Bld-20-002975 '• (may ' /`�i�4
ONE & TWO FAMILY ONLY- BUILDING PERMIT
Town of Yarmouth Building Department of "r`
1146 Route 28, South Yarmouth,MA 02664-4492 ,
508-398-2231 ext. 1261 Fax 508-398-0836
Massachusetts State Building Code,780 CMR
Building Permit Application To Construct, Repair, Renovate Or Demolish .a One-or Two-Family Dwelling
oo�� This Section or Official Use Only
Building Permit Number: BO "& / 2 7TDate Applied:
I,.1. SeArs -a.(-)c,‘
Building Official(Print Name) Signa re Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors p&Parcel Numbe
(ompSireet Ortii- /Oc ��r'.9'
1.1 a Is this an accepted street?yes V no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 WWI
Novice,
n�Cr'of Reco�d pe g-VQ 4/CaA
Name(Print) City,State,ZIP t
6.-9'7(v-990
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) L7 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2: Instal! eta ci1ept(ce ►Y1 f C .lr.G ~4
444 Roam Geferorwall
SECTION 4: ESTIMATED CONSTRUCTION COSTS. 'Oj ! Af�
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ /640.06 1. Building Permit Fee:$ 5 d Indicate how fee is determined:
2.Electrical $ aStandard City/Town Application Fee
`06 0 Total Project Cost'(Item 6)x multiplier 2‘. /l
3.Plumbing $ 2. Other Fees: $ (3.<67)
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 1660.O6 0 Paid in Full ki Outstanding Balance Due:It S
• SECTION 5: CONSTRUCTION SERVICES
' 5.1 Construction Supervisor License(CSL) y�x lO El
�(.i It Parr License NumberExpir Lion to
Name oICSL Holder
ICI tt)W ece (irtU n List CSL Type(see below)
No.and Streit 4'J Type Description
u}p5I- y,� *i Act /�'^� i 1 Unrestricted(Buildings up to 35,000 Cu.ft.)
1v1�w�� ��1r�^u' '�eV I W1 vQl R Restricted I&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding _
V SF Solid Fuel Burning Appliances
h/
1 I,8V b ONS pldesi n tbf`d g torl•( I Insulation
Telephone Email address LJ D Demolition
5.2 Registered Home Improvement Contractor(HIC) -`�
IAbe RAY _''' , • , '1
HIC Registration Number xp ation/Daatee
HI��Co�e or HICRegistrant Name (�C1_
No.and Str et
Y ��11�,�0 di itiCk COO( 1119g loo rp V Email address
City/Town, State,ZIP COO 1`(DTelephone
O
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 Issua 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.
Print Owner's Name(Electronic Signature) Date
• 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.
-nnnt 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.aov/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
Number 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
1. Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
r;,.•'•y 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): be t:Ivrr
Address: 19 tAkirieAf, ( rrVP.
•
City/State/Zip: i't Orl /4(, (p'l( Phone #: 991480 OI4g
Are you an employer?Check the appropriate box:
Type of project (required):
l.E/am a employer with employees(full and/or part-time).* 7. New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. El Remodeling
any capacity.[No workers'comp. insurance required.]
3. I am a homeowner doing all work myself. [No workers'comp. insurance required.]t 9. El Demolition
4.❑I am a homeowner and will be hiring contractors to conduct all work on m property.Y
I will 10 Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11. Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
5.O 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.t 13. Roof repairs
6.D We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other W
152,§1(4),and we have no employees. [No workers'comp.insurance required.] rii
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I
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. If the 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: AIM
1
Policy#or Self-ins.Lic.#: f at/0011(P OS Expiration Date: 06194a
Job Site Address: f J Cal 6f t A f City/State/Zip: A0 YYanzo -islot Cv673
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$250.00 a
day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date: oo/rci
Phone#: 'r�I�(f Xi 0 olL`$
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#:
art. Y'''41. TOWN OF YARMOTH
� y
csp
o BUILDING DEPARTMENT
,x 1146 Route 28, South Yarmouth,UNIA 02664
�..•y 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 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at 149 1 6•wlp it v1i la I klotverivoctli
Work Address
Is to be disposed of at the following location: &r3
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A,
Si 19
tare of Application
�1/� r
Date
Permit No.
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Constrrt 5pg,rvisor
CS-112010 ices: 10104/2021
•
KYLE FANNING PARR r `t -
PO BOX 467
EAST HARWICH MA 06
C'^'Commissioner
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Cipro, Linda
From: Josh Lyerla <totalimpactt@comcast.net>
Sent: Wednesday, November 20, 2019 12:04 PM
To: Cipro, Linda
Subject: Permission 121 Camp St
Attention! This email originates outside of the organization. Do not open attachments or click links unless you are sure
this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete
this email.
