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HomeMy WebLinkAboutBuilding Permit Application-45 Russett Lane - Building Permit - 45 RUSSETT LANE 6/29/2021 7/13/2021 Record 609.54-ViewPoint Cloud *Building Permit 60954 Your Submission Attachments Guests (0) Building Department Review Fire Department Review Treasurer Review Conservation Review Planning Review Health Review DPW Engineering Review DPW Operations Review Building Inspector Approval Additions/Alterations/Remodeling Building Permit Fees Building Permit Issued Temporary Dumpster Permit Issued Your submission Submitted Jun 29, 2021 at 9:32am Contact Information Doug Legare Email address twomeyandlegare@verizon.net Phone Number ltttos:ilnortllandoverma.viewnoi ntclmid.cnmttrarkn67R7lcEehmiccinn I r� 7/13/2021 Record 60954-ViewPoint Cloud 978-4238476 Mailing Address 87 BELMONT STREET , NORTH ANDOVER, MA01845 Location 45 RUSSETT LANE NORTH ANDOVER, MA 01845 E E I©iY'�,1'J] - fl1.4L1'4@OpkekiKSU� Application Submission Are you submitting this application as the Homeowner? NO Primary Contractor Firm (Business) Name Licensee Twomey and Legare Contracting Inc License # 136779 License Expiration Date 08/25/2022 License Type Home Improvement Contractor littps:!lnortliandoverma.viewpointcloud.com/track/76282tsubmission 216 7/13/2021 Record 60954-ViewPoint Cloud License Active O ' License Status Current Mailing Address 87 BELMONT ST N. ANDOVER MA 01846, Preferred Telephone #: 978-423-8476 Alternate Phone # Email I certify, under the pains and penalties of perjury, that the information on this application is true and complete. G Project Information Type of Project Construction of Addition, Alteration, and Remodeling Type of Improvement Addition Proposed Use One Two Family Description of Work to be Performed detached 20x24 garage addition Is property on Town water. Yes Is property on Town sewer https;llnorlhandoverma.viewpointcloud.coin/track/76282/submi ssion 3/6 7/13/2021 Record 60954-ViewPoint Cloud Yes Project Cost (if new construction base on $1.25 per square foot and if addition/alteration/renovation base on actual contract price) 125 Does this project require a temporary construction dumpster? Yes 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 Martha Macinnis Architect/Engineer Address 58 Regent Ave. Bradford Ma. Architect/Engineer Phone Number 978-374-8714 Architect/Engineer Reg. # Construction Dumpster Permit Application Name of Dumpster Company(if applicable) Arrow container service Dumpster Arrival Date 09/01/2021 https:#tiorthaudoverma.viewpointcloud.comltrackt76282/submission 416 7/1 31202 1 Record 60954-ViewPoint Cloud State clearly purpose for which the Construction Dumpster Permit is requested wood debris Insurance I have a current liability insurance policy or its substantial equivalent. Yes If yes, indicate the type of coverage Liability If other, specify Worker's Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers 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 * 10 Building addition am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name (Attach a copy of workers' compensation policy declaration page showing the policy number and expiration date) Travelers Insurance company Policy# or Self-Ins. License # 6hub0290m99420 Expiration Date 09/18/2021 httos://northandoverma,viewnointeloud.com/track/76292/giihmigsion vti 7/13/2021 Rccord 60954-ViewPoint Cloud Workers' Compensation Affidavit Signature I do herdk �certify under the pains and penalties of perjury that the information provided above is true and correct. G undefined https:/Inorthandoverma.viewpointcloud.comltrack/76282/submission 616