32C-020 (8) Wv
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File#SM-2020-0007 j J
APPLICANT/CONTACT PERSON M J MORAN
ADDRESS/PHONE P O BOX 278 (413)268-7251
PROPERTY LOCATION 21 PLEASANT ST-DOWN TOWN SOUNDS
MAP 32C PARCEL 020 001 ZONE CB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tyaeof Construction:_ADD SUPPLY DUCTS TO 4 NEW LESSON ROOMS
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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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 from Elm Street Commission Permit DPW Storm Water Management
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Sig ture of Building Official 06 Daie
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.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.
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Sheet Metal Permit �]
Date: !l Permit#
Estimated Job Cost: $ 2 gelo�. ° — Permit Fee*: $ 2 S '
*Permit Fee based on estimated cost of job- $10/$1,000 (or fraction thereof)plus $30
administrative fee –round up to nearest$1,000, divide by 100 and add$30.
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License# 172 Applicant License# 267 _
Business Information: Property Owner/Job Location
Information: /
Name: M.J. Moran, Inc _ Name: I)OW4 �w✓1 ")04•t4 s
Street: 4 South Main Street Street: ,21 Plecis�..f Sf
City/Town: Haydenville, MA City/Town:
Telephone: 413-268-7251 Telephone: yl.3 0`r?? Y
Photo I.D. required/Copy of Photo I.D. attached: YES NO
Staff Initials
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 Retail ✓Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. ✓over 10,000 sq. ft. Number of Stories: Z
Sheet metal work to be completed: New Work: Renovation: L,---
HVAC
/HVAC Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done–attach additional sheets if necessary:
14)d Sypp[,/ dads fv e/ New Lesso., /too,.•,s
SMnspectionAPERNIIT APPLICATION FORMS\Sheet Metal-TOA I.doc
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OAISURAWCE COVERAGE:
l have a.current Rialhin insurance policy or its equivalent Which meets the requirements of M.G.L.Ch.112 Yes ❑
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 IMSURANCE WAIVER:I am aware that the licensee Anes not ha., the insurance coverage required by Chapter 112 of the
Massachusetts General taws,and that my signature on this perrnit application wahie this requirement.
Check One Only
Omer ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this b.A, ,u hereby certifythat all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of any 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 192 of the General Laws.
Duct inspection required prior to insulation installation:YES No
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Data ommantc
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Data o mento
Type of license:
By DU
Master
Title ❑Master-Restricted 10
City/Town
_ ❑Journeyperson
Permit#
Signature-of Licensee❑Journeyperson-Restricted
Fee$ License Number; 0?e�57
Check at ma ran m gs p cAn9
lector Signature of Permit Approval
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