HomeMy WebLinkAboutBLDR-23-12807 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 �`' ;" -'i
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 F C E 6 '*; F.- D
Building Permit Number: 13(Z P)-2 3--17�(2� Date Applied:
r [[ JUL«122113
Building Official(Print Name) Si re Date _
BUIL9INC BCRAR1 M ENT
SECTION 1:SITE INFORMATION By ---_
1.1 Property dress: 1.2 Assessors Map&Parcel Numbers
7 !o/Aro-Cc Tyr/rd-Cc u /cf z Z
1.1 a Is this an accepted street?yes no Map Number Parcel Number
LA Zng Information: 1.4 PropertyDimensions:
'l0 3 , 197, ‘f
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required I Provided Required Provided Required Provided
30 13.1 sT
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: ZC Outside Flood Zone? Municipaldisposal system Public 1�' Private 04)
0 On site Check if yes❑ y '�
SECTION 2: PROPERTY OW*ERSA3P1
2.1 Own r'of Record: i ‘c*-\\
-� ?1M4riA, 0 Oti j, yetwevart
Name(Prig City,State,ZIP
/7 i✓'IIrvle rerrike S, yao-I ..4F 3G7-001-9 OvrJanc�ofi CYo 'r
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 f Existing Building 0 Owner-Occupied 0 l Repairs(s) 0 Alteration(s) 0 I Addition
Demolition ❑ Accessory Bldg. 0 Number of Units . Other ❑ Specify:
Brief Description of Prop sed Work2: ✓ --be eta. e/0,fro
f•-tw o p Ti cr/k-6rkrn►r fr c /3 / eweve•Ttow y raedr1
p p y j 01, ,s y' % hoe 7amf N67#4 472sy/ rilt- r
SECTION 4:ESTIMATED CONSTRUCTION COSTS. �. 7e
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ /94 130 1. Building Permit Fee:$`j0C? Indicate how fee is determined:
OPO la Standard City/Town Application Fee
2.Electrical $ / U Total Project Costa(Item 6)x multiplier x
3.Plumbing $ /2 370 2. Other Fees: $
4.Mechanical (HVAC) $ G/00 List: IP i').®D , I,3c-78'
•
5.Mechanical (Fire - .
$ Total All Fees:$
Suppression) _
/ O' Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ Zlli`VGQ 0 Paid in Full ill Outstanding Balance Due: 440
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License (CST.) �`1� �/ �,,j6�Lv
i,4j fl�T"�jGf / Liccn`e Number Expiration Date
Name ofCSL Ioide:
j� s �� f 013e� � � iire Lis;CSL't we(see below)
67� /�/ O C , Tyco Description
No.and Street 1
L U i Unrestricted(Buildings up to 35,00C cu. ft.)
__ _ . _—�._ R i Restricted l&x2 Family Dwelling
CityrTown,State, i.T? 1 NI i !vlasoary
� Y( , j1 z q its 1 hoofing
- Covering
/ WS ? Window and Siding i
SF 1 Solid Fuel Burning Appliances
,;-cam-eP7-333Y je/+yo7iSYr j' &P 'ri1/./ver. E insulation _i
Telephone Emali address D 1 Demolition __ — __
I,. 5.2 Registered Home Improvement Contractor(HIC)
fir� .r1`" G'` /�tiflt�n�//kr> //✓�
y i HIC Registration Number Expiration Dace
HIC Company Narne or HIC Registrant Name _
No. and Street Email address.4 M'PiScre s% _ .e;--y»-33cY
City/Town, State,ZIP Tele p:,one j _ _ --
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 t:-:e denial'f the Issuance of the building permit.
Signed Affidavit Attached? Yes No t=
_
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 autborize#X /
si/fl Qth y d, C. —
to act on my behalf, in all hatters relative to work authorized by this building permit appli anon.
,{ //f IOr/a.I/ '.. /6 7— /2 -' 3
j 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.
'17 0"r/'.1 - - 7- 2'L3
Print Owner's or Authorized agent's Name(Electronic Signature) Date
NOTES:
I. 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)Proem), will not have access to the arbitration ';
program or guaranty fund under I.G.L. c. 142A. Other important information on the HIC Program can be found at j
www.mass.aoy/oca Information on the Construction Supervisor License can be found at vwww.mass.Qov/dos
2. When substantial work is alarmed,provide the information below
Total floor area(sq. ft.) _ (including garage, finished basemenJattics.decks or porch)
Gross living area(sq. f<.)—__ Habitable room count Number of fireplaces Number of bedrooms
Number of bathrooms_ _ Number of ha':f oaths_--- _—_
Type oI heating system Number of decks,porches ___
_• Open
Type of cooling system Enclosed -
3. "Total Project Square Footage" may be substituted for"Total Project Cost"
• • The Commonwealth of Massac/zccsetts
*J� I, Department of Industrial Accidents
•cal_ 1 Congress Street, Suite 100
, Boston,MA 02114-2017
www.mass.gov/dia
Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information �J, /� Please Print Legibly
7 Name (Business/Organization/Individual): i 'i'4 �/''� ,9Cll/(.t./V '(/ c,lcchJ'/ •
Address: /3"- TO5/SreJ 4
City/State/Zip: m16340 / `% Phone#: 7'33`y
Are you an employer?Check the appropriate box: Type of project (required):
I. ,1 am a employer with employees(full and/or part-time).* 7. gf New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ®Remodeling '
any capacity.[No workers'comp.insurance required.]
