BLDR-23-13060- ONE &TWO FAMILY ONLY- BUILDING PERMIT
Town of Yarmouth Building Department of 4.*;k1r' ..
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 S0 on_For Official Use Only
Building Permit Number: kip , '--' '6Date Applied: / . /..2_6 7
to l-�.- �,� E C E 1 V ��D
Buifiiing Official tName) • ,Zsi tore r`_ Date-
SECTION 1:STTE INFORMATION i DEC 11 '023 •
1.1 Property Address: t"'``51' , 1.2 Assessors Map&Parcel Numbers I
4)1 Pk,.A-.9 Le:.�,,-c_ L ,c N gn.Mc�iE'� 4 7 Z eutuc,ini; DEPARTMENT
1.1 a Is this an accepted street?yes no Map Number Parcel Number g -y
1.3 Zoning Information: 1.4 Property Dimensions: t
R- aS 42.E. S-. � 4i1
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
1.6 Water Supply:(M.G.L c.40,'1 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public l9� Private❑ Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Zt„-e vilAv 1Ck f t t _&c Y s 7 L LC. F1..,II 4. _ . it Y.14
Name(Print) City,State,ZIP
Cd.(301 7 1 Ic � �i ���`) l.l�/jU1,r.so./, e4vL, cam
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction iYExisting Building 0 I Owner-Occupied lRep airs(s) 0 Alteration(s) 0 I Addition 0
Demolition 0 I Accessory Bldg.0 Number of Units / Other 0 Specify:
Brief Description of Proposed Work2: (v.,--5-\i ., Cr &) i-1 c,"--x-,e-
'_ 1 L 0--; -- , S,- a- --e__. E Z C, — � -4'1,4-S-e__
3 t ` sects-i.
SECTION 4:ESTIMATED CONSTRUCTION COSTS.
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building $ 6 5 t ow 1. Building Permit Fee:S . Indicate how fee is determined:
El Standard City/Town Application Fee
2.Electrical $ J 3-, crtro 0 Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ -4,, cro 2. Other Fees: $
List: 69 h4 6O 0(M gat/
4_Mechanical (HVAC) $ I
S.Mechanical (Fire $ Total All Fees:$
Suppression)
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ C: /t (Tin) 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
LC)al t Lq,ti ,ii�St jC License Number Expiration LS _ 5 �rl (U S ��(
Date
Name of CSL Holder
/
I L4 uL� List CSL Type(see below) L�.
No.and Street !n t Type Description
\ r-ii ` `o,t,16 ' `"4"l,,t ck)1 -�-, ,fin'4 o 7S-- U I Unrestricted(Buildings up to 35,000 cu.R)
R Restricted 1&2 Family Dwelling
City/T wn,State,ZIP M Masonry
RC I Roofing Covering
WS Window and Siding
5.� G i 47 r; 14) 2�4 y ;j( SF Solid Fuel Burning Appliances
c 1 S 7`, .< -7� I Insulation _
Telephone Email address D Demolition
. 5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name HIC Registration Number Expiration Date
/� L-- 't A S -(-. A., L-4 u-. A=i Au., .4.,( ‘,.s.( 1 aCr,-(14, LT 4 fi
No.and Street
altiu,.r -LI t,.� .-7k-; 4 -0E `2(4//(.'(jc Email address
Cityffown,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 ofthe building permit.
Signed Affidavit Attached? Yes LrtY No
. SEC t1ON 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 SPn��5 r"c.-I v`\A a-A-- e.'C . C. L L-C-
to act on my behalf,in all matters relative to work orized by this building permit application.
NAt�C., j 4,C4- 50.E �/ A,-(f.. 1, l I i ` j
Print Owner'ss.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] PPlicpdcuri ate t best of my knowledge and understanding.
Jae'
3
Print Owner's or Authorized Agent's Name(Electronic Sign ture) 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)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.00v/oca Information on the Construction Supervisor License can be found at www.mass.novldps
2. When substantial work is planned,provide the information below:
Total floor area(sq.IL) ''7,I ?' (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) , ?t Ss' Habitable room count C.
