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HomeMy WebLinkAboutBuilding Permit # 4/5/2017 4/13/2017 "Building Permit#23789-View Point Cloud 23789 *Building Permit—Construction of Additions,Alterations, and Remodeling O Building Permit Issued TIMELINE OSubmission received Mar 22,2017 at 3:18pm OBuilding Department Review IP 0 Completed Apr 1,2017 at 9:22am © Conservation Department Review on fb Skipped Apr 3, 2017 at 12:38pm OPlanning Department Review Completed Apr 3,2017 at 8:10am OHealth Department Revies Completed Apr 4,2017 at 9:00am ODPW Engineering Review Completed Apr 2,2017 at 10:22am ODPW Operations Review Completed Apr 3,2017 at 8:05am OFire Department Review Completed Apr 3,2017 at 7:45am https://northandover m a.vi ewpoi ntcl oud.com/#/records/23789 1/6 4/13/2017 "Building Permit#23789-View Point Cloud OTreasurer Review Completed Apr 3,2017 at 1:15pm 0 OBuilding Inspector Approval Completed Apr 5,2017 at 8:30am 0 OAdditions/Alterations/Remodeling Bldg Permit Fee Paid Apr 5,2017 at 8:34am OPermit Issued Issued Apr 5,2017 at 8:34am *Building Permit#23789 Construction of Additions,Alterations,and Remodeling Applicant Location Andrzej Bolalek 143 CASTLEMERE PLACE , NORTH ANDOVER, MA k. 781-821-4234 Owner @ bola lek.co@g mail.com... JOHN RODERICK LARSON REVOCABLE T Attachments PDF Form032220171405.PDF Unloaded March 22.2017 by Andrzei Bolalek https://northandoverma.viewpointcloud.com/#/records/23789 2/6 4/13/20 17 *Building Permit#cnroo vw*PomClov PDF WC-DIANE_L4RSON]817.POF Uploaded March 22.2017byAndrzej Bo|a|ek pdf 2O47_|ice nae_and_neg.pdf Uploaded March 22'2017byAndrzej Bo|o|ek pdf Laoon_p|ans_vvith_nntes.pdf Uploaded March 22'2017byAndrzej Bo|a|ek pdf Lamon_agreement_signed.pdf Uploaded March 22.2O17byAndrzej ao|a|ox pdf scan 2OO4_Tue_K4e[_28_2O17_1.pdf Uploaded March 28.2817byPaul Hutchins 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 Liconooe" License#^ License Expiration Date" License Type~ License Active BDL4LEKCONSTRUCTION LLC 153457 12/05/2016 Home Improvement Contractor [] License Status Mailing Address^ Preferred Telephone#:~ Alternate Phnne# Email Active 189ROCKL4NOST, CANTON K8/\O2021 781-8214234 617-7210881 bola|ek.ro(c-bgmai|rom |certify,under the pains and penalties of perjury,that the information on this application is true and complete.^ �Z hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrdd23789 3/6 4/13/2017 *Building Permit#23789-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 Alteration One-Two Family Kitchen remodeling; additional lights;floor refinishing; door replacements; Yes Is property on Town sewer Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 172,300 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 AKl­ Ar ki+nn+/r_­;,n Arlr+.ncc A. ki+nn+/r_­innn.Dhnnn KI—k—, Ar k;+nn+/Gnni,n D­ hftps://northandoverma.viewpointcloud.com/#"/rer,ords/23789 hftps://northandoverma.viewpointcloud.com/#/records/23789 4/6 4/13/2017 *Building Permit#23789-View Point Cloud rli i.i nc.uuynicci ivanic ri i.i uci.uuiyuicci r+uuicaa ru�i ucuiuiyuicci iwiic ivunivci —i.i1­ —iyncci ncy.rr Margaret Booz 25 Mount Auburn Street, Suite 206 617.576.2720 8214 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 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. https://northandoverma.viewpointcloud.com/#/records/23789 5/6 4/13/20 17 *Building Permit#cnroo vw*PomClov insurance�-ompany mame(ATtacn a COPY mwn,wers'compensation pnnoyoor/aramnn peg*snowing me poncy numoe,eno*«p/emnn oaoy- Atlantic Charter Insurance Policy#orSe|#ns. License#^ Expiration Det*^ CIL Hollis Insurance#VVCV011S4800 11/04/2017 Workers' Compensation Affidavit Signature |do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.^ R la To Be Completed By Town Staff 16Zoning District~ 16|athis a1O0Year orolder structure~ �|sproperty within anOverlay District~ |ythe property within the Floodplain ~ No |sthe project within 10U'nfWetlands? ~ Not Applicable hups://nonxandove,mumewpoimo|md.00m/#"/rmmrdd23789 6/6