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Home My WebLink AboutBuilding Permit # 4/11/2017 4/13/2017 "Building Permit#24173-View Point Cloud 241 7'3 *Building Permit—Alterations: Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 6,2017 at 1:01pm OBuilding Department Review 0 Completed Apr 6,2017 at 3:57pm OTreasurer Review Completed Apr 7,2017 at 49 11:48am OBuilding Inspector dl Approval Completed Apr 10,2017 at 6:25pm OAlteration Roofing and/of Windows/Doors Paid Apr 11,2017 at 9:26am OPermit Issued Issued Apr 11,2017 at 9:25am *Building Permit#24173 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24173 1/6 4/13/20 17 *Building Permit#c4 rn vw*PomClov lJ` 0 Applicant Location Morin 38 EVERGREEN DRIVE , NORTH ANDOVER, MA k= 508'351'2241 Own*, @ brian.|abaireCdandersu.. MEYER REALTY TRUST Attachments pdf Town_of_North_4ndoveLThu_Ap[-OG_2017_1.pdf Uploaded April 6.2017by]a|meMorin pdf CSL_--H|C_Thu_4pL86_20171.pdf Uploaded April 8.2017byJaime Morin pdf G|ide[_Thu_Ap[_05_2017_1.pdf Uploaded April 5.2017byJaime Morin pdf Meye[-Contract_Thu_Ap[-O6_2O17_1.pdf Uploaded April 6'2O17UyJaime Morin Application Submission Required information varies depending on who is applying for a building permit. Are you submitting this application aythe Homeowner? ~ NO hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24173 2/6 4/13/2017 *Building Permit#24173-View Point Cloud Primary Contractor Search for your contractor using the search bar below. Either the Licensee Name or License#is required. Firm(Business)Name Licensee* License#* License Expiration Date* License Type* License Active License Status JAIME L MORIN CS-090125 10/06/2018 Construction Supervisor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email , LYNN MA 01905 508-351-2241 brian.labaire@andersencorp.com I certify,under the pains and penalties of perjury,that the information on this application is true and complete.' C Project Information Persons contracting with unregistered contractors do not have access to the guaranty fund. Fee Schedule: Building Permit: Project Cost(if new construction base on $125 per square foot and if addition/alteration/renovation base on actual contract price). ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector. Type of Improvement* Proposed Use* Description of Work to be Performed* Is property on Town water* Is property on Town sewer Repair, Replacement One-Two Family Replace 11 windows Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 21,545 Does this project require a temporary construction trailer? NO Does this project require a temporary construction sign? NO hftps://northandoverma.viewpointcloud.com/#/records/24173 3/6 4/13/2017 *Building Permit#24173-View Point Cloud Danger Zone Literature(MGL CHapter 166 Section 21A-F and G min.$100-$1,000 fine) NO Registered Design Professional Architect/Engineer Name Architect/Engineer Address Architect/Engineer Phone Number Architect/Engineer Reg.# 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 Window Replacement hftps://northandoverma.viewpointcloud.com/#/records/24173 4/6 4/13/2017 *Building Permit#24173-View Point Cloud 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) Old Republic Insurance Co. Policy#or Self-Ins. License#* Expiration Date MWC30823100 10/01/2017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. C la To Be Completed By Town Staff G Zoning District* G Is this a 100 Year or older structure* Is property within an Overlay District* Is the property within the Floodplain R2 No No No Is the project within 100'of Wetlands? No hftps://northandoverma.viewpointcloud.com/#/records/24173 5/6 4/13/2017 "Building Permit#24173-View Point Cloud https://northandoverma.viewpointcloud.com/#/records/24173 6/6