I Donna Maurice
Please give Kyle parr rt permit for fireplace Sent from my iPhone
i
A�R� CERTIFICATE OF LIABILITY INSURANCE �l%a(o%ao �
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER 1-800-851-7740 CONTACT
NAM Petra Tatum (Account* 181356)
Florists' Mutual Insurance Company/Hortica,
Florists' Insurance Services Inc fAfCr�.rsct 800-851-7740 �k 866-819-9256
P 0 Box 428 ADE-MAILDR : petra.tatumehortica.com
1 Horticultural Lane INSURER(S)AFFORDING COVERAGE NAC#
Edwardsville, IL 62025 INSURERA: FLORISTS MDT INS CO 13978
INSURED
Cooper Landscaping Inc WSURERe:
INSURER C:
P 0 Box 1048 INSURER 0:
INSURER E:
South Yarmouth, NA 02664 INSURER F:
COVERAGES CERTIFICATE NUMBER:57824806 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR (ADDL SUBR POLICY EFF EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER ( IDONYVYY) IM iDIYYYTY) LRfTS
A I COMMERCIAL GENERAL LIABILITY BP 11850 08/01/19 08/01/20 EACH OCCURRENCE $ 1,000,000
DAMA TO RENTED
CLAIMS MADE I OCCUR PREMISES Eaococanrencel $ 1,000,000
MED EXP(My one person) $ 5,000
PERSONAL&ADVINJURY $ 1,000,000
GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
I POLICY �jEcTPRO- LOC
PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER:
S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)accident)ANY AUTO
BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per aoddent) $
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY _ AUTOS ONLY (Per accident)
$
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
A WORKERS COMPENSATION WON 29464 03/08/19 03/08/20
AND EMPLOYERS'LIMMU TYPER OTF+
ANVPROPRIETOR/PARTNERIDECUTIVE YIN
I STATUTE ER
OFFICER/MEMBEREXCLUDED9 ;N/A E.L EACH ACCIDENT $ 500,000
(Mandatory hi NH) E.L.DISEASE-EA EMPLOYEE 8 500,000
If yes,describe under ( _
DESRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,000
A Pesticide/Herbicide BP 11850 08/01/19 08/01/20 Per Occurrence 1,000,000
Applicator Coverage
Aggregate 2,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached I more Waal Is ragdred)
Evidence of Insurance
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Cooper Landscaping Inc THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P 0 Box 1048
AUTHORIZED REPRESENTATIVE
South Yarmouth, NA 02664 _y/ �L/ /)
I USA ./y _, � ,
®1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
kareamorgan
57824806
Poirra)001.3 42geotileCi03
Ki 1,6rr amor
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OIr�:
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TOWN OF YArJ GOUTH
REVIEWED FOR BUILDING ANC ZONING CODE COMPLI-
ANCE. ERRORS OR 01r;.11SSIONS DO NOT RELIEVE THE FILE
��� ��
APPLICANT FROM THE RESPONSIBILITY OF"AS BUILT"
COMPLIANCE.
DATE:t -)4-19
BUILDIN [CAL
E
1:11
®solse Cascade - Triple 1-3/4" x 5-1/2" VERSA-LAM®2.0 3100 SP PASSEDJ
FB01 (Floor Beam)
BC CALC®Member Report Dry I 1 span No cant. November 20, 2019 10:55:15
Build 7480
Job name: 129 Camp Street File name: Parr- 129 Camp Street
Address: 129 Camp Street Description:
City, State,Zip: West Yarmouth, MA, 02673 Specifier:
Customer: Kyle Parr Designer: Kevin Lonkart
Code reports: ESR-1040 Company: Mid Cape Home Centers
1 1 1 _ 1 1 1 1 . 1 1 _ 1 1_ 1 ._1 1 , 1 4 2 4 4 4 1 4 4 4 4 4 4 4
4 4 4 4 1
1 1 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 1 1 1
4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 404 4 4 4 4 4 4 4 4 4 1 1 1 1 1 1
J �k
08-04-00
B1 B2
Total Horizontal Product Length=08-04-00
Reaction Summary (Down / Uplift) (Ibs)
Bearing Live Dead Snow Wind Roof Live
B1, 3-1/2" 1250/0 827/0
B2, 3-1/2" 1250/0 827/0
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 08-04-00 Top 8 00-00-00
1 2nd floor Unf.Area(Ib/ft2) L 00-00-00 08-04-00 Top 30 10 10-00-00
2 Gable Wall Unf. Lin. (Ib/ft) L 00-00-00 08-04-00 Top 90 n\a
Controls Summary Value %Allowable Duration Case Location
Pos. Moment 3863 ft-lbs 51.8% 100% 1 04-02-00
End Shear 1703 lbs 31.0% 100% 1 00-09-00
Total Load Deflection L/319(0.296") 75.2% n\a 1 04-02-00
Live Load Deflection L/530(0.178") 67.9% n\a 2 04-02-00
Max Defl. 0.296" 29.6% n\a 1 04-02-00
Span/Depth 17.2
%Allow %Allow
Bearing Supports Dim.(LxW) Value Support Member Material
B1 Column 3-1/2"x 5-1/4" 2077 lbs n\a 15.1% Unspecified
B2 Column 3-1/2"x 5-1/4" 2077 lbs n\a 15.1% Unspecified
Notes
Design meets Code minimum(U240)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.
Connection Diagram: Full Length of Member
b d
a
•
•
• • •
Page 1 of 2
*MS.Cascade - ED Triple 1-3/4" x 5-1/2" VERSA-LAM® 2.0 3100 SP PASS
FB01 (Floor Beam)
BC CALC®Member Report Dry I 1 span I No cant. November 20,2019 10:55:15
Build 7480
Job name: 129 Camp Street File name: Parr- 129 Camp Street
Address: 129 Camp Street Description:
City, State,Zip: West Yarmouth, MA, 02673 Specifier:
Customer: Kyle Parr Designer: Kevin Lonkart
Code reports: ESR-1040 Company: Mid Cape Home Centers
Connection Diagram: Full Length of Member
a minimum=2" c= 1-1/2"
b minimum=4" d =24"
e minimum= 1"
All FastenMaster screws may be installed from one side of multiply Versa-Lam beams.
Connectors are: FMFLOO5
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®,AJSTM',
ALLJOIST®,BC RIM BOARDTM',BCI®,
BOISE GLULAMTM',BC FloorValue®,
VERSA-LAM®,VERSA-RIM PLUS®,
Page 2 of 2