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HomeMy WebLinkAboutBuilding Permit # 3/16/2017 3/21/2017 *Building Permit#23487-View Point Cloud 23487 *Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued TIMELINE OSubmission received Mar 13,2017 at 8:52am 10 Building Department Review Completed Mar 13,2017 at 10:25am © Conservation Department Review Ono Skipped Mar 13,2017 at 10:41am © Planning Department Review Skipped Mar 13,2017 at 10:42am OHealth Department Revies Completed Mar 13,2017 at 10:44am ODPW Engineering Review Completed Mar 13,2017 at 11:51am ODPW Operations Review /f/ Completed Mar 13,2017 at 11:26am 101N1%1 Fire Department Review Completed Mar 15,2017 at 12:38pm dPPP, OTreasurer Review Completed Mar 13,2017 at 4:32pm https://northandover m a.vi ewpoi ntcl oud.com/#/records/23487 1/5 3/21/2017 *Building Permit#23487-View Point Cloud OBuilding Inspector Approval Completed Mar 16,2017 at 11:56am OAdditions/Alterations/Remodeling Bldg Permit Fee Paid Mar 16,2017 at 2:47pm OPermit Issued Issued Mar 16,2017 at 2:47pm *Building Permit#23487 Construction of Additions,Alterations,and Remodeling jApplicant Location Theodore Kelley 42 SKYVIEW TERRACE , NORTH ANDOVER, MA t- 978-852-4491 Owner @ tedkelley@tmkremode... BARKER, BRIAN Attachments PDF ^'OTKNLD1001F Mon Mar 13 2017 0.PDF Uploaded March 13,2017 by Theodore Kelley Application Submission Required information varies depending on who is applying for a building permit. Are you submitting this application as the Homeowner? https://northandoverma.viewpointcloud.com/#/records/23487 2/5 3/21/2017 *Building Permit#23487-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 THEODORE M KELLEY CS-105086 10/08/2017 Construction Supervisor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email , NORTH ANDOVER MA 01845 978 852-4491 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 Alteration One-Two Family Master Bath remodel approx 115 SF in existing footprint Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price)" 42,600 Does this project require a temporary construction trailer? NO Does this project require a temporary construction sign? NO hftps://northandoverma.viewpointcloud.com/#/records/23487 3/5 3/21/2017 *Building Permit#23487-View Point Cloud 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.# 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* 8. Remodeling I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. hftps://northandoverma.viewpointcloud.com/#/records/23487 4/5 3/21/20 17 *Building Permit#ca4or 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) ABC Policy#o,oelf-mo.License#~ Expiration Date VVCC'500'5011872'2016Ap> 04/01/2017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. 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? ~ Not Applicable mps://northandovermumewpointc|oud.com/#"/rmmrdd23487 5/5