HomeMy WebLinkAboutBld-20-002978 ,.. i
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TWO) 1FIAIIT1Y 0.PPLY, RrIMITITIG P.F2R1.1171
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I TDWIL1 of Ykrolrolia,iBuilllithine Depurtmeat
1146 Route 28, South Yarmouth,MA 02664 4492
1 508-398-2231 ext, 1261 Fax 508-398.0836
Massachusetts State Building Code,780 Oa.
Building Pe7mit Application To Construct,Repair, Renovate Or Demolish . -...._ ,.
a One-or Two-Family Dwelling
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- This Section For Official Use only
I Eding PernaitNumL.j.)" AZ/ :799 Dace Appli ` . ! : ! .-- -
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Building Official(Pririt Name-) iguature. •
SECTION 1 g SrlIrE 1,117CDRMATION , .
1,1 Trope i Addres3, i ; 1,2 Assesso7a,&Parcel Numbers
kili• cquad Cie. yaitwooth eitt- '
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1.-la is this an ccepted street?yes X no i Map Number Parcel Number
1,-3 Boning Information-,; i IA Property IDimelasions:.
Zoning Distict Proposed Use ' Lot Area(sq ft) Frontage(ft)
de Y ai-cpo
r-co video, kquIrftd - i'revi-te6 Kequ a-a.ct i ri-ovLcaff.
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Zone Outsidr,F133.1;.„'o.v..2
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I DP.Tion ,il-.,c.i.a LI , ,40,:ce8s01.-3,.}11(.1g,,11 INTuati- :cf.iiiiits 1 "...7)tht).- 1,1 Specify:, J'i•-,,-,7.1.:!•::-. .c.,1-ipt.,00,c-/:::',.,;:po3c,d t_Ica
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SECTION 5:.CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted I&2 Family Dwelling
City/Town,State,ZIP • M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street
Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes ❑ No ❑
. SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ..
I,as Owner of the subject property,hereby authorize
to act on my behalf;in all matters relative to work authorized by this building permit application.
�•, , CIWK114ae19. i CU.TOV Nov.OXPL 02019
•'l:,f-f Name(Electronic Signature) Dke
• SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft) Habitable room count
Nnmher of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost'
The Commonwealth of Massachusetts
►�=-. 'lll►=?t Department oflndustrialAccidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
e.� • www.mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): grlrc flue e. and SrizEsefh CAAtut
Address: 1-J19 C'eck„.300l
City/State/Zip:yclncmW)s)k\i) &r All OZ35 Phone#: ?3M- G, Li- G15.Z
Are you an employer?Check the appropriate box: Type of project(required):
1.0 I am a employer with employees(full and/or part-time).* 7. 0 New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling
any capacity.[No workers'comp.insurance required.]
3�q.I am a homeowner doingall work t 9. ❑Demolition
i�1 myself.[No workers'comp,insurance required.]
4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Q Building addition
ensure that all contractors either have workers'compensation insurance or are sol 11.0 Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet
These sub-contractors have employees and have workers'comp.insurance.; 13. Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. lithe sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL 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.
1 do hereby certify nder tl • ••'ns and penalties of perjury that the information provided above is true and correct.
Signature: ( .' 4Ifl!. Date: I J90 / 2oI')
Phone#: " - • e; :7'-.8
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
TOWN OF YARMOUTH
•
BUILDING DEPARTMENT
cs 1146 Route 28, South Yarmouth,MA 02664 508-398-2231 ext. 1261
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE: ( l d°/(24)1�
JOB LOCATION: 4L4 Oo Ci�cAe aimoo IOz �Pk
N S ADDRESS SECTION OF TOWN
"HOMEOWNER" c 3r r1 iUd k &1 ��--e)�44-6*5�
NAME ME PHONE 'J ORK PHONE
PRESENT MAILING ADDRESS (p� `"�Y)V�p qt 1 QY1n b N n" D.Z17I
J
CITY OR TOWN STATE ZIP CODE
The current exemption for `Homeowner' was extended to include owner—occupied dwellings of one or two units
and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such
homeowner shall act as supervisor. (State Building Code Section 110 R5.1.3.1)
Definition of Homeowner:
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to
be, a one or two family attached or detached structure assessory to such use and/or farm structures. A person who
constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall
submit to the building official,on a form acceptable to the building official,that he/she shall be responsible for all
such work performed under the building permit. (Section 110 R5.1.3.1)
The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other
applicable codes,by-laws,rules and regulations.
