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Home My WebLink AboutBuilding Permit # 3/28/2017 3/30/2017 *Building Permit#23842-View Point Cloud 23842 *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Mar 24,2017 at 1:27pm Building Department Review Completed Mar 25,2017 at 7:50am OTreasurer Review Completed Mar 27,2017 at 4:22pm OBuilding Inspector Approval Completed Mar 27,2017 at 4:49pm OAlteration Roofing and/of Windows/Doors Paid Mar 28,2017 at 11:13am OPermit Issued Issued Mar 28,2017 at 11:12am *Building Permit#23842 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/23842 1/5 3/30/2017 "Building Permit#23842-View Point Cloud Applicant Location Michael Russell 1550 SALEM STREET , NORTH ANDOVER, MA t. 603-324-1974 Owner @ michael.russell@trutea... Sean Carter Attachments pdf Ricky_CSL_Exp_09.26.18_Fri_Mar_24_2017_1.pdf Uploaded March 24,2017 by Michael Russell pdf HIC_Insurance_CSL_Fri_Mar_24_2017_1.pdf Uploaded March 24,2017 by Michael Russell pdf Carter_427433_Phase_2_Fri_Mar_24_2017_1.pdf Uploaded March 24,2017 by Michael Russell pdf Top BuiId—Co rp._Town_of_North_Andover_1610257968281_Fri_Mar_24_2017_1.pdf Uploaded March 24,2017 by Michael Russell 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 https://northandoverma.viewpointcloud.com/#/records/23842 2/5 3/30/2017 *Building Permit#23842-View Point Cloud 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 RICHARD SCHWARTZ CSSL-105992 09/26/2018 CSSL-IC-Insulation Contractor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email , Daytona Beach FL 32114 6033241980 rick.schwartz(Otruteam.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 WEATHERIZATION Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 3,603 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 hftps://northandoverma.viewpointcloud.com/#/records/23842 3/5 3/30/2017 *Building Permit#23842-View Point Cloud 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* Please explain'other'project: 14.Other weatherization 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)" hftps://northandoverma.viewpointcloud.com/#/records/23842 4/5 3/30/2017 *Building Permit#23842-View Point Cloud ACE AMERICAN INSURANCE COMPANY Policy#or Self-Ins.License#* Expiration Date WLRC47860780 06/30/2017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. iV 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 hftps://northandoverma.viewpointcloud.com/#/records/23842 5/5