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HomeMy WebLinkAboutBuilding Permit # 4/5/2017 4/13/2017 "Building Permit#24032-View Point Cloud uum *Building Permit—Construction of Additions,Alterations, and Remodeling O Building Permit Issued TIMELINE OSubmission received Mar 31,2017 at 4:08pm OBuilding Department Review Completed Apr 1,2017 at 8:06am 0 OConservation Department Review IP fb Completed Apr 3,2017 at 12:35pm OPlanning Department Review Completed Apr 3,2017 at 8:09am OHealth Department Revies Completed Apr 4,2017 at 9:01am ODPW Engineering Review Completed Apr 2,2017 at 10:21am ODPW Operations Review Completed Apr 3,2017 at 8:05am Fire Department Review © l� Skipped Apr 3, 2017 at 7:38am https://northandover m a.vi ewpoi ntcl oud.com/#/records/24032 1/6 4/13/2017 "Building Permit#24032-View Point Cloud OTreasurer Review Completed Apr 3,2017 at 1:15pm 0 OBuilding Inspector Approval da �%//////// Completed Apr 4,2017 at 2:06pm °' OAdditions/Alterations/Remodeling Bldg Permit Fee Paid Apr 5,2017 at 4:14pm OPermit Issued Issued Apr 5,2017 at 4:13pm *Building Permit#24032 Construction of Additions,Alterations,and Remodeling CoOINP Laborers With Christ Applicant Location Robert Keen 60 RALEIGH TAVERN LANE , NORTH ANDOVER, MA k. 978-479-8003 Owner @ sales4keenconstructi... ROGERS, ROBERT Attachments jpg Rogers_B_Fri_Mar_31_2017_1.jpg Unloaded March 31.2017 by Robert Keen https://northandoverma.viewpointcloud.com/#/records/24032 2/6 4/13/2017 *Building Permit#24032-View Point Cloud jpg Rogers_A_Fri_Mar_31_2017_1.jpg Uploaded March 31,2017 by Robert Keen jpg Permit_Licenses_Fri_Mar_31_2017_1.jpg Uploaded March 31,2017 by Robert Keen jpg WC_CI_Fri_Mar_31_2017_1.jpg Uploaded March 31,2017 by Robert Keen jpg WC_form_Fri_Mar_31_2017_1.jpg Uploaded March 31,2017 by Robert Keen 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 ROBERT A KEEN CS-076691 08/16/2017 Construction Supervisor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email , NORTH ANDOVER MA 01845 978-691-5201 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. C hftps://northandoverma.viewpointcloud.com/#/records/24032 3/6 4/13/2017 *Building Permit#24032-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 Repair, Replacement One-Two Family Remove and replace deck suface and railings. No excavation or framing. 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) 13,550 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.# hftps://northandoverma.viewpointcloud.com/#/records/24032 4/6 4/13/2017 *Building Permit#24032-View Point Cloud 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 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 Comtpanv Name(Attach a coov of workers'compensation policv declaration page showing the policv number and expiration date) hftps://northandoverma.viewpointcloud.com/#/records/24032 5/6 4/13/20 17 *Building Permit#c4oao vw*PomClov Travelers Ins Policy#n,Self-|ns. License#~ Expiration Date 6HUB9991K458215 10/08/2017 Workers' Compensation Affidavit Signature |do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.~ R da To Be Completed By Town Staff 16Zoning District~ 16|othis a100Year n,older structure~ �|oproperty within anOverlay District^ |sthe property within the Floodplain ~ R2 No No Yea |sthe project within 100'ofWetlands? ^ Yes hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24032 6/6