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HomeMy WebLinkAboutBLDR-24-452 application •
ONE & TWO FAMILY ONLY- BUILDING PERMIT
Town of Yarmouth Building Department :• ''oF
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: 13 L.])/L-o -q$off-- Date Applied:
Building Official(Print Name) Signature Date
kr- j al)n O SECTION 1:SITE INFORMATION
1.1 Property Address:ig W L1 1.2 Assessors Map&Parcel Numbers RECEIVED
1.la Is this an accepted street?yes no Map Number Parcel Nun ber sex
03 2024
1.3 Zoning Information: 1.4 Proggy Dimensions:
BUILDING DEPARTMENT
Zoning District Proposed Use Lot Area(sq ) Frontage(f)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water S pply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system (R
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Recorg,.. �` �� �j
-P.tdjyGAie UC/►�ICt�/5 �19R'07C'i.' 7 "G� rov!/f /'i Oc7 -C
Name(Print) City,State,ZIP
�'him��.ti.'C� lid' r -.j66c� „A/5 e fio 40.4)sr-NfC
No.and Street Telephone Email Address
SECCTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction Vaisting Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑
Demolition 0 Accessory Bldg. Ia" Number of Units Other 0 Specify:
Brief Description of Proposed Work2:
j( 4' /: e• .51#,AJ /AIG Got2 CO. P 4 )
SECTION 4:ESTIMATED CONSTRUCTION COSTS.
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 6'et g d ex) 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 1.4 Ube 60
0 Standard City/Town Application Fee
0 Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ 0 List: 1190.00 0, ,4
5.Mechanical (Fire $ _
Suppression) b Total All Fees:$
06 Check No. Check Amount: Cash Amount:
6.Total Project Cost: / 8 8 tr.
l J� � 0 Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
941:0/4-34)C.s> \IP rLtiZ.e04,9 12-i v .2 License Number E piration Date
Name of CSL Holder 5 P<y1
c, E.
Le.€ - List CSL Type(see below) V
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted I&2 Family Dwelling
City/Town,State,ZIP M Masonry
r .-rn 0v-r-► Mn ?'� RC Roofing Covering
y '"`i' WS Window and Siding
SF Solid Fuel Burning Appliances
G41 1t'i2-.zig pc giltul z. a_‘ I Insulation
Telephone Email address j'1I.6jo, 404( D Demolition
5.2 Registered Home Improvement Contractor(HIC)
o, ,o� an�e� Ll derz t, aq Gix {oLe
23
HIC Registration Number
HIC Company Name or HIC Registrant Name
3 Aro
No.and Street Email address
t..pe tiJ S-4—
City/Town, State,ZIP tit rn mO Telephone Ti 0w2?2f Cl.' ►1A 'L),e.e)nI
SECTION 6:WOKII 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 Issuanc the building permit.
Signed Affidavit Attached? Yes No .❑
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 authorize 961....%4 zto it)e,t,t1 e
to act o y behalf, in all matter rely e to wo authorized by this building permit application.
- %/j) Sti)VoFF
rint 0 er's Name(Electronic Sl re) 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 appli . .. . ►e and accurate to the best of my knowledd ee and understanding. �l
�A e, G - 6 Je /A.'i f /
Print Owner's or Autho 1-zed isSignature) D Name(Electronic ate
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.2ovIota Information on the Construction Supervisor License can be found at www.mass.aov/dps
2. When substantial work is planned provide the information below:
Total floor area(sq.ft.) G`1<4G r(� (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) 6 Habitable room count
Number of fireplaces D Number of bedrooms
Number of bathrooms 0 Number of half/baths PA
Type of heating system 0 Number of decks/porches
Type of cooling system 0 Enclosed Open D
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
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 g t kui D
Work Address
Is to be disposed of at the following location: 90i2,0 001-1-1- C. 64 JA
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
614.1dfil74 4/4"-,(1/;-,
Signature of Applicant Date
Permit No.
