HomeMy WebLinkAboutBuilding Permit # 5/3/2017 5/10/2017 *Building Permit#24782-View Point Cloud
24,782
*Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued
TIMELINE
OSubmission received
May 2,2017 at 10:06am
Building Department
Review
Completed May 2,2017 at 12:26pm
OTreasurer Review
Completed May 2,2017 at
4:14pm
OBuilding Inspector
Approval
Completed May 2,2017 at 8:03pm
OAlteration Roofing and/of
Windows/Doors
Paid May 3,2017 at 8:37am
OPermit Issued
Issued May 3,2017 at 8:37am
*Building Permit#24782 Alterations:Roofing/Siding and/or Windows/Doors
https://northandover m a.vi ewpoi ntcl oud.com/#/records/24782 1/5
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(D
Applicant Location
-- Scott Wright 160 COLONIAL AVENUE , NORTH ANDOVER, MA
"~ 978-587-2247 Owner
@ vvrightgu8amod-gmaiic— LAT|NA. MARK,A.
Attachments
( �
\ /
RequiMd for ALL BuUding PermftAppUcnfions� VVorkei s CompAffidav[t& |nsurance B|ndeT, Ph00o Copy ofH1CAnd [SlUcenses Copy ufSigned Contmc[, F:1mur F11nn or
Proposed |nter|orWork, Eng|neer|ngAMdav�tafor En8|neereUPmduds
No File
poF ~OTKX4S001FJPDF
Uploaded by Scott Wright onMay o2.20m1m06mw
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(Buymeys)Name Licensee~ License w^ License Expiration Date~ License Type~ License Active License Status Mailing Address
SCOTT VVWRIGHT CS102563 08/12/2017 [] Active . North Andover MA01845
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Preferred Telephone#:* Alternate Phone# Email
9786872247
1 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& reroof Yes Yes
Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price)
9,900
Does this project require a temporary construction trailer?
NO
Does this project require a temporary construction sign?
YES
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.#
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5/10/20 17 *Building Permit#c4rm2 vw*PomClov
Insurance
INSURANCE COVERAGE:
/have acurrent liability insurance policy o,its substantial equivalent.
~
Yes
nyes,indicate the type ofcoverage~ nother,specify
Liability
Worker's Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
To befiled with the permitting authority
Are you anemployer?Select the appropriate type.Any applicant that selects#1must also fill out the section below showing their workers'compensation policy information.
~
1. | am an employer with employees(full and/or part-time)
Type nfproject~
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 NG>c.152.25A is a criminal violation punishable by fine up to$1.50ODOand/or one-year imprisonment,as well as civil
penalties in the form of 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
ofthe DIA for insurance coverage verification.
Insurance Company Name(Attach a copy of workers'compensation policy declaration page showing the policy number and expiration date)
Liberty Mutual
Policy#o,se|wns.License#~ Expiration Date
VVC531S387187015 09/30/2017
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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?"
R2 No No No No
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