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Home My WebLink AboutBuilding Permit # 4/28/2017 5/4/2017 *Building Permit#24512-View Point Cloud !I *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 21,2017 at 4:42pm Building Department Review %J Completed Apr 26,2017 at 4:26pm OTreasurer Review Completed Apr 27,2017 at 11:54am OBuilding Inspector Approval J 1 , Completed Apr 27,2017 at 3:42pm OAlteration Roofing and/of Windows/Doors Paid Apr 28,2017 at 1:54pm OPermit Issued Issued Apr 28,2017 at 1:53pm *Building Permit#24512 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24512 1/5 5/4/20 17 *Building Permit#u451c wewPnmQmm Noi-th Andover o% ` ~ m m ` w m « � w Applicantmc�u —�— jessniabet 15SlACYDRIVE Uo>' NORTH ANDOVER, WY4 t~ 503-580-5368 Owner @jeyaoP)diemondhi||bui|d— Great North Property Management/Prescott Village Condo Assoc. Attachments pur ScanO15O_Fri_Apr_21_2D17_1 � Uploaded uy]eon/sue/onApr z1.2n1/«:«1pm puf SconO148_Fit, Apt, 21_2O17_1 � Uploaded uv]essn/»uetonApr z1.2n/,4:4/pm pu, 5canO148_FrLApr_21_3O17_1 � Uploaded uyjessn/sbe/onApr 21.2ovo:^2pw 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 orLicense#iyrequired. hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24512 2/5 5/4/2017 "Building Permit#24512-Mew Point Cloud Firm(Business)Name Licensee* License#* License Expiration Date* License Type* License Active License Status PAUL RABENIUS CS-059504 09/19/2018 Construction Supervisor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email 134 Mill Rd, NORTH HAMPTON NH 03862 603-580-5368 officeCg)diamondhillbuilders.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* Number of Units* Description of Work to be Performed* Is property on Town water* Is property on Town sewer Repair, Replacement Three of more family 4 Siding Replacement and Rot Repair Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 32,995 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.$10041,000 fine) NO Registered Design Professional hftps://northandoverma.viewpointcloud.com/#/records/24512 3/5 5/4/2017 "Building Permit#24512-V ewPoint Cloud 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* Please explain'other'project: 14.Other Siding Replacement and Rot Repair 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) Cross Insurance-Laconia hftps://northandoverma.viewpointcloud.com/#/records/24512 4/5 5/4/20 17 *Building Permit#u451c wewPnmQmm Policy#n,semns.License#~ Expiration Date BOP6165548 09/19/2017 Workers' Compensation Affidavit Signature /uohereby certify under the pains and penalties nfperjury that the information provided above/strue and correct. ~ Br ig To Be Completed By Town Staff laZoning District~ la|sthis a1ooYear o,older structure~ la|sproperty within anOverlay District~ |sthe property within the Floodplain~ |sthe project within 1oo'of Weuanus~ hftps://northandovermumewpointc|oud.com/#"/rmmrds/24512 5/5