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Home My WebLink AboutBuilding Permit Application-39 Russell - Building Permit - 39 RUSSELL STREET 1/23/2021 2/10/2021 OpenGov *Building Permit Expiration--Date- Stopped DO 58085 ------------------------------- ---------------------------- -------Awl -1----------------------------- Details Submitted on Jan 23,20215:05 PM Attachments Ifile Activity Feed all Latest activity on Jan 25, 2021 Applicant Kevin Murphy Location 39 RUSSELL STREET, NORTH ANDOVER, MA 01845 ----------- Timeline Building Department Review Rejected Jan 25, 2021 at 7:33am Fire Department Review Review Treasurer Review Review Conservation Review Review Planning Review Review Health Review Review DPW Engineering Review Review https://northandoverma.viewpointeloud.iol#/6xplore/records[70076/form 2/10/2021 OpenGov DPW Operations Review Review Building Inspector Approval Review Ii Additions/Alterations/Remodeling Building Permit Fees Payment Building Permit Issued Document 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 information using the search bar below. Either the Licensee Name or License # is required. Firm (Business)Name Licensee* KEVIN MURPHY License# 101874 License Expiration Date 06/28/2022 License Type Home Improvement Contractor License Active hftps://noTthandoverfna.viewpointoloud.io/#/explore/records/70076/form 2/6 2/10/2027 OpenGov INSURANCE COVERAGE: 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 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 10 Building addition 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) Guard Insurance Co Policy#or Self-Ins. License# KEWC 162823 Expiration Date 07/01/2021 https;l/northandoverma.viewpointeloud.lol#/0xplore/recordsf70076/form 5/6 2/10/2021 OpenGov 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 A To Be Completed By Town Staff a Zoning District* G Is this a 100 Year or older structure la Is property within an Overlay District Is the property within the F'loodplain Is the project within 100' of Wetlands? la Building Code Edition ------------- undefined https://northandoverfna.viewpointoloud.io/41explore/recordsf70076/form 6/6