HomeMy WebLinkAboutBLDSM-23-001879 'Cidl--
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REC IfVED
:, OF ,-, SHEET METAL PERMIT OCT �f
+ ,� `, Commonwealth of Massachusetts 2.
Town of Yarmouth Building Department Bui� TMENT
Date: 1 -R -010/da Permit#: S S111—Z j--Wl r79
Estimated Job Cost: $ nm ,(ThoPermit Fee: $
Plans Submitted: YES / NO Plans Reviewed: YES/ NO
Business License # Application License # 1315
Business Information Property Owner/Job Location Information
Name: Vitt".
/ 4,v, A. C, Name: S►Juif eit Titoo tnato MfiL,l J I
Street: �� l STpNA (jjQC Q,p, Street: Son n
City/Town: VaL6p(I((, City/Town:ypkintak Cc(Ct-
Telephone: -)(1, -1 (I.- Oc.`) 0 Telephone: l
Photo I.D. required/ Copy of Photo I.D. attached: YES / NO Staff Initial:
1-1/�1 �inr stri Pri li ence
1-2 / 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 Ind strial Educational Institutional Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of stories:
Sheet metal ork to be completed: 1 /
New work Renovation: HVAC: V Metal Watershed Roofing:
Kitchen Exhaust System: Metal Chimney/Vents: Air Balancing:
Provide etailed description of work to be done:
S KMl 'uer. 3rke,M 11J Afic 4 fAS€A-4 TO 3taUk 40`r -,
A/c, eq U
I
1
i
1
-1
INSURANCE COVERAGE:
I have a current liability insur nce policy or its equivalent which meets the requirements of
M.G.L. Ch. 112 Yes V No
If you have checked Yes, indic e 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 ins.irance 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 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:
- I
Date: Comments:
Typ of license:
By: Master
Title: Master-Restricted gnature.of Licensee 'f` _
City/Town: Journeyperson
Permit#: Journeyperson-Restricted License Number: /3 f 5-
Fee: $ Check at www.mass.gov/dpl
�...:: IG -11-. -
'i` Inspector Signature of Permit 'I`
of Permit Approval
COMMONWEALTH OF WIASSACHUSETTS
BOARD OF
SHEET METAL WORKOiS
ISSUES THE FOLLOWING LIB
MASTER-UNRESTRICTED
MATTHEW C DALEY
23 STONE RIDGE RD
BREWSTER,MA 02631-1735
1315 08/28/2023 83866