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HomeMy WebLinkAboutBuilding Permit # 4/4/2017 4/13/2017 "Building Permit#23982-View Point Cloud 23982 *Building Permit—Construction of Additions,Alterations, and Remodeling O Building Permit Issued TIMELINE OSubmission received Mar 29,2017 at 4:53pm OBuilding Department Review Completed Mar 30,2017 at 7:40am 0 © Conservation Department Review on fb Skipped Mar 30,2017 at 9:49am OPlanning Department Review Completed Mar 30,2017 at 9:06am OHealth Department Revies Completed Mar 30,2017 at 8:11am 0 ODPW Engineering Review Completed Mar 31,2017 at 10:15am ODPW Operations Review Completed Mar 30,2017 at 7:47am OFire Department Review Completed Mar 31,2017 at 5:18pm https://northandover m a.vi ewpoi ntcl oud.com/#/records/23982 1/6 4/13/20 17 *Building Permit#cnem2 vw*PomClov Treasurer Review Completed Mar 3O.2O17at12:57pm 0 Building Inspector Approval Completed Apr 3.207at218pm �R Additions/Alterations/Remodeling Bldg Permit Fee Paid Apr 4'2017at7:01pm Permit Issued �mmr Issued Apr 4'2017atr:O1pm *Building Permit#23982 Construction mAdditions,Alterations,and Remodeling 4DApplicant Location eLuis 67HICKORY HILL ROAD , NORTH ANDOVER, MA k= 978'285'2560 Owner @ ]oe|uis2OO74yehoozo' PALAZZO,JAMES F Attachments pdf permit_docs_foL_Pa|azzo_baih.pdf uo|oaueuMarch ze.zo17uvJoe Luis hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrdd23882 2/6 4/13/20 17 *Building Permit#cnem2 vw*PomClov Application Submission Required information varies depending on who is applying for a building permit. Are you submitting this application asthe Homeowner? ~ NO Primary Contractor Search for your contractor using the search bar below. Either the Licensee Name or License#is required. Firm(Business)Name Licensoo^ License#~ License Expiration Date~ License Type~ License Active ESSEX CONTRACTORS, INC. 075252 12/2EV2015 Construction Supervisor 1 & 2Family S? License Status Mailing Address^ Preferred Telephone#:^ Alternate Phone# Email Active 3OWEST ST. GEORGETOWN K84O1833 8782652560 joe|uis20078dyahuozom |certify,under the pains and penalties of perjury,that the information on this application is true and complete.^ R 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 add ition/a Iteration/ren ovation base on actual contract price). ELECTRICAL: Movement of Meter location, mast orservice drop requires approval ofElectrical Inspector. Type ofImprovement~ Proposed Use^ Description ofWork to be Performed~ Is property on Town water^ Repair, Replacement (]ne'TwoFami|y Remove and replace bath fixtures, install new tile, and paint Yes mps://northandovermumewpointc|oud.com/#"/rmmrdd23982 3/6 4/13/20 17 *Building Permit#cnem2 vw*PomClov |sproperty onTown sewer ° ,es Project Cost(if new construction baso on$125 per square foot and ifaddition/a|temtion/,enovadon base on actual contract price)~ 17,200 Does this project require atemporary construction trailer? ^ NO Does this project require atemporary construction sign? ^ NO Danger Zone Literature(MGL CHapter 166 Section 21A-F and G min.$100-$1,000 fine) NO Registered Design Professional Arch itect/Engineer Name Aohhrct/EngineerAUgress Architect/Engineer Phone Number Architect/Engineer Reg.# none Insurance INSURANCE COVERAGE: | have a current liability insurance policy or its substantial equivalent.~ ,es hftps://northandovermumewpointc|oud.com/#"/rmmrdd23982 4/6 4/13/2017 *Building Permit#23982-View Point Cloud 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. 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) Berkshire Hathaway Guard Policy#or Self-Ins. License#* Expiration Date ESWC849156 02/18/2018 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. hftps://northandoverma.viewpointcloud.com/#/records/23982 5/6 4/13/2017 *Building Permit#23982-View Point Cloud 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 Is the project within 100'of Wetlands?* https://northandoverma.viewpointcloud.com/#/records/23982 6/6