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HomeMy WebLinkAboutBuilding Permit # 4/25/2017 5/4/2017 *Building Permit#24273-View Point Cloud 24,273 *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 11,2017 at 12:28pm Building Department Review Completed Apr 13,2017 at 9:01am OTreasurer Review Completed Apr 13,2017 at 3:13pm OBuilding Inspector Approval Completed Apr 14,2017 at 7:51am OAlteration Roofing and/of Windows/Doors Paid Apr 25,2017 at 8:31am OPermit Issued Issued Apr 25,2017 at 8:31am *Building Permit#24273 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24273 1/5 5/4/20 17 *Building Permit#u42rn wewPnmQmm *� r� /�^ � �y 0xpp|icant LocationRichard Huet 23 HUCKLEBERRY LANE , NORTH ANDOVER, MA t~ 978-255-8353 Owner @ dt102od-verizon.net<m... DOUGHTY,JAMES Attachments PDF 0TXCTN|O01F_Tue_Apr_11_2O|7_1 � Uploaded uyRichard F/uetnnApr 11.zn1/12:2npm PDF 'UTY6VVO|O01F_Tue_Apc-11_2017_1 � Uploaded uvRichard rmetonApr n.2n/,m:zspm 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(uusmess)Name Licensee~ License#~ License Expiration Date~ License Type~ License Type~ License Active License Status RICHARD AFLUET CS'050710 04/22/2017 Construction Supervisor [] Active hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24273 2/5 5/4/2017 *Building Permit#u42rn wewPnmQmm Mailing Address~ Preferred Telephone#:~ Alternate Phone# Email . METHUEN M401844 978 255-8353 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 no/have access/nthe guaranty fund. Fee Schedule: Building Permit: Project Cost(if new construction base on $125 per square foot and ifaddition/a|teration/venovation base on actual contract price). ELECTRICAL: Movement of Meter|ocadon, mast or service drop requires approval of Electrical Inspector. Type mImprovement~ Proposed Use^ Description mWork muoPerformed~ |sproperty onTown water~ |oproperty onTown sewer ~ Alteration One-Two Family Replace 9windows and one door \to Yes Project Cost(if new construction,base on$125 per square foot and if add ition/a Iteration/renovation base on actual contract price) 10,403 Does this project require atemporary construction trailer? NO Does this project require atemporary construction sign? ~ NO Danger Zone Literature(MGL cHapte,1ssSection 21*Fand smin.$1no-$1.onofine) NO Registered Design Professional Arch nerusnoineer Name Arch uecusnoineer Address Arch mscusnoinee,Phone Number Arch uecusnoinee,Reg.# mps://northandovermumewpointc|oud.com/#"/rmmrds/24273 3/5 5/4/2017 "Building Permit#24273-Mew Point Cloud 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. 1. 1 am an employer with employees(full and/or part-time) Type of project* Please explain'other'project: 14.Other Window replacement 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) Arbella Policy#or Self-Ins.License#* Expiration Date 9104340308 03/31/2018 hftps://northandoverma.viewpointcloud.com/#/records/24273 4/5 5/4/20 17 *Building Permit#u42rn wewPnmQmm Workers' Compensation Affidavit Signature /unhereby certify under the pains and penalties mperjury that the information provided above/strue and correct. ~ Br igTo Be Completed By Town Staff la Zoning District~ la|sthis a1nnYear n,older structure~ la|sproperty within anOverlay District~ |sthe property within the Floodplain~ |sthe project within 1on'of Wetlands?~ R2 No No No Yes mps://northandovermumewpointc|oud.com/#"/rmmrds/24273 5/5