31B-225 (11) File# SM-2016-0048
APPLICANT/CONTACT PERSON M J MORAN
ADDRESS/PHONE P O BOX 278 (413)268-7251
PROPERTY LOCATION DAWES HOUSE- 8 BEDFORD TER
MAP 31B PARCEL 225 001 ZONE EU(100VURC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FF LLLED OUT 4�z
Fee Paid c- �+'
- aI CI et 615
Building Permit Filled out Flea&
Fee Paid [1'
TvoeofConstruction: 4 NEW BATHROOM EF,ONE RESIDENTIAL TYPE HOOD AND SMALL STOVE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 267
3 sets of Plans/Plot Plan
THE FOLL 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
_ Permit fro Elm Street et Co • Permit DPW Storm Water Management
Sig - • e Bui ding fficial 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.
AEC,__„
JUN 2 0 commonwealth of Massachusetts
City Of Northampton
DEPT P :InVs
Sheet Metal Permit /,,
Date. Za„7 Pemtit#. -/ it -
70
Estimated Job Cost: $ Permit Fee: $ 51' r— ei q 4Z
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License# 1 a Applicant License# alp}
Business Information: Property Owner/Job Location Information:
Name: tn.S Mogan ,Tine . Name: DIALA J ljrbt-/dJ
Street: 4 Sovth mo.Cn Stfte-t Street: g dt ' f'i-P' T tt-.
City/Town: 1 °ideaL 11L City/Town: !L^�[sA.t /v5./}
Telephone: HI-5- ab55- taSI Telephone: y/)- ftar'et YV
Photo I.D. required/Copy of Photo I.D. attached: YES NO X
Staff Iniad
J-1 62_01nrestricted license
J-2 I 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 sr
Institutional Other
Square Footage: under 10,000 sq. ft. V over 10,000 sq. ft. Number of Stories: 3
Sheet metal work to be completed: New Work: Renovation: ;r
HVAC_ .r Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done: r_--"A
y 1-te — O? � RUp' Cf L c.-{ JV'to d-,,—i,1L TY/'/ "CO
J i.,.a.
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,$100.00 Commercial
•
INSURANCE COVERAGE.
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes No 171
If you have checked Yes,indicate the type of coverage by checking the appropriate box below:
A liability insurance policy ® Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER:l am aware that the licensee dpea not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waivrsthis requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this boxD,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued far this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation:YES NO
Frogrett inppertinng
Dale Conga-nen-Os
Final Intpertipp
Date rnmmentk
Typepof License:
By Via Master �r
Title 0 Master-Restricted
? /' --
City/Town
❑Journeyperson Signature of Licensee
Permit# 6
OJourneyperson-Restricted (�/./
License Number:
Fee$ O
Check at www maga gnvlrlpl
Inspector Signature of Permit Approval