HomeMy WebLinkAboutBuilding Permit # 4/11/2017 4/13/2017 "Building Permit#23823-View Point Cloud
23823
*Building Permit—Alterations: Roofing/Siding and/or Windows/Doors O Building Permit Issued
TIMELINE
OSubmission received
Mar 23,2017 at 3:37pm
OBuilding Department
Review 0
Completed Mar 25,2017 at 6:55am
OTreasurer Review
Completed Apr 11,2017 at 49
10:06am
OBuilding Inspector dl
Approval
Completed Apr 11,2017 at 10:27am
OAlteration Roofing and/of
Windows/Doors
Paid Apr 11,2017 at 11:51am
OPermit Issued
Issued Apr 11,2017 at 11:51am
*Building Permit#23823 Alterations:Roofing/Siding and/or Windows/Doors
https://northandover m a.vi ewpoi ntcl oud.com/#/records/23823 1/6
4/13/2017 *Building Permit#23823-View Point Cloud
eu
Applicant Location
Jaime Morin 1577 SALEM STREET , NORTH ANDOVER, MA
k. 508-351-2241 Owner
@ brian.labaire@anderse... BURKE,JOSEPH P
Attachments
pdf Burke_Contract_Thu_Mar_23_2017_1.pdf
Uploaded March 23,2017 by Jaime Morin
pdf Town_of_North_Andover_Thu_Mar_23_2017_1.pdf
Uploaded March 23,2017 by Jaime Morin
pdf CSL_&_HIC_Thu_Mar_23_2017_1.pdf
Uploaded March 23,2017 by Jaime Morin
pdf Double_Hung_Thu_Mar_23_2017_1.pdf
Uploaded March 23,2017 by Jaime Morin
Application Submission
Required information varies depending on who is applying for a building permit.
Are you submitting this application as the Homeowner?
NO
https://northandoverma.viewpointcloud.com/#/records/23823 2/6
4/13/2017 *Building Permit#23823-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 5 windows Yes Yes
Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price)
7,538
Does this project require a temporary construction trailer?
NO
Does this project require a temporary construction sign?
NO
hftps://northandoverma.viewpointcloud.com/#/records/23823 3/6
4/13/2017 *Building Permit#23823-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/23823 4/6
4/13/2017 *Building Permit#23823-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
Is the project within 100'of Wetlands?
hftps://northandoverma.viewpointcloud.com/#/records/23823 5/6
4/13/2017 "Building Permit#23823-View Point Cloud
https://northandoverma.viewpointcloud.com/#/records/23823 6/6