HomeMy WebLinkAboutBuilding Permit # 3/6/2017 (2) 3/9/2017 *Building Permit#23310-View Point Cloud
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*Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued
TIMELINE
OSubmission received
Mar 6,2017 at 1:19pm
Building Department
Review Ion
Completed Mar 6,2017 at 1:26pm
OTreasurer Review
Completed Mar 6,2017 at
4:23pm
OBuilding Inspector
Approval
Completed Mar 6,2017 at 4:43pm
OAlteration Roofing and/of
Windows/Doors
Paid Mar 7,2017 at 9:08am
OPermit Issued
Issued Mar 7,2017 at 9:07am
*Building Permit#23310 Alterations:Roofing/Siding and/or Windows/Doors
https://northandover m a.vi ewpoi ntcl oud.com/#/records/23310 1/5
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ApplicantApplicantv,caLocationJohn Mason 39 PRESCQTTSTREET , NORTH ANDOVER, YN4
t~ 978-575-5765 Owner
@ j|mpro43C4gmaiicom(.' 5ARN|E'ANDREW M.
Attachments
No Files...
Application Submission
Required information varies depending on who is applying for a building permit.
Are you submitting this application as the nvmomw^*n~
NO
Primary Contractor
Search for your contractor using the search bar below. Either the Licensee Name or License#isrequired.
Firm(Business)Name Licensee~ License#~ License Expiration mate^ License Type~ License Active License Status Mailing Address
JOHN LMASON CS-090499 03/04/2018 Construction Supervisor [] Active . North Billerica K48O1862
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Preferred Telephone#:~ Alternate Phone# Email
9786756765
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Br
Project Information
Persons contracting with unregistered contractors do not have access tothe guaranty fund. Fee Schedule: Building Permit: Project Cost(if new construction base on $125 per
square foot and ifadd|tion/a|temtion/renovation base on actual contract price). ELECTRICAL: Movement of Meter|ocaUon, mast or service drop requires approval of Electrical
Inspector.
Type vrImprovement~ Proposed Use~ Description«rWork muePerformed^ /sproperty onTown water~ /sproperty onTown sewer
~
Repair, Replacement One-Two Family Replace Decking Yea Yes
Project Cost(if new construction base on$125 per square foot and if add ition/a Iteration/renovation base on actual contract price)
9,000
Does this project require atemporary construction trailer?
~
NO
Does this project require vtemporary construction sign?
~
NO
Danger Zone Literature(MGL CHapter 166 Section 21A-F and G min.$100-$1,000 fine)
NO
Registered Design Professional
xohmocucnomee,mame Arch xecucnnme*,Address Arch necucnnme*rPhone Number Arch necucnnme*rReg.#
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3/9/2017 "Building Permit#23310-Mew Point Cloud
Insurance
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent.
Yes
If yes,indicate the type of coverage* If other,specify
Liability
Worker's Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
To be filed with the permitting authority
Are you an employer?Select the appropriate type.Any applicant that selects#1 must also fill out the section below showing their workers'compensation policy information.
1. 1 am an employer with employees(full and/or part-time)
Type of project*
8. Remodeling
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information.
Failure to secure coverage as required under MG>c.152,25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil
penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations
of the DIA for insurance coverage verification.
Insurance Company Name(Attach a copy of workers'compensation policy declaration page showing the policy number and expiration date)
A.I.M. Mutual Insurance Company
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Policy#n,semns.License#~ Expiration Date
VYVC-1O0-6019080-201GA 07/19/0017
Workers' Compensation Affidavit Signature
/uohereby certify under the pains and penalties nfperjury that the information provided above/strue and correct.
~
Br
ig To Be Completed By Town Staff
laZoning District~ la|sthis a1ooYear o,older structure~ la|sproperty within anOverlay District~ |sthe property within the Floodplain~ |sthe project within 1oo'of Wetlands?~
R4 No
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