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HomeMy WebLinkAboutBLD-23-005941 V ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 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: 8 23--on 9 { Date Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Prope/rty Address: .2 Assessors Map&Parcel Numbers MapNumber Parcel Number l.la Is this an accepted street?yes no I P D u 1.3 Zoning Information: 1.4 Property Dimensions: / 90o ' / a 0 (� /�pp ;231Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) A- �'+ 26 1.5 Building Setbacks(ft) BUILDING DEPARTMENT Front Yard Side Yards Rear YadBy ________ Required Provided Required Provided Required Provided 30 act , 3 i Qo 30,20 v0 Zl7 i# 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private ElZone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: / / ,/ f j/ 4 02 6 p T01A4S 're 0,iLC- Jov/�&. Yc v0h ovI&, fri Name(Print) / City,State,ZIP 29 L4 kc.wuv� 1oc&e, COS 597--O$C7 710044.3 . Gc rCiaiu fie.. eWi ciacrr>f No.and Street Telephone Email Address CO/►'t SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition X Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: 22' )(l Yl 4 oai l/U SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) 1.Building $ LjO 0/30 1. Building Permit Fee:$' 5"(7 Indicate how fee is determined: Standard City/Town Application Fee 2.Electrical $ /Of G0 CI 0 Total Project Cost3(Item 6)x multiplier . x 3.Plumbing $ /0- U 0 0 2. Other Fees: $ 4.Mechanical (HVAC) $ / 0 pV CI List: (O i, OD tf'rT' 13 61-7 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash o t: 6.Total Project Cost: $ '�(�� �C7 0 Paid in Full Outstanding Balance ue: �L' I-- 1, . SECTION S: CONSTRUCTION RUCTION SERVICES 1 5.1 Con r r rr.� C'S?. n. I /.��,s lam. f;� tt�ir� c �1 1� tp - ra y .rr�U A G j� ,d. .L T 1so , ,1'r ,,:et # t} , 4t t'}�' « �j'' i Litstrutrxtext Btzis a 35.Ga cxa i i fitewn,Stet_ZIP d It i 3 # M 1 Man l C Fl�r)o ,► ;r r Iutd€ vatttS ¢r ,q s G .. Solid Fx.1 Bt ,� pplianoa i AA { T e - _. Email.address R ` 't 1} Teltiott ik/ titian 1 -1 eti5#eered Homy 1•r,p m::ient Contrac€orORO irtt RTC )is -e ' :t:ps r t Tt teiPT4604 L°icpur;ovir. t _ itrrc Zti /CrJa-t#+ d 1 trAlevlt u�r23 )pi . '`l',S/f1' ?,sate.7_lp. ,_,.... Tsltp } 1 t TION 6:WORK RS'CO PE.' SA'I'roN I SURAiscE A't 11)4,vrr( 152. 2 Worker.;C mpc:)a, rrr I ,racsoe affidavit mast be x} mat stagnated6)) - o._. , this affidonttu ll.es_:t ntcI . rr this ay Ei pro.;. , o... -teagrvid f ::t�n of the pe,Wit. i SizedAi c am. ._.._ .r it rrc)ti 'a. u\t\}.t. ,il:l}t01(12A}ION IQat>COMPUTED WHEN 011`.'r n'S ,.ENt r)t.(r)YrR4CT4)Iz A i'll IFS FORBUILDING PERMIT vie`.e.. t#.' r t,s et .. lacarr y a e A - to act,e eta r:a f. i suers refer s'e to work authorized b�..eel w_ _ > lit _0 v >J se_O ter.*N 4E csacc Signa..ar^ .. Zcs Z7. are LTIIORTZXD.it.}'\1 })1•c LARATIi �., By entering myname below,1 hcrerry rderst under the pains and Mies ofpesjtrty that ail of ttte information a contained«.this applitatinn€s tic and accurate to the hest*army knOwltdite and imderstanding. ,.u_. �aC .Jw"i'4'3..:t14�'C^rt 5 3sTik.` .°CtKitb ° '- [, M a Ni)TEN:7 1~1f4 i s. An Owner Whoobta€ s a bti�pant"i't # or _ ...,.r ..,.