3.0 I am a homeowner doing all work myself. (No workers'comp.insurance required.]t
9. El Demolition
10 ❑ Building addition
4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will
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. 13. Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
6.0 We 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 t/1 must also till 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.
tContractors 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:,,r t /i.11/7 6.'/ s Qg/7 j
Policy or Self-ins.Lie.#: ZaO/t/G3'fI Expiration Date: / ,-%.S 2 3
Job Site Address: /7 P./f/(/(rv-rta T/%"! City/State/Zip:--S. Arletea:Th
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 underthe pains and penalties of perjury that the information provided above is true and correct.
Sisnaturer ;// : 'JP / �7 Date: -7--I z a3
Phone#:.S 77-33Gq/ saI--may-7fr/7eel/
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License r
Issuing Authority(circle one):
I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
§TOWN OF YA . OUTS[
1146 Route 28, South Yarmouth, MA 02664
508-398-223*1 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 /7 ‘v/�itair rive s• y `' o20Y
Work Address
Is to be disposed of oat the following location:�Acerf '" r fw'
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Ch. 111, §150A.
ignature of Application Date
Permit No.
Registration valid for individual use only before the
expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
1000 Washington Street -Suite 710
Boston,MA 02118
Not valid without signature
THE COMMONWEALTH OF MASSAC-HUSETT:S
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE:Corporation
Registration Expiration
102634 07/0112024
€MOTHY GRAY BUILDING&REMODELING,INC.
'IMOTHY GRAY
;&K NICOLETTAS WAY iw
fiASHPEE,MA 02649
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Triple 1-3/4" x 9-1/2" VERSA-LAM® LVL 2.1E 3100 SP I PASSED I
RB01 (Roof Drop Beam)
BC CALC®Member Report Dry 11 span I No cant. January 24,2023 13:43:14
Build 8381
Job name: 17 Wild Rose Terrace File name:
Address: Description:
City,State,Zip: South Yarmouth, MA Specifier:
Customer: Ann Michniewicz Designer: Joe Madera
Code reports: ESR-1040 Company: Shepley Wood Products
Connection Diagram: Full Length of Member
b r
Ci
•
•
•
C
a minimum= 1-3/4" c=6"
b minimum=6" d=24"
e minimum= 1"
Calculated Side Load=0.0 lb/ft
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 BOARDT",BCI®,
BOISE GLULAMT",BC FloorValue®,
VERSA-LAM®,VERSA-RIM PLUS®,
to Triple 1-3/4" x 9-1/2" VERSA-LAM® LVL 2.1E 3100 SP PASSED ED
Dr*
RB01 (Roof Drop Beam)
BC CALC®Member Report Dry 11 span I No cant. January 24,2023 13:43:14
Build 8381
Job name: 17 Wild Rose Terrace File name:
Address: Description:
City,State,Zip: South Yarmouth, MA Specifier:
Customer: Ann Michniewicz Designer: Joe Madera
Code reports: ESR-1040 Company: Shepley Wood Products
<10
12
y . . _.. 1 i • +_.. • .-- • ♦ • 2- . 1 1 2 1 1 . • _• . . • __.1 • 1 _...I • 1 1
1 -
• • 1 . 1 • • • • . • 1 1
• ♦ 1 ♦ • VVV • ♦ V • • • ♦ 0 • V
V 1
S �'S, q Y v, -kr 4 ti
14-00-00 B2
B1
Total Horizontal Product Length=14-00-00
Reaction Summary (Down/Uplift) (Ibs)
Bearing Live Dead Snow Wind Roof Live
B1,3-1/2" 700/0 1659/0 2415/0
B2,3-1/2" 700/0 1659/0 2415/0
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 14-00-00 Top 14 00-00-00
1 Unf.Area(Ib/ft2) L 00-00-00 14-00-00 Top 15 30 11-06-00
2 Unf.Area(Ib/ft2) L 00-00-00 14-00-00 Top 20 10 05-00-00
Controls Summary Value %Allowable Duration Case Location
Pos.Moment 13339 ft-lbs 55.4% 115% 5 07-00-00
End Shear 3443 lbs 31.6% 115% 5 01-01-00
Total Load Deflection L/276(0.588") 86.9% n\a 5 07-00-00
Live Load Deflection L/466(0.349") 77.3% n\a 8 07-00-00
Max Defl. 0.588" 58.8% n\a 5 07-00-00
Span/Depth 17.1
%Allow %Allow
Bearing Supports Dim.(LxW) Value Support Member Material
B1 Wall/Plate 3-1/2"x 5-1/4" 4074 lbs n\a 29.6% Unspecified
B2 Wall/Plate 3-1/2"x 5-1/4" 4074 lbs n\a 29.6% Unspecified
Cautions
For roof members with slope(1/4)/12 or less final design must ensure that ponding instability will not
occur.
For roof members with slope(1/2)/12 or less final design must account for Rain-on-Snow surcharge
load.
Notes
Design meets User specified(U240)Total load deflection criteria.
Design meets User specified(U360)Live load deflection criteria.
Design meets arbitrary(1")Maximum Total load deflection criteria.
Design based on Dry Service Condition.
BC CALC®analysis is based on IBC 2015.
Calculations assume member is fully braced.
Dane. -al