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HomeMy WebLinkAboutBuilding Permits (2)PERMIT 756 10/15/96 10/15/96 LOT X3 D'Amico, Joe & Zabelle 53 Lewis Bay Boulevard West Yarmouth, MA 02673 Strip & re -roof $6,000.00 SHEET 12 �4 {o ONE & TWO FAMILY ONLY — BUILDING PERMIT Sy C APPLICATION TO CONSTRUCT. REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING o H Town of Yarmouth Building Department 1146 Route 28 • South Yarmouth, MA 02664-4492 ' 508-398-2231 ext.1261 Fax 508-398-0836 Office Use only Planning Board Information Assenon Department Information: 0! a Plan Type Map La Permit Fee $ 35 orsement oats / Recording Date New Deposit Rec'd. $ Oat Ma. _, 1.4 Property Dimensions Net Dab $ Other Lot Area (sf) Frortlage (ft) Lot Coverage This 3ecdoo for Off tt ula 3tilk9hil P16rmitNUmbel:;::-••.,�;�: '--. m&ftIt3f#tiect4 ~ %•' CertiticaEsoiOivpeit�t ilia vt7.4 ammm z - Qwnershl Authorized Zt ObewadReconk Name q Ma Address -- v- S- _F;7 33 Name (print) cl z Lit > >! N l� 1 l"J I �� o U #� w 7wd w � u' m1 � 32 ;U011 :s • l:OrlsUtlCtlOfl S Licen"d Cowmitnatlon L a-w Neg)1= e• 'o O^ S& /, Mailing Address Fax Perrtecn 1C XlN Not Applicable Q (J,A 1ll 71�1'/�f o �� `icens. Number CS 4510.9 p2lQ �` L/ - t ( Expi ' Da eleph - 3 / r nwrt Contractor: Not Applicable ❑ / J� Licen a Num n Ex ira' Date/V Teleptwro 6 Iof2 OVER L0 CA SecttoA.4sVYotiCe'si Carn ert tsrrlrislutiititAtrtdavK 3t'tlt tt�(b� M*` 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. f� Signed Affidavit Attached Yes .......... No .......... section &-Dot of I?ro VYbrk (cheer all apW-aIA) New Con*ucgon ❑ No. of Udrooms Na of SaftmMs Existing 214 ❑ Fffpalr(s) ❑ Altntiona ❑ Addnlat ❑ Accessory Bkfg. ❑ Type Dernolitkm Other Specify: Brief Description of Proposed Work Section 5- Estfinated Cdnat xdOn Casts item Estimated Coat (Dollars) to be Check Below completed by permit applicant t. Bulk" ❑ Conservodo-Commlaaton F11Ing 2. Seetrleal (it applicable) 3. /Gas ❑ Old Tanga Highway a Htstorkal 4. Machanfcal (HVAC) Conimlaslon approval S. Fire Protecdon (it applicable) e.Totalw(t +2+3+4+5) 7. total Square Ft. Ow Mu" A bmsma) SecttOR.7l1. OyrrtKAuthbrtzsdm- TO tM Completed WNan Ownses-Aawt or Contractor Applies for Mildhil Permit ,.J .Q A / , as owner of the subject prop" I• �% /C/v L A t,01 e A/c °� • tl �y �t/ a `� to act on hereby authorize = N. In all matters relative to work authorized by this building permit application. my —WU Date sign M 75.Ow net/Authorized/A Agent tD� aedaraticn r4AW h� x/e K' !1 `P AP A) �/ . as A*edAuthadzedAgent hereby declare that the statements and information on the foregoing application aretrue and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of ppenury. hr.v 1,7%e N cp. li . A),v `Gl Pr" name Sfgnaft" or perar/Agent Date t 9-15-99 2 of 2 ror umce use uniy Permit No. Date TOWN OF YARMOUTH ' �z AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c 142A► requires that the 'reemwuction, alteradca, reaovatieo, repair, modenizwcN conveisim, improveneit, removal, demolition Or construction of an addition to nay pro-adsfmg ownercoded building containing at least one but not more than four dwelling units or sutxttres which are adjacert to mch resideam or building' be done by registered cedars, with c=tda exceptions, along with outer requiremeam Type of Work: /r d it) Est Cost 8b moo . Address of Work � � CLVi.S Roy 734J VJ 7)/4 %1 "a ` i 17 Owner Name: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,Ooo Building not owner occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c, 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: /y /`f �bwAfAUCV_ �PN� jo y 3 Date Contractor Name Registration No, C91L4 Not►►thstanding the above notice, I hereby apply .for a permit as the owner of the above property. Date Owner Name .I PLEASE PRMTs Job Location:_ TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Owner of Property. 3 �lJ 1�p h "re fiY// /`/�i� . Village Construction supervisor. J. V CS sine. a9 h0� �3G h� N/ � m� License No. n Phone No. Address: L) r< N W e w y6l^ met, a %%A - Licensed Designee: (If other than Supervisor) Name • License No. 2.15 Responsibility of each license holder. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state buildingcode and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of tfie discovery of any violations which are covered by the building permit. 2.15A Any licensee who shallwillfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and those rules and regulations. In the event that such licensee is no longersupervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license bolder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building officiaL INSURANCE COVERAGE I have a current I bitty insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No fa If you have checked al please indicate the type coverage by checking the appropriate box. A liability Insurance policy Q3-� Other type of Indemnity Bond OWNER'S INSURANCE WAIVER: I am Chapter 152-DLthe Mass. GeneralP5m v, of Oanw or 0 re that the licensee does not have the insurance coverage required by that mScsignature on this permit application waives this requirement. Check one: Urnw ❑ Agant (', -- Signature: Building Official Approval: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Address: /,& o c7 o /(/. v o,t. !WeY Citv/State-/Zin: ILI o It( c 11-7 3 Phone #:. AO Are you an employer? Check the appropriate box: 1. L'1 t am a employer with 4• ❑ I am a general contractor and I employees (full and/or part-tim4* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required:] 3. ❑ I am a homeowner doing all work myself [No workers' comp. 3a. ❑ Imam ance ] t homeowner acting as a general contractor (refer to :4) listed on the attached sheet These sub -contractors have employees and have workers' comp. insuranCe.; 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.l s 37 S-5 Type of project (required): 6. EINew construction 7. [Blemodeling 8. [3temolition 9. [R Mailding addition 10.C1 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other 'Any applir- t that checks box #1 must dso tell out the section below showing their wcd=e eompcosatiod�olicy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractotz must submit a new d8davit iodiating such. tCoaaactors that check this box mutt attached an additional shed showing the name of the sub -contractors and state whetba at not than mmin have employees. if the tub•monadas have employees, they must provide their wmkcr ' comp. policy number. Ian an employer that is providing workers' compensation insurance for my employees Below is the policy and Job site fnformtation. Insurance Company Policy # or Self -ins. Lic. #: W C O I l 3 }, y l: Expiration Date: l C O Job Site Address: kv W t 3 / r- cC City/State/Zip: (�U • �A h N e �II �'f,/� 