-..., Ord.or as owner who lines as unregistered ',not registered to the Home improver- hzati iststtetar ., +; i*to ,�'.will rant lt:sr��s to theatb� o P �or pzira f ul'.m&r P ,. �"�"`rM mass CSk a Y� 1 .�•- i � �;, IlC pcv�: t can be totttsd at t'4v ormaL olt a ..,r.1 u c. svr L.__., . ..;o found at ww. 2 When sub .:s..1! . rk is the info -----�.- ,.. s istltdina pimp ..:.::. ed erne t'amen,decks or porch) i..,. e r t bi r`ma Number or� ces ,..»�.x» _ f4t ...,... - - ._ F �b of bathrooms I cct��. I w , Typo of bc„ti *vein 3"utt)t+�r Typeof coolin system Et l h o: _.�'.: r )c e — 1 .3. j-Total Project "e Fo • may be sub ttttted for'"CGt31 Project .., i ti 1 I f SECTION 5: CONSTRUCTION SERVICES • f 5.1 Construction Supervisor License(CSL) C s- ®CT«f f-_� / �/lri s ��%,- s �C one(� License Number Expi anon ate Name of CSL Hold GQ 3 Lit j / CI r it40 s?(•1 le cad List CSL Type(see below) U No.and Street Type Description I146ev ® U Unrestricted(Buildings up to 35,000 Cu.ft.) t ity/ n,State,ZIP it, I R Restricted 1 Pu.2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding D 3 1-3/1/ a e by„,. / SolidFuel Burning Appliances J Q c/INL 46J4 �t� I Insulation / Telephone Email address o CAN D Demolition 5.2 Regi stered Home Improvement Contractor(HIC) ! F1256 _rho;- 1f INll a L'/(&.1/'S .h L' HIC Registration Number Expiratibn Date HI�3m-j Nar9eoSo' Regi/ Name / / �,,// Weeks N��o/an Str tL .4 rm av �GGi!j1' �(`/i e9 44 II i ldCti �I t 414 (/"`S 1 krmav Ill/ /7 4 02673 S-�8 3�°(7/ 3/// Email address City/Town, State,ZIP Telephone 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 No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT riI,as Owner of the subject property,hereby authorize eJr/J/p k elite eeki eto act qn ehalf,in all ers rel 've to work authorized by this building permit application. /,/ ' 4..._..- 5/e 11 —, ''t 494? _........._...t.___ ________ Print wner s Name(Electronic Signa ure) Date SECTION 7b: OWNER1 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. Print Owner's 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.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/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 10.11411.11 l Department oflndustrialAccidents p'� I Con;ress Street, Suite 100 �,r�� 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 i� Please Print Legibly Name (Business/Organization/Individual): leeti I t At,// i f _`A.0 1 Address: 60,3 j / Yrl44GLi t le,,o ,„( City/State/Zip:j% 15 ievili /14 O,�C�Phone #: _5--or „ '47- —3r// Are you an employer?Check the appropriate box: Type of project(required): 1'�4 I am a employer with C) employees(full and/or part-time).* N2.0 I am a sole proprietor or partnership and have no employees working for me in 7. ❑Rem delinruction any capacity.[No workers'comp. insurance required.] 8. n Remodeling 3._1 am a homeowner doing all work myself [No workers'comp. insurance required.]t 9 C Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. 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. 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12. Plumbing repairs or additions These sub-contractors have employees and have workers'comp. insurance.t 13. Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(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. 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. er Insurance Company Name: 4iicr, iti /) p y Z or( L !