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HomeMy WebLinkAboutBuilding Permit # 4/28/2017 5/5/2017 *Building Permit#24696-View Point Cloud 24,696 *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 28,2017 at 9:25am Building Department Review Completed Apr 28,2017 at 9:37am OTreasurer Review Completed Apr 28,2017 at 11:31am OBuilding Inspector Approval J tli, Completed Apr 28,2017 at 12:35pm OAlteration Roofing and/of Windows/Doors Paid Apr 28,2017 at 4:13pm OPermit Issued Issued Apr 28,2017 at 4:13pm *Building Permit#24696 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24696 1/5 5/5/20 17 *Building Permit#u46on wewPnmQmm 1'�,zza Factury —^ Lowell Five Bank f�'/c . ��� ApplicantLocation Kenneth Duval 44OMAIN STREET, NORTH ANDOVER, K84 t~ 978-564-2557 Owner @ k.duva|Cdcomcastoet(— SMITH,TODD, M. Attachments PDF OTN9JO1O01F_Fr!_Apr_28_2017_O � Uploaded uyKenneth Duval nnApr 2a'2n17e:2sxm PDF 'UTDA3L|OO1F_Fri_Apr_28_2O17_O � Uploaded uvKenneth Duval onApr 2o.2nn9:2sxm 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 Active License Status Mailing Address KENNETH P DUVAL CS'058443 12/10/2017 [] Active . North Reading K8AO1Oh4 hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24886 2/5 5/5/2017 *Building Permit#u46on wewPnmQmm Preferred Telephone#:~ Alternate Phone# Email 978-664-2557 kduva|o@comcastoot 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 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~ |oproperty onTown water~ /sproperty onTown sewer ~ Alteration One-Two Family Strip and Re-Roof main roof only 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) 3,720 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/24696 3/5 5/5/2017 "Building Permit#24696-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 Other 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) Travelers Policy#or Self-Ins.License#* Expiration Date 7PJUB0230N91915 03/11/2018 hftps://northandoverma.viewpointcloud.com/#/records/24696 4/5 5/5/20 17 *Building Permit#u46on 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?~ R4 No No No mps://northandovermumewpointc|oud.com/#"/rmmrds/24696 5/5