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HomeMy WebLinkAboutBuilding Permit # 4/25/2017 5/4/2017 *Building Permit#24470-View Point Cloud *Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued TIMELINE OSubmission received Apr 20,2017 at 11:56am 10 Building Department Review Completed Apr 21,2017 at 7:58am © Conservation Department Review Ono Skipped Apr 24,2017 at 9:47am © Planning Department Review * !!% Skipped Apr 21,2017 at 9:06am OHealth Department Revies Completed Apr 21,2017 at 9:09am ODPW Engineering Review Completed Apr 21,2017 at 8:43am ODPW Operations Review Completed Apr 21,2017 at 8:13am J1%% © Fire Department Review IP Skipped Apr 21,2017 at 8:01am �� OTreasurer Review Completed Apr 21,2017 at 12:13pm https://northandover m a.vi ewpoi ntcl oud.com/#/records/24470 1/5 5/4/20 17 *Building Permit#u#ro wewPnmQmm Building Inspector Approval ��� �� Completed Apr 2s.2nnn/nu4am ~=� Add idonsAA|teradona/Remode|ingBldg Permit Fee Paid Apr 2s.2ona,004am Permit Issued Issued Apr us.zn1ratay4am *Building Permit#24470 Construction o/Additions,Alterations,and Remodeling Carl Thomas Field Pvt. AlThomson � 0 E| entary School -�- ~ ^ ~— _in Applicant Location v,cauun -- Steven Pouasand 15 WILLIAM STREET, NORTH ANDOVER, NY4 "~ 207-312-1755 Owner @ steve.pousoerd4revis... MCGOVERN. LYNN Attachments jpg Nevv_C5L_ThuApr_2O_2O17_| � Uploaded by Steven Poussa,u on Apr 20,201711:55xm pmr north_nndover_Thu_Apr_30_3O17_1 � Uploaded by Steven pouosa,u on Apr 20,znnn:ssxw pu, H|C_Thu�Apr_2O_2O17_1 � un/oaueu by Steven poussa,d on Apr 20,201711:56xm nuf 43O492_PV_(1)_Thu_4pr_JO_2O17_1 � Uploaded by Steven pousso,u on Apr 20,201711:56xw hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24470 2/5 5/4/2017 "Building Permit#24470-Mew Point Cloud pdf 430,19 f"MItIM(A '.4i(;Mlld (i) 1 hU _ ,p20 2017 _"1 Uploaded by Steven Poussard on Apr 20,201711:56 AM , 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 Mailing Address* Preferred Telephone#: John D Cullen CS-056846 04/03/2019 O Active Wakefield MA 01880 2073121755 Alternate Phone# Email steve.poussa rd@reviseenergy.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* Is property on Town water* Is property on Town sewer Repair, Replacement 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) hftps://northandoverma.viewpointcloud.com/#/records/24470 3/5 5/4/2017 "Building Permit#24470-V ewPoint Cloud 926 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 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/#/records/24470 4/5 5/4/2017 "Building Permit#24470-Mew Point Cloud 1. 1 am an employer with employees(full and/or part-time) Type of project* Please explain'other'project: 14.Other Weatherization 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#or Self-Ins.License#* Expiration Date PACEP305047 04/25/2017 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 GI 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* Is the project within 100'of Wetlands? R4 Yes No hftps://northandoverma.viewpointcloud.com/#/records/24470 5/5