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007 °F , SHEET METAL PERMIT 1
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Iti I Commonwealth of Massachusetts
cii=i p Town of Yarmouth Building Department/
Date: 1,.//fPermit#: 23405/4-23405/4— /9.4v3s/y
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Estimated Job Cost: $ -' 1 /019 Ory) Permit Fee: $ _
l Plans Submitted: YES/ NO Plans Reviewed: YES/NO
Business License it g)9 Application License it /a-7 f 7
Business Information Property Owner/Job Location Information
Name: Zechre 5hentMeta/ -SNC- Name: D PIS L..LC &dIci.+y Q
Street: ice W,GymoutA 5*- treet: Id/oy Main st _`6gl Rout'- 39
City/Town: Rock/and 444 023 p0 City/Town: Wa ifant M A ,South /atnlout(•t
Telephone:in t ) 87/ —Scao7 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 Multl-family Condo/Townhouses Other
Commercial: Office Retail Industrial Educational Institutional _Other =
Square Footage: under 10,000 sq.ft._over 10,000 sq. ft. V Number of stciies: .3-'- -
I 2o,��
Sheet metal work to be completed: [1t� 19
/ I ! 276S PARTIAL
New work /Renovation:_HVAC: V Metal Watershed Roofing:_ ,i
Kitchen Exhaust System: Metal Chimney/Vents:—Air Balancing:—
Provide detailed description of work to be done:
QVCA WDvIA For 14e.-1-4—A&v- cor\v' 1 Dite-i' 1-cJ-1
Kt-4-r,hert. ¶11316+ 1 bfryev r hausil-
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INSURANCE COVERAGE:
I have a current liability insuranc policy or its equivalent which meets the requirements of
M.G.L. Ch. 112 Yes No
If you have checked yes,indicatq the 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 waives this
requirement. •
Owner
�il . _ ?zto4 Check One O y
" 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:
Type of license:
By: _ Master
Title: Master-Restricted - t Signature of Licensee t
City/Town: Journeyperson
PermitCheck
Journeyperson-Restricted iNumber
License
Fee:: $ � at www.mass.gov/dpl
/—�- -ot- ,s —
'' Inspector Signature of Permit t
of Permit Approval
UUMMUNWtALIH Uh MAbbAliMUSt I IJ
DIVISION OF PROFESSIONAL LICENSURE
BOARD OF
ll SHEET METAL WORKERS
ISSUES THE FOLLOWING LICENSE w
MASTER-UNRESTRICTED 134
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SHAWN D TOLLIVER
241'S WALKER ST w a;
TAUNTON,MA 02780-4364
12797 0612812020 484678