HomeMy WebLinkAboutBuilding Permit # 4/28/2017 5/5/2017 *Building Permit#24553-View Point Cloud
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*Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued
TIMELINE
OSubmission received
Apr 24,2017 at 3:22pm
Building Department
Review Ion
Completed Apr 26,2017 at 9:09am
OTreasurer Review
Completed Apr 26,2017 at
4:13pm
OBuilding Inspector
Approval
Completed Apr 26,2017 at 4:38pm
OAlteration Roofing and/of
Windows/Doors
Paid Apr 28,2017 at 10:57am
OPermit Issued
Issued Apr 28,2017 at 10:56am
*Building Permit#24553 Alterations:Roofing/Siding and/or Windows/Doors
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Applicant Location
David Castricone Roofing Siding 62 LISA LANE , NORTH ANDOVER, MA
t. 978-683-3420 Owner
@ castriconeroof ing(cover... WHITTAKER,STEPHEN J
Attachments
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Application Submission
Required information varies depending on who is applying for a building permit.
Are you submitting this application as the Homeowner?
NO
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Primary Contractor
Search for your contractor using the search bar below. Either the Licensee Name or License#isrequired.
Firm(aysmex$Name Licensee^ License#~ License Expiration Date^ License Type~ License Active License Status
D/YV|DCASTR|CONE ROOFING,SIDING& 099358 12/16/2017 O Active
Mailing Address~ Preferred Telephone#:~ Alternate Phone# Email
231RSUTTON ST.SUITE 3A. NORTH ANDOVER K8AO1845 9786833420 9788528875 castriconemofing(Overizonoet
I 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 wImprovement~ Proposed Use~ mesc,/pt/onmwm,xmuepexo,meu^ /sproperty onTown water~ /sproperty onTown sewer
~
Repair, Replacement One-Two Family Strip and re-shingle roof Yes Yes
Project Cost(if new construction base on$125 per square foot and if add ition/a Iteration/renovation base on actual contract price)
13.970
Does this project require atemporary construction trailer?
~
NO
Does this project require atemporary construction sign?
~
NO
Danger Zone Literature(MGL CHapter 166 Section 21A-F and G min.$100-$1,000 fine)
NO
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Registered Design Professional
Architect/Engineer Name Architect/Engineer Address Architect/Engineer Phone Number Architect/Engineer Reg.#
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.
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Insurance Company Name(Attach a copy of workers'compensation policy declaration page showing the policy number and expiration date)
Granite State Insurance
Policy#or Self-Ins.License#* Expiration Date
Wc003989723 09/23/2017
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
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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