HomeMy WebLinkAboutBld-20-003509 A
1-Nif Y . ,/etk i r� l - / r Tr V j `'- MAW'< i/�I
ONE & TWO FAMILY ONLY- BUILDING PERMIT
t Town of Yarmouth Building Department '' ....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
This Section For Official Use Only
Building Permit Number:231..i)-, Al) "07) 3509 Date Applied:
J ; ," SPArs ✓ 4-P -(i
Building Official(Print Name) Si re Date
SECTION 1:SITE INFORMATION
1.1 Propert 4ddress: 1.2 Assessors Map&Parcel Numbers
4' 1. 310 061tC` 1
1.1 a Is this art accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions: C (4 7
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 Dis osal,„SYs a ,, ,
Zone: Outside Flood Zone? '�" s
Public❑ Private El Municipal Municipal 0 s'e°,di posaksysre t 6--�"
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP' 3 ;} 20A
2.1 Owner' ec rd: `- t
Le of AN&4 ROWd ,1M18U .e 1 4 �v z ,
Nam (Print)„, City tate,ZIP
164 Sproler- LA-i 1----------
No.and Stre Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) rd Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other .D Specify: .,
Brief Description of Proposed Work2: �,Q�L�j'e- ��6e X' I1 tail— _gi
L C.u SN rr VQ,®-
SECTION 4:ESTIMATED CONSTRUCTION COSTS. phi S
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ /kcb , i)4 1. Building Permit Fee:$ I cO Indicate how fee is determined:
2.Electrical $
f 0 Standard City/Town Application Fee
0 Total Project Costa Item 0 x multiplier . . x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
;1. Check N.o. Check Amount: Ca Amount:
6.Total Project Cost: $ �.t 0 Paid in Full 0 Outstanding Balanc Due: /I(
SECTION 5: CONSTRUCTION SERVICES
5.1 nstru ion Supervisor License(CSL) ([Z ?�
` td II �,lii a License Number Ex ' atio ate
f Narw of CSL Holder
`' 1^`(f X 6 7! ki List CSL Type(see below)
No.evid Street Type Description
rL
/J p1 p v 04- _,l Z�e “ U Unrestricted(Buildings up to 35,000 cu. ft.)
(1 R Restricted 1&.2 Family Dwelling
City/To n,State,ZIP � M Masonry
RC Roofing Covering
WS Window and Siding _
�/� r� 2 �; 1 , _ SF Solid Fuel Burning Appliances
W - 33 _i� 3 !Q cc i tl► cier e I Insulation
Telephone Email addresa M4A-S f; Pa D Demolition
5.2 Registered Home Improvement Contractor(HIC) r / C e
C? C �I ' '� � HIC!Registration Number Exp' do Date
HI mpyNanie1 or I e istranj�Nameiti .ZSC C1 j U1 Icir� e
N dd Str ���� T /fJ1 b Icier
I,1 1s #* 1 L(72- 6i 1_331 i �7 /' 1 Email,addressd
City/Town, State,ZIP l✓ Telephone 'l e�+64'1Cr �J f - /�t r
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 2" No 0
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 S(,,13 IT 1mer i
to 4t4Av-4
act on my behalf,in all matters relative to work authorized by this building permit application.
lild 1-t J 13 . t f 2d I `i
Print Owner's Name(Electronic Signature) Dal
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.
J, e.e n C etzi- t h i IIl f
Print Owner's or Authorized Agent's Name(Electronic Signature) Dattt
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
s*
} Department of IndustrialAccidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
t�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): C/M pie ylc 4c/'r1 4-�
Address: e 6 Dd yt~ 'tide
City/State/Zip: S '� -
� � 1�toMt(� /W� Phone : ��
Are you an employer?Check the appropriate box: v)6—'
Type of project(required):
l.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction
2.❑I am a sole proprietor or partnership and have no employees working for me in 8. FaRemodeling
any capacity.[No workers'comp.insurance required.]
3.E I am a homeowner doing all work myself. [No workers'comp. insurance required.]t 9. ❑ Demolition
4.❑I am a homeowner and will be hiring contractors to conduct all work on m y p roPrh'
e I will 10 El Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions
proprietors with no employees.
12.❑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.'eWe are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§I(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.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
1Contractors 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:
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.
I do hereby cer ' ains and penalties of perjury that the information provided above is true and correct.
Signature: — Date: it)Q _- i 211 ei
Phone#: &t �� —15-3
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
1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ext. 1261 Fax 508-398-0836
Office of the Building Commissioner
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4.
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at 162, .. e4i4 L t4
Work Address
Is to be disposed of oat the following location: m jag. ke bort
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Ch. 111, §150A.
tore of Application Date
Permit No.
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eBoiseCascade — Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP PASSED
Second Floor Beam (Floor Beam)
BC CALC®Member Report Dry I 1 span I No cant. December 11, 2019 09:14:44
Build 7480
Job name: Morrison File name: Cimco-Morrison
Address: 162 Springer Lane Description:
City, State,Zip: West Yarmouth, MA, 02673 Specifier:
Customer: Cimco Construction 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 1 111 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
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
11-09-00
B1
B2
Total Horizontal Product Length=12-04-00
Reaction Summary (Down / Uplift) (Ibs)
Bearing Live Dead Snow Wind Roof Live
B1,3-1/2" 2960/0 829/0
B2, 3-1/2" 2960/0 829/0
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 12-04-00 Top 14 00-00-00
1 Second Floor Unf.Area(Ib/ft2) L 00-00-00 12-04-00 Top 40 10 12-00-00
Controls Summary Value %Allowable Duration Case Location
Pos. Moment 10831 ft-lbs 51.7% 100% 1 06-02-00
End Shear 3123 lbs 33.0% 100% 1 01-01-00
Total Load Deflection -_L/389-(0..366") — 61.7%- -- n\a - - - - 1 06-02-90- -
Live Load Deflection L/498 (0.286") 72.3% n\a 2 06-02-00
Max Defl. 0.366" 36.6% n\a 1 06-02-00
Span/Depth 15.0
Allow %Allow
Bearing Supports Dim.(LxW) Value Support Member Material
B1 Column 3-1/2"x 5-1/4" 3789 lbs n\a 27.5% Unspecified
B2 Column 3-1/2"x 5-1/4" 3789 lbs n\a 27.5% Unspecified
Notes
Design meets Code minimum (L/24O)Total load deflection criteria.
Design meets Code minimum (L/36O) 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 .r d —�
a
4 �• •
•
• �—
�.- a I-�--
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ISoiseCascade - Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP PASSED
Second Floor Beam (Floor Beam)
BC CALC®Member Report Dry I 1 span I No cant. December 11,2019 09:14:44
Build 7480
Job name: Morrison File name: Cimco-Morrison
Address: 162 Springer Lane Description:
City, State,Zip: West Yarmouth, MA, 02673 Specifier:
Customer: Cimco Construction Designer: Kevin Lonkart
Code reports: ESR-1040 Company: Mid Cape Home Centers
Connection Diagram: Full Length of Member
a minimum =2" c=5-1/2"
b minimum =4" d= 12"
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®,AJST"",
ALLJOIST®, BC RIM BOARDTM,BCI®,
BOISE GLULAMTm,BC FloorValue®,
VERSA-LAM®,VERSA-RIM PLUS®,
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