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HomeMy WebLinkAboutBuilding Permit # 4/3/2017 4/13/2017 "Building Permit#23832-View Point Cloud 23832 *Building Permit—Construction of Additions,Alterations, and Remodeling O Building Permit Issued TIMELINE OSubmission received Mar 24,2017 at 8:37am OBuilding Department Review Completed Mar 25,2017 at 7:03am 0 © Conservation Department Review IP 0 Skipped Mar 27,2017 at 8:53am 0 Planning Department Review Skipped Mar 27,2017 at 12:32pm OHealth Department Revies Completed Mar 28,2017 at 11:08am ODPW Engineering Review Completed Mar 25,2017 at 12:41pm ODPW Operations Review Completed Mar 25,2017 at 12:37pm © Fire Department Review Skipped Mar 28,2017 at 8:16am https://northandover m a.vi ewpoi ntcl oud.com/#/records/23832 1/6 4/13/20 17 *Building Permit#cnoao vw*PomClov Treasurer Review Completed Mar 27,2017at4:23pm 0 Building Inspector Approval Completed Mar 29,2O17at1:58pm �R Additions/Alterations/Remodeling Bldg Permit Fee Paid Apr 3'2017at1O:35am Permit Issued �mmr Issued Apr 3'2017at1O:3sam *Building Permit#23832 Construction mAdditions,Alterations,and Remodeling Cusack John 0 Applicant Location �— Steven Pousserd 79 KARA DRIVE , NORTH ANDOVER, MA k= 207'312'1755 Owner @ ateve.pousserdCd-revia... {3/\|S5. MICHAEL Attachments pdf Fo|de[Jennife[_gaias_pv_Fri_K4a[_24_2017_8.pdf uo|oaueu March z4.zu17uvSteven Pousaaru hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrdd23832 2/6 4/13/2017 *Building Permit#23832-View Point Cloud pdf Folder_Jennifer_gaiss_Fri_Mar_24_2017_0.pdf Uploaded March 24,2017 by Steven Poussard jpg CSL_Fri_Mar_24_2017_0.jpg Uploaded March 24,2017 by Steven Poussard pdf HIC_Fri_Mar_24_2017_O.pdf Uploaded March 24,2017 by Steven Poussard PDF north andover Fri Mar_24_2017_0.PDF Uploaded March 24,2017 by Steven Poussard 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 DIPIETRO HOME ENERGY cs056846 04/03/2017 Construction Supervisor 1 & 2 Family O License Status Mailing Address* Preferred Telephone#:* Alternate Phone# Email Active 5 SOUTH SUMMER ST., HAVERHILL MA 01830 2073121755 steve.poussard@reviseenergy.com I certify,under the pains and penalties of perjury,that the information on this application is true and complete. C hftps://northandoverma.viewpointcloud.com/#/records/23832 3/6 4/13/2017 *Building Permit#23832-View Point Cloud 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) 2,637 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 hftps://northandoverma.viewpointcloud.com/#/records/23832 4/6 4/13/20 17 *Building Permit#cnoao vw*PomClov INSURANCE COVERAGE: | have acurrent liability insurance policy o,its substantial equivalent. ~ ,es |fyes,indicate the type ofcoverage~ |fother,specify Liability Worker's Compensation Insurance Affidavit: Bui|ders/Contnactors/Bec±hcians/PI umbers To befiled with the permitting authority Are you an employer?Select the appropriate type.Any applicant that selects»n must also ho out the section below showing their workers'compensation policy information.^ 1. | amanemployer with employees (full and/or part-time) Type ofproject^ Please explain 'other'project: 14. Other VVeatherizatiun 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)^ Costello Insurance Agency Inc Policy#or5e|Anu. License#~ Expiration Dote~ FY\CEP305047 04/25/2017 mps://northandovermumewpointc|oud.com/#"/rmmrdd23832 5/6 4/13/2017 *Building Permit#23832-View Point Cloud Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. C la To Be Completed By Town Staff G Zoning District* G Is this a 100 Year or older structure* Is property within an Overlay District* Is the property within the Floodplain No Is the project within 100'of Wetlands? Not Applicable hftps://northandoverma.viewpointcloud.com/#/records/23832 6/6