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HomeMy WebLinkAboutBLDR-24-319 RECEIVED \.. I JUN13-- 2024 &TWO FAMILY ONLY-BUILDING PERMIT Town of Yarmouth Building Department ,r- 1146 Route 28,South Yarmouth,MA 02664-4492 BUILDING DEPARTMENT 508-398-2231 ext.1261 Fax 508-398-0836 BY Massachusetts State Building Code,780 CMR Building Permit Application To Construct,Repair,Renovate Or Demolish a One-or Two-Family Dwelling s SectionFor Official Use Only Building Permit Number: 6( .2, 31 Date Applied: q � i ! '7/� Building Official(Pi Name) • /Si store DateSECTION 1:3iTERMATION 1.J,Pfopyity A dress: / f 1.2 Assessors Map&Parcel Numbers jj'I raid/an/19w�C U /r 1.1 a Is this an accepted street?yes '— no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Wat r Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone:_ Outside Flood one? Publi Privaty,� Check if ye Municipal 0 On site disposal system SECTION 2: PROPERTY OWNERSHIP' 2.1 /ert gMRecord: wC//� Plat S.7) Name(Print) City,State,ZIP 7 w 4,.... /9i-c, 7-)ya3o 7331, No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied 0 I Repairs(s) 0 Alteration(s)lid Addition 0 Demolition ❑ Accessory Bldg.0 um er of Units Other P pecify. Brief Des irip-ti^on of Proposed W0 ': 1 e, �s Ie— SECTION 4:ESTIMATED CONSTRUCTION COSTS. I Item Estimated Costs: Ofllcial.Use Only (Labor and Materials) I.Building $ 1.Building Permit Fee:$ • Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town,Application Fee ❑Total Project Costs(iyep{6)i pultiplier x 3.Plumbing $ 2.Other Fees:$ `//'CVJi^�I /11 (-lOth • 4.Mechanical(HVAC) $ List 5.Mechanical(Fire $ Suppression) Total All Pies:$ • Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ /Q j ODD _ 0 Paid in Full 0 Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL)n /Dals7 ,I I?&1 Zr tos/ LL i /iq� �^S.-/3 o License Number Expiration Date Name of CSL Holder GI k k F/f, n .d,v List CSL Type(see below) Na.an Street l-/�O La rJ t/G Type Description pvOti i/ 1.114 DIS7/ U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted l&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding -7 1il2' SF Solid Fuel Burning Appliances �)/ LJG7D l aot(r. -Insulation Telephone Email add D Demolition 5.2 Registered Home Improvement Contractor(HIC) fit / ti��� � � rl Z� W(�,'t�/gry, / Cg�s�en"en/��{rE RICl Registration Number Expi on Date MC No.ndiSteet y h- C/r7) 7 v yam,? -n) Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AP'I''WAVIT(N.I.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 o(,.the Issuance of the building permit. Signed Affidavit Attached? Yes No..........❑ SECTION 7a:0 AUTHORIZATION TO BE COMPLETED WHEN • OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize IA 4 Lf-14711 LIAlc L to act on my behalf,in all matters relative to work authorized by this building permit application. fr/74-777-11) WI-u..s '/yIz y 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. la,/1-1-/ Z-1/a/16L /y/zy 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 IHC Program can be found at www.mass.sov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dos 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 mom 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" p4,Y'gP` ! TOWN OF YARMOUTH o_mt.`, _ BUILDING DEPARTMENT Y�� 4• 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext.1261 HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: DATE: G /I1 b�/y /� JOB LOCATION: r/ A W�q✓el4t,1/C of /y� NAME � STREET A_ DPJES S SECTION OF TOWN "HOMEOWNER" Wes( NAME inME PHONE WORK PHONE PRESENT MAILING ADDRESS 7 v4 cmac° *JC vuot4.Y 0119- 6/5-7I . CITY OR TOWN STATE ZIP CODE The current exemption for'Homeowner'was extended to include owner—occupied dwellings of one or two units and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such homeowner shall act as supervisor. (State Building Code Section 110 R5.1.3.1) Definition of Homeowner: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to be,a one or two family attached or detached structure assessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall submit to the building official,on a form acceptable to the building official,that he/she shall be responsible for all such work performed under the building permit.