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HomeMy WebLinkAboutBuilding Permit # 4/26/2017 5/4/2017 *Building Permit#24568-View Point Cloud 2 4, 6 8c *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 25,2017 at 12:50pm Building Department Review Completed Apr 25,2017 at 3:39pm OTreasurer Review Completed Apr 25,2017 at 5:52pm OBuilding Inspector Approval Completed Apr 26,2017 at 9:50am OAlteration Roofing and/of Windows/Doors Paid Apr 26,2017 at 11:21am OPermit Issued Issued Apr 26,2017 at 11:20am *Building Permit#24568 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24568 1/5 5/4/20 17 *Building Permit#u45no wewPnmQmm ' �. —�c)/7/c�� QT Applicantmc�u --- Lawrence Morgan GOPLEASANT STREET , NORTH ANDOVER, YN4 t~ 978-570-4747 Owner @ |morganconstructionCd— KL|S|EYY|CZ.TADEU5Z KVDD Realty Trust) Attachments pur Scan_000Q_Tue_Apr_25_2O17_1 � Uploaded uyLawrence Morgan onApr zs'2n1/12:s1pm 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 Active License Status Mailing Address LAWRENCE EMORGAN,JR C5-079476 05/03/2017 [] Active ' North Billerica MA01862 Preferred Telephone#:~ Alternate Phone# Email 9786704747 |morganconstmction#comcast.net mps://northandovermumewpointc|oud.com/#"/rmmrds/24568 2/5 5/4/2017 "Building Permit#24568-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& Re-Roof No No Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 9,840 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.# N/A hftps://northandoverma.viewpointcloud.com/#/records/24568 3/5 5/4/2017 "Building Permit#24568-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* 13. Roof Repair 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) American Zurich Policy#or Self-Ins.License#* Expiration Date 6ZZ U 65673831216 12/14/2017 hftps://northandoverma.viewpointcloud.com/#/records/24568 4/5 5/4/2017 "Building Permit#24568-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 No Not Applicable hftps://northandoverma.viewpointcloud.com/#/records/24568 5/5