HomeMy WebLinkAboutSM-19-1852 `� - I I.
' RECEIVED
r.!-r+„ SHEET METAL PERMIT SEP 2$ 2018i4g� Commonwealth of Massachusetts BUILDING DEPARTMENT
!Ara" Town of Yarmouth Building Department 9Y
NalA
Date: / - oar7- /p G
Permit#:
Estimated Job Cost: $ /G,OcO.00 Permit Fee: $ SO
Plans Submitted: YES/ NO Plans Reviewed: YES/ NO
Business License# rtq$y Application License#
Business Information Property Owner/Job Location Information
Name: Mi r e( HEA%n/L tnt. Name: LELLIPS � (3LLYX.
Street: 2 .4& AAL Oa Street: 3 (34y i? .
City/Town: ntek'rH 073 (0 City/Town: WEST 41.2tiedLihri
Telephone: rear- ,17-90 Telephone: cos. -2a ,362.,
Photo I.D. required/Copy of Photo I.D. attached: YES/NO Staff Initial:
1-1 CM 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 Multl-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:_HVAC: 1� Metal Watershed Roofing:_
Kitchen Exhaust System:_Metal Chimney/Vents:_Air Balancing:_
Provide detailed description of work to be done:
n(S rifle4a—orlf or Sf EEr {t1 EmL prier c.DC 2(L
Foil r'Zut An(2 //B1r4 d c1v1724L .4r____
i
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INSURANCE COVERAGE:
I have a current liability insura a policy or its equivalent which meets the requirements of
M.G.L. Ch. 112 Yes No
If you have checked ye, indica he type of coverage by checking the appropriate box below:
A liability insurance policy 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 waivPc this
requirement.
Check One Only
Owner Agent
Signature of Owner or Owner's Agent
By checking here—) ,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 installation 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.
Inspections shall be called for prior to insulation installation.
Duct inspection required prior to insulation installation: Yes No
Date: Comments:
Date: Comments:
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Type of license:
By: _ Master
Title: Master-Restricted t Signature of Licensee t
City/Town: Journeyperson
PermitchNumber
q: Journeyperson-Restricted License
Fee:: $ Check at www.mass.gov/dpi
t Inspector Signature of Permit t
of Permit Approval
•1•
M
Q'COMMONW A TH O MASSA HU a S
DIVISION OF PROFESSIONAL LICENSURE
BOARD OF
SHEET METAL WORKERS •
a F"
.. ISSUES THE FOLLOWING LICENSE s'
MASTER-UNRESTRICTED a •
. -SEAN F O'LEARY,, W_. c.
2FABYANRD " ..
PLYMOUTH,MA 02360-2390
7985 04/28/2020 `` • 472164 -