(Section 110 R5.1.3.1) The undersigned'homeowner'assumes responsibility for compliance with the State Building Code and other applicable codes,by-laws,rules and regulations. The undersigned'homeowner'certifies that he/she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he/ she will comply with said procedures and requirements. HOMEOWNER"S SIGNATURE APPROVAL OF BUILDING OFFICIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent,which meets the requirements of MGL Ch.142. Yes No If you have checked vves,please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass.General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent h:homeownrlicexemp §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 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 crq tut Work Address �► Is to be disposed of oat the following location: A f-fG '0 j44/- Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. // )2 Signature of Appl to Date Permit No. Zip code Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The fist is current as of Thursday, June 1, 2023. Search Results .. R. 0 Ls t r ri 04 a M. ! RESP C.A.4 S RE, Csi S T MAD R S ?; D P4.11 D ij A E$ R 174'-i• A'71;" WILLIAM LEPAGE LEPAGE, 168480 521 Potere Drive .05/04/2025 Current WILLIAM Davenport, FL 33837 - • • . • • Site Policies Contact Us © 2018 Commonwealth of Massachusetts. Mass.Gov0 is a registered service mark of the Commonwealth of Massachusetts. • 0.... * Commonwealth of Massachusetts ,,,, ,ft Division of Occupational Licensure - Board of Building Regulations and Standards fqi T-i L ., Constrict:kb/ion 8-tm,rvisor CS-102957 E*ptres: 04/26/2025 WILLIAM P LP AGE f 521 POTEREACIRIVE DAVENPORI‘ L 33837 ; 4.7 „., ..,„ , . 0 ,.... ef/1 . fy_1:1 ,..7 ....h• 6 ( L; rw. . i . . % ft^v ....., r ). , Boise Cascade lia Double 1-3/4" x 14" VERSA-LAM® LVL 2.1E 3100 SP PASSED ENGINEERED WO011%RUJUC'!S FB01 (Drop Beam) BC CALC®Member Report Dry 11 span I No cant. May 31,2024 15:34:55 Build 16959 Job name: Cape House File name: Address: Description: 2nd floor girder City, State,Zip: Dudley,MA,02537 Specifier: Customer: Chace Woodstock Designer: Charles Coombs Code reports: ESR-1040 Company: Boise Cascade 1 1 1 + 1 1 1 1 1 1 1 1 111 1 i 1 1 1 1 1 1 i 1 1 : i : 1 1 1 1 1 1 1 t 1 1 1 1 1 1 1 4. t 01 1 1 1 1 1 1 1 1 l 1 1 1 1 1 1 k - 61 17-06-00 B2 Total Horizontal Product Length=17-06-00 Reaction Summary (Down / Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live B1, 3-1/2" 3019/0 1130/0 B2, 3-1/2" 3019/0 1130/0 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.(Ib/ft) L 00-00-00 17-06-00 Top 14 00-00-00 1 Unf.Area(Ib/ft2) L 00-00-00 17-06-00 Top 30 10 11-06-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 17214 ft-lbs 59.3% 100% 1 08-09-00 End Shear 3458 lbs 37.1% 100% 1 01-05-08 Total Load Deflection U356(0.574") 67.4% n\a 1 08-09-00 Live Load Deflection U490(0.418") 73.5% n\a 2 08-09-00 Max Defl. 0.574" 57.4% n\a 1 08-09-00 Span/Depth 14.6 %Allow %Allow Bearing Supports Dim.(LxW) Value Support Member Material B1 Wall/Plate 3-1/2"x 3-1/2" 4149 lbs n\a 45.2% Unspecified B2 Wall/Plate 3-1/2"x 3-1/2" 4149 lbs n\a 45.2% Unspecified Notes Design meets Code minimum(L/240)Total load deflection criteria. Design meets Code minimum(L/360)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 2021. Calculations assume member is fully braced. Connection Diagram: Full Length of Member -11 .1 b r._ ....__d --or— t i . • t—• • e L Page 1 of 2 Boise Cascade Double 1-3/4" x 14" VERSA-LAM® LVL 2.1E 3100 SP PASSED ENF.I"EEH ED WOOD'ROO.C'S FB01 (Drop Beam) BC CALC®Member Report Dry I 1 span I No cant. May 31,2024 15:34:55 Build 16959 Job name: Cape House File name: Address: Description: 2nd floor girder City,State, Zip: Dudley, MA,02537 Specifier: Customer: Chace Woodstock Designer: Charles Coombs Code reports: ESR-1040 Company: Boise Cascade Connection Diagram: Full Length of Member a minimum= 1-1/2" c= 11" b minimum=4" d=24" e minimum= 1" Calculated Side Load=0.0 lb/ft Connectors are:SDS 1/4 x 3-1/2 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®,AJS'"', ALLJOIST®,BC RIM BOARDT*',BCI®, BOISE GLULAM'"',BC FloorValue®, VERSA-LAM®,VERSA-RIM PLUS®, Page 2 of 2 LEPAGEWI03 SCOSTEN AcoRo CERTIFICATE OF LIABILITY INSURANCE DATE 6/5/2024(MM/DD/YYYY) `--� 2024 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 Suzan Costen NAME: O'Connor&Co.Insurance Agency Inc. PHONE I FAX 135 Thompson Road (A/C,No,Ext): (A/C,No): P.O.Box 1090 E-MAIL suzant@oconnorinsur.com Webster,MA 01570 ADDxEss. INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Merchants Preferred Insurance Co INSURED INSURER B: • William Lepage(c/I) INSURER C: 56 Schofield Ave INSURER D: Dudley,MA 01571 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBRI POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR ,INSD WVD, IMM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CTRI014745 5/20/2024 5/20/2025 DAMAGEES(TOEa RENTEDoccurrence) $ 500,000 PREMIS MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A COMBINED SINGLE LIMIT AU LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HAU TOS S ONLY ,__ AUTOS ONE PROPERTY accidentDAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I 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 Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD