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HomeMy WebLinkAboutBldg Permit App-34 Wentworth Ave - Permits - 34 Wentworth Avenue 8/18/2021€f f f *Building Permit 61883 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 New Construction Building Permit Fees Building Permit Issued Your submission Submitted Aug 18, 2021 at 9:14am Contact Information Jonathan Grasso Email address jonathan@grassoconstruction.net Phone Number 978-688-8895 Mailing Address 865 Turnpike St. , North Andover, MA 01845 Location 34 WENTWORTH AVENUE NORTH ANDOVER, MA 01845 Application Submission Are you submitting this application as the Homeowner? NO Primary Contractor Firm (Business) Name Licensee JOHN GRASSO License# * CS-022988 License Expiration Date 10/31/2021 License Type Construction Supervisor License Active 0 License Status Active Mailing Address 865 TURNPIKE STREET, North Andover MA 01845 Preferred Telephone #: 978-688-8895 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 New Construction Type of Improvement New Building Proposed Use One Two Family Description of Work to be Performed Construction of new single family dwelling. Is property on Town water Yes Is property on Town sewer Yes Project Cost if new construction base on 125 per square foot and if Project ( $ P q addition/alteration/renovation base on actual contract price) 200,000 Does this project require a temporary construction dumpster? No 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 Architect/Engineer Name Architect/Engineer Address Architect/Engineer Phone Number Architect/Engineer Reg. # Insurance I have a current liability insurance policy or its substantial equivalent. Yes If yes, indicate the type of coverage Liability If other, specify E p E € 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. 5. 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers' compensation insurance. Contractors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees, they must provide their workers' comp, policy number. Type of project 7. New Construction Workers' Compensation Affidavit Signature do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. E- undefined