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HomeMy WebLinkAboutBuilding Permit # 4/17/2017 4/19/2017 *Building Permit#23772-View Point Cloud 23772 *Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued TIMELINE OSubmission received Mar 27,2017 at 1:24pm 10 Building Department Review IP 0 Completed Apr 5,2017 at 1:21pm © Conservation Department Review Ono Skipped Apr 10,2017 at 12:16pm Planning Department Review O * !!% Completed Apr 6,2017 at 8:23am OHealth Department Revies Completed Apr 6,2017 at 10:20am ODPW Engineering Review Completed Apr 6,2017 at 1:30pm ODPW Operations Review Completed Apr 6,2017 at 8:36am J/%O © Fire Department Review Skipped Apr 6,2017 at 9:24am r (f OTreasurer Review Completed Apr 6,2017 at 1:24pm https://northandover m a.vi ewpoi ntcl oud.com/#/records/23772 1/5 4/19/2017 *Building Permit#23772-View Point Cloud OBuilding Inspector Approval Completed Apr 12,2017 at 4:33pm OAdditions/Alterations/Remodeling Bldg Permit Fee Paid Apr 17,2017 at 12:01pm OPermit Issued Issued Apr 17,2017 at 12:01pm *Building Permit#23772 Construction of Additions,Alterations,and Remodeling E� Applicant Location Mathew Previte 101 SPRING HILL ROAD , NORTH ANDOVER, MA t. 978-604-5243 Owner @ mat@acehomemedics... 101 SPRING HILL RD Attachments pdf North_Andove r_Permit_lnfo_Wed_M ar_22_2017_1.pdf Uploaded March 22,2017 by Mathew Previte pdf Spring_Hill_Rd_Contract_Mon_Mar_27_2017_1.pdf Uploaded March 27,2017 by Mathew Previte pdf Spring_Hill_Rd_Plans_Mon_Mar_27_2017_1.pdf Uploaded March 27,2017 by Mathew Previte pdf 101_Spring_Hill_Road_04052017_Wed_Apr_05_2017_1.pdf Uploaded April 5,2017 by Mathew Previte https://northandoverma.viewpointcloud.com/#/records/23772 2/5 4/19/2017 *Building Permit#23772-View Point Cloud 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 MATHEW S PREVITE CS-100212 03/23/2018 Construction Supervisor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email ,ANDOVER MA 01810 978-604-5243 978-207-0326 mat(Oacehomemedics.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 Addition One-Two Family Construction of a deck off rear addition per plan. Deckto have 1 step to grade on 2 sides& rails on the one side Is property on Town water* Is property on Town sewer Yes No Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) hftps://northandoverma.viewpointcloud.com/#/records/23772 3/5 4/19/2017 *Building Permit#23772-View Point Cloud 9,890 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 Arch itect/Engineer Address Arch itect/Engineer Phone Number Arch itect/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. hftps://northandoverma.viewpointcloud.com/#"/rer,ords/23772 4/5 4/19/2017 *Building Permit#23772-View Point Cloud 1. 1 am an employer with employees(full and/or part-time) Type of project* 10 Building addition 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) Utica Mutual Insurance Co. Policy#or Self-Ins.License#` Expiration Date 4687246 09/27/2017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. G 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 R2 No No No Is the project within 100'of Wetlands? No hftps://northandoverma.viewpointcloud.com/#/records/23772 5/5