/f' tGC C 14 AR Policy#or Self-ins.Lic.#: C Z Z vI) eh 3 37`/76/7 Expiration Date: 17/25142 Job Site Address: zq . try -,/ /eakei City/State/Zip:number t/ ,/��0�;r/'Attach a copy of the workers' compensation policy declaration page(showing e policyn m e a d expiration i►Gd�� � 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 ud t e pains nd pena ies of perjury that the information provided above is true and correct. Sienature: Date: 5/7/03 Phone#: 5-0? 6 V` ,?/// 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. 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 Z I Lc%kb./)0if ✓(god SCc�/ 1"I47i) / h It/A Work Address Is to be disposed of at the following location: ]l"./41/ct'er/1 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. 3 7 z3 Signature of Applicant Date Permit No. 5/2/23. 10:57mw ma 'Sears,Tim ovuoox 29 [8kemm.od Sears, Tim <tS88rS@V8rnoOuth.Dl8.US» rue5/2/2O2370:57AM To:Chris Kenney <konneybui|ders@hotnnai|.cono> Chris, | have reviewed your application and there are some items needed. ' /1- Health Department sign off/un�errevievv\ . ' ^, � ^^ 2. Rescheok based on 2031 |ECC -- ���� *�/�� ^� /�v'Z' 3 /,0 '-50 Please submit these items for review Timothy Sears [8O Deputy Building Commissioner Town of Yarmouth 508-398'2231 Ext. 1259 mai|toAsearsfflyarmouth.ma.us h«ps:8uuUook.offioo.00n/maiVsandtemv/igAw.QxxDsaMoQ5wvvzmLTxOYz|tmo|wwi1imoQxuwwxmGQywmE4wzEswAAQA*aqvopY6u000nv|wEx 1/1 AcoREP® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/06/2023 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 CONTACT Alan Burstein NAME: Peter M.Bakker Agency,Inc. PHONE (860)378-2700 FAX (A/C,No,Ext): (A/C,No): 302 West Main St ADDRESS: alan.burstein@optisure.com INSURER(S)AFFORDING COVERAGE NAIC# Avon CT 06001 INSURER A: American Zurich Insurance Comp 40142 INSURED INSURER B: Main Street America Assurance Company Kenney Builders Inc. INSURER C: 603 W YARMOUTH RD INSURER D INSURER E: WEST YARMOUTH MA 02673-'459 INSURER F: COVERAGES CERTIFICATE NUMBER: CL233624254 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 POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER X COMMERCIAL GENERAL LIABILITY (MM/DDfYYYY) (MM/DD/YYYY) LIMITS EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 B MPJ7842M 04/06/2022 04/06/2023 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC 2,000,000 PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION _ AND EMPLOYERS'LIABILITY Y/N X PER STATUTE EERH A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A UB-8H337476-22 09/25/2022 09/25/2023 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Tom Cardone ACCORDANCE WITH THE POLICY PROVISIONS. 21 Lakewood Rd AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 { A ©1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • — Corrartonwea.311 t hea•seachusz.rh Ore16,ezm of Occupattonal :..crosure Duard ot kluttairee ,4r0 *• :1 C:onstartlion,Supe„ritiLor CS-CC181I& rpir= a 1 1340 24 CHRISTOPHER T KENNEY 603 WEST YARMOUTH RD WEST YARMOUTH MA OD173 • • • C011arrliSSIOtier I7'.