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HomeMy WebLinkAboutBuilding Permit # 4/25/2017 5/4/2017 *Building Permit#24375-View Point Cloud 5 *Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued TIMELINE OSubmission received Apr 18,2017 at 8:25am Building Department Review Completed Apr 18,2017 at 12:57pm OConservation Department Review Completed Apr 24,2017 at 3:41pm © Planning Department Review * !!% Skipped Apr 18,2017 at 1:08pm OHealth Department Revies Completed Apr 20,2017 at 9:29am ODPW Engineering Review Completed Apr 18,2017 at 5:42pm ODPW Operations Review Completed Apr 18,2017 at 4:29pm J1%% © Fire Department Review Skipped Apr 18,2017 at 1:39pm �� OTreasurer Review Completed Apr 19,2017 at 1:32pm https://northandover m a.vi ewpoi ntcl oud.com/#/records/24375 1/5 5/4/20 17 *Building Permit#u43rn wewPnmQmm Building Inspector Approval ��� �� Completed Apr 2s.2nnn/12:47nm ~�~ Add idonsAA|teradona/Remode|ingBldg Permit Fee Paid Apr 2s.2ona,os4pm Permit Issued Issued Apr us.zn1rat 12:53pm *Building Permit#24375 Construction o/Additions,Alterations,and Remodeling fonte Funer'4Un Homes C� � Applicant Location --- |eonardaantosuoaso 90 MAPLE AVENUE , NORTH ANDOVER, Kn4 t~ 503-432-8599 Owner @ |ennyapp|ewood&"gm... MUSHATY, DAVID, L Attachments PDF -()T43U8|0O1F_Tue_4pr_|8_2O17_O � Uploaded uy|eona,usamosuossnnnApr 1o.zn1/o:2sxm puf 5con0010_Mon_Apr_24_2017_1 � Uploaded uv/eona,usantomossoonApr z4.2nn/2xupw Application Submission hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24375 2/5 5/4/2017 "Building Permit#24375-View Point Cloud 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 Type* License Active License Status LEONARD SANTOSUOSSO III CS-087691 09/21/2017 Construction Supervisor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email , LONDONDERRY NH 03053 603 432 8599 1 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 remove deck and replace same footprint Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 15,250 Does this project require a temporary construction trailer? NO hftps://northandoverma.viewpointcloud.com/#/records/24375 3/5 5/4/2017 "Building Permit#24375-V ewPoint Cloud 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. 1. 1 am an employer with employees(full and/or part-time) Type of project* 8. Remodeling hftps://northandoverma.viewpointcloud.com/#/records/24375 4/5 5/4/2017 "Building Permit#24375-Mew Point Cloud 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) liberty mutal Policy#or Self-Ins.License#* Expiration Date wc7025199 07/24/0019 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 hftps://northandoverma.viewpointcloud.com/#/records/24375 5/5