Number of fireplaces t Number of bedrooms 9
Number of bathrooms 3 Number of half/baths _
Type of heating system ' 4 S Number of decks/porches .-
Type of cooling system ��t-ec:_ Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
rto Cu 1 l) yC /ncar
t,, f
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
:._ Boston,MA 02114-2017
www.mass.gov/dig
Workers'Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers.
TO BE FILED WITH TILE PERtMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): vac) .L C •
Address: 15 G-t "' t/c - //
City/State/Zip: \)401‘tvi(-AA( 00/4_i riti4 Phone#: 5' d� t ce 6 - / e - '{
Are you an employer?Cheek the appropriate box:
Type of p oject(required):
I. am aemployerwith 3 employees(full and/or part-time).* 7. aiveW construction
2.0 I am a sole proprietor or partnership and have no employees working for me in •
any capacity.[No workers'comp.insurance required.] $• Remodeling
3. I am a homeowner doingall work myself. t 9. ❑Demolition
❑ y [No workers'comp-insurance required.]
4.0 I am a homeowner and will be hiring contractors to conduct all work on my prope I will €0 Building addition
rty.
ensure that all contractors either have workers'compensation insurance or are sole 11.E Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
5_9-Yarn 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.t 13. Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§t(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#i 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 cheek 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.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: 'RUA. c e.-'L S
Policy#or Self-ins.Lic.#: 6 F(. 1J (3 I I. c66 L L - Expiration Date:
Job Site Address: ^- L z 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.
z ::'
certify tin the ntiesoferju hat the it formation provided above is true and correct±air/ f � ! f ) f t
Date: 1.?--
Phone 7:
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.CitylTown Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
§TOWN OF YARMOUTH
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 L (PL)
Work Address
Is to be disposed of oat the following location: \ �1 ad—IL L4 `'t"c i 1t
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Ch. 111, §150A.
ft
Signa of Application Date
Permit No.
TRAVELERS
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
TYPE AR INFORMATION PAGE WC 00 00 01 ( A)
POLICY NUMBER: (6HUB-1K86160-0-23)
RENEWAL OF (6HUB-1K86160-0-22)
INSURER: THE TRAVELERS INDEMNITY COMPANY OF AMERICA
A STOCK COMPANY
NCC1 CO CODE: 13439
INSURED: PRODUCER:
PROJECT MANAGERS CC LLC MURRAY & MACDONALD INS
15 LEXINGTON LANE 550 MACARTHUR BLVD
Y_A.RMOUTHPORT MA 02675 BOURNE MA 02532
Insured IS A LIMITED LIABILITY COMPANY
Other work places and identification numbers are shown in the schedule(s)attached.
2. The policy period is from 02-25-23 to 02-25-24 12:01 A.M. at the insured's mailing address.
3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers
Compensation Law of the state(s) listed here:
MA
B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in
item 3.A. The limits of our liability under Part Two are:
Bodily Injury by Accident: $ 500000 Each Accident
Bodily Injury by Disease: $ 500000 Policy Limit
Bodily Injury by Disease: $ 500000 Each Employee
C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here:
COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06B
D. This policy includes these endorsements and schedules:
SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE
4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans. All required information is subject to verification and change by audit to be made ANNUALLY.
DATE OF ISSUE: 01-30-23 WC ST ASSIGN: MA
OFFICE: RMD POOL 161
PRODUCER: MURRAY & MACDONALD INS 75NHN
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Update Address and R5tu?Card.
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(Xitue of Consumer Affairs c=Busins5 RdsulaUon "ecisnatiOia valid for individual us oni j before the
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ONE or TWO FAMILY— BULDING PERMIT
APPLICATION REGULATORY APPROVALS NOTICE
Address of Proposed Work: Cuiv,0 C�v �`� L-, +p h
Scope of Proposed Work: � � f- tc-9
Date: f /11
Based on the scope of work described above,the applicant is required to obtain approval sign-
offs from the following departments as checked-of below:
Health Dept.—508-398-2231 ext. 1241
Conservation—508-398-2231 ext. 1288
Water Dept. —99 Buck Island Road, 508-771-7921
Old Kings HWY. Hist. Comm. —508-398-22631 ext. 1292
Engineering Dept.—508-398-2231 ext. 1250
Fire Dept.—Kevin Huck/Scott Smith,96 Old Main Street, SY
Note:Please call Fire Department for an appointment. 508-398-2212
TOther
Appropriate plans and/or application shall be provided to each departments checked-off above.