‘! - , • " '".7 /././/P12/;"Y',07 // .ar• of/efZe' / Office of Consumer Affairs and Business Regulation *:000 Washington Street-Suite 710 Boston, Massaohosetts 02118 Home Improvement Contractor Reoistraton 1 ype: Ccrp-cratitxt LiJLDERS 17%31ratieri 113,r1.5,1Cati- et):3 WEST YALIMOUTH ROAD WEST YARMOUTH,MA E.1421,;7:71 Upd.ste Ar art%Return Ca:tl oirree-et Celt:414CW Aitati;it.fleshless Reoula:Sen HOUL iMPROVEMFM'S CONTRAST011 Res•41:ration valid for iradtvidual use Only before tao expiration dele If Mond return RtaitaeiLori ExpiNtion °flit*of Canner Affairs WV riumater.r.RegtOltior Washi,AgtOr,street -Suite 710 1:tt..411 ...ft-.NC. Easton.MA 0e2114 CE9 Kt-Hr-J1Y 'ATSIYATIMou:H RCAD --- -- ws - YAP:VOL:14,MA 14872. Not vaiici withqursignature zindersecroury • Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards II Cons Ian Svisor CS-001895 � 6tpires:01/13/2024 CHRISTOPHER T KENNEY 603 WEST YARMOUTH RD WEST YARMO_,,UTH MA 02673 Commissioner 0fi. U �t1i� • 6V7M740-./W}ealia-/ o,-4*zeJe/A',; Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 181256 KENNEY BUILDERS INC. Expiration: 03/16/2023 603 WEST YARMOUTH ROAD WEST YARMOUTH,MA 02673 Update Address and Return Card. SCA 1 0 20M-05/17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 181256 03/16/2023 1000 Washington Street -Suite 710 KENNEY BUILDERS INC. Boston,MA 02118 CHRISTOPHER KENNEY 1,���� 603 WEST YARMOUTH ROADj�r� C z?i'' (l�r0/c. ' d WEST YARMOUTH,MA 02673 Undersecretary Not vaii without signature ..,_ C.) .. .. :,,/ ..... kf r•. C),/ -----.44 co 1 ... e g.) c ..- is c cc 4) 0 -..-- ce e - 1 $11 Ci) "cil o Z o c 9, 2 ' C ill C1 2 CI) I 7., :- -,-; 4., ; 8 i (,) r7: cr.) (.1) I.-a 7.$ , c.--• (..)., , 1 ....t. c .._. cu -•.- cr.,,., f , V 1;-- —..-4.,% It ,,,,,,: =5 0 14. n_ i i , I -a ..-34 .- = ci) ` .... -rs< =rg c,- ,,,,_ , a. ws di 2.EV '',;‘, '.. gr.... .<13 0:Z ;_*,...--4,..: .: 3...0 4111Z,. ., 8'38z -...lie2 -2....F.,..oise 6 xre,41 MuOv-C1 t *'' . -.. .0 ' CP- : --"'-'' "'",....•------: ' . a) 69,.. .6- ',.--'---'•-• Z E ....- ti o —+.'-zl---..:'..----, 0 m .... Ti; c o CO — , -,,,,, •,.., ,„..* 0 3 '''.... . 0 0 c 0 E 11-x .....tli ° = 1 0 i 4c ri o cv 0-zi z c ,6 <a ta 9 5 m'et° --.2 2 at a 4 g 'k)8±- I:I t„.,•-"' .-1 r- to iii ' .,... 0 g ccPis . ta >,u .c _7...., t3.-- ul iii m...0.; ,„, at tutt. •••U 0 7 ...„-..01 =Si 03 0.. C >. 0 tti 1.6..I.r. 0 Tli x c1.23 SOWN OF YARMOUTH 4A . ' HEALTH DEPARTMENT r'" ``'C PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant:Building Site Location: (C� 4 -� cy °� /?--.01 ,�A ik- Proposed , provement: Q / 4 4 ,r/ ✓ G / / Applicant: J e/i- 3 �i 1 t/�5"' / Al Tel.No.:-3®3 3 CI 3" 1 Address: 6 6 3 VO-. .� lI P f',co i 1AS Date Filed: 1/,;?C 9 j "If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: ✓ 4 0 '(,45 C 2 r(4) , Owner Address: ci. ,/i, e:?_ IA,a cY 0 a Owner Tel. No.: 5-C O -.,i -O G 7 L 'V4AA /Y4 0- RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: RECE/V'Elb (1.) Site Plan showing existing buildings, water line location, and septic system cation; APR 2023 (2.) Floorplan labeling rooms g within building HEALTH peps (all existing and proposed)- Note:Floor plans not required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY. iyy410 DATE: rS Z� PLEASE NOTE COMMENTS/CONDITIONS: pF' \VN OF Y R iOUTf {., WATER DEPARTMENT -$ � 99 Buck island Road ` C� l\'e t Yarmou th, ,MA 026� 3 Tel phone: 15081 71-7921 • Fay.: (5081 771-7998 BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: 7 s, ®m<0 Pc=f) PROPOSED WORK: L ea6..e, 6 .)