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Building Permit # 5/3/2017
5/10/2017 *Building Permit#24679-View Point Cloud 24,6 79 *Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued TIMELINE OSubmission received Apr 27,2017 at 12:33pm 10 Building Department Review Completed Apr 27,2017 at 1:05pm © Conservation Department Review Ono Skipped Apr 28,2017 at 10:07am © Planning Department Review * !!% Skipped Apr 28,2017 at 9:01am OHealth Department Revies Completed May 3,2017 at 8:21am ODPW Engineering Review Completed Apr 28,2017 at 9:45am ODPW Operations Review Completed Apr 27,2017 at 1:38pm J1%% © Fire Department Review IP Skipped Apr 28,2017 at 7:33am �� OTreasurer Review Completed Apr 28,2017 at 9:31am https://northandover m a.vi ewpoi ntcl oud.com/#/records/24679 1/5 5/10/20 17 *Building Permit#c4nro vw*PomClov Building Inspector Approval 15 Completed May a.2onntz:n7pm ~�~ ��� Add idonsAA|teradona/Remode|ingBldg ���� Permit Fee �� Paid May s.2o17vtaozpm Permit Issued �� �� �°~ Issued May a.2nna'3ounm *Building Permit#24679 Construction ofAdditions,Alterations,and Remodeling ~� 0xpp|icant Location yBrand 14GAKABERV|LLEROAD , NORTH ANDOVER, Kn4 t~ 517-500-3019 Owner @ annaguig|im»uunbugso.' YYONG'CRA|G Attachments pur PD11 Merge8833982755447890132 � Uploaded uyCheney Brand onApr 27,zun12ospm Application Submission Required information varies depending on who is applying for a building permit. Are you submitting this application asthe Homeowner? ~ hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24879 2/5 5/10/2017 *Building Permit#24679-View Point Cloud NO Primary Contractor Search for your contractor using the search bar below. Either the Licensee Name or License#is required. Firm(Business)Name Licensee* License#* License Expiration Date* License Type* License Active License Status CHENEY C BRAND CS-099037 02/12/2018 O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email 411A Highland Ave,Suite 312,SOMERVILLE MA 02144 6175003019 anna.guigli@sunbugsolar.com 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 Alteration One-Two Family 30 solar panels to be installed on roof No No Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price)" 30,561 Does this project require a temporary construction trailer? NO Does this project require a temporary construction sign? NO hftps://northandoverma.viewpointcloud.com/#/records/24679 3/5 5/10/20 17 *Building Permit#c4nro vw*PomClov Danger Zone Literature(MGL CHapter 166 Section 21A-F and G min.$100-$1,000 fine) NO Registered Design Professional Architect/Engineer wame Arch necusnomee,Address Arch nerusnomee,Phone Number Arch nerusnomee,Reg.# Elaine Huang 11PonybmokLane, Lexington, MAOZ421 9784058921 49029 Insurance INSURANCE COVERAGE: |have acurrent liability insurance policy o,its substantial equivalent. ~ ,es nyes,indicate the type mcoverage^ nother,specify Liability Worker's Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers To be filed with the permitting authority Are you anemployer?Select the appropriate type.Any applicant that selects*nmust also fill out the section below showing their workers'compensation policy information. ~ 1. | am an employer with employees(full and/or part-time) Type mproject~ Please explain'mxe,'project: 14.Other solar install I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. hftps://northandovermumewpointc|oud.com/#"/rmmrds/24679 4/5 5/10/20 17 *Building Permit#c4nro vw*PomClov Failure to secure coverage as required under k4G>c.152.25A is a criminal violation punishable by fine up to$1.5O(lOOand/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 Insurance Group Policy#o,oelf-mo.License#~ Expiration Date VVC231S381595'016 04/30/0017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Br igTb Be Completed By Town Staff la Zoning District^ la/ythis v1noYear o,older structure~ la/sproperty within anOverlay District~ /,the property within the Floodplain^ /sthe project within 1oo'orWetlands? ~ VR No No Yes No mps://northandovermumewpointc|oud.com/#"/rmmrds/24679 5/5