HomeMy WebLinkAboutBLDSM-24-31 • ! RECEIVED
f1. MAY 28, 2024d
of Y; SHEET METAL PERMIT
g',., Commonwealth of Massachusetts BUILDING DEPARTMENT
By.
Town of Yarmouth Building Department
Date: 6 j.9q 1c)OoLt Permit #: 8/5 olt-4
Estimated Job Cost:-S.., �/Su. Permit Fee: $ jU,[�
Plans Submitted YES;/ NO Plans Reviewed: YES/ NO
Business License # 3Qg'I Application License #
Business Information Property Owner/Job Location Information
Name: �r�Orlvi r C rn¢ Name: r l,-\�
Street: 0S / 54- 5 t ' Street: Xe
~\Ytbc�c�
City/Town: br(c 1,x jk/ V r K, City/Town: O r ryf c
Telephone: Telephone:p .�C�$�-�'74-��33 p 5-OS. ' qAa--9D83
Photo I.D. required/ Copy of Photo I.D. attached: 4110/ NO Staff Initial:
J-1 /I unrestricted 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
/overSquare Footage: under 10,000 sq. ft. 10,000 sq. ft. Number of stories:
Sheet metal work to be completed:
New work �HVA Renovation: :o C 1 Metal Watershed Roofing:
Kitchen Exhaust System: Xetal Chimney/Vents: Air Balancing: i/
Provide detailed description of work to be done:
—
S`'f'p l`J G a-n 640.1k all 6 u c ..),,r L- -c-t , a
I ood b u s s yes
C ftir. , 54— OI L- t (v 0- —
a s lq ?/ ®:sync �
CkY , fo1'11
alS 8S raw ,
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INSURANCE COVERAGE :
I have a current liability insura e policy or its equivalent which meets the requirements of
M . G . L. Ch . 112 Yes 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 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 Vo
Date: Comments :
i
i
Date : Comments :
Typ f license:
By: Master
Title: Master- Restricted '1I` Signature of Licensee '(`
City/Town: Journeyperson
Permit #: Journeyperson- Restricted License Number:
Fee: $ Check at www.mass.gov/dpl
..."-7-7-ce -0/4 y
1` Inspector Signature of Permit 1`
of Permit Approval
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