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.