HomeMy WebLinkAboutBldsm-23-004360 •
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RECEIVED
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�� of SHEET METAL PERMIT FEB 03 2023
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`i� � ► 'ga`. Commonwealth of Massachusetts
.�-,`s. ; BUILDING DEPARTMENT
1.� '.� , Town of Yarmouth Building Department •By. -
Date: Permit#: 5Lbsm-,13-d1)(430)
Estimated Job Cost: $ L5 1 K. Permit Fee: $ 5j.do
Plans Submitted: YES/ NO Plans Reviewed: YES / NO
Business License # L, l90,_, Application License #
Business Information Property Owner/Job Location Information
Name: 0-•,/t4-e.lL I4 47,4 44" Name: POr/eCrJ `'"L M o kJA-C.Q
Street: 2—tell + -(2CCC 4 I— Street: tP-O dits Kt Era 00c/C
City/Town: gA AJ#1, - , !fit Pt City/Town: syi�fZ ()L3T(-4
Telephone: 6t —g28. �992 Telephone: 04 — /14, #441)
Photo I.D. required/ Copy of Photo I.D. attached: YES / NO Staff Initial:
J-1/ M-1 inrestricted 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 works Renovation: HVAC:} Metal Watershed Roofing:
Kitchen Exhaust System: Metal Chimney/Vents: Air Balancing:
Provide detailed description of work to b done:
1 n S t-Ai C. D- L �( Q- .K'u2-vc.(4 eld-wS �` 'rt-'L`-e-
2 k.. , 1- ,r) Sic-0- ( r - i— ,-
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of
M.G.L. Ch. 112 Yes (J No
If 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 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 Owner's Agent
By checking here4 ,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 at 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 'I`
City/Town: Journeyperson ��®�
Permit#: Journeyperson-Restricted License Number:
Fee: $ Check at www.mass.gov/dpl
I` Inspector ignature of Permit 1'
of Permit Approval
•
OMM•NW LTH OF M.. S^CHU
DIVISION OF PROFESSIONAL LICENSURE
BOARD OF
SHEET METAL WORKERS
ISSUES THE FOLLOWING LICENSE
MASTER 4 UNRESTRICTED 4
NHAN1 H NGUYEN
284 BRIDGE ST
RAYNHAM,MA 02767.1975
3605 10/28/2023 148925
LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER