SOLUTIONS ADDRESS/PHONE P 0 BOX 262 (413)374-8500 PROPERTY LOCATION 22 ATWOOD DR MAP 39 PARCEL 060 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid y�c Building Permit Filled out 33o 3 s 5 b Fee Paid Typeof Construction: INSTALL PARTIAL SUPPLY&RETURN AIR DUCT MAINS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 508 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER: § Intermediate Project: Site Plan AND/OR Special Permit with Site Plan Major Project: Site Plan AND/OR Special Permit with Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee ' r Elm Street )mmission Permit DPW Storm Water Management /7 /$ VV •uild m_ - cial 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. 22 ATWOOD DR SM-2014-0031 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS#: 10423 a'"""'Pr Block: _ —060 =.�,m��,'j1 Map: 39 ft_ . � SHEETMETAL PERMIT ILot 001— �,, t 'Permit: SHEETMETAL ' rEecFNiEei (Category: SHEETMETAL Permit# SM 2014 0031 PERMISSION IS HEREBY GRANTED TO: Project# JS-2013-000615 Contractor: License: Est. Cost: $25,000.00 Expires: (Fee Charged:$50.00 RK SOLUTIONS Sheetmetal-508 03/20/2014 (Balance Due:$.00 Owner: Oxbow Professional Park LLC I#of Fixtures: _ 'Applicant: RK SOLUTIONS DigSafe# AT: 22 ATWOOD DR UseGroup ConstClass ISSUED ON: 18-Nov-2013 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK: INSTALL PARTIAL SUPPLY&RETURN AIR DUCT MAINS 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-2014-002184 14-Nov-13 3203 $50.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.