31D-169 (16) File p SM-2016-0051
APPLICANT/CONTACT PERSON ALLSTATE HOOD&DUCT INC
ADDRESS/PHONE 24 MAINLINE DR (413)568-4663
PROPERTY LOCATION I OLD SOUTH ST A
MAP 31D PARCEL 169 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid b33 l00
Building Permit Filled out
Fee Paid
Typeof Construction: REPLACE KITCHEN HOOD EXHAUST, REPAIR EXISTING HOOD DUCT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 25236
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
1NFOR ATION PRESENTED:
pproved 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
I treet Co I is - Permit DPW Storm Water Management
or
c< -4o7,-AV
r . t- tldi mea 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.
INSURANCE COVERAGE:
I have a current Pah-Pity insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Mese No 0
If you have checked Vas,indicate the type of coverage by checking the appropriate box heiow:
A liability insurance policy t. Other type of indemnity 0 Bond 0
OWNER'S INSURANCE WAIVER:I am aware that the licenseeoec nor hemp the Insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application v'an'esthis requirement.
Check One Only
l� f
(e. '-�/ Owner 0 Agent 4E3
Signature of Owner or Owner's Agent
By cheoking this box❑,i hereby certify that ell of the details and information I have submitted for 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 appiication 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
prngraac Jncpoetionti
Date CS:.ts
kans1 Thera^tinn
Date Pn..'mnntc
Type of License:
By in Master - j/
Title ❑Master-Restricted
_ ri�"�j lis 2
Cityffown
❑Journsyperaon Signature of Licensee
Permit* ( ❑Joume anion-Restricted
)P- License Number: ;2"S---) 3 G
Fee$ ❑
.. Check atmwunv panes
Inspector Signature of Permit Approval
Commonwealth of.Massachusetts
jJ
/ City Of Northampton
Date: (v( j Sheet Metal Permit
Permit_.
Estimated Job Cost $ w Om° Permit Fee: $ ( CO C 41333
Pians Submitted: YES NO - Plans Reviewed: YES- NO
--
•
Business license#._723 Applicant License ?6.23Ca
Business Information: Property Owner/Job Location Information:
Name: /(f74 4s 4714 Uc JName: 8o,$mt Pc !fe
ro
Street 2Steed: I, old C„,“/4 S ?t
ao E City/Town: ttis-1/etcf7474° City/Town: .4.6,4 Gyt
cJ
Telephone: 1r3 (ata S _ Telephone:
_ Photo ID. required/Copy of Photo LD. attached: YES - NO
Staff Initial
_.-. J-11 . esticted 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: T2 family Multi-family Condo/Townhouses Other
Commercial: Office _ Retail r Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft.J_ over 10.000 sq. ft._ Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC_ Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing_
Provide detailed description of work to be done:
QettPikde- NI-hem 1? ,0,21
(ep4:rs xs /ln / .J duct
Fees with Building Permit:$25.00 Residential, $50.00 Commerciai.Fees for jobs without a Strafing Permit$6,00 per$1000
Minimum fees for jobs without Building Permit$5600 Residential, $100.00 Commercial