--rk, APPLICANT: / 1 1'/t.„,�'�- — r.,,f led,_ ADDRESS: 1,, ReV' • .I.ELPHONE: d r-- 2 c., y r1/ eV-- RESIDENTIAL AND/OR COMMERCIAL BUILDING Water Department: Determines Compliance of Water Availability and or existing location Engineering Department: Determines Compliance for Parking and Drainage Conservation Commission: Determines Compliance to 'Wetlands Act; i.e. If lot(s)border any type of wetlands streams,ponds,rivers, ocean, bogs, boys, marshland, ETC... Ilealth Department: Determines Compliance to State and "fown Regulations, i.e. requirements Ior Septage Disposal and other Public Health Activites Eire Department: Determines Compliance to State and Town Requirements for Personal Safety, Property Protections, i.e.Smoke Detectors, Sprinkler Systems,etc APPLICA SIGNATURE /9 -2-3 DOTE OFFICE USE:COMM EN" ON PE:R IIT APPROVAL OR DENIAL Or_z/C.,\_....../--- 1 REVIEWS BY'WATER DIVISION(SIGNATURE) DATE • /9e9-6 SERVICE NO. 2895- NAME/e/ Thomas A. Cardone 8-30-96 STREET Gi/f (:2/ c3e6 c7 VILLAGE -572 METER NO. /O3 CO&15 ./1/6/4 L1-*' JrD / 4•101. )/ • Y1 qi k, ,ZZ 0781f it1'4411:.,,,O, v •\ . 44' l#Ts' (12 71cm.4,) 7,1w.P T''e ,P7 p-7- • / '`'� �, fi"mane to Wood Ceilstruct?on in.High Wind Areas:110 mph Wind Zone Pill_a: s cb se is CeCK JSt tar Co ` b ce(780 CI,_R 53o1. .1.1'- Q Check Compliance 1.1 SCOPE Wind Speed(3-sec.gust) 110 mph ✓ Wind Exposure Category B _Ite"..-- 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope stall be considered a story) stories 5 2 stories `' Roof Pitch (Fig 2) /2 <12:12 1.----- Mean Roof Height (Fig 2) ` ft 5 33' Building Width,W (Fig 3) 1 ft 5 80' _— Building Length, L (Fig 3) 24 ft 5 80' ✓ Building Aspect Ratio(L W) (Fig 4) . iI . 5 3:1 a/ Nominal Height of Tallest Opening2 (Fig 4) lap-8 5 6'8" __J.4 1.3 FRAMING CONNECTIONS General compliance with framing connections (Table 2) te-"--- 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete i.Concrete Masonry __&i tret*. 2.2 ANCHORAGE TO FOUNDATION.° 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general Bolt Spacing from end/joint of plate (Fig 5)4) 6 in.5 6"-12" ---- -- Bolt Embedment—concrete (Fig 5) 1 in.>7" ---- ' Bolt Embedment—masonry (Fig 5) in.>_15" al& Plate Washer (Fig 5) >3"x 3"x%" 3.1 FLOORS Floor framing member spans checked (per 780 CMR Chapter 55) 2141015 ei i`"o/v Maximum Floor Opening Dimension (Fig 6) .it.ft 5 12' �r Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6) it.. Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall (Fig 7) t ft <d MIX. Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall ;Fig 8) 6 ft 5 d /.1.6 Floor Bracing at Endwalls ;Fig 9) Floor Sheathing Type per 780 CMR Chapter 55) b/ Floor Sheathing Thickness i:per 780 CMR Chapter 55) in. 8/ Floor Sheathing Fastening ITable 2).10 d nails at Lin edge/IZ in field 1/ 4.1 WALLS Wall Height Loadbearing walls (Fig 10 and Table 5) '. ft 510' ✓ Non-Loadbearing walls (Fig 10 and Table 5) ft <_20' Wall Stud Spacing (Fig 10 and Table 5) lG i�24"o.c. Wall Story Offsets (Figs 7&8) ft <d 4.2 EXTERIOR WALLS3 Wood Studs Loadbearing walls (Table 5) 2x 6 - 0 ft 0 in. 6,-'' Non-Loadbearing walls (Table 5) 2x - 'A ft O in. _ Gable End Wall Bracing' Full Height Endwall Studs (Fig 10) 100/ WSP Attic Floor Length (Fig 11) ft aW/3 DNA. Gypsum Ceiling Length(if WSP not used) (Fig 11) ft>0.9W and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c...