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HomeMy WebLinkAboutBuilding Permit # 5/4/2017 5/10/2017 *Building Permit#24295-View Point Cloud 24,29z"5'" *Building Permit—Construction of Additions,Alterations,and Remodeling O Building Permit Issued TIMELINE OSubmission received Apr 13,2017 at 3:34pm 10 Building Department Review IP 0 Completed Apr 26,2017 at 12:03pm © Conservation Department Review IP 0 Skipped Apr 27,2017 at 9:38am © Planning Department Review * !!% Skipped Apr 26,2017 at 1:55pm OHealth Department Revies Completed Apr 26,2017 at 3:54pm ODPW Engineering Review Completed Apr 28,2017 at 9:39am ODPW Operations Review Completed Apr 26,2017 at 2:02pm J1%% Fire Department Review Completed Apr 28,2017 at 7:21am � OTreasurer Review Completed Apr 26,2017 at 4:10pm https://northandover m a.vi ewpoi ntcl oud.com/#/records/24295 1/5 5/10/2017 *Building Permit#24295-View Point Cloud Building Inspector Approval O Completed May 2,2017 at 8:12pm OAdditions/Alterations/Remodeling Bldg Permit Fee Paid May 4,2017 at 11:04am OPermit Issued Issued May 4,2017 at 11:03am *Building Permit#24295 Construction of Additions,Alterations,and Remodeling Mobil �")� Fari's Diner �,. North Andover Mall Applicant Location Scott Minton 350 WINTHROP AVENUE (12), NORTH ANDOVER, MA t. 603-233-1671 Owner @ massefire@yahoo.com... DSM Realty Trust Attachments pdf WC . (hi.1 )i 13 2017 1 Uploaded by Scott Minton on Apr 13,2017 3:34 PM , pdf Copy,,,0,,_(;onti�tictots...I.i<,....I&iio-...:;pr..1uu....011....1 s . Uploaded by Scott Minton on Apr 13,2017 3:35 PM , pdf N-Andoverl,` on _Apr 17 1710 Uploaded by Scott Minton on Apr 17,2017 6:35 AM https://northandoverma.viewpointcloud.com/#/records/24295 2/5 5/10/2017 *Building Permit#24295-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 Type* License Active License Status Mailing Address Scott Minton 146881 11/26/2018 Sprinkler Contractor G PO Box 64 Pelham, NH 03076 Preferred Telephone#:* Alternate Phone# Email 603-233-1671 603-635-3120 massefireCdyahoo.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* Describe the type of use* Description of Work to be Performed* Is property on Town water* Is property on Town sewer Alteration Non-Residential Building Hair Salon Relocate sprinkler heads Yes Yes Project Cost(if new construction base on$125 per square foot and if addition/alteration/renovation base on actual contract price) 3,200 Does this project require a temporary construction trailer? NO hftps://northandoverma.viewpointcloud.com/#/records/24295 3/5 5/10/2017 *Building Permit#24295-View Point 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/24295 4/5 5/10/20 17 *Building Permit#c4cno'vw*PomCloud 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 ay required under K4G>c.152.25A is a criminal violation punishable by fine up to$1.50O.0Oand/or one-year imprisonment,as well as civil penalties in the form of 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 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) Zurich-American Insurance Company Policy#o,semns.License#~ Expiration Date WC 48-65-810-11 10/01/2017 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 igTo 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 1on'orWetlands? ~ B3 No No Yea Not Applicable mps://northandovermumewpointc|oud.com/#"/rmmrds/24295 5/5