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Home My WebLink AboutBuilding Permit # 4/17/2017 4/19/2017 *Building Permit#24279-View Point Cloud 24279 *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 11,2017 at 8:12pm Building Department Review %J Completed Apr 12,2017 at 5:38pm OTreasurer Review Completed Apr 13,2017 at 3:18pm OBuilding Inspector Approval Completed Apr 14,2017 at 7:50am OAlteration Roofing and/of Windows/Doors Paid Apr 17,2017 at 9:53am OPermit Issued Issued Apr 17,2017 at 9:53am *Building Permit#24279 Alterations:Roofing/Siding and/or Windows/Doors .„ https://northandover m a.vi ewpoi ntcl oud.com/#/records/24279 1/5 4/19/2017 "Building Permit#24279-View Point Cloud f 'uuuuum I Applicant Location michael dudley 240 MARBLERIDGE ROAD , NORTH ANDOVER, MA t- 508-881-8555 Owner @ service@unitedhomee..• MORGAN, KATHARINE Attachments pdf liabit_Tue_Apr_11_2017_1.pdf Uploaded April 11,2017 by michael dudley pdf linc_Tue_Apr_11_2017_1.pdf Uploaded April 11,2017 by michael dudley pdf Scan_20170411_(2)_Tue_Apr_11_2017_2.pdf Uploaded April 11,2017 by michael dudley pdf Scan_20170411_Tue_Apr_11_2017_2.pdf Uploaded April 11,2017 by michael dudley 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 MICHAEL K DUDLEY CS-100077 05/06/2018 Construction Supervisor O Active https://northandoverma.viewpointcloud.com/#/records/24279 2/5 4/19/2017 *Building Permit#24279-View Point Cloud Mailing Address* Preferred Telephone#:* Alternate Phone# Email ,Ashland MA 01721 5088818555 serviceCounitedhomeexperts.com I certify,under the pains and penalties of perjury,that the information on this application is true and complete. G 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 install new replacement windows(integrity by marvin) No No Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 1,200 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.# hftps://northandoverma.viewpointcloud.com/#/records/24279 3/5 4/19/20 17 *Building Permit#c4cro vw*PomClov Insurance INSURANCE COVERAGE: /have acurrent liability insurance policy o,its substantial equivalent. ~ Yes nyes,indicate the type ofcoverage~ nother,specify Liability Worker's Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Tohefiled 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. | amanemployer with employees(full and/or part-time) Type ofproject~ Please explain'om*,'project: 14.Other replace windows 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 ascivil penalties inthe form ofaSTOP WORK ORDER and afine ofupto$25O.0Oa day against the violator.Acopy ofthis statement may beforwarded 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) aeic Policy#n,se/wno.License#~ Expiration Date wcc5010274012015 08/15/2017 mps://northandovermumewpointc|oud.com/#"/rmmrds/24279 4/5 4/19/2017 "Building Permit#24279-View Point Cloud Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. G 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 Is the project within 100'of Wetlands?* hftps://northandoverma.viewpointcloud.com/#/records/24279 5/5