(Fig 11) —" or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays ✓� iiii Double Top Plate Splice Length (Fig 13 and Table 6) L ft 1 .---- Splice Connection(no.of 16d common nails) (Table 6) t/ _`Wr Gedde to Wood ti.os?a':le'c€_'o_2 iA High Wind A?eos, 110 mho? Whgd Zo:,te a,-,sP,R entree tss Chec! i..,`L _',For Compliance(no Ct R 5301.2.1.'J- Loadbearing Wall Connections Lateral(no.of 16d common nails) (Tables 7) 2 I/ Non-Loadbearing Wall Connections Lateral(no.of 16d common nails) (Table 8) 2. Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans (Table 9) 6 ft 1 in.<_11' / Sill Plate Spans (Table 9) Wji ft in.s 11' i�/ Full Height Studs (no.of studs) (Table 9) Z Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans (Table 9) L ft Ij in.<12' Sill Plate Spans (Table 9) _ft_in.<_12" Full Height Studs(no.of studs) (Table 9 Z _he/ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously` Minimum Building Dimension,W •, Nominal Height of Tallest Opening2 Gas 6'8" 1,/' Sheathing Type (note 4) V/_ Edge Nail Spacing (Table 10 or note 4 if less) to in. Field Nail Spacing (Table 10) 7T in. ✓ Shear Connection(no.of 16d common nails)(Table 10) �o:T Percent Full-Height Sheathing (Table 10) $7% �/ 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts) Maximum Building Dimension,L / Nominal Height of Tallest Opening2 6<6'8a 6� Sheathing Type (note 4) T/f 6 a/ Edge Nail Spacing (Table 11 or note 4 if less) 6 in. Field Nail Spacing (Table 11) /2 in. / Shear Connection(no.of 16d common nails)(Table 11) er Bi Percent Full-Height Sheathing (Table 11) °!o 5%Additional Sheathing for Wall wish Opening>6'8"(Design Concepts) _I/ Wall Cladding Rated for Wind Speed? 5.1 ROOFS Roof framing member spans checked? (For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ;Figure 19) ft<_smaller of 2'or U3 ,/ Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift (Table 12) U=id,plf Lateral (Table 12) L=L 7 4, plf Shear (Table 12) S= -17 plf ✓/ Ridge Strap Connections,if collar ties not used per page 21... (Table 13) T=t' O plf 1, Gable Rake Outlooker (Figure 20) _ft s smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift (Table 14) U= lb. - Lateral(no.of 16d common nails)..(Table 14) L= lb. Roof Sheathing Type (per 780 CMR Chapters 58 and 59) Roof Sheathing Thickness _in.z 7/16"WSP / Roof Sheathing Fastening (Table 2) ` Notes: — 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to.comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. A C Guide to Wood Construction in High Wind Areas.110 mph Wind one Massachusetts Checklist for o h ce(789 cII R 5301.2.1._1 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment —•-WHEN TEM EDGE RESTS ON FRAMING()SEW NAILS AT Vac. • II II 11 II Ii I. 1 7I I1 I Y I.1 II II II 1 11 II II II II I1 II II - I. 1 II Ut •I 71 II 7I YI I I I„ it It a 1" i1 11 mI �I II 73. i1 �� Q S11 CO. fl ;1 'K z l i fillW2t :I 1; 1 11 Qr 1l If g p „ 1. U III II JI 1 1. II 11 11 3e 1: 1.7 17 f I tl 1 I II 11 11 11 I II 7 1 - ..-+4l . id.. ''OLE EDGE ��r.-.. IO� MALSPACNVG i i 1 PANEL _ a s ...- See Detail on Next Page Vertical and -lorizontal Nailing for Panel Attachment