The undersigned `homeowner' certifies that he/ she understands the Town of Yarmouth Building Department
minimum inspection procedures and requirements and that he / she will comply with said procedures and
requirements.
TArr*(1.
HOMEOWNER"S SIGNATURE / N.
,�!:
APPROVAL OF BUILDING OFFICIAL
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL
Ch.142. Yes No
If you have checked y ,please indicate the type coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity Bond
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner Agent
h:homeownrlicexemp
o "(Do.
TOWN OF YARMOUTH
c B UILD NG DEPARTMENT
`� 1146 Route 28,South Yarmouth,MA 02664
`�-•� 5=� 508-398-2231 ext. 1261 Fax 508-398-0836
BUILDING DEPARTMENT
•
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L. Chapter 40,Section 54 and 780 CMR, Chapter I,Section 1113,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at vl"1 f c Uo ct de r ycieriwk.Nft V36 , f i 'p.t C 6
Work Address
Is to be disposed of at the following location: (y e10(-4T C -er a 'OVA
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
ao) aoict
giMication Date
Permit No.
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REVIEWED FOP,r,311IL!•;;NO AND,—.:CNI;-.3 CODE COMPLI.....1
ANCE. ERRORS U C.s.,.!iSE:-)NS DO NOT RELIEVE
APPLICANT FROM THE P.ESONSIBILI—i Y OF AS BUILT" :
COMPLIANCE.
DATE://- 0tC-ic
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BUILDING oFFICIAL
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®Boise Cascade - Double 1-3/4" x 14" VERSA-LAM®2.0 3100 SP PASSED
FB02 (Floor Beam)
BC CALC®Member Report Dry 12 spans I No cant. November 20,2019 16:24:25
Build 7480
Job name: Rossi Curry File name: 44 Pequod Circle
Address: 44 Pequod Circle Description:
City, State,Zip: Yarmouthport, MA,02675 Specifier: Boise
Customer: Designer: Stefan Richman
Code reports: ESR-1040 Company: Mid Cape Home Centers
1 1 1 1 1 1 1 1 1 1 1 1 1 1I
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 01 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
lm t:S
k k k
20-00-00 03-00-00
B1 B2 B3
Total Horizontal Product Length=23-00-00
Reaction Summary (Down / Uplift) (Ibs)
Bearing Live Dead Snow Wind Roof Live
B1,3-1/2" 2742/0 1027/0
B2,5-1/2" 9494/0 3576/0
B3,3-1/2" 0/5336 0/1976
Load Summary Live Dead Snow Wind Roof Tributary
Live
Tag Description Load Type Ref. Start End Loc. 100% 90% 115% 160% 125%
0 Self-Weight Unf. Lin.(lb/ft) L 00-00-00 23-00-00 Top 14 00-00-00
1 Unf.Area(Ib/ft2) L 00-00-00 20-00-00 Top 30 10 11-06-00
Controls Summary Value %Allowable Duration Case Location
Pos. Moment 14121 ft-lbs 48.6% 100% 1 07-10-11
Neg. Moment -20323 ft-lbs 70.0% 100% 1 20-00-00
End Shear 7299 lbs 78.4% 100% 1 21-06-08
Cont.Shear 7334 lbs 78.8% 100% 1 21-04-12
Total Load Deflection L/481 (0.494") 49.9% n\a 1 08-09-15
Live Load Deflection L/660(0.359") 54.5% n\a 2 08-09-15
Total Neg.Defl. L/999(-0.011") n\a n\a 1 21-02-02
Max Defl. 0.494" 49.4% n\a 1 08-09-15
Span/Depth 16.9
%Allow %Allow
Bearing Supports Dim.(LxW) Value Support Member Material
B1 Wall/Plate 3-1/2"x 3-1/2" 3768 lbs n\a 41.0% Unspecified
B2 Wall/Plate 5-1/2"x 3-1/2" 13070 lbs n\a 90.5% Unspecified
B3 Wall/Plate 3-1/2"x 3-1/2" 0 lbs n\a n\a Unspecified
B3 Uplift 7312 lbs
Cautions
Uplift of-7312 lbs found at bearing B3.