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 S 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 certify and painand that the information provided abm)t it true and correct Of elal use only. Do not write in this area, to be completed by city or town off iclal CIty or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Citylrown Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone #: Information and Instructions Massuhnae m General Laws chapter 152 uquirss all employbn to provide workers' c°mpcnssoO° fai their emp)yees: ' Ptasmat to this statute, an exTky- t is defined as "_every person in the service of another under any caatraat of hire, express oe implied, oral or written." A. .pkydr is defined as "era indi.idttd. Pulnuship, usociatioa. cocpocstion oe other legal entity, of any two a more engaged in a joint eakip and ;,,,hjdi�= tit kW rower of a decesaed envloM ere tit recei.a or ti ostet of an individual, psrtoesM a:aoeildw Or otbmr Ind entalo employing emQloyem Howrwe tit owner of a dwelling home baring not more than tbtse and who trsidea thasist. or the of the dwlingelbout cf another wbo employs persons to do muntenuwA cm- , ' -i arc* wait on such dwelfiag honer at on the Qouoda a building spptatenaat &ereto shall not beaters of such employment be deemed to be as employer;' MGL chsptw 152.125M)110 states that "wary stab a fora! Beemfag agora!'"9 withhold the tusisa ee renewal of a liaaee or path to operab s bath err to eamettt> - b%Gdhp h the MMGnweait>r fir of apphieaat wM hat not produced scagOble cvkksa of conspHaneg with the Im man ev rep rogwkW Addida=Dy. MGL cbapta 152.12XM stele "Neither the coamsonweslth mot nay of its PohidW subdMsiooa shall enter into say e - i @ for the perbrounce of poblia wait until acceptable n idcacs of with tbt iasuranes of tMs cb:ptw have been peed to the coafracda9 unharitY." APpuelaw Please tilt out the wosi n, compensation Laidant eompietely6 by checHa; the bosses that apply to your situation and. if , supply sab.eontraetoe(s) nanw(s), addresses) and pbous number(s) along with their eerdfieate(s) of imsrmamce. Limited Liabft Companies (LLC) cc Limited Ltabfiity Putaaaho (LLP) with coo employers other lira the mambas ce Imo; ace not regoitcd tin cater wockxrs' em penaad m instaanm If m LLC or LLP does haw employees, a policy Is required. Be advised that this affidzrit may be sobc� to the Deportment of Dial Accidents floc confirms im of b m =@ coveragar Abe be two to sip and data the amdavtt The afadavit should be retaemd to the city or tows that the spplieadoin for the permit at Iieras is beingregoes0ed. met the Department of Industrial Aecklemm Should you have any questions the aw err if you am tegmtsd to obtain a wocixn' compesmtioa policy. Phase can tit Department at the combat listed below. Self -insured caqenies should enter their City or Taws Otltefsis Please be sure that the affidavit is complete and printed le&l . The Department has provided i space at the I of the a®davit foe you to fM out in the event the MCI of Investigations has to coated you tt9 1;1 tbt sPPHCSnL Please be sure to M In the perma Meer" cumber which will be used u a reference tsarnbe r Im addidom, an applicsat that aaaat mbmt multiple perrnititiaass applications in any gives year. need only aobmit Dort affidavit mdiatiag antra! policy i Lhmnd m (if necessary) ad unties "Job Site Mhese the app[feant rhould writt "all Ioatlons In---(cky or town)." A copy of tit affidavit that has bees officially also ped or mul d by the city or town may be provided 10 the opplicaat is pouf that i valid affidavit is o, fiL Bsr l4stuc* ptsmib ur lieeoaes. A naw affidavit snort be filled out each year. Wben a hams owner at citizen is obtaining a license at permit not related to any bodnen at caamereial venture (Le. a dot lieems or petit to burn leave: etr") said person is NOT requited to complete this d 5davit The OnSa of lavestigsdow would Mi to thank you in edvaace for your cooperation and abould you haw any gsaesBoos, please do not hesitate to pw as a alL rho Department's addres& telepbona and far : The Commonwealth of Massachusetts Department of ftxhutriid Accidents Mee of Iavttstiptielta 600 Washing = Stmet Boston. MA 02111 Tel. 11617-727-4900 ext 406 or 1-977-MASSAFE Fax # 617-727-7749 Revised 11.22.06 www.massgov/dis STAR 1 N S U R A N C E C O M P A N Y 26255 American Drive Southfield, MI 48034-6112 1. Named LAWRENCE K. KE21NEY 100 SULLIVAN RD YIEST YARMOUTH KA 02673-3544 Workers Compensation and Employers Liability Insurance Policy Policy Number Fromolicy Period To WC 0113246 01/26/2014 01/26/2015 12:01 A.M. Standard Time a1 themaifing address Renewal Of Transaction Policy Declaration COCHRANE E. PORTER INSURANCE AGENCY INC 981 WORCESTER STP MET WELLESLEY NA 02482 UNEMPLOYMENT ID # CARRIER # FEIN # Risk ID # Entity of Insured 24562 1 105287178 1 0162432 1 INDIVIDUAL Other Workplaces Not Shown Above: 2. The Policy Period is from 01/26/2014 to 01/26/2015 12:01 a.m. Standard Time at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500, 000 policy limit Bodily Injury by Disease $ 100, 000 each employee C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: All states except North Dakota, Ohio, Washington, Wyoming, and states designated in item 3.A. above. D. This policy includes these endorsements and schedules: See attached schedule 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. Assessments and Taxes SEE EXTENSION OF INFORMATION PAGE MA $659 If the premium is paid on an installment basis, a $5.00 per payment charge applies. Total Estimated Annual Premium $ 23,374 Expense Constant $ 338 Minimum Premium S 500 Premium Discount S - 852 ❑ This is a Three Year Fixed Rate Policy Deposit Premium $ 24,033 Premium Adjustment Period: ® Annual; ❑ Semiannual; ❑ Quarterly; ❑ Monthly Issued Date: 05/22/2014 Authorized Representative Issuing Office WC000001(Ed.12Pu4( INSURED COPY I Massachusetts - Department of Public Safety Board of Building Regulations and Standards Conrtruction Supcnicor License: CS-005609 LAWRENCE K KOW 100 SULUVAN W YARMOUTH MA Io �- Expiration Commissioner 03/08/2016 C-/�e �oneinoiiiaeal� o��'l�a.Akrc�tue(�i Office of C0nannlerAffairs & Business Regulation W5OMEIMPROVEMENTCONTRACTOR egis : 10113 TYPE iPiration:bon: 625/2016 - Individual LAWRENCE K. KENNEY + Lawrence Kenney I 10aSullivan Road W. Yarmouth, MA 02673� iUndersecretary Joseph A. D'Amico 1355 Main Street Holden MA, 01520 September 16, 2014 608-829-2033 TO WHOME IT MAY CONCERN LARRY KENNY represents me and will be the builder in charge of my project at my home at 53 Lewis Bay Blvd. Sincerely; *sepA. Am/0&t4jc� i a Joseph A. D'Amico 1355 Main Street E C F IV E D Holden MA, 01520 September 16, 2014 SEP ` 2 14 608-829-2033 BUILDINV J RT Ni ur = — —_-- TO WHOME IT MAY CONCERN LARRY KENNY represents me and will be the builder in charge of my project at my home at 53 Lewis Bay Blvd. Sincerely; J sep A. Ami� / r n ONE & TWO FAhM- :--�-- BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department 1146 Route 28 • South Yarmouth, MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 a Use DNyI Permit Nol�te i Permit Fee $,S� Deposit Rec'd. $Aw Dateh Net Due S Planning Baud Infomution Pun Type Endorsement Date Recording Due 1.4 Property Dimensions: r Okea (sf) Fro=ga (it) tot covw3. Department INarmuion M Lot New t r= - K= IOr OrfttX Uftl Btjikffhd Pe Numb rt;. Sectlon•t - Site Ittfbtrristttxt FUse Grou : R-4 Type: 5 8 1.1 Pnowty Adrresq s3 12 Zoning InGxmatiore Zoning District Proposed Use 1.3 building seamec s (R) Front Yard Side Yards Rear Yard Required Provided Regaired Provided R fired / rEc;� 1 j Supply (e AA- a:. 