HomeMy WebLinkAboutImage_003.pdf - BLSM-24-3 33810SHEET METAL PERMIT
Co m m onw e o lth of M ossochusetts
Town of Yormouth Building Deportment
Propetty Owner/ Job Location lnlormation
required/ Copy of Photo l.D. attached: YES / NO
)-t / M-t unrestracted license
restricted to dwellings 3 stories or less and commercial up to 10,000 sq. ft./ 2
stories or less
Retail lndustrial Educational lnstitutional
RECEIVED
JAN 12 20211
BUILDING DEPARTMENT
Othe r
I
)-2 / M-2
Residential: 1 2 family
Commerciol: Office
l2fiultifami\- Condo/Townhouses Other
Squore Footage: under 10,000 sq. ft._ over 10,000 sq. ft._Number oI stories: _
Sheet metol work to be completed:
./ -/New work/ Renovation: _HVAC:ZaMetal Watershed Roofing:_
Kitchen Exhaust Systemt_ Metal Chimney/ Vents:_ Air Balancing:_
Provide detaiied descri t on of work to be one
Date t/ti/3y'Permit $
Estimatl6 Job Cost: 5 ^ / (t A)Permit Fee: 5
Pla ns Submitted vs li'to) /Plans Reviewed: YES / NO
Bu siness License #Application License # t 37 C
Name
Street:St reet i,
Cny I 1 oiiyla7n* r11,7t,,f City/ Town
Telepho ne r Telephone
l2\-
{*w'tlY l;t -Z @ o9 il ^ co,,r
Business lnformotion
Name:
Sta ff ln itia l:
INSURANCE COVERAGE:
I have a current liability in
M.G.L. Ch. 112 Yes
SUra policy or its equivalent which meets the requirements of
No
lf Vou have checked Yes, indicate t e type of coverage by checking the appropriate box below
A liability insu rance policy Other type of indemnity _ Bond _
OWNER'S INSURANCE WAIVERi I am aware that the licensee dles-Dqlhlye 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 _
SiBnature of Owner or Owner's Agent
EYcheckinS h€re+
-,lhereby
certifythal allof the details and roiornlation r hav€ !ubmrtted Ior entered)regardrng thrs appticarion are true
and ac.urale to the besl of my knowledge and that all eh€e! metal work and rnstallatron performed under the permit issued for this applacatron
wrll be in compliance wrth all pe(1nen! provrron of the Massachuse$s Building Code and Chapter 112 of the Generat Laws.
lnspections shall be colled lor prior to insulotion instollotion.
Duct inspection required prior to insulation installation: Yes /Vo
1 lnspector Signature of permit ,l
of Permit Approval
Date Com ments
Date Comments
Type of license
By l\,4 a ster
Tlt le Master, Restricted 1sl nature of Licensee
Ci loLr rn e e150n
Pe.mit f JoLrrne erson- Restricted License NumberFee
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