Notes
Design meets Code minimum(L/240)Total load deflection criteria.
Design meets Code minimum(L/360)Live load deflection criteria.
Design meets arbitrary(1")Maximum Total load deflection criteria.
Calculations assume member is fully braced.
BC CALC®analysis is based on IBC 2009.
Design based on Dry Service Condition.
Page 1 of 2
Boise Cascade - Double 1-3/4" x 14" VERSA-LAM®2.0 3100 SP PASSED'
FB02(Floor Beam)
BC CALC®Member Report Dry 2 spans No cant. November 20,2019 16:24:25
Build 7480
Job name: Rossi Curry File name: 44 Pequod Circle
Address: 44 Pequod Circle Description:
City,State,Zip: Yarmouthport, MA,02675 Specifier: Boise
Customer: Designer: Stefan Richman
Code reports: ESR-1040 Company: Mid Cape Home Centers
Connection Diagram: Full Length of Member
I • •
w�w
a minimum=2" c= 10"
b minimum=2-1/2" d=24"
Bolts are assumed to be Grade A307 or Grade 2 or higher.
Connectors are: 1/2 in.Staggered Through Bolt
•
Disclosure
Use of the Boise Cascade Software is
subject to the terms of the End User
License Agreement(EULA).
Completeness and accuracy of input
must be reviewed and verified by a
qualified engineer or other appropriate
expert to assure its adequacy,prior to
anyone relying on such output as
evidence of suitability for a particular
application.The output here is based on
building code-accepted design
properties and analysis methods.
Installation of Boise Cascade
engineered wood products must be in
accordance with current Installation
Guide and applicable building codes.To
obtain Installation Guide or ask
questions,please call(800)232-0788
before installation.
BC CALC®,BC FRAMER®,AJST"',
ALLJOIST®,BC RIM BOARDT",BCI®,
BOISE GLULAMTu,BC FloorValue®,
VERSA-LAM®,VERSA-RIM PLUS®,
Page 2 of 2
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47) REVIEWED FOR BUILDING AND ZONING CODE COMPLI-
ANCE. ERRORS OF Ci,,.fiiSSIONS DO NOT RELIEVE THE
0
1 APPLICANT FROM THE RESPONSIBILITY OF"AS BUILT"
COMPLIANCE.