Each of these regulatory authorities has their own requirements outside the jurisdiction of the
Building Department. All applicable approvals shall be obtained prior to submitting a building
permit application to the Building Dept.
Thank you for your cooperation.
Receipt AcknoyGI ge ent•
- /
Applicant's Sig ure Date
Rev.Jan. 2019
AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone
Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)'
Q Check
Compliance
1.1 SCOPE
Wind Speed (3-sec. gust) 110 mph ✓
Wind Exposure Category B
1.2 APPLICABILITY
Number of Stories (a roof which exceeds 8 in 12 slope shall be considered a story) 2 stories 5 2 stories
Roof Pitch (Fig 2) JZ/,t <_ 12:12
Mean Roof Height (Fig 2) 2 9 ft <_33'
Building Width,W (Fig 3) ft <_80' tr
Building Length, L (Fig 3) +-tii ft <_80' 1,--
Building Aspect Ratio(L/W) (Fig 4) j <_3:1 r—
Nominal Height of Tallest Opening2 (Fig 4) <_6'8" t•-'"-
1.3 FRAMING CONNECTIONS
General compliance with framing connections (Table 2)
2.1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1 -
Concrete -
Concrete Masonry
2.2 ANCHORAGE TO FOUNDATION''3
5/8"Anchor Bolts imbedded or 5/8" Proprietary Mechanical Anchors as an alternative in concrete only
Bolt Spacing-general (Table 4) ).51c, in.
Bolt Spacing from end/joint of plate (Fig 5) in. <_6"-12" ✓
Bolt Embedment-concrete (Fig 5)...... ._in. >_7" r
Bolt Embedment-masonry (Fig 5) in. ? 15" ,-
Plate Washer (Fig 5) >3"x 3"x 1/a' v,
3.1 FLOORS
Floor framing member spans checked (per 780 CMR Chapter 55) 4."
Maximum Floor Opening Dimension (Fig 6) 10 ft 5 12' •.---'
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall (Fig 6) N ioN
Maximum Floor Joist Setbacks
Supporting Loadbearing Walls or Shearwall (Fig 7) ft <_d ''' `
Maximum Cantilevered Floor Joists
Supporting Loadbearing Walls or Shearwall (Fig 8) ft <_d + 'i'
Floor Bracing at Endwalls (Fig 9)
Floor Sheathing Type (per 780 CMR Chapter 55) ."
Floor Sheathing Thickness (per 780 CMR Chapter 55) _'1�\ in. 600"
Floor Sheathing Fastening (Table 2)...ig d nails at .6 in edge/ IA in field t...,-
4.1 WALLS
Wall Height
Loadbearing walls (Fig 10 and Table 5) k ft <_ 10' +
Non-Loadbearing walls (Fig 10 and Table 5) (4 ft <_20' sr
Wall Stud Spacing (Fig 10 and Table 5) 1 lj in. <_24"o.c. t/
Wall Story Offsets (Figs 7&8) ft 5 d _46,LA
4.2 EXTERIOR WALLS3
Wood Studs I.-
Loadbearing walls (Table 5) 2x 6 - Y ft in.
