HomeMy WebLinkAboutBuilding Permit # 4/20/2017 5/4/2017 *Building Permit#24420-View Point Cloud
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*Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued
TIMELINE
OSubmission received
Apr 19,2017 at 9:06am
Building Department
Review
Completed Apr 20,2017 at 7:47am
OTreasurer Review
Completed Apr 20,2017 at
8:18a m
OBuilding Inspector
Approval
Completed Apr 20,2017 at 8:22am
OAlteration Roofing and/of
Windows/Doors
Paid Apr 20,2017 at 1:28pm
OPermit Issued
Issued Apr 20,2017 at 1:28pm
*Building Permit#24420 Alterations:Roofing/Siding and/or Windows/Doors
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Applicant Location
-- John Lanzafame 34SARGENT STREET , NORTH ANDOVER, MA
t~ 978-518-2985 Owner
@ troyCo)a||underoneroot... DONOHUE. BRIAN
Attachments
PDF 0TJOQB|OO|F_Wed_Apr_19_2D17_O �
Uploaded uyJohn LanzafameonApr 1s.zo17eo/xm
Application Submission
Required information varies depending on who is applying for a building permit.
Are you submitting this application asthe Homeowner?
~
NO
Primary Contractor
Search for your contractor using the search bar below. Either the Licensee Name or License#is required.
Firm(ausmess)Name Licensee~ License#~ License Expiration Date^ License Type~ License Type~ License Active License Status
JOHN VYLANZAFAME CS'069120 04/03/2019 Construction Supervisor [] Active
Mailing Address~ Preferred Telephone x:~ Alternate Phone# Email
. METHUENMA01844 9786182986
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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 strip and re-roof Yes Yes
Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price)
6,800
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)
Registered Design Professional
Architect/Engineer Name Architect/Engineer Address Architect/Engineer Phone Number Architect/Engineer Reg.#
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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.
5. 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet.These sub-contractors have employees and have workers'compensation
insurance.Contractors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If
the sub-contractors have employees,they must provide their workers'comp. policy number.
Type of project* Please explain'other'project:
14.Other strip and re-roof
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?
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