I' DATE: _
BUILDING-6 w
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APPLICANT'S COPY \ic(
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i®BolseCascade - Double 1-3/4" x 14" VERSA-LAM®2.0 3100 SP PASSED-k
FB02(Floor Beam)
BC CALC®Member Report Dry J 2 spans I No cant. November 20,2019 16:24:25
Build 7480
Job name: Rossi Curry File name: 44 Pequod Circle
Address: 44 Pequod Circle Description:
City,State,Zip: Yarmouthport, MA,02675 Specifier: Boise
Customer: Designer: Stefan Richman
Code reports: ESR-1040 Company: Mid Cape Home Centers
1 1 1 1 1 1 1 1 1 1 1 1 1 111 1 1 1 1 1 1 1 1 1 1 1 1 11
1 1 1 1 1 4 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
S
20-00-00 03-00-00
B1 B2 B3
Total Horizontal Product Length=23-00-00
Reaction Summary(Down /Uplift) (Ibs)
Bearing Live Dead Snow Wind Roof Live
B1,3-1/2" 2742/0 1027/0
B2,5-1/2" 9494/0 3576/0
B3,3-1/2" 0/5336 0/1976
Load Summary Live Dead Snow Wind Roof Tributary
Live
Tag Description Load Type Ref. Start End Loc. 100% 90% 115% 160% 125%
0 Self-Weight Unf.Lin.(lb/ft) L 00-00-00 23-00-00 Top 14 00-00-00
1 Unf.Area(Ib/ft2) L 00-00-00 20-00-00 Top 30 10 11-06-00
Controls Summary Value %Allowable Duration Case Location
Pos.Moment 14121 ft-lbs 48.6% 100% 1 07-10-11
Neg.Moment -20323 ft-lbs 70.0% 100% 1 20-00-00
End Shear 7299 lbs 78.4% 100% 1 21-06-08
Cont.Shear 7334 lbs 78.8% 100% 1 21-04-12
Total Load Deflection U481 (0.494") 49.9% n\a 1 08-09-15
Live Load Deflection U660(0.359") 54.5% n\a 2 08-09-15
Total Neg.Defl. U999(-0.011") n\a n\a 1 21-02-02
Max Defl. 0.494" 49.4% n\a 1 08-09-15
Span/Depth 16.9
%Allow %Allow
Bearing Supports Dim.(LxW) Value Support Member Material
B1 Wall/Plate 3-1/2"x 3-1/2" 3768 lbs n\a 41.0% Unspecified
B2 Wall/Plate 5-1/2"x 3-1/2" 13070 lbs n\a 90.5% Unspecified
B3 Wall/Plate 3-1/2"x 3-1/2" 0 lbs n\a n\a Unspecified
B3 Uplift 7312 lbs
Cautions
Uplift of-7312 lbs found at bearing B3.
Notes
Design meets Code minimum(U240)Total load deflection criteria.
Design meets Code minimum(U360)Live load deflection criteria.
Design meets arbitrary(1")Maximum Total load deflection criteria.
Calculations assume member is fully braced.
BC CALC®analysis is based on IBC 2009.
Design based on Dry Service Condition.
Page 1 of 2
Boise Cascade - Double 1-3/4" x 14" VERSA-LAM®2.0 3100 SP PASSED
FB02(Floor Beam)
BC CALC®Member Report Dry 12 spans I No cant. November 20,2019 16:24:25
Build 7480
Job name: Rossi Curry File name: 44 Pequod Circle
Address: 44 Pequod Circle Description:
City,State,Zip: Yarmouthport, MA,02675 Specifier: Boise
Customer: Designer: Stefan Richman
Code reports: ESR-1040 Company: Mid Cape Home Centers
Connection Diagram: Full Length of Member
a IbI I d
• • •
I • ,
a minimum=2" c= 10"
b minimum=2-1/2" d=24"
Bolts are assumed to be Grade A307 or Grade 2 or higher.
Connectors are: 1/2 in.Staggered Through Bolt
•
Disclosure
Use of the Boise Cascade Software is
subject to the terms of the End User
License Agreement(EULA).
Completeness and accuracy of input
must be reviewed and verified by a
qualified engineer or other appropriate
expert to assure its adequacy,prior to
anyone relyin,t on such output as
evidence of suitability for a particular
application.The output here is based on
building code-accepted design
properties and analysis methods.
Installation of Boise Cascade
engineered wood products must be in
accordance with current Installation
Guide and applicable building codes.To
obtain Installation Guide or ask
questions,please call(800)232-0788
before installation.
BC CALC®,BC FRAMER®,AJSTM,
ALLJOIST®,BC RIM BOARDTM,BCI®,
BOISE GLULAMTM',BC FloorValue®,
VERSA-LAM®,VERSA-RIM PLUS®,
Page 2 of 2