HomeMy WebLinkAboutBLDR-25-213 APPLICATION 0
0 E & TWO FAMILY ONLY- BUILDING PERMIT
• ' 0.
Town of Yarmouth Building Department pF,-Y``�
k ' 1p Q? 1146 Route 28, South Yarmouth,MA 02664-4492 ,,'e" , p
Q`it • . ,. 508-398-2231 ext. 1261 Fax 508-398-0836 t o . _•H
�� Massachusetts State Building Code, 780 CMR
\' MATTACHECSIL
�p` Building Permit Application To Construct, Repair, Renovate Or Demolish ''~,,,,,_ AtEo`,,,
00. a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number. /3 L iD R 'a s-•9-4Date Applied:
Building Official(Print Name) Signature I)ate
SECTION 1: SITE INFORMATION
1.1 Property Address: 4_ r 1 1.2 Assessors Map&Parcel Numbers
1.1a 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 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP' C Jrvi /Sorrh yafrtnI &2. Omier'nf Record:
c-rL rd lid
iC L 6( VOA/UV�,r Pal/ / A It!` Chili
e(Print) ty,State,ZIP
6vc�. LN SOC(((3059C( C;P'tN's4 r111(e, /rti� .
No.and Street Telephone Email Address c ,(4Q'FI4'(.CC 4
SECTION 3: DESCRIPTION OF PROPOSED WORD(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:Brief Description of Proposed Work2: (C-4e 1,-(2( /?29-19( ON Ck. Fait (0ccue/�i'`' (.ack' PQ.4° t
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ Vir d0 1. Building Permit Fee:$ Indicate how fee is determined:
g 0 Standard City/Town Application Fee
2.Electrical $ 0�t OQC7-e970 0 Total Project Cost3(Itemmx multiplier x
3.Plumbing $ 2. Other Fees: $ UL!
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
/�
6. Total Project Cost: $ ` g! lO0 0 Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofmg Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street 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 0 No . 0
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
to act on my behalf,in all matters relative to work authorized by this building permit application.
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 .i I l�lication is true and accurate to the best of my knowledge and understanding.
SN Print• , s or Authorized Agent's Name(Electronic Signature) Date
g � )
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
ww.mass „i Information on the Construction Supervisor License can be found at wwNN.mass.govidpc
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"
1
TOWN OF YARMOUTH
og�+YA Office of the Building ffiommissioner
WIZ A 1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ext. 1260 Fax 508-398-0836
�'-Oq'OPATE `-
HOMEOWNER LICENSE EXEMPTION
DATE:
JOB LOCATION: D 5 4 6U Ck, LA)
NAME STREET ADDRESS SEC ON 1OF TOWN
C
HOMEOWNER &1 I Z tt� 50 I-I( (
NAME HOME PHONE WORK PHONE ,/`,,
PRESENT LING ADDRESS �(o %�!Clt 1--/�) tAA/st e 1 ii pant‘-
vjekkciov+h 04 73-
CITY OR TOWN STATE ZIP CODE
Definition of Homeowner:
Person(s)who owns a parcel of land on which he or sheresides or intends to reside, on which there is or is intended
to be, a one or two family attached or detached structure accessory 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.
Any homeowner performing work for which a building permit is required shall be exempt from the licensing
provisions of780 CMR 110.R5,provided that if a homeowner engages a person(s)for hire to do such work, then
such homeowner shall act as supervisor. This exception shall not apply to the field erection of manufactured
buildings constructed pursuant to 780 CMR 110.R3
The undersigned 'homeowner' assumes responsibility for compliance with the State Building Code and other
applicable codes,by-laws, rules and regulations,and certifies that he or she understands the Town of Yarmouth
Building Department minimum inspection procedures and requirements and that he or she will comply with said
procedures and requirements.
HOMEOWNER"S SIGNATURE
;og . TOWN OF YARMOUTH
Office of the Building Commissioner
°
sr 1 ys 1146 Route 28, South Yarmouth, MA 02664
:y wrneHee �Y�
508-398-2231 ext. 1260 Fax 508-398-0836
DEMOLITION DEBRIS DISPOSAL APPLICATION
Pursuant to M.G.L. c.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. 85 7�lo`l46JC( 1- j/A4f /LA 19 04,4i T' •
Work Address
Is to be disposed of at the following location: yfillikte u 4 6 oGi '
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, §150A.
Signature of Applicant Date
Permit No.
The Commonwealth of Massachusetts
b, Department of Industrial Accidents
,=' Office of Investigations
_ l_ i Lafayette City Center
_� #
_. .�� 2 Avenue de Lafayette, Boston, MA 02111-1750
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):
Address: e6 Zi UC k A.)
City/State/Zip: 4ewe(ifc p0 (' Phone #: 5 Q g 4 ( 3 0 5-0 c(
Are you an employev Check the appropriate box:
Type of project(required):
1.0 I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. El New construction
listed on the attached sheet. 7. ElRemodeling
2.0 I am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor me in anycapacity. employees and have workers'
P h' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.+
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3. g I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.❑Other
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.
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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby cery u der the pains and penalties of perjury that the information provided above is true and correct.
Si nature: Date:
Phone#:
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License #
Issuing Authority(check one):
10Board of Health 20 Building Department 3.0City/Town Clerk 4.0 Electrical Inspector 5Elumbing
Inspector 6.0Other
Contact Person: Phone#:
®Boise Cascade" Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP PASSED
ENGINEERED W000 PRODUCTS
RB01 (Roof Flush Beam) .
ii3C CALC®Member Report Dry 13 spans I No cant. September 4, 2024 11:35:54
Build 8892
Job name: File name:
Address: 86 Starbuck Lane Description:
City, State, Zip: Yarnouthport, MA, 02675 Specifier:
Customer: CP Home Improvement Designer: William Campbell
Code reports: ESR-1040 Company:
0
12
1 1 1 . . 1 . . . . . 1 . 1 1 . . l . 1 1 1 1 1 1 1 1 1 4:-
1 1 1 . 1 4 4 1 1 1 1 . -1 l 0 1 1 1 1 1 _-1 - 1 -1-__1 1 1 1 + 1 1
i
10-06-00 10-06-00 10-06-00
B1 B2 B3 B4
Total Horizontal Product Length=31-06-00
Reaction Summary (Down / Uplift) (lbs)
Bearing Live Dead Snow Wind Roof Live
B 1, 5-1/4" 458/0 825/0
B2, 5-1/4" 1186/0 2132/0
B3, 5-1/4" 1186/0 2132/0
B4, 5-1/4" 458/0 825/0
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 31-06-00 Top 14 00-00-00
1 Roof Unf. Area (Ib/ft2) L 00-00-00 31-06-00 Front 15 30 06-00-00
Controls Summary Value %Allowable Duration Case Location
Pos. Moment 2432 ft-lbs 10.1% 115% 10 04-05-04
Neg. Moment -3171 ft-lbs 13.2% 115% 13 10-06-00
End Shear 934 lbs 8.6% 115% 10 01-02-12
Cont. Shear 1466 lbs 13.5% 115% 13 09-05-14
Total Load Deflection L/999 (0.051") n\a n\a 10 04-10-12
Live Load Deflection L/999 (0.034") n\a n\a 15 05-00-10
Total Neg. Defl. L/999 (-0.006") n\a n\a 10 12-04-02
Max Defl. 0.051" n\a n\a 10 04-10-12
Span/Depth 12.8
Allow %Allow
Bearing Supports Dim.(LxW) Value Support Member Material
B1 Column 5-1/4"x 5-1/4" 1283 lbs n\a 6.2% Unspecified
B2 Column 5-1/4"x 5-1/4" 3319 lbs n\a 16.1% Unspecified
B3 Column 5-1/4"x 5-1/4" 3319 lbs n\a 16.1% Unspecified
B4 Column 5-1/4"x 5-1/4" 1283 lbs n\a 6.2% 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.
Page 1 of 2
Boise Cascade = Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP PASSED
ENGINEERED WOOD PRODUCTS
RB01 (Roof Flush Beam)
BC CALC®Member Report Dry I 3 spans i No cant. September 4, 2024 11:35:54
Build 8892
Job name: File name:
Address: 86 Starbuck Lane Description:
City, State,Zip: Yarnouthport, MA,02675 Specifier:
Customer: CP Home Improvement Designer: William Campbell
Code reports: ESR-1040 Company:
Notes
Design meets Code minimum(L/180)Total load deflection criteria.
Design meets Code minimum(L/240) 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.
1-3/4"x 9-1/2"VERSA-LAM®2.0 3100 SP is a discontinued product. Discontinued products are not
available for purchase.
Calculations assume member is fully braced.
Connection Diagram: Full Length of Member
b d
I,
c
• • •
- - e -.m-
a minimum = 1-1/2" c=3-1/4"
b minimum =4" d = 12"
e minimum= 1"
Calculated Side Load=270.0 lb/ft
Install screws from both sides,staggering screws by half of the spacing to avoid splitting.
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®,AJSTM
ALLJOIST®,BC RIM BOARDTM,BCI®,
BOISE GLULAMTM,BC FloorValue®,
VERSA-LAM®,VERSA-RIM PLUS®,
Page 2 of 2
®BoiseCascadelillTriple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP PASSED
ENGINEERED WOOD PRODUCTS
RB02 (Roof Flush Beam)
BC CALC®Member Report Dry 12 spans I No cant. September 4, 2024 11:35:54
Build 8892
Job name: File name:
Address: 86 Starbuck Lane Description:
City, State, Zip: Yarnouthport, MA, 02675 Specifier:
Customer: CP Home Improvement Designer: William Campbell
Code reports: ESR-1040 Company:
0
12
1 1 1 1- 1 1 1 1 Z 1_ 1 7 1 1 Z 1 -1 1- 1 1 1— 1 1 1 1 1 1 1 1 T--1
+ . 1 1 1 1 1 1 1 1 1 1 1 1 0 1 l 1 1 1 1 1 1 1 1 1 1 1 1 1 : J
. k
15-06-00 15-06-00
B1 B2 B3
Total Horizontal Product Length=31-00-00
Reaction Summary (Down I Uplift) (Ibs)
Bearing Live Dead Snow Wind Roof Live
B1, 5-1/4" 1176/0 2347/0
B2, 5-1/4" 3676/0 6806/0
B3, 5-1/4" 1176/0 2347/0
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 31-00-00 Top 14 00-00-00
1 Roof Unf. Area (Ib/ft2) L 00-00-00 31-00-00 Front 15 30 12-00-00
Controls Summary Value %Allowable Duration Case Location
Pos. Moment 9909 ft-lbs 41.2% 115% 7 06-04-12
Neg. Moment -15855 ft-lbs 65.8% 115% 9 15-06-00
End Shear 2841 lbs 26.1% 115% 7 01-02-12
Cont. Shear 4681 lbs 43.0% 115% 9 14-05-14
Total Load Deflection L/411 (0.441") 43.8% n\a 7 07-01-02
Live Load Deflection L/576 (0.315") 41.6% n\a 10 07-02-15
Total Neg. Defl. L/999 (-0.016") n\a n\a 7 16-08-10
Max Defl. 0.441" 44.1% n\a 7 07-01-02
Span/Depth 19.1
%Allow %Allow
Bearing Supports Dim.(LxW) Value Support Member Material
B1 Column 5-1/4"x 5-1/4" 3523 lbs n\a 17.0% Unspecified
B2 Column 5-1/4"x 5-1/4" 10482 lbs n\a 50.7% Unspecified
B3 Column 5-1/4"x 5-1/4" 3523 lbs n\a 17.0% 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.
Page 1 of 2
Boise Cascade Triple 1-3/4" n x 9-1/2 VERSA-LAM® 2.0 3100 SP PASSED
ENGINEERED'.00D PRODUCTS
RB02 (Roof Flush Beam)
BC CALC®Member Report Dry 12 spans I No cant. September 4, 2024 11:35:54
Build 8892
Job name: File name:
Address: 86 Starbuck Lane Description:
City,State,Zip: Yarnouthport, MA,02675 Specifier:
Customer: CP Home Improvement Designer: William Campbell
Code reports: ESR-1040 Company:
Notes
Design meets Code minimum(L/180)Total load deflection criteria.
Design meets Code minimum (L/240)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.
1-3/4"x 9-1/2"VERSA-LAM®2.0 3100 SP is a discontinued product. Discontinued products are not
available for purchase.
Calculations assume member is fully braced.
User Notes
Roof beam (center)
Connection Diagram: Full Length of Member
a
c
•
•
• •
A.- e
a minimum= 1-1/2" c=3-1/4"
b minimum=4" d = 12"
e minimum= 1"
Calculated Side Load=540.0 lb/ft
Install screws from both sides,staggering screws by half of the spacing to avoid splitting.
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 TM,
ALLJOIST®,BC RIM BOARDTM,BCl®,
BOISE GLULAMTM,BC FloorValue®,
VERSA-LAM®,VERSA-RIM PLUS®,
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