Non-Loadbearing walls (Table 5) 2x 6 - etc-ft_in. ____L•--
Gable End Wall Bracing'
Full Height Endwall Studs (Fig 10) 1'eS
WSP Attic Floor Length (Fig 11) ft>_W/3 tv la"+
Gypsum Ceiling Length (if WSP not used) (Fig 11) _ft>_0.9W _bLA
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-
Double Top Plate
Splice Length (Fig 13 and Table 6) 0 ft
Splice Connection (no. of 16d common nails) (Table 6)
. A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone
Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)'
.. Loadbearing Wall Connections
Lateral (no. of 16d common nails) (Tables 7)
Non-Loadbearing Wall Connections
Lateral (no. of 16d common nails) (Table 8) .)-
Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9)
Header Spans (Table 9) L ft . - in. <_ 11' 1,.,-
Sill Plate Spans (Table 9) 6-ft_in. <_ 11' '
Full Height Studs (no. of studs) (Table 9) L
Non-Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9)
Header Spans (Table 9) 1 ft_in. <_ 12' 1`
Sill Plate Spans (Table 9) 3 ft in. <_ 12" le'
Full Height Studs(no. of studs) (Table 9) i'(
Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4
Minimum Building Dimension, W
Nominal Height of Tallest Opening2 _<_6'8" rr
Sheathing Type (note 4) Z ►i.)
Edge Nail Spacing (Table 10 or note 4 if less) '3 in. ..
Field Nail Spacing (Table 10) 6, in. e
Shear Connection (no. of 16d common nails)(Table 10) _`L "'
Percent Full-Height Sheathing (Table 10) '?�
5%Additional Sheathing for Wall with Opening > 6'8" (Design Concepts)
Maximum Building Dimension, L E R/
Nominal Height of Tallest Opening2 1 <_6'8" i--"---to
Sheathing Type (note 4) I.v CO
Edge Nail Spacing (Table 11 or note 4 if less) 3 in,
Field Nail Spacing (Table 11) 6, in. --
Shear Connection (no. of 16d common nails)(Table 11) LA 4''
Percent Full Height Sheathing (Table 11) "2171 1-----
_
5`)/0 Additional Sheathing for Wall with Opening >6'8" (Design Concepts)
Wall Cladding
Rated for Wind Speed?
5.1 ROOFS
Roof framing member spans checked? V- (For Rafters use AWC Span Tool, see BBRS Website) 1.''~
Roof Overhang (Figure 19) / ft<_ smaller of 2' or L/3
Truss or Rafter Connections at Loadbearing Walls
Proprietary Connectors
Uplift (Table 12) U=1'e)t'plf
Lateral (Table 12) L=/ 76 plf --------
Shear (Table 12) S=7 7 plf L`
Ridge Strap Connections, if collar ties not used per page 21... (Table 13)..Co1.l , -,-,; T= plf v
Gable Rake Outlooker (Figure 20) c ft<_smaller of 2' or L/2
Truss or Rafter Connections at Non-Loadbearing Walls
Proprietary Connectors r�
Uplift (Table 14) U=I't) f Ib. ...
Lateral (no. of 16d common nails)...(Table 14) L=TNlb.
Roof Sheathing Type (per 780 CMR Chapters 58 and 59) ....t.A-. P
Roof Sheathing Thickness 1 f 'in. >_7/16"WSP
Roof Sheathing Fastening (Table 2) 614 --
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.
AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone
Massachusetts Checklist for Compliance (780 CMR 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 THIS EDGE RESTS ON
FRAMING USE&1 NAILS
6-o.c.
AT o.c. •
u i Ip
11 li
17
N
11 li
1
M I y
1 �1
11 1
1 N 1zzI AI
S 11
11
IT
I 0 11
F1 1 A
11 41 i ii
R O n H
1 Q ij
fi d i o p
1 l Q 1 0 ,^I d
N I' ri - z i1 z
II pp 1 11/1 a
M1 Q A
t O 1 11
\ RI
1 1 11
.Z W li
u i K 13
13
a u
1 11
11
'11 1 W-y
i 1 Lt
DOUBLE EDGE
NAIL SPACING 1
PANEt_ • `
See Detail on Next Page
Vertical and Horizontal Nailing
for Panel Attachment
AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone
Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)'
¢=N 1
I
z W ' ,
d i IFRAMING MEMBERS
EDGE INTERMEDIATE I I
Z 1- .
STAGGERED MIN
AWL PATTERN PANEL
PANEL EDGE 1 DOUBLE NAIL EDGE SPACING DETAL
Detail
Vertical and Horizontal Nailing
for Panel Attachment