HomeMy WebLinkAboutBuilding Permit # 3/29/2017 3/30/2017 *Building Permit#23812-View Point Cloud
238,0112
*Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued
TIMELINE
OSubmission received
Mar 27,2017 at 2:53pm
Building Department
Review
Completed Mar 28,2017 at 9:12am
OTreasurer Review
Completed Mar 28,2017 at
12:54pm
OBuilding Inspector
Approval
Completed Mar 29,2017 at 8:01am
OAlteration Roofing and/of
Windows/Doors
Paid Mar 29,2017 at 9:10am
OPermit Issued
Issued Mar 29,2017 at 9:09am
*Building Permit#23812 Alterations:Roofing/Siding and/or Windows/Doors
https://northandover m a.vi ewpoi ntcl oud.com/#/records/23812 1/5
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Applicant Location
mcatiu
--' doug|aasnom 88 BLUE RIDGE ROAD , NORTH ANDOVER, M4
"~ 781-893-4546 Owner
@emsnmwincCOrcnzom .' LEACH,GLENN F
Attachments
pur 89_B|ue_Ridge_Rd_Permit_Mon_K4a,_27_2017_1.pdf
Uploaded March 2<zo1/uyuoun/assnow
Application Submission
Required information varies depending on who is applying for a building permit.
Are you submitting this application asthe Homeowner?
~
NO
Primary Contractor
Search for your contractor using the search bar below. Either the Licensee Name or License#is required.
Firm(uusmess)Name Licensee~ License#~ License Expiration Date~ License Type~ License Active License Status
E.M. SNOW INC. 103258 07/07/2018 Home Improvement Contractor [] Active
Mailing Address^ Preferred Telephone#:~ Alternate Phone# smvo
971Main Ex,Waltham M4O2451 781-893-4546 emsnowinodrcnzom
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I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
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 ifaddition/a|temtion/enovation base on actual contract price). ELECTRICAL: Movement of Meter|ocadon, mast or service drop requires approval of Electrical
Inspector.
Type mImprovement~ Proposed Use~ oosc,/pt/onmwm,xmuepexu,mou~
Repair, Replacement One-Two Family replace 1 entry door with fiberglass door&1 bay window with new whtievinyl bay windmw.27 U factor Glass
/sproperty onTown water~ /sproperty onTown sewer
~
Yes Yes
Project Cost(if new construction base on$125 per square foot and if add ition/a Iteration/renovation base on actual contract price)
10,975
Does this project require atemporary construction trailer?
~
NO
Does this project require atemporary construction sign?
~
NO
Danger Zone Literature(MGL CHapter 166 Section 21A-F and G min.$100-$1,000 fine)
NO
Registered Design Professional
Archnecus^omee,mame Arch necusnomrerAddress Arch uocucnomee,Phone Number Arch necucnomee,Reg.#
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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* Please explain'other'project:
14.Other Replacement window and door
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)
STAR INSURANCE
Policy#or Self-Ins.License#* Expiration Date
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VVC0632074 05/02/2017
Workers' Compensation Affidavit Signature
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Br
igTo Be Completed By Town Staff
laZoning District~ la|sthis a1nnYear o,older structure~ la|sproperty within anOverlay District~ |sthe property within the Floodplain~ /ythe project within/on'orWetlands?
~
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