HomeMy WebLinkAboutWLC Initial CC Affidavit 12.01.2022Version 06_11_2013 – mod 08_21_2013 tvp
Initital 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 No:
010122
Project Title: South Yarmouth Wise Living Retirement Community Date: 12.23.2022
Property Address: 822 Main Street, South Yarmouth, MA 02664
Project: Check (x) one or both as applicable: New construction X Existing Construction
Project description: Renovations to existing building
I , Erik Robert Tolley, MA Registration Number:10730 Expiration date: August 31, 2023,
am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and
specifications concerning:
XX Entire Project 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. The contractor is responsible for the performance of the work in accordance with the
contract documents and shall be exclusively responsible for its construction means, methods, sequences, performance, warranties, and
procedures, and for construction safety.
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’.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107 or 521 CMR.
Enter in the space to the right a “wet” or
electronic signature and seal:
__________________________
Phone number: 508.362.8883 Email: Erik@ERTArchitects.com
Building Official Use Only
Building Official Name: _____________________________________________ Permit No.: _______________ Date: ____________________
Version 06_11_2013 – mod 08_21_2013 tvp