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Home My WebLink AboutBuilding Permit # 4/26/2017 5/5/2017 *Building Permit#24574-View Point Cloud EI *Building Permit—Alterations:Roofing/Siding and/or Windows/Doors O Building Permit Issued TIMELINE OSubmission received Apr 25,2017 at 3:35pm Building Department Review Completed Apr 26,2017 at 7:59am OTreasurer Review Completed Apr 26,2017 at 8:30am Building Inspector Approval Completed Apr 26,2017 at 10:OOam OAlteration Roofing and/of Windows/Doors Paid Apr 26,2017 at 5:04pm OPermit Issued Issued Apr 26,2017 at 5:03pm *Building Permit#24574 Alterations:Roofing/Siding and/or Windows/Doors https://northandover m a.vi ewpoi ntcl oud.com/#/records/24574 1/5 5/5/20 17 *Building Permit#u45r4 wewPnmQmm Cr -T ] ('13 O U_ 7J Applicant Location -- GaryPaMsch 111FRENCH FARM ROAD , NORTH ANDOVER, K4A "~ 503-231-4979 Owner @ garyCd)e|itesvmzom (m... 5CHM|TTK4|CHAEL Attachments pur 5CHM|TT_-_Bathronm_Design_Tue_Apr_25_12O|7_1 � Uploaded uyGary partschonApr 2s.2o17z:sspm puf Gary_C5L_H|C_Tue_Apt, 25_2017_1 � Uploaded uvGary partscxo^Apr 2s.zo/,3:32pm pu, VVorkera_[omp_proof_|nsumnce_Tue_Apr_25_2O17_1 � Uploaded uyGary pnrtscxonApr 2s.zonsospm nuf VVorhers_Comp_Affiidav|i_TueApt--25_2O17_1 � Uploaded uvGary partncxonApr 2s.2o/rz:z4pm pu, E|ite_Cons�ruct|on_Cert|ficate_|nsuronce_-_N�_Andover_named_VVed_Apr_2G_2O17_1 � Uploaded uyGary pnrtychonApr u6.2onso2pm Application Submission Required information varies depending on who is applying for a building permit. Are you submitting this application asthe Homeowner? ~ NO hmpe:0nonxandove,muxiewpoimo|ovd.00m/#"/rmmrda/24574 2/5 5/5/2017 "Building Permit#24574-V ewPoint Cloud 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 GARY PARTSCH CS-106203 01/04/2018 Construction Supervisor O Active Mailing Address* Preferred Telephone#:* Alternate Phone# Email 26 Valleyview Farm rd. Haverhill MA 01835 603-231-4979 gary(Oelitesvm.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 Alteration One-Two Family Description of Work to be Performed* Add 3/4 bath to second floor of home. Requires minor interior framing (non load bearing), new plumbing, new electrical,drywall-to finish.Also adding new led recessed lights (combination of old work and new work)to all bedrooms, kitchen, informal dining. Is property on Town water* Is property on Town sewer Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 16,000 Does this project require a temporary construction trailer? NO hftps://northandoverma.viewpointcloud.com/#/records/24574 3/5 5/5/2017 "Building Permit#24574-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.# N/A 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/24574 4/5 5/5/20 17 *Building Permit#u45r4 wewPnmQmm 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 K4G>c.152.25A is a criminal violation punishable by fine up to$1.5OO.O0and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and o fine of up to$250.00 a day against the violator.8 copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. Insurance Company Name(Attach a copy of workers'compensation policy declaration page showing the policy number and expiration date) Peerless Insurance Policy#o,self-ms.License#~ Expiration Date VVC8994621 08/29/2017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.~ Br ig To Be Completed By Town Staff laZoning District~ la|othis a1ooYear o,older structure~ la|sproperty within anOverlay District~ Q Which Overlay District~ |othe property within the Floodplain ~ R2 No Yes Watershed Protection District No /xthe project within 1oo'mWetlands? ~ No mps://northandovermumewpointc|oud.com/#"/rmmrds/24574 5/5