ONE or TWO FAMILY- BULDING PERMIT
APPLICATION REGULATORY APPROVALS NOTICE
Address of Proposed Work: C.Q� AN tic)
Scope of Proposed Work: X 2-4't Tcc AC4 e ( tee S -V(20/A)C
Date: 3� .
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/Matt Bearse, 96 Old Main Street, SY
Note: Please call Fire Department for an appointment. 508-398-2212
Other
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.
ReceAot Acknowledgem nt:
Applicant's Signature (Date
Rev. March 2022
J Telephone(508)398 2231 Ext`1292-Fax(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COM m .0..
APPLICATION FOR
?fIRKO (Tr TO4N CLEN'‘� {} CERTIFICATE OF APPROPRIATENESS
2) 24 Hm,W r..."4
Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 4StQ,1 11,
amended,for proposed work as described below&on plans,drawings,photographs,&other supplemental
application. PLEASE SUBMIT 4 copies OF SPEC SHEET(S),ELEVATIONS,PHOTOS,&SUPPLEMENTAL INFORMATION.
Check All Catecaories That Apply: Indicate type of Building: Commercial !/ Residentia/l _-
1)Exterior Building Construction: New Building Addition Alterations Reroof :.- arage
Shed Solar Panels Other:
2)Exterior Painting: Siding Shutters Doors _Trim Other:
3)Signs/Billboards: New Sign Change to Existing Sign
4)Miscellaneous Structures: Fence Wall Flagpole Pool Other:
Please type or print legibly:
Address of proposed work: ,4//,1rii,d/7 Map/Lot# 1A
Owner(s):Arui✓L.v / /%J / pliffd/A/AY'�,5 Phone s• I' -iiy-Jfz5
All applications must be submitted by owner of accompanied by letter from owner approving submittal of application.
Mailing address: _5:4 Year built: "997
EmaiL�3 � _✓`IVs�I�LN1CA / '�t/ _Preferred notification method 7 il" P4e Email
Ag- 'contractor: Tox, 1'"113.rz.tze_tsi P t 0.67 Phone#: 5"o e-
Mailing Address: ,`�t.6 1 t L-P,v q,} S'F
_ek4l Pr/ n7-e•
Email: `DI N 4 W(.L A6 ,E„ 1►-15A) C.6!1't Preferred notification method: Phone I' Email
Description of Proposed Work:
5-5 1,0iLJ/ a, a- , c -e ctf +) rLvske ovt/L H-€A. Odod2,
.e412-AveQ O4700e7? 4 O/yi lid'titer B �c.� e�.J d°L,osr G/C
,tg2 ea -r cis . -reJ
Signed(Owner or agent): e ,jam ae.ier.,_,C Date: OA,"
▪ Owner/contractor/agent is aware that a permit is required from the Building Department.(Check other departments,also.)
If application is approved,approval is subject to a 10-day appeal period required by the Act.
This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later.
✓ AU new construction will be subject to inspection by OKH.OKH-approved plans MUST be available on-site for framing&final inspections.
for Committee u$e.only: IV-Approved Approved with Modifications Denied
Rcvd Date:_ Reason for Denial:
Amount • LD
Cash/CK f>~ (Adti
Revd by: U S, Signed: = - � ,.'r
45 Days:
41(14 Af .._ ---� _ APPROVED
Gir, rF
Date Signed: _ f rri�tvipi„i t4
.^OL KUNG'jS/Hita/HHWAY -
1 APPLICATION#: (/-f '/T 1U1
- � • The Commonwealth of Massachusetts
1 '�. 1, Department of Industrial Accidents
�!� 1 Congress Street, Suite 100
Boston, MA 02114-2017
\Iti„. www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organiaation/Individual): TO Lb I fq,� e-74- 4.al .
Address: o < <- -e
City/State/Zip: j-'001440(1-11-31)/4 du7h Phone #: ".dg r.L—"(i4/•<,
Are you an employer?Check the appropriate box: Type of project(required):
l.❑I am a over with employees(full and/or part-time).* 7. ❑New construction
2 am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling
any capacity.[No workers'comp. insurance required.]
9. ❑ De ton
3.❑I am a homeowner doing all work myself. [No workers'comp. insurance required.]t
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 uilding addition
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.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.El Roof repairs
These sub-contractors have employees and have workers'comp.insurance.:
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑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'corn ' n insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: 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.
I do hereby certify rnder the
�pains and penalties of perjury that the information provided above is true and correct.
Signature: hr �e-GG( L -' G1 'fd•C Date: gl3j6c Ir
Phone#: 4-0g—64Z_ t1L4
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#:
Licensee Details
Demographic Information
uti Nm ae: Donald J Harkenrider '
caner Name:
License Address Information
City: Yarmouth Port
tate: MA
ipcode: 02675
oust . United States
License Information
License No:—---
Profession: CS-014978 License Type: Construction Supervisor
Da Building Licenses c of Last Renewal: 4/10/2024
Il eco Date: 5/12/2010 Expiration Date: 5/12/2026
�cense Status: Active Today's Date: 5/9/2024
econdary License Type:
oitu Business As:
Status Change Reason: License Renewal
Prerequisite Information
No Prerequisite Information L
No Available Documents ___�__.___ _.._.__. ..._—._._.__t
Commonwealth of Massachusetts
Division of Occupational Licensure
}C Board of Building Regulations and Standards
C 0 nstkilttion S
CS-014978 ti
spires:05/1212024
i
DONALD J HARKENRIDER f
20 EILEEN S`F RT MA 02675 .. _
YARMOUTH P9
a f ICIErn LeA--
Commissioner �U
THE COMMONWEALTH EALTH OF BA Busmess Regulation SETTS Registration valid for individual use only be€ore the
expiration date. If found return to: Regulation
Office HOMEf Consumer VEMEAffair T CONTRACTOR IMPROVEMENTduat Office of Consumer Affairs and Business
r(pE'Inwidual
Real tration 1000 Washington Street -Suite 710
Boston,MA 02118
ion
t00909 06123/2026
DONALD HARKENRIDER '
DOA DONALD J.HARKENRIDER' �
t,, r' '" le�� '
DONALD J. T RKENRtdER '
N valid without signature
20 EILEEN STREET Undersecretary
YARMOUTH,MA 02675
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AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone
Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)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) 1 stories s 2 stories
Roof Pitch (Fig 2) s 12:12
Mean Roof Height (Fig 2) ill ft <_33'
Building Width,W (Fig 3) .. 1'ft 5.80'
Building Length, L (Fig 3) T27 ft <_80'
Building Aspect Ratio(LNV) (Fig 4) .+-O <_3:1
Nominal Height of Tallest Opening2 (Fig 4) .1° <_6'8"
1.3 FRAMING CONNECTIONS
General compliance with framing connections (Table 2)
2.1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1 y/
Concrete
Concrete Masonry
2.2 ANCHORAGE TO FOUNDATION13
5/8"Anchor Bolts imbedded or 5/8" Proprietary Mechanical Anchors as an alternative in concrete only
Bolt Spacing-general (Table 4) iif in.
Bolt Spacing from end/joint of plate (Fig 5) 2Q.in.s 6"-12"
Bolt Embedment-concrete (Fig 5) '7 in. >_7"
Bolt Embedment-masonry (Fig 5) i.,. 15"
Plate Washer (Fig 5) >_3"x 3"x 1/4"
3.1 FLOORS
Floor framing member spans checked (per 780 CMR Chapter 55)
Maximum Floor Opening Dimension (Fig 6) 0 ft<_ 12'
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6 -..=-'
Maximum Floor Joist Setbacks
Supporting Loadbearing Walls or Shearwall (Fig 7) ft 5d
Maximum Cantilevered Floor Joists L�b'�LJ t�� —
Supporting Loadbearing Walls or Shearwall (Fig —ft 5 d
Floor Bracing at Endwalls (Fi 9)
Floor Sheathing Type er 780 CMR Chapter 55)
Floor Sheathing Thickness (per 780 CMR Chapter 55) in.
Floor Sheathing Fastening (Table 2)..._d nails at in edge/ in field
4.1 WALLS
Wall Height
Loadbearing walls (Fig 10 and Table 5) g..ez...ft <_ 10'
Non-Loadbearing walls (Fig 10 and Table 5) 42 ft <_20'
—
Wall Stud Spacing (Fig 10 and Table 5) / 7'in. <_24"o.c.
Wall Story Offsets (Figs 7&8) ..,,_. mac d
4.2 EXTERIOR WALLS'
Wood Studs
Loadbearing walls (Table 5) 2x - ft in.
Non-Loadbearing walls (Table 5) 2x j- . ft/L in.
Gable End Wall Bracing'
Full Height Endwall Studs (Fig 10)
WSP Attic Floor Length (Fig 11) ft?.W/3Gypsum 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 4..----
Double Top Plate
Splice Length (Fig 13 and Table 6) E ft
Splice Connection(no. of 16d common nails) (Table'6) 4.—
ik
211 CHECKLIST
110 MPH EXPOSURE B WIND ZONE
Bracing Gable End Walls
WSP Attic Floor Length (Figur ) ft. z W/3
Gypsum Ceiling Length ' ure 11) ._ft. z 0.9W
Double Top Plate
Splice Length (Figure 13) ,g--ft.
Splice Connection (no. of 16d common nails) (Table 6) .-
Loadbearing Wall Connections
Uplift.(proprietary connectors) (Table 7) U 4 0t lb.
Lateral(no.of 16d common nails) (Table 7) 2,-
Non-Loadbearing Wall Connections
Uplift. (proprietary connectors) (Table 8) U= 18 lb.
Lateral(no. of 16d common nails) (Table 8) -T
Wall Openings
Header Spans (Table 9) lit._in.5 11'
Sill Plate Spans (Table 9) _.ft. in.512'
Full Height Studs(no. of studs) (Table 9)
Connections at each end of header or sill
Uplift. (proprietary connectors) (Table 9) —lb.
Lateral(proprietary connectors) (Table 9) _lb.
Wall Sheathing
Minimum Building Dimension, W
Sheathing Type (Table 10) i - Goys
Edge Nail Spacing (Table 10) in.
Field Nail Spacing (Table 10) / in.
Shear Connection (no. of 16d common nails) (Table 10) _
Hold Down Capacity (Table 10) _lb.
Percent Full-Height Sheathing (Table 10) 94
. Maximum Building Dimension, L `,- _
Sheathing Type (Table 11)
x
Edge Nail Spacing (Table 11) ._ in.
Field Nail Spacing (Table 11) /.Z-_ in.
Shear Connection (no. of 16d common nails) (Table 11)
Hold Down Capacity (Table 11) _lb.
Percent Full-Height Sheathing (Table 11) %
Wall Cladding
Rated for Wind Speed?
5.1 ROOFS
Roof framing member spans checked? (IRC or WFCM) V.`.
Roof Overhang (Figure 19) P4'ft.5 2'or L/3
Truss, I-Joist,or Rafter Connections at Loadbearing Walls
Proprietary Connectors
Uplift. (Table 12) U= 'Ib.
Lateral (Table 12) L=i.7 . lb.
Shear (Table 12) S= 7 lb.
Ridge Strap Connections-Tension (Table 13) T= ',iplf
Gable Rafter Outlooker (Figure 20) e)ft. ft.<2'or L/2
Outlooker Connections at Non-Loadbearing Walls
Proprietary Connectors
Uplift. (Table 14) U-*7 lb.
Lateral (Table 14) L# lb.
Roof Sheathing Type (IRC or WFCM) l Z encL
Roof Sheathing Thickness Y.& in z 3/8'wsp
Roof Sheathing Fastening (Table 2) .1,0 _
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