4e. S b4) 1 3 Flcaa Zatd» fraoen,aeors Pubfic Prtvate , zone: L LL BFE 1 Z I Q ml Section 2 - Bqmdy Ownerahl Aut odzed Agenty.. 2.1 Ownmeat Rseorvfi SUZU I ; , , •, ..,,,. Signature Telephone r MaiGngAddresaphone ®RUME2: Fax Section 3 - Construction Services &I Licensed ConstrucUen Srgarrlson Not Applicable _ (//al Lken" Number Addrem Telephone 32 RGQkWW Hom Impmernem Contractor: JAN 17 2014 //Hom. ` OAddress 5 OPld7Ue � ©"ter 3 Expiration Date OVER Sectiolt.4sWoritenfCam llit�aitottln3UraftCli+rtraatvn �.:�������. Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit wiA result In the denlal of Pe Issuance of the building permit. Signed Affidavit Attached Yes .......... No .......... ction S- COW of Pro Wbrlt (checft ar Constructioe ❑ No. at B#drooms No. d 1lzttuoamsting tlte0. ❑ Rec9r(s) ❑ atteritlons ❑ Adattlan ❑ j Accessory 1314 ❑ Type mortlon 143 Other SpecifY- Brief Description of Proposed Work t , 3edion �- Estimted Cdncosts Item Estimated Cost (Dollars) to be Check Below completed by permit applkant 1. But ❑ Conservadon•Commlabn Filing 2. Electrical (M applicable) 3. / am 0 ❑ Old King• Hk hwey 3 Historical 4. Meehankai (HVAC) Cominlesbn approval S. Fre ProtectionAl (If applicable) B.Totals(1 +2+3+4+.% 7. rotel square FL Ow rya i +eabsl S 77! • Owner uthbrtzadW- Th be Completed WhW Ownmeg-A or Contractor ApplIes for ElUlkMa Permit as owner of the subject property vgtl L ��� to act on hereby authorize my behalf, In ad matters ref a to wo authorized by this building permit application. Date Authorized A ent Dedaradon s- !I 6°f,(!S rw . as owner/Authorized Agent erythe statements and information on the foregoing application are true and accurate, to the best of rr y knowledge and belief. Signed tinder the pains and penaitles of penury. � G i<•L. 1 P_ Prk+t name /?0/3 - oats 9. fs- 99 2 of 2 t-or Uthce Use Only Permit No. •:�. Date TOWN OF YARMOUTH ' R: xx AFFIDAVIT Home Improvement Contractor Lan Supplement to Permit AppUeatioa MGL a 142A requires that the 'r won&trcxion, 0t ation, reaovatioq repair, mmkmiadoa. conversion, improvement, removal, demolition or crosuucdcn of an addition to any F"x sting owner-o=*ied bOdmg cmtairmg at least one but not more than ford dwelling units or whkb ere adjscwt to sods residmm or building' be done by registered cmtrz=r% with eertsin exceptions, along with other regrrct�eait Type of work: Address of Work \h3 /, Ion S Owner Name: Data of Permit Application: I hereby certify that. 1 Est. Cost Registration. is not required for the following reason(s): Work excluded by law Job ursder sl,000 Building not owner occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a peftnit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply .for a permit as the owner of the above property. Date Owner Name G .• '�_ ° � Two PLEASE PRINT Job Location: TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM 1r73 Number Owner of Property: Construe Address: Village c i Licensed Designee: (If other than Supervisor) Name • License No. 2.15 Responsibility of each license holder. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawin as approved by the building offiiciaL gs 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15 4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any o ther section of these license by s and regulation and any procedures, as amended, shall be subject to revocation or suspension of the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE I have a txurent Itabifi surancs policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes J,,, No If you have checked = please indicate the type coverage by checking the appropriate box. A liability Insurance policy �� Other type of Indemnity ElBond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter i 52 of General Laws, and that my signature on this permit application waives this requirement Check one: Signature of owner a Owners Agent Owner Q Agent Fj—' Signature: Building Official Approval: Tire Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name / L Are you an employer? Check the appropriate box: Type of project (required): 1. [9-ram a employer with a 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).' have hired the sub -contractors listed 7. doling 2. ❑ I am a sole proprietor or partoer- on the attached sheet ship and have no employees Tie sub-contractan have a. I'itio. worlds for me in as capacity. g Y P tY• employees and have workers' 9. ❑Building addition [No workers' comp. insurance required.] comp. insurance.: 5. ❑ We are a corporation and its IOQ-Ef't:ctrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. uanbin repairs aus or additions �� g myself. [No workers comp. right of exemption per MGL 12.94w' frepairs insurance required.) t c. 152, § 1(4), and we have no 13.❑ Other employees. (No workers' comp. insurance required.) •Any applicant that checks box #1 taut also fill out the section below showing tidy workers' compensation policy inforaadon. t Homeowners who submit this affidavit indicating thcy ate doing all work and then hire outside ennrscu= mist submit a new affidavit indicating such. :Contractors clot check this box must attached an additional sheet showing the name of the sub-conwwtocs and state whether or not those entities have ernployees. If the subtowzwtors have ernpbyccs, 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� i t// 6�Uf9l, a7&� r Policy # or Self -ins. Lic. M Wlid) � S %% Expiration Date: Job Site Address-K; L�(„//S Ai 22 Z ZZ ld , City/StIL-Mp: /L `190t/ Attach a copy of the workers' compensation policy declaration page (showing the polity. number nd 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 S 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 S250.00 a day against th4 violator. Be advised that a copy of this statement may be forwarded to the Office of Investieations of the DIA for insurance coverage verification. I do hereby certify under the pairand penalties of perjury that the information provided above is true and correct. -3 9a use only. Do not write dr this area, City or Town: or town official. Permit/LIcense # �u 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 #: Information and Instructions A,V Diassachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employers. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings In the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for. the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage: Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self -insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would lucre to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone -and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. 9 617-7274900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 11-22-06 www.mass.gov/dia ti TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, NIA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 1 1 1 1 �1' • 1 F Pursuant to M.G.L Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 1115, I hereby certify that the debris resulting from the proposed work/demolitioa to be conducted Work Address Is to be disposed of at the Following location: /9tj Said disposal site shall be a licensed solid waste facility as defined by AG.L. Chapter 111, Section 150A. Zor/�,/ ��� ignature of Application Permit No. Date roassachusetts - Department of Public Safety and Standards ' Board of Building Regulations Cu m ti Sup.ni.ur License: CS-049883i k f. IS RICHARD E DESMARAIS r. IIS OLD TOWNIIOUSE RD S YARMOUTII MA 026" ExpiratioD Commissioner 03/31/2014 Regnlatioo Office of Consumer Affairs & Business ME IMPROVEMENT CONTRACTOR Type: r �egistraUon: 107239 Individ14 ual Expiration: 7130120. RICHARD DESMARAIS Richard Desmarais 115 OLD TOWN HOUSE RD- SOUTH YARMOUTH, MA 02664 Undersecretary ACNov. 4., 2013 2:46PM No, 4963 P. 2 CERTIFICATE OF LIABILITY INSURANCE F DA'E(M '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: It the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and condlilons of tho 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 NAME• Joanne Bretton Southeastern Insurance Agency, Inc. PHONE;!EjX. 508.997.6061 .508.990.2731 439 State Rd. E-MAIL REtO' P.O. Box 79398 APAOO�q— I .• North Dartmouth, MA 02?4? INSURER AFFORDING COVERAGE NAICA INSURID .-__-�- -- _ •• - - _ _ _ RICHARD DESMARAIS BUILDER LLC INwRaRe: Merchants Insurance Group 115 OLD TOWN HOUSE RD INSURER C: - SOUTH YARMOUTH, MA 02664-1679 INSURERS) .. .. INSURER fi: •�.:'' INSURER F: COVERAGES CERTIFICATE NIIMREQ- 2n13-1 L• a oe,.ea,nu s,,,.tnvo. .. . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THETNSURED NAMED ABOVE FOR THE POUCYPERIOO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W1TH 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. CTSR TYPE Da INSURANCE AND V D POLICY NUMBfiR MMID POUCYE'/ MOLIC YY LIMITS GENERAL W6°m BOP909450 o5fo1n013 0510112014 EACHOCCURRENCE : 1 000 00 COMMERCIAL GENERAL LIABILITY SOO OD 01 MEDE7VWyen.paaan) f 15100 CLAW -MADE ff)OCCUT A X PERSONAL EAOVINJURY S 1 ODO OOO - GENERAL AGGREGATE S 2,000,00m GEICL AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGO S 2'000OO POLICY FEC n LOC f AUTOMOBILE LIABILITY ( COMBINED SINGLE LIMIT AUTO ME acadEm) S MANY BODILY INJURY (PM p9mon) S ' ALL OWNEDAUTDS I BODILY INJURY (Pa accidariu S SCHEDULEDAUTOS _ I PROPERTY DAMAGE (Par Accdwo f HIREDAUTOS i S NON -OWNED AUTOS I s UMBAELLAUAB OCCUR EACH OCCURRENC! is AGGREGATE Is EACE66LW CLAWS -MADE DEDUCTIBLE s I S RETENTION S WORKERSCOMP"UTION ewtorr LIABILITYN WCA909657 05/01l2013 05/01 ORY U/2014AND OT„. AEL B ANY REXDEDAECUTN OFFCE BRXCLUEDIO NIA E.L.WHACCIDENT E 11000,000 E.LDISEASE-EA EMPLOYEEf 1 OOO OOO IMAPA M"IA NN) IYes. aHnee ,Iqn EL. DISEASE -POLICY LIMIT S 1,000,0010 ESCRIPTION OF OftKATION4 M„IOw OWNER INCLUD DESCRVTION Or OPERATIONS I LOCATIONS I VEHICLES 1AM30 ACORD 141,A"DoW Reloads SauauE- IF non sPaca la 1911wrem ,.ERTIFICATE HOLDER CANCELLATION Joseph D'Amico 53 Lewis Day Blvd W Ylarmouth, MA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Bret %CORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD a TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398.2231 ext1261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-14-210 Applicant Name: Richard Desmarais Applicant Phone: 5083940052 Building Location: 0053 LEWIS BAY BLVD Owner's Name: DAMICO, JOSEPH A TRS Owner's Addres 1355 Main Street Holden MA 01520 Owner's Telephone: (508) 523-5580 REVIEWED BY: (OFFICE USE ONLY Recorded By. Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 6944 Net Owed: ($50.00) Application Date: 12/5/2013 Issue Date: Expiration Date Comments: Map/Lot: 016.47 remove existing garage and construct new garage with 2nd floor bedroom and bathroom NOTICE An as built plan must be submitted to this department prior to foundation inspection or any further construction. 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE • oW-,d- :F�%/lam>��_�i%r��% 00 / � �. mil//ems �//I1.I� , i•�i i� _ �__._� RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 12/10/2013 TOWN OF YARMOUTH ° HEALTH DEPARTMENT O _t V •% PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site tea, i _ I -rn / I - _ _ / --;;17 Address S 5 - i<r Date Filed: /1 —1,el "l,_3 vacc 40- *Ifyou would like e-mail notification ofsign off, please provide e-mail address: /- / C l e l p A l' CG%!r �/1$ • Owner Name: SOh'ln I? A/," ! U Owner Owner Tel. No.,5719 " �p 3Snd 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. REVIEWED BY: Please submit three (3) copies of plans, to include: (L) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (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. TE: llh y113 PLEASE NOTE M 4, L'I 5 — a—Ll Gti a"� If10a 2 — �151' ctll - e Ca-k 4 eaY,n Sr L TO yosna-^ rr fe— Rpawt Town of Yarmouth Conservation Commission Building Permit Sign -off Application TO BE FILLED OUT BY APPLICANT: Building Site Location: Map # Lot(s) # Property Owner: Jpaigy� y Applicant: ,,a/,7 � ��l/^q / S ,CJ�ii��i�G' L. L/' Applicant Address: /.� 0/d z 1. 7;of me/� Telephone: c�_08-LV54 -CV t;� Date Filed //-6 -7,o3 6 v%-- Plans: TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR: Does the Proposed Project Require a Permit?\'N�1D Commentsfrom Conservatioi mmission: Approved Conditionally Approved Rejected %<All work related debris shall be taken offsite or disposed in a legal upland location :9 At the end of each day, the area shall be clean and no debris shall be in the Resource Area Refer to: SE83- or DOA permit Conservation Commission Sign -off Signature: 4tt? / zt, Date: (l_-4-i3 TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmcuth, MA 02673 Telephone: (508) 771-7921 0 Far.: (508) 77-1-7998 BUILDING PERMIT APPLICATION —nEPARTMEHTgL c-I`H riFPTP.p��rE�ii�"~L r�:dET Bldg. Site Location SJ L.!