Loading...
HomeMy WebLinkAboutBuilding Permit # 4/26/2017 5/4/2017 *Building Permit#24572-View Point Cloud EI *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 25,2017 at 2:09pm Building Department Review Completed Apr 25,2017 at 3:46pm OTreasurer Review Completed Apr 25,2017 at 5:51pm OBuilding Inspector Approval J tli, Completed Apr 25,2017 at 6:25pm OAlteration Roofing and/of Windows/Doors Paid Apr 26,2017 at 10:49am OPermit Issued Issued Apr 26,2017 at 10:49am *Building Permit#24572 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24572 1/5 5/4/20 17 *Building Permit#u45rc wewPnmQmm w^ �+ 0 Applicant Location Michael Dudley 12 UPLAND STREET, NORTH ANDOVER, NY4 t~ 508-881-8555 Owner @ semice¢^unitedhomee— NOONE' DANIEL,l Attachments pur Noone-_NAnUover_TueApr_25_2017_| � Uploaded uyMichael Dudley nnApr 2s.2o1/2oepm Application Submission Required information varies depending on who is applying for a building pe/mit. 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 Active License Status Mailing Address^ Preferred Telephone#:~ MICHAEL KDUDLEY C5-100077 05/06/2018 [] Active .Ashland MA01721 5088818555 Alternate Phone# Email semice(0)unitedhomeexportszom hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24572 2/5 5/4/2017 "Building Permit#24572-Mew Point Cloud 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 install new siding on left side only Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 8,300 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/24572 3/5 5/4/2017 "Building Permit#24572-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 Siding 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) AEIC Policy#or Self-Ins.License#* Expiration Date WCC5010274012014 08/15/2017 hftps://northandoverma.viewpointcloud.com/#/records/24572 4/5 5/4/2017 "Building Permit#24572-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? R-4 No No Yes Not Applicable hftps://northandoverma.viewpointcloud.com/#/records/24572 5/5