HomeMy WebLinkAboutBLSM-24-4 RECEIVED
JAN 18 2024
u �AtzZ r METALP�MIT 1b/)/d&J �&3i
s �y - Commonwealth of Massachusetts
w.,, • ' Town of Yarmouth Building Department ( /1
1146 Fbute 28, 9 uth Yarmouth, MA 02664-4492
Date: I-/' - FFrmit#: 5 S lyl - Lj
Estimated JDb Cbst:$ /j-O6 Fbrmit Fee:$ St),/() /5'J')
Rans Nbmitted: YES/ NO AV Rans Feviewed: YES/ NO
Business License# Application License#
Business Info nation Property Owner/.bb Location Infatuation
Name: -Ia lls- ( / y Name: ?Z) A/ 6=e4.1.,.. 1t$
areet: 7 c' t r3% - Pt' Street: %//ii/sit.c) ID
City/ Town: jcugf��c/ems - 'tat Oty/Town: , U) ./( l/J,'L
Telephone: -- lie; >eye- (Teo Telephone: -50p} 56v-
Rioto I.D. required/ Cbpyof Photo ID. attached: YEr/ NO Staff Initial:
1/ M- unrestricted license
J•2/ M-2 restricted to dwellings3 storiesor less and commercial up to 10,000 sq.ft./ 2
stories or less
Fimidential: 1-2 family/ Multi-family Condo/ Townhouses Other__
Cbmrnerdal: Office Fbtail Industrial Educational Institutional Other___
aware Footage: under 10,000 sq.ft.-Lover 10,000 sq.ft. Number of stories:
9aeet metal work to be aornpletea:
New work iFenovation:._HVAC/ Metal Watershed Fbofing:__
Kitchen Exhaust System: Metal Chimney/ Vents: Air Balancing:___
Provide detailed description of work to be done:
`�i
INS.IRANCECOV ACf:
I have a current liability incur policy or its equivalent which meets the requirements of
M.G.L Ch. 112 Yes 1' No
If you have checked Yes, indicate the type of°overage by checking the appropriate box below:
A liability insurance policy Other type of indemnity Bond
OWNERS INS JRANCEWAJVBR 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
requirem
Check Cne Only
c.-
Owner /Agent
sgnature of Owner or 'sAgent
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()ode and Chapter 112 of the General Laws.
Inspections shall be called for prior to insulation installation
Dud in 3ertion required prior to insulation installation: Yes No
Progress Inspections
Date: Comments:
Final Inspections
Date: Comments:
Type of license:
Master
Title: Master-Restricted T suture of Licensee T
aty/Town: ,burneyperson
Fbrmit#: ,burneyperson-Restricted License Number:
Fee: $ Check at www.massgov/dpl
T Inspector Sgnatureof Permit T
of permit Approval
•
pleasevisit our web site at h ; ! and .
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