Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutBuilding Permit # 4/20/2017 5/4/2017 *Building Permit#23919-View Point Cloud
23919
*Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued
TIMELINE
OSubmission received
Mar 28,2017 at 3:39pm
10 Building Department Review
Completed Mar 28,2017 at 4:18pm
© Conservation Department
Review Ono
Skipped Apr 11,2017 at 9:17am
© Planning Department Review
* !!%
Skipped Mar 28,2017 at 4:20pm
OHealth Department Revies
Completed Mar 29,2017 at 8:31am
ODPW Engineering Review
Completed Mar 31,2017 at 10:13am
ODPW Operations Review
Completed Mar 28,2017 at 4:40pm J1%%
Fire Department Review
Completed Mar 29,2017 at 7:30am �
OTreasurer Review
Completed Mar 28,2017 at 5:42pm
https://northandover m a.vi ewpoi ntcl oud.com/#/records/23919 1/5
5/4/2017 *Building Permit#23919-View Point Cloud
OBuilding Inspector Approval J j/
Completed Apr 12,2017 at 4:19pm
OAdditions/Alterations/Remodeling Bldg
Permit Fee
Paid Apr 20,2017 at 2:53pm
OPermit Issued
Issued Apr 20,2017 at 2:52pm
*Building Permit#23919 Construction of Additions,Alterations,and Remodeling
OCVS
u1u irogan' Field a Cama GOU
C.
muuuu�
uiuiuu�
Applicant Location
Gregg Lacasse 28 PATRIOT STREET , NORTH ANDOVER, MA
t. 508-291-0007 Owner
@ brittany.nunes@trinitys... WILLARD,JOHN
Attachments
pdf <'0I\LI i&,11'tt:i.. II e.ie Mar 28 2017 1
Uploaded by Gregg Lacasse on Mar 28,2017 3:39 PM ,
pdf Ki SII...Data...SIlr!';^ xt�,...�1�ilr�...ivl�ur`....a?8...2017....1
Uploaded by Gregg Lacasse on Mar 28,2017 3:39 PM ,
pdf @ ioirwr,v non ILIrc ri7�.Lirlar111,
Uploaded by Gregg Lacasse on Mar 28,2017 3:39 PM
pdf MA .CSt. irf:':'r kpL Tue IIlAm 2 2L;117 1
Uploaded by Gregg Lacasse on Mar 28,2017 3:39 PM ,
https://northandoverma.viewpointcloud.com/#/records/23919 2/5
5/4/20 17 *Building Permit#oan e wewPnmQmm
pn VVUlmvd^,�ohn_eng|needettecieedo_sructum|)]Oe_Mo,_38_2O17"1 1 �
Uploaded uyGregg u,causeonMar 2n.2mrs:4opm
Pdf VV|LLAR1)._J01-111IN_'_FULL_SET_Tue_Va,28_2017 1
Uploaded uvGregg LacasseonMar 2a.2nns:4opm
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(aysmess)Name Licensee~ License#~ License Expiration Date~ License Type~ License Type~ License Active License Status
GREG8LACASSE CS-103631 08/30/2017 Construction Supervisor [] Active
Mailing Address~ p,*o^,,ed Telephone#:~ Alternate Phone# Email
. Mattapoisett M402739 508-291-0007
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
Br
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«rImprovement~ Proposed Use~ Description mWork touePerformed~ |sproperty onTown water
~
Alteration One'TwoFami|y Install 4.56kW solar panels on roof.Will not exceed roof panel, but will add 6"to roof height.16 total panels. Yes
hups://nonxandove,mumewpoimo|md.00m/#"/rmmrdd23819 3/5
5/4/2017 "Building Permit#23919-V ewPoint Cloud
Is property on Town sewer
Yes
Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price)
13,000
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.#
Richard Gordon PO Box 264 Farmville,VA 23901 434-315-5759 49993
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
hftps://northandoverma.viewpointcloud.com/#/records/23919 4/5
5/4/2017 "Building Permit#23919-View Point Cloud
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 Solar
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)
HDI-Global Insurance Company
Policy#or Self-Ins.License#* Expiration Date
EWGCC00006516 11/01/2017
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
GI 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/23919 5/5