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HomeMy WebLinkAboutBuilding Permit # 3/21/2017 3/28/2017 *Building Permit#23478-View Point Cloud 23478 *Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued TIMELINE OSubmission received Mar 12,2017 at 3:57pm 10 Building Department Review Completed Mar 13,2017 at 10:20am © Conservation Department Review Ono Skipped Mar 13,2017 at 10:48am © Planning Department Review Skipped Mar 13,2017 at 10:40am OHealth Department Revies Completed Mar 13,2017 at 10:45am ODPW Engineering Review Completed Mar 13,2017 at 11:31am ODPW Operations Review /f/ Completed Mar 13,2017 at 10:41am 101N1%1 Fire Department Review Completed Mar 15,2017 at 9:11am dPPP, OTreasurer Review Completed Mar 13,2017 at 4:33pm https://northandover m a.vi ewpoi ntcl oud.com/#/records/23478 1/5 3/28/20 17 *Building Permit#ca4ro vw*PomClov Building Inspector Approval Completed Mar 1s.2o17otz:sspm ~�~ Add idonsAA|teradona/Remode|ingBldg Permit Fee Paid Mar 2n.2onaty:1«am Permit Issued Issued Mar zo.2o17ats:mum *Building Permit#23478 Construction"/Additions,Alterations,and Remodeling '��` Applicant Location -- Adam Brien 1GREEy4E STREET , NORTH ANDOVER, KnA t~ 3784791526 Owner @ adambricoCd-gmaiicom— DALEYSEAN& DEBORAD Attachments uocx Da|ey_Bathronm_contractJ_discnunt.docx Uploaded March 12.2n1/uyAdam Brien pu, Certificate-16.pdf Uploaded March 1z.2ovuyAdam Brien pu, Certificate_of_Liobi|ity_|nsurence_20160713_093814-5.pdf Uploaded March m.aonuyAdam Brien pu/ Doc_Mac12._2017,_3-39_PM.pdf Uploaded March 12.2on»yAdam Brien hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrdd23478 2/5 3/28/2017 *Building Permit#23478-View Point Cloud pdf Doc_Mar_12,_2017,_3-39_PM-2.pdf Uploaded March 12,2017 by Adam Brien pdf Doc_Mar_12,_2017,_3-55_PM.pdf Uploaded March 12,2017 by Adam Brien Application Submission Required information varies depending on who is applying for a building permit. Are you submitting this application as the Homeowner? 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 Mailing Address ADAM J BRIEN CS-104428 05/12/2018 Construction Supervisor O Active North Andover MA 01845 Preferred Telephone#:* Alternate Phone# Email 9784791526 9782586953 adambrico@gmail.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 Repair, Replacement One-Two Family Bathroom Remodel Yes Yes hftps://northandoverma.viewpointcloud.com/#/records/23478 3/5 3/28/2017 *Building Permit#23478-View Point Cloud Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 19,100 Does this project require a temporary construction trailer? NO Does this project require a temporary construction sign? NO 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 hftps://northandoverma.viewpointcloud.com/#/records/23478 4/5 3/28/2017 *Building Permit#23478-View Point Cloud 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. 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 7Pjub4618P50716 04/19/0017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. G ig 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? R4 No Not Applicable hftps://northandoverma.viewpointcloud.com/#/records/23478 5/5