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39-063 (9) INSURANCE COVERAGE: 1 have a current liabiliLlt insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes® No❑ If you have checked YPs,indicate the type of coverage by checking the appropriate box below: A liability insurance policy FKI Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee dn—nn+hasp 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 Owner's Agent By checking this box®,1 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 PrnorPCe InenPrtinnc .Date its Einal Inepeetion Date Cats Type of License: i By ❑Master Title ❑ Master-Restricted City/Town ❑Joumeyperson -/ Signature of Licensee Permit# ❑Joume erson-Restric d YP License Number: � > Fee El ...Check at www maSC Inspector Signature of Permit Approval Commonwealth of Massachusetts JAS 3 0 ZQ16 City Of Northampton 4 ,R,�1NSuEan'00 16 Sheet Metal Permit Permit# ��j1✓l ' l(o 9 N�R� Estimated Job Cost: $ 2 5 0 0 0 _ Permit Fee: $_g_&_()0 — 1411-3 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 NameDevelopment Associates Street: PO Box 262 Street:8 Atwond Drive City/Town:Agawam City/TownNorthampton Telephone: 413-374-8500 Telephone: 413-789-3720 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. X over 10,000 sq. ft. Number of Stories: 1 Sheet metal work to be completed: New Work: Renovation:x— HVAC x Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Fabricate and install insulated supply, exhaust and outside air 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 File# SM-2016-0029 APPLICANT/CONTACT PERSON RK SOLUTIONS ADDRESS/PHONE 9 FERNWOOD RD (413)374-8500 PROPERTY LOCATION 8 ATWOOD DR-SUITE 101 MAP 39 PARCEL 063 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: INSTALL EXHAUST&OUTSIDE AIR DUCT SYS 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 INFORMATION PRESENTED: roved 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 from Elm Street Commi ion Permit DPW Storm Water Management 1:2 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. 8 ATWOOD DR - SUITE 101 SM-2016-0029 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS#: 10426 Map— 39 Block: -tool 063 Lot - HEETMETAL PERMIT Lot: Permit: JSHEETMETAL Category: ;SHEETMETAL Permit# SM 2016 0029_ PERMISSION IS HEREBY GRANTED TO: Project# JS-2016-001538 Est.Cost: $25,00_0.00 Contractor: License: Expires: Fee Charged:$50.00 W RK SOLUTIONS Sheetmetal-508 03/20/2014 Balance Due:$00 Owner: ATWOOD DRIVE LLC #of Fixtures Applicant: RK SOLUTIONS Di Safe# g _ AT: 8 ATWOOD DR- SUITE 101 UseGri:w ronstClass ISSUED ON: 02-Feb-2016 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK: INSTALL EXHAUST&OUTSIDE AIR DUCT SYS 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-2016-003464 01-Feb-16 4113 $50.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:Ihasbrouck@northamptonma.gov GcoTMS a 2016 Des Lauriers Municipal Solutions,Inc.