°� �Map #: Proposed Improvement: Applicant: P Lot #: v Address,4 �, i1 fa Tel. #: Date Filed: S•� RESIDENTIAL AND / OR COMMERCIAL BUILDING Water Department: Engineering Department: Conservation Commission: Health Department: Fire Department: nature or applicant COMMENTS: Determines Compliance of Water Availability and or Existing Location Determines Compliance for Parking and Drainage Determines Compliance to Wetlands Acts; i.e. If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Ocean, Bogs, Bays, Marshland, Etc... Determines Compliance to State and Town Regulations, i.e., Requirements for Septage Disposal and other Public Health Activities Determines Compliance to State and Town Requirements for Personal, Safety, Property Protection;, Le. Smoke Detectors, Sprinkler Systems, Etc... PLEASE NOTE: Date PHILBROOK ENGINEERING & CONSTRUCTION 107 Beach Street, Dennis, MA 02638-1826 Phone — 508-385-8682 E-mail — Tvarnphil@Verizon.net BUILDING ALTERATIONS & AMMONS Date: 5 December 2013 To: Mr. Ken Bates Building Inspector —Town of Yarmouth From: T. Vamum Philbrook, P.E. RE: DAMICO, 53 Lewis Bay Blvd.,, West Yarmouth, MA Dear Mr. Bates; I am getting into the design review for the DAMICO addition and alterations for Richard Desmarais builder. The job has several facets to it; high wind, narrow width and floodzone requirements. At this point the floodzone requirements will necessitate raising the new foundation and adding some compliant flood openings. This information is shown on plan and I have attached a design affidavit outlining the regulatory requirements. In addition I am working out of the appendix C section of the WFCM 1 & 2 Family Construction Manual for high wind loads in exposure zone C. Consequently the narrow portal walls of the new garage will require stiffer construction elements and Simpson High Wind panels have been selected — also noted on the plan. We are submitting this set to begin the permitting process. Meanwhile I will fetish the wind design packet to include foundation anchor- age and reinforcement taking into account the FEMA floodzone requirements noted on the affidavit. Please look this over and let me know what additional concerns you have. 1 will finish the rest of the design packet prior to the issuance of the building permit 'Thank you for your consideration in this matter. My cellphone number is 508-364-1301. U4r4N-... FirW.W3Y4.0JL-- T. Vamum Philbrook, P.E. 2 encls; Floodzone Design Affidavit & Plan Set T VARNUM HHIL13ROOX MECHANICAL 1p No.30690 SFC'STEFEQ/' L/ONA VV� LJ r I PHILBROOK ENGINEERING i CONSTRUCTION 107 BEACB STREET Project: DANICO Garage G 2nd Story DENNIS, INA 02638 Project No: P13-62 1-508-385-8682 Date: 4 December 2013 cusw QR PILE INTiORNATION • Address - 53 Lewis Bay Blvd., Nest Yarmout, NA • Survey - Downcape Engineering, Inc. #13-260 dtd. 4 NOV 2013 • FIRM - #250015 0005D dtd 2 JUL 1992 a Community Panel - Town of Yarmouth • tons - Al2 (BFE - 12.01) subject to 0.0' clearance IAN Para. R322.2.1.1 NA Amend e Function - This will be a now lateral addition with some retro vertical elements. This 'Now Work' must be considered as an independent structure in order to Meet FENA requirements IAN Sao. R322 IRC 2009 w/ Amends of the 8th ed. State Building Code. Essentially it may not rely on any non -complying construction for any structural support. This way upgrade requirements will not apply to any parts of the existing structure. It will be fully enclosed so it must be designed to automatically equalise hydrostatic forces on the walls. All of the inverts for the equalisation openings (Smart -Vents) can be no higher than 110" above the lowest adjacent grade and/or the crawl level. The vents will be placed on a minimum of two separate non -planar wall faces. • Elevations Referenoed to NSL (NGVD): 2nd Floor (Top of Subfloor) — 20.5+/- ft Top of Now Concrete Foundation i Floodproofing a 12.0 ft Design Flood Elevation -- 12.0 ft Smart -Vent Inverts o 11.0 ft (NO higher than 12" above adjacent gradas Top of Now Garage Concrete Floor a 10.4 ft Average Compliant Grades 8 Outlets -- 10.0 ft level Top of Foundation Footing o 7.0 ft Groundwater <- 4.0 ft (averaged Q high tide) • Techniques - basic flooding techniques will be used: it - Smart -Vents will be used to provide hydrostatic equalisation for the garage. Areas are provided at the rate of 1 Unit/200 sq ft. For 360 sq ft 2 units will be required. i2 - 2 ea Smart -Vents will be used to relieve pressure at the rear of the garage into the existing crawl space. No further reinforcement will be undertaken there #3 - Oversize footings and positive connection between all walls, foot- ings and sill plates. Provide continuous (26" ZW) corner bars in the foundation and 5/8"x 12" anchor bolts @ 218" c/o. Walls to have top i bottom 05 continuous bars and footing to have i5 continuous bars. Wet -set 316" shear dowels 8 210" c/o. The large opening will receive portal framing and the now over -framed 2nd floor will be supported on independent columns/footer pads i4 - Sub -foundation fill to be insitu free -draining medium -coarse sand. Roll and compact sub -grade before footing formwork NOTE - In all cases, all mechanical equipment must be elevated to or above the DFS - 12.0 ft to include condenser units. Any electrical circuits below the BFE are to be GPI circuit protected. I affirm to the beat of my knowledge that this information is in compliance w/ the provisions of the 2009 IRC C NA Amends Sections R322.1 i R322.2.1. tN CF l�gss T. VARNUM PHILBROOK, P. �° T VARNUM Mass. Reg. No. 30690 PHIL9RppK I MECHANICAL 4 No.30690 q, C ly 0 P W 9Q� SS C N A L CREScheck Software Version 4.5.0 �J( Compliance Certificate Project Damico Addition Energy Code: 2012 IECC Location: Yarmouth, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 Permit Date: Permit Number. Construction Site: Owner/Agent: Designer/Contractor: 53 Lewis Bay Blvd Mr & Mrs Joseph Damico Richard Desmarais W. Yarmouth, MA 1355 Main St 115 Old Townhouse Rd Holden, MA So. Yarmouth, MA Compliance: 0.0% Better Than Code Maximum UA: 124 Your UA: 124 The % Better or Worse Than Code Index reflects how close to compliance the house Is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum -code hone. Envelope Assemblies Ceiling 1: Flat Ceiling or Scissor Truss 700 38.0 0.0 0.030 21 Ceiling 2: Cathedral Ceiling 60 30.0 0.0 0.034 2 Wall 1: Wood Frame, 16" o.c. 990 21.0 0.0 0.057 48 Window 1: Vinyl Frame:Double Pane with Low-E 125 0.290 36 Door 1: Solid 19 0.350 7 Floor 1: All -Wood joist/Truss:Over Unconditioned Space 290 30.0 0.0 0.033 10 Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2012 IECC requirements in REScheck Version 4.5.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name - Title Signature Date Project Title: Damico Addition Report date: 11/1211 Data filename: Untitled.rck Pagel of 8 2012 IECC Energy Efficiency Certificate Wall 21.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): — Window 0.29 MEE%ge �Lcy� Heating System: Cooling System: Water Heater: Name: Comments Date: W CENTERS'II >K.ustna.cw.,u..� WARNING rweYrr ® r »» _ is »...-._... cac�»rex»e r..wr ��r.w... A complete Javelins; framing pan require, Me From»'s Packet Guide Sea the Fromw's Panel Guide for Pmdud Tradamxt Information ee• a rn. 2' 1V 1 1/2' 1' 31/ ' 5' 101/2' 1 14' 0" MI ll w II w n Nii MI ill w ll w w K2' K2 Y K2 0' 0' 0' — r a, D' 0' KO' K2 A3 U A3 q F K2)' l K2)' K2 K2)' K2 Y0 K2 K2)' K2 K2 K2)' K2)' K2)' K2)' K2)' 1' 7• 5' 101/2• MI. I , 10' 1 1/2" V 7' 12' 0' ' 3 1/2' 33' 51/2• PlotID ci w 7 elt Second Floor Framing Plain Scale: 3/16" = 1*41 I NOTE: JOIST SIZE INCREASED TO MEET CODE SPAN MIN - Method Foce Nails Top Nails Member Nails Sher Slope Back"glut Filler Web Stiff id 10.10d x 1-112 - - - Ne Na No Products P6tID Lagth Product PIw Not city K20' 20'0' 117/8'TJIO 230 1 27 MI-2 20' 0' 13/4' x It 7/8' 1.9E Micmllame LVL 2 2 M2-2 10, 0" 13/4' x 117/8.1.9E Mimikune LVL 2 2 TSLal 16' 0• 11/4' x 117/8' 1.3E Thn6arStrwde LSL 1 4 Accessories P6tID Lwgth Product Phe, Net city 23/32'x4B'x96- dsr10 Edge Gold Perot (0/24)U&SF 1 21 LEVEL NOTE5 Current Date: 10/3/2013 File None: DE5MARAI5-DAMIC0.'vl Level Name: Second Floor TJ-Pro Rating (Weighted Average} 37 Minimum Level TJ - Pro Rating 6 Joist: TJ-Pro rating = 37, joist = K20'(il46) Maximum Level TJ - Pro Rating S Joist: TJ-Pro rating = 38, Joist = K20'(i140) Building Code - Design Methodology: IBC 2009 Floor Container: FC1 Floor Area Loading is: 40 Live Load 612 Dead Load Maximum Allowed Deflection: U480 Live Load 6 U240 Total Load TJ-Pro Rating Information: Weighted Average: 37 Directly Applied Ceiling: None Decking Attachment: GlueAndNail Frameworks Floor. No Decking Material: 23/32'x48'x96• (Level® Edge Gold Panel (0/24) T&& SF Perpendicular Partition: No Stra 1 : None Blocking: No Poured Flooring: No S j Sheet: lot 1 PHILBROOK ENGINEERING & CONSTRUCTION 107 Beach Street, Dennis, MA 02638-1826 Phone — 508-385-8682 E-mail — Tvarnphil@Verizon.net BUILDING ALTERATIONS & ADDITIONS Date: 14 January 2014 To: Ken ates Building%p'eector —Town of Yarmouth From: T. Vamum Philbrook, P.E. RE: DAMICO, 53 Lewis Bay Blvd.,, West Yarmouth, MA Dear Mr. Bates; i have finished my design review for the DAMICO addition and alterations for Richard Desmarais, Builder. This includes shearwall, floodzone, Gaming and foundation modifications along with special nailing & attachment requirements. My approach followed the WFCM 1&2 Family Manual for Prescriptive Design (Chp. 3) for 110 MPH Wind in wind exposure C. There are also some I Engineered Design (Chp. 2) or CMR 780 Para. R301.1.3 requirements. That work addresses the beams, foundation and anchor bolt attachments. This work will be fully sheathed with a combination of plywood and older board sheathing. Upgrades required include the new work (roof; floors & foundation) along with major modifications to the 2 floor support system. This beam/column system will have direct bearing to foundation elements and not rely on vertical support from the existing below floodzone construction. Design parameters and copies are attached. For this job: a. All rafter spans and ceiling joist ties will require supplemental Simpson H2.5 hurricane clips. b. Over ridge steel straps Simpson LSTA24 strap ties will be installed. c. WFCM 1&2 Family 110 MPH Exp. C Manual provided the shearwall area requirements. Heavier nailing is required at the inside garage/house common wall and the APA Portal Framing around the garage door. Special Simpson anchor straps are specified here also. d. Floodzone requirements are satisfied by the use of Smart -vents and holding the new concrete wall construction up to the base flood elevation. New work is flood resistant. Additional Smart -vents provide hydrostatic equalization to the older portion of the wing foundation where new pad footers will be installed. This narrative outlines the key requirements for the job as the 8'e ed. of the State Building Code is applied. Thank you and as always please call me with any questions or comments. � g%04.nvtL T. Vamum Philbrook, P.E. encls; Design Submittal Packet & Plan Sets P13•6'L- OF T VARNUM PHILBROOK MECHANICAI No.3000 Q i � 1 I/ILYIIV VI\ ENGINEERING FIELD REPORTMORKSHEET Project No: P13 I.z 10"6'0°°I Sheet No: �,�,_ of 4 GENERAL DESCRIPTION DAMICO Garage/2nd Floor Floodsono Addition 81h od. P13-tit i Narrative: Review in -situ soil conditions and construction plans for loading cb605 capacities for spread footings for 1 Family Residence Client: DAMICO/Rich Desmarais Number - 508-394-0052 Location: 53 Lewis Bay Blvd., West Yarmouth, MA i SPECIAL CONSIDERATIONS 1 & 2 Family Wood Frame Construction I AW Paras. R322.1 and R322.2.1 ME bends This project review includes: Soils Review and Presumptive Bearing Capacities, Design Work -up w/ Loading Analysis and Notes w/ Certification for Foundation 'DESIGN CONSIDERATIONS General: Check for adequate bearing, scour, anchorages and lateral/uplift frame connections. HOUSE DOWN DESIGN requirements Loads & Loadings: Unless specifcally noted the following apply. i Live Loads SBC Location #/aq ft Dur Note 1st Floor (Garage) 50 1.0 Thl. R301.5 2nd Floor (Stiffer) 40 1.0 Thl. R3O1.5 Attic - non-Expan 5 1.0 Thl. R301.5 WFCM 1&2 Family - Chp 3; Prescriptive Method for Snow & Wind UoN Snow - m = 4/12 (18.40) 30 1.15 Tb1.R3O1.2(5)(MA) Wind - Speed =110 MPH ESP = C 1.60 Thl. R301.2(4)(MA) Roof Pitch > 10" to 300 Mean Roof Heights = 20 ft ��t'A OF MuSs Height & Exposure Coef. = 1.29 Thl. R3O1.2(3) Ref Pros (Vert) Zone 1= -23 MWFRS Thl, R301.2(2) T VARNUM s� Ref Pres (Vert) Zone 3 = -51 C&C Tbl. R3O1.2(2) PHIL©ROOK Ref Pros (Horix) Zone 4 = -26 MWFRS Thl. R3O1.2(2) MECHANICAL Ref Pros (Horiz) Zone S = -36 C&C Thl. R301.2(2) p �No.30690� i Dead Loads BBC Location Wood Floors 9.5", 5/8" GWB, 3/4" Sub -floor Attic Partitions: 4&6 Conventional Roof 2"x 8"/10" @ loll O.C. C-I-P Concrete #/sq ft Dur 13 1.0 Note 8 1.0 10 1.0 8 1.15 w/o Cathedrals before DL&W SC ISO lb/cub A NET UPLIFT = (10° to 301)" - -6x L) _ _-3 lb/sq ft w/ C&C (-51) - .6 x (20) _ -39 lb/sq R for MWFRS (-23) - .6 x (15) _ -14 lb/sq ft Misc or Comments: Global Checks - MWFRS WIND - Gable Ends; Lateral horiz = 520 lb/If x 20 ft/2 = 51200 lb - Lateral horiz/lf = 11733 lb/lf therefore 2 ea 5/811 dia. bolts WIND - Gable Ends; Shear Uplift Max Iz 59200 lb x 8'/18' _ -2,311 lb - neglect Wall Resisting- Use Simpson LSTHDB Strap -Tie Holdowns WIND - Lineal Walls; Wind Uplift max = 20' x 231b/sq ft x 20/2/20 = -230 lb/If - neglect Frame Resisting = -613 lbs/bolts Q 2'8" GRAVITY - Side Eaveline Wall = Roof/2 + Wall + Floor/2 _ (30+15+10)x 20/2 + 2x 8x1O + (50+15)x 20/2 + 5'x 100 =11800 lb/lf I'H JAa zoIL) Thl. A3.4 -383 per eau -467 raft tan -186 16" o/c COPY P82-FRW-7 ZAAMF NGINEERING FIELD REPORTMORKSHEET Project No: Q13.6Z. Sheet No: Z- of Ll NE FOUNDATION: DAMICO Oarage/2nd Floor essaxxsssa Location: 53 Lewis Bay Blvd., West Yarmouth, MA FIItM Map: 250015-MSD Town of Yarmouth Rev. 2 IUL 1992 Zone: Al2 - Elevation 12.0 ft - Baso Flood Elevation 8th ed. P13-62 Choice Concrete Foundation Surge - < 3 n Flood Velocity - < 10 ft/sec Design elevation for floodproofing to be 12.0 R; Top of Foundation for NEW work. No insulatioa & No bouyancy uplift checks are required Soil Data: Site Plan or Boring Log available: YES - Downcape Engineering Job #13-260 thru 4 DEC 2013 Direct Observation: YES - Site & P13-48 USCS = SP; Medium -Coarse Sand in Medium -Dense State IIevatioa Statements: I Elevation to Lowest Floor (Exist lot Floor) from M.S.L. =11.4 ft Elevation to Floodproofing (Top of Concrete Foundation) from M.S.L. =12.0 ft Elevation to Garage Floor (approx. Finish) from M.S.L. = 10.4 ft B.F.E. taken to be 12.0 ft above M.S.L. based on above FIRM ;Design Considerations: Soils - In -situ Conditions, Frost, Scour & Volume Change Foundation - Bearing, Sliding, Stability & Uplift Building - Sliding & Uplift, Structural Life/Safety Misc: - Approximate finish grade <=10.0+ ft - Therefore full Wetted Perimeter Based on the surrounding topography (lack of a BFE "dry side") a continuity of occupancy is not recommended. ;Additional Considerations Back fin - sloped: Away from House; Pitch - virtually 0, very gentle Water table height into footer line = NO Frost Protection Requirements - none, deeper footing depths in coarse sand Performance Criteria: A.1- Strength (Bearing): Soil Br(allow) => 1.5 (W/A) A.2 - Stability & Flotation (Sliding, Overturning & Uplift): W(Fc) => 1.5 Thrust, M(re) => 1.6 M(ov), W => 1.5 Tot Bony A.3 - Debris & Scour: Normal Impact, Use hp formula Force Requirements: FOUNDATION CHECK; FEMA 55 - Chp. 11 Pg. 11-34 Breaking Wave (Fbrkw) =1,295 lb Q EL =12.0' w/ 1' scour Debris Impact (Fi) = 621 lb @ EL =12.0' for 1,000 lb load Buoyancy (Fbuoy) = 85 lb/sq & Extreme - No design 8"x ST" Concrete Foundation on 12"x 18" Concrete Strip Footing 2 ea #5 bars horizontal in Footing & Wall plus 18" o/c vertical @ 36" o/c Download =1,800 lb/if Lateral Load = 3,875 lb max, along sides Ups = -0 lb/U w/ foundation & frame using .6 factor (-1/ 1.5) P13.62 N OF /dqS, T VARNWA G PNIL[3ROOK J MECHANICAL 4 N .3 90 Q� S'r1ONAL S ly 1na• zak y P82•FRW7 R ENGINEERING ENGINNG ADEGF I FIELD REPORTMORKSHEET ' Project No: - F%3.6'L Sheet No: _�_ of L_ DESCREMON DAhUCO Garage/2ad Roos Floodsons addition Client: DEMICO/Bich Desmarais Number - 508-39"052 8th ed. P13-62 j SA OF Location: 53 Lewis Bay Blvd., West Yarmouth, INU 'DESIGN NOTES - Shear Wells T VARNUfd c3 PHILDROOK Isaasaaa asmaaas:aa sax:xxa y � ICAL MECHANECHAN9D TITLE Elevationre (axposupace) 6 Level (Location) o p Wind to Midge Orientation, Parallel or Perpendicular P ' O j A Endwrall Width (W ft) or Length (L ft) B zmcTx" pull Haight sheathing (WrcH 162 Tbla. A-3.17A or /ONAL C Wall Height Adjust --t (8/8) D Wall Height E Effective sheathing panel Length (8/3.5) 11 W F NICK Thl. 3.17D Adjnstmaot for Types of Conatrvction G Adjusted Minimum Required Length of rull Height sheathing H Available Length of Effective Full Height sheathing TITLE Garage - Front (Roof 3 Cell) TITLE Garage - Interior (Roof 3 Coll) Wind Perpendicular to Garage Ridge Wind Perpendicular to Garage Ridge A Eave Wall (L) 18.0 It Eave Wall (L) 35.0 R B Min. Eft Len. 4.0 ft (from Tbl A-3.17A) Min. Eff Lon. 7.7 ft (from Tbl A-3.17A) C Wall AdJ 1.00 HIS Wail Adj 1.00 HM 4 D Wall Height 8.0 R Wall Height 8.0 It E Eff. Panel 27.4 in Eft. Panel 27A In F TbL 3-1 TO Adj 1.0 none taken Tbl. 3-170 Adj 1.0 none taken G AdJ. Eft Len 4.0 R Adj. Eff Len 7.7 It H Avail Eft Len 6.0 ft Avail Eff Len 14.0 it SW-1; Thl. 3.17D; 6" Edga, 120 Field 6 1/2" wB. Solid block plywood seams TITLE Garage - Left side (Roof 3 Caiq TITLE Garage -)tight Side (Roof S Coil) Wind Parallel to House Ridge Wind Parallel to Garage Ridge A End Wall (W) 20.0 It End Wall (W) 20.0 ft B Min. Eft Len. 3.7 it (from Tbl A-3.170) Min. Eff Len. 3.7 R (from Tbl A-3.170) C Wall Adj 1.00 We Wall Adj 1.00 K18 D Wail Height 8.0 it Wall Height 8.0 ft E Eft. Panel 27.4 in Eft. Panel 27.4 In F TbL 3-17D Adj 1.0 none taken TbL 3-170 Adj 1.0 none taken G Adj. Eff Len 3.7 It Adj. Eff Len 3.7 ft H Avail Eft Lon 9.0 R Avall Eft Len 9.0 ft Sn-1; Tbl. 3.17D; 6" Edge, 12" Field 6 1/2" MD. Solid block plywood seams TITLE Garage - Front (Roof, Co0 6 Floor) TITLE Garage - Interior (Roof, Coil tl Floor) Wind Perpendicular to Garage Ridge Wind Perpendicular to Garage Ridge A Eave Wall (L) 20.0 It Eave Wall (L) B C Min. Eft Len. 10.2 f•. (from Tbl A-3.17A) Min. Eft Lon. 18.2 ft (from T ;; A-3.17A) Wall Adj 0.94 )f;S Wall Adj 0.94 w8 0 Wall Height 7.5 It Wall Height 7.5 ft E Eft. Panel 25.7 in Eft. Panel 25.7 in F Thl. 3-1TOAdj 0.60 (from: Tbl 3.17D) Tbl. 3-17DAdj 0.74 (from %12.170) G Adj. Eft Len 5.7 ft Adj. Eft Len 12.6 it H Avail Eft Len 3.0 ft- HG - use APA Avail Eff Len 16.0 it •• SW1TC8 to APA Narrow Wall Details 111 Frout Garage Door Nall) SW-2f lbl. 3.170; 4" Edge,il2" Field 6'1/2" Gn. Solid block plywood seams TITLE Garage - Left Side (Roof, Coil ti Floor) TITLE Garage - Right Side (Roof, Coil 3 Floor) A Wind PSMM to House Ridge Wind Parallel to Garage Ridge Eave Wall (L) 20.0 ft End Wall (W) 20.0 ft B C Min. Eft Lan. Wall Adj 7.7 ft (from TLI A-3.1701 1.00 Min. Eft Lon. 7.7 H (from. Tbl A-3.1713, D Wau Height H;8 8.0 It WallAdj 1.00 Hie E Eft. Panel 27.4 in Wau Height Eft. Panel 8.0 ft 27.4 In F G TbL 3.1TO Adj 1.0 none taken Tbl. 3.171) Adj 1.0 none takarr,. H Adj. Eft Lon Avail Eft Len 7.7 ft 12.0 it Adj. Eft Len Avail Eff L on 7.7 ft py 11.0 it I, SW-1; Tbl. 3.17D; 6" sdge. 12" Field C. 1/2" Gus. solid block plywood sagas P82-FRW-7 ADI I16 LwllVwl% ENGINEEF RING FIELD REPORTMIORKSHEET Project No: P13-L-L. Sheet No: 4 of 4 DESCRIPTION DAMICO Garage/2nd Floor Floodsone Addition ath Client: DAMICO/Riah Desnuuata Number - 508-394-0052 Location: 53 Lewis Bay Blvd., West Yarmouth, MA T VARNUM10 I co�i PHILBROOK k)EBIGN ANALYSIS - Engineered Wood MECHANICAL f° ® "� 0 9No 30690 ood Fraser Const. Manual 1-2 Family - Chp 3 Prescriptive w/ EXP C - UCN i a PS � NA_L EC1'� tnfter Lateral i Uplift; 2"x 8" @ 16" - New Connections (Thl. A-3.4 <8 ft) - -383 lb i @ 245 lb/nail Na 6 - 16d bx nails 14,mtatuly Therefore add Simpson H2.5A Clips (OK to -535 lb) OK by Mfg. Table Headers; 2/2"x 8" KD SPF in Load Bearing Walls (Tbl. 3.22A) For 5110" or less @ 2nd Floor w/ Roof i Floor 2/2"x 8" KD SPF in Load Bearing Gable Wall (Tbl. 3.22B) For 510" or less @ 1st Floor w/ Roof Jack Studs; 2"z 4" KD SPF (Tbl. 3.22F i note 1) For Main Floors up to 4,0" Opening use 1 jj King Studs; 2"x 4" KD SPF (Tbl. 3.23C note 1 - Tbl. 3.23D) For Main Floors up to 216" Opening use 1 For Main Floors up to 516" Opening use 2 For Garage Doors, (Gable) 1610" Opening use 3 .2nd Floor Joists; 9.5" AJS® 25 Series @ 16" c/o Wul - 1.33 z (40 + 15) - 73 lb/If Span - 1817" OK by Table OK by Table OK by Table OK by Table OK by Table OK by Table OK by AJSO Tables 5/8"z 10" Anchor Bolts; New Construction (Tbl. A-3.2C) for combined loads 33" o/c MAX w/ corner bolts. Set to 32" o/c OK by Table Engineered Design (LAW Para. R301.1.3) for Ties, Beams i Posts Right Outside Beam; 5.25"x 9.5" Versa -Lam 2.0 3100 Wul - 181/2/2x (40+10+10+30+15) + 100 - 575 lb/lf 1 Span; 1416" Mmaz - 15,050 ft-lb f(b)req - 2,286 PSI Fb - 3,181 PSI w/ Cd - 1.00 DEFinaz - .62" (w/ 85%) DEFact - .48" OK by BCIO Specifier Left Inside Beam w/ Cantilever; 5.25"x 9.5" Versa -Lam 2.0 3100 Wul - 181/2/2x (40+10+10+30+15) + 100 - 575 lb/lf Pt - (120 + 25) x 19.5/2 - 1,415 lb @ 406" 2 Spans; 910" as + 416 Cant Mmax cant - 12,190 ft-lb f(b)req - 1,853 PSI Fb - 3,181 PSI w/ Cd - 1.00 DEFinax - .38" (w/ 85%) DEFaot - .17" OK by BCIO Specifier Columns; 3.5"x3.5"x3/16" HSS Tube Columns Paaz - 7,900+ lbs Leff - 810" max. Pallow - 40 kips OK by AISC Tables Foundation Bearing; 12" x 310" square concrete pad Bearing Area - 9.0 aq ft Total Weight - Column from Floor Load above - 8,000 lbs x 1.5 (Flood) Bearing Act.- 1,333 lb/sq ft Bearing Allow - (Sb - Footing)/1.5 - 1,500 lb/sq ft OK by design "• APA Narrow Wall Bracing Method - Front Garage Door Opening Minimum Wall Length to Full Height Plywood - 15" (6:1) for 716" waYly� i-^� i Actual Wall Lengths to Full Height Plywood - 2 @ 18" (5:1) �� 1� ''1 1 V(roofifloor) - Mrh-H(lat) x Zone A/C x (Width)/2 - 4,370 lb/end ';�`r• (((JJJ V(wall) - V/eff wall - 1,457 lb/If - Requires 2 ea 5/8" bolts as panel '' Wall End Uplift - V(roof)/2 x Height/Total Width - 1,945 lb Uplift - 1 945 lb - Requi Si rem mpaon LSTHDB strap ties at all ends P82•FRW7 Calculator arm nual BE W- FORMULA CALCULATOR 11.1 Design Stillwater Flood Depth Esw: 12.00 i ds: 2.00 ! ft dws• 0.00 GS: 10.00 'cr a4+ r- N .�. sr 't .+,}"',,..^ :.:p,. ' , •,-tii .t %. !c �• yy';SS"=7r'..�' '"Y$[ t [' sz'°s _..:,• A..•a,: ,�,,. y.� [C. .v 1, i'`' 1Y���R .i i� '� .ii `..: i.;• Ail d},n:, i � A /��iippL �J.A j. :i1'r�,x ��L 2 y.�x �$ y d •M, u`+.V r4Pv7A'ir>"'kF,i4[RXY e,•ln�.. ..�.Fe�rZft_r!rltin ii`�'w t:voRi.N S. �'Fa f�'t�ify�r[iT.w �i�'�riY �,yL :R"i i"y rurt.. . i 1 4i ri x 41 Cbmpfl y.,�:. t ,Reset ds = design stillwater flood depth (feet) Esw = design stillwater flood evelation in feet above datum (e.g., NGVD, NAVD) dws = wave setup in feet GS = lowest eroded ground elevation, in feet above datum, adjacent to building, excluding effects of localized scour around pilings file:///Conet9/FEMA ProjecWolume One/11-1.html 17/18/2000 6:24:16 PM] Calculator in all FORMULA CALCULATOR 11.3 Lateral Hydrostatic Load 7 162.40 o fsta = 124.80 Iblft 13o/l-F ds: 2.00 Fsta = 2,496.00 Ib Z�,LOv� w : 20.00 �i�N 5{rfSf;AF�i Iliv x.a{�,�f4�al �/ t'�s�t raN.. r f x �3_�� ll riit�{{k'��- r.T �%. 1; 4'{+`r{rN { 1 1u.T 1 fi Wl7 Mfsfa,s~.�(�i/2+),Y� ��,,,,����z�r•�'<�<�Fst „{+ a tikl I...ir..�JniM�[Yt'�:'��'1M��+'Sl'�'�'tf•.F=s9�Srn2"{�Ja"'L�rthlr`�7�i11...,#Y'Y. Pia aiiiY1� vl�'�1:.'t'.. � ��6+I .ror . f yyyy�� r of y yy } �1 #li�h. r %. t� T F. V�F�u M�.4tia� i1 V �L�� 1 �W �. .a' IS• iI , trY '. i..' �.<F♦ 1 rot :f�.-Y[�f ,. �k���;^f i:',E"aY�TI+-�w-��..e .- w P,iS �., 1 # ��:3r"a 1,� 1:1 Comput" -Reset fsta = hydrostatic force per unit width (lb/ft) resulting from flooding against vertical element Y = specific weight of water (62.4 lb/ft3 for fresh water and 64.0 Ib/ft3 for salt water) ds = design stillwater flood depth in feet w = width of vertical element in feet Fsta = total equivalent lateral hydrostatic force on structure in lb WENEWMEMOMMM Othe'f Cal'cblators file:///Conet9/FEMA ProjecWolume One/11.3.html [7/1912000 12:36:48 PMj Calculator ko Invall New FORMULA CALCULATOR 11.6 Breaking Wave Load on Vertical Walls y : 62.40 65.0 fbrkw - 1,370.30 _ Ib/ft Cp : 2.80 Fbrkw - 1,245.50 lb ds : 2.00 j J1 vi 5 ��..,,. 4 ♦ Z xN k Y 1SWr.. {. iwM'1: ♦ f t Sy T <'t4 N t... ✓.1.� { � lyy IlrxJl r- .wh'�t = 1!`t �. ^I J(T r,.aSJµ� µ�t F' A�, q2 f1.. y rf 1 � iYW Li' i �Y T �1P y ! �P�, { i! �1J^4 �]f l � 1 .CasB"�17• u .,•' >w �i,. - �r{��4,r+�.G+c: < r'r V .�:,e..aT•«xiv,.mwn...:,.e..ti.,i�.ai��';�i�ke�r...M1i.��lfs.rr,,:.w-{�+"..,_�:..�...r�t,r,3:;tz:c�.s:-�a9., r.�,�.:.c:tr..n:l.»..,�.. ...... t +"ea ♦'./'Y9" - s.R a u .:y GL ity S 1 "•Y r yye {. �� er c rr r �:,+ A .�„ ,* r "tie ,fl tr i:,} r ,r '1i Lf � �•. ♦ � "�'i �2W. 6.IuyN>b:' a fY .t { Case.fF y cal 11: ,d,. SFra��4+ ,-�1�1C` br C( t ''w W rh a�.vrY=.-r.e✓h'.t^M ifL7i riM.Y�w.''IiEi`��+!'i•.",�l�i+tii'9T"J:�i-.i�Yu-:T�b-09%•ru�•1w`d.�. ".^r."•'W�'�'+�..Yai 'N�tLI=a,.r{�-•ylY .... Cbmptffei •;ftes�f fbrkw = total breaking wave load per unit length of wall (lb/ft) acting at the stillwater level F brkw_ total breaking wave load (lb) acting at the stillwater level = fbrkw w, where w = width ' of wall in feet y = specific weight of water (62.4 Ib/ft3 for fresh water and 64.0 Ib/ft3 for salt water) Cp = dynamic pressure coefficient from Table 11.1 ds = design stillwater flood depth in feet Note: Formula 11.6 includes the hydrostatic component calculated by Formula 11.3. If Formula 11.6 is used, do not add a lateral hydrostatic force from Formula 11.3. � p Other Calcufators � � = 1 `1 O-5 �j�r' d,a 8r{ �� F�u� � — r 1p lZ _ 1H1-5 4 12 13y P,r e�p�L r)PP 1�ewrt-' file:///Conet9/FEMA ProjectNolume One/11-6.html [7/19/20001:35:38 PMJ t;alculAtor falw Imiho FORMULA CALCULATOR 11.9 Debris Impact Load w : 1,000.00 Fi = 621.12 lb V t g : 32.2 ft/sec2 J 3 , 1 }I 1� was l � ),il.'. y♦ IY 1[1 'i Xti.�.!'!7 iL Y} .i. \i iPj Y k 1 � .n,,: ' Wl { �'A w . wj t}`2L^vidXti r K, �, sS,Jyr yJl.r k xy W.V� C7. N l -d al 7' 1 � " ♦ ,... } 14 J :x T � t L.L. 1 v Yu— .I Y - ,Compute, •Rest Fi = impact force in lb acting at the stillwater level w = weight of the object in lb V = velocity of water in ft/sec or approximated by 1/2(gds)1/2 g = gravitational constant (32.2 ft/sec2) t = duration of impact in seconds Othee;'Calculators ri1e:/IlConet9/FEMA ProjectNolume One/11-9.html 17/19/2000 2:07:19 PM) LOCUS IS A.M. 16, PARCEL 47. / LOCUS IS ALL IN FLOOD ZONE Al2 0, ON FIRM DATED JULY 2, 1992. FILE COPY N M G- � p tioo� & FND L NELD �+ m a 000, A �OPO LOT 3A OG� 27,000ts.F. ,� J 0LA roc 7 N/F CHALUPKA CA FND L FOR LINE THIS PLAN IS A VALID COPY ONLY IF IT B AN ORIGINAL RED STAMP AND SIGNATURE. ASBUILT PLAN FOR LEWIS BAY REALTY TRUST LOT 3A, 53 LEWIS BAY BOULEVARD, W. YARMOUTH, MA SCALE: 1 "= 50' OCTOBER 