HomeMy WebLinkAboutBuilding Permit # 4/14/2017 4/19/2017 *Building Permit#24275-View Point Cloud
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*Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued
TIMELINE
OSubmission received
Apr 11,2017 at 3:14pm
Building Department
Review
Completed Apr 13,2017 at 9:19am
OTreasurer Review
Completed Apr 13,2017 at
3:12 pm
OBuilding Inspector
Approval
Completed Apr 14,2017 at 8:08am
OAlteration Roofing and/of
Windows/Doors
Paid Apr 14,2017 at 1:05pm
OPermit Issued
Issued Apr 14,2017 at 1:05pm
*Building Permit#24275 Alterations:Roofing/Siding and/or Windows/Doors
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Applicant Location
Joel Macario 31 MARBLEHEAD STREET , NORTH ANDOVER, MA
t- 781-953-2592 Owner
@ macconstruction09@9... LACHANCE,THOMAS E
Attachments
PDF -OTKDMF1001F_Tue_Apr_11_2017_1.PDF
Uploaded April 11,2017 by Joel Macario
PDF -OTEQ6VI001F_Tue_Apr_11_2017_1.PDF
Uploaded April 11,2017 by Joel Macario
Application Submission
Required information varies depending on who is applying for a building permit.
Are you submitting this application as the Homeowner?
NO
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 Mailing Address
JOEL MACARIO CS-110219 12/14/2019 Construction Supervisor O Active Lynn MA 01902
Preferred Telephone#:* Alternate Phone# Email
7819532592
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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 ridge vent, replace rubber on all low slope roofs Yes Yes
Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price)
6
Does this project require a temporary construction trailer?
NO
Does this project require a temporary construction sign?
NO
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:
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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*
13. Roof Repair
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)
AmGuard Insurance
Policy#or Self-Ins.License#* Expiration Date
R2WC747013 07/29/2017
Workers' Compensation Affidavit Signature
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I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
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tl To Be Completed By Town Staff
la Zoning District* la Is this a 100 Year or older structure* la Is property within an Overlay District* Is the property within the Floodplain
R4 Yes No No
Is the project within 100'of Wetlands?
No
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