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Home My WebLink AboutBuilding Permit # 4/19/2017 5/4/2017 *Building Permit#24370-View Point Cloud *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 17,2017 at 4:22pm Building Department Review Ion Completed Apr 18,2017 at 12:58pm OTreasurer Review Completed Apr 19,2017 at 1:33pm OBuilding Inspector Approval J 1 , Completed Apr 19,2017 at 4:58pm OAlteration Roofing and/of Windows/Doors Paid Apr 19,2017 at 5:30pm OPermit Issued Issued Apr 19,2017 at 5:30pm *Building Permit#24370 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24370 1/5 5/4/2017 *Building Permit#u43ro wewPnmQmm Applicant Location Jaime Morin 28nAORN|NGS|DELANE , NORTH ANDOVER, K0A t~ 5O8-351-2241ext. ... Owner @ brian]abaie4aendeme— EVANGEL|5TA' DAV|D Attachments pur Evangelista_Controct_VonApr_17_12O|7_1 � Uploaded by Jaime Morin onApr 17,2017 4:20 pm puf EvangeHsta_VVorkmons_Comp_and_Liab||ity_|nsuronce_Mon_Apr_17_2O17_1 � Uploaded by Jaime mo,m onApr/T 2017 4:21 pw pu, CSL...-...H|C_\4on_Apr_17_2O17_1 � un/oaueu by Jaime wo,m on Apr 17,2017 4:21 pm nuf Town_mf_North_Andove,_IlMon_4pc-17_2O17_1 � Uploaded by Jaime wo,m onApr/z 2017 4:22 pm pu, Doub1e_Hung_Mon_Ap,_17_2O17_1 � un/oaueu by Jaime mo,m onApr 1T 20/7 4:22 pm vuf 200Se"es �on��pc-17 �O17 1 _ _ _ _ � Uploaded by Jaime mn,/n onApr/T 2017 4:22 pm Application Submission Required information varies depending on who is applying for a building permit. Are you submitting this application as the Homeowner?~ NO hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24370 2/5 5/4/2017 "Building Permit#24370-Mew 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 Type* License Active RENEWAL BY ANDERSON LLC. 090125 10/06/2018 Construction Supervisor 1&2 Family O License Status Mailing Address* Preferred Telephone#:* Alternate Phone# Email Active 30 FORBES RD, NORTHBOROUGH MA 01532 508-351-2277 brian.labaire(Oandersencorp.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 Replace 14 windows and 1 door Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 24,592 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.$10041,000 fine) hftps://northandoverma.viewpointcloud.com/#/records/24370 3/5 5/4/2017 *Building Permit#u43ro wewPnmQmm NO Registered Design Professional xohmecusnoinee,wame Arch mecusnoinee,Address Arch xecusnoinee,Phone Number Arch xecusnoinee,Reg.# Insurance INSURANCE COVERAGE: |have acurrent liability insurance policy o,its substantial equivalent. ~ Yes nyes,indicate the type ofcoverage~ xother,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. | am an employer with employees(full end/or part-time} Type wproject~ Please explain'v,he,'project: 14.Other VYindow/DoorRep|acement I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24370 4/5 5/4/2017 "Building Permit#24370-View Point Cloud 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 M WC30823100 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. 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* G Which Overlay District* Is the property within the Floodplain R1 Yes Yes Watershed Protection District No Is the project within 100'of Wetlands? Yes hftps://northandoverma.viewpointcloud.com/#/records/24370 5/5