HomeMy WebLinkAboutInitial Const Control Affidavit - 9th Edition - ARCHVersion 06_11_2013
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the 9th edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: NEW PUBLIC WORKS FACILITY – TOWN OF YARMOUTH Date: December 10, 2019
Property Address: 507 Buck Island Road, Yarmouth, MA 02673
Project: Check (x) one or both as applicable: XX New construction Existing Construction
Project description: The scope of work includes construction of a new DPW Facility. The project includes, but is not limited
to, construction of a pre-engineered metal building, including office area, employee facilities, workshops, vehicle
maintenance, wash bay, and vehicle storage. The site development work will include, but is not limited to, earthwork,
grading, drainage, paving for circulation/parking, curbing, site lighting, and landscaping.
I, Daniel G. Tenney III, MA Registration Number: 6688 Expiration date: 8/31/2020, am a registered design professional, and I
have prepared or directly supervised the preparation of all design plans, computations and specifications concerning1:
XX Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications
meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the
proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on
the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor
in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of
the work and to determine if the work is being performed in a manner consistent with the approved construction documents
and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form
acceptable to the building official.
Upon completion of the work, I shall submit to the building official a ‘Final Construction Control Document’.
Enter in the space to the right a “wet” or
electronic signature and seal:
Phone number: 617.412.4480 Email: tenneyd@wseinc.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1. Indicate with an ‘x’ project design plans, computations and specifications that you prepared or directly supervised. If ‘other’ is chosen,
provide a description.