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17C-223 SM-2023-0015 76 MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-223-001 CITY OF NORTHAMPTON Permit: Sheet Metal PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# SM-2023-0015 PERMISSION IS HEREBY GRANTED TO: Project# 2023 76 MAPLE ST RENO Contractor: License: Est. Cost: PAWEL TABOR Const.Class: Exp.Date: Use Group: Owner: LLC BLUE MOUNTAIN PROPERTIES, Lot Size (sq.ft.) Zoning: GB Applicant: PAWEL TABOR DBA TABOR HEATING&COOLING Applicant Address Phone: Insurance: 3 CROW HILL RD (413)563-0389 WCB30293 MONSON, MA 01057 ISSUED ON: 04/03/2023 TO PERFORM THE FOLLOWING WORK: UNIT#76 INSTALL BATH FAN VENT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: V I Fees Paid: $50.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner Commonwealth of Massachusetts �7,. Sheet Metal Permit Date:03/�j 1//-/,3 Permit # '-262-3 —od LS' Estimated Job Cost: $______________C/ C) Permit Fee: $ k)�� G r/2 3 t f Plans Submitted: YES NO Plans Reviewed: YES NO Business License# 0 L\ Applicant License # Business IInformation: Property Owner/Job Location Information: Name: r q uJ I To bo (' Name: Street: 3 G row; / 1( g Street: ?C Ma City/Town: l D/( 5 cT t City/Town: F f O r e/l C Telephone: 6 /3) -d 3%7 Telephone: Photo I.D. required/ Copy of Photo I.D. attached: YES NO 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 Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq.ft. over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation:4 HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: /1 4 c7 1( a - n a P- )Da (�oo lam_ INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes.2 No❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ie. Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have 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 Z Agent ❑ Signature of Owner or Owner's Agent By checking this box0I 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 Progress Inspections Date Comments Final Inspection Date Comments Type of License: By g Master I/1! Title ❑ Master-Restricted City/Town Journeyperson ❑ Signature of Licensee Permit# ❑Journeyperson Restricted License Number: 5 0 Fee$ ❑ Check at www.mass.aovldnl Inspector Signature of Permit Approval • • • eu Perforations ASSACHUSTS COMMERCIAL DRIVER'S LICENSE NOT FOR FEDERAL ID �•. • aT ass as�xaaER 0111112019 ' S30124098 aU CWSS REST ov0812024`3 01/08/1980 0,r. AM NONE NONE a©R PAWEL PIOTR �. s3CROWNILLRD MONSON,MA01057.9787 I- ,,/ I✓/��//^' ll///�,�_/1�/1 G R N 1S5S:07MA3120;i19{GR,e v5071-02D72 0" lY76 01/08/80 Fold,Then Detach Along All Perforations ':''''''......'::::...........'::::.V, COMMONWEALTH OF MASSACHUSETTS . 11 • • " • • A • : . .. BOAR. 'OF .--, 1 SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE MASTER-UNRESTRICTED cc ......, . PAWEL P TABOR . 3 CROWI-111-,.L-RD ;t41 .:-.::..::..:... ... . . ; MONSON;.--MA 01057-9787-- :a ' ,..,,..i 5024 01/28/.2024 --,-:--- 184508 LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER .......,....... . • • t'08/90/1.0 gay-a/Ka Aa8 61-Olt£M0 00 . .. 4. tgalgOL.0 Vil NOSNOW 08 11111MOZIO£a , tliOld 731ftVd .. H ' aoavi,. — ...,,... ,3NON ,,, ,