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SHEET METAL PERMIT
Commonwealth of Massachusetts
of
\.. „.._,..' Town of Yarmouth Building Department
1146 Route 28, South Yarmouth, MA 02664-4492
Date: /— 9- a-0 Permit#: ZCZ:ssM— o -0,3 7
Estimated Job Cost:$ /ao°• d& Permit Fee:$
Plans Submitted: YES Plans Reviewed: YES/ NO
Business License# act 6 9 Application License# a ell A
Business Information Property Owner/Job Location Information
Name: Boy _ its �T` Name: p,9G t7'/ 4
Street: t2oc.tz at sr- Street: 37t Seroci<eT UZU
City/Town: Creet,pqk T`a,� City!Town: 11ar,.. c-r., gem vds jet
7
Telephone: t — V 31 a-- 073$' Telephone: `c 5,-- Wit— 4.17 s-
Photo I.D. required/Copy of Photo I.D.attached: YES I NO Staff Initial:
5)M-1 unrestricted license
3 22/ 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: A
Sheet metal work to be completed
New work Renovation:-HVAC:_Metal Watershed Roofing:,
Kitchen Exhaust System: S.Metal Chimney/Vents:Air Balancing:_.
Provided tailed description of work to be done: kg.irPe47 /L'i i` ' 1- T
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INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of
M.G.L.Ch.112 Yes f< No
if you have checked Yam,indicate 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.
Check One Only
Owner Agent
Signature of Owner or Owners Agent
By checking here- ,1 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 an pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Inspections shall be called for Ow to Insulation installation.
Duct inspection required prior to insulation installation:Yip No bc
Progress Inspections
Date: Comments:
Final Inspections
Date: Comments:
idi/
Type of license:
By: )4 Master ?.4 q -
Title: Master-Restricted T Signature of Licensee T
City/Town: Journeyperson
Permit# Journeyperson-Restricted License Number: '1.4 ell..
Fee: S Check at www.mass gov/dpI
T Inspector Signature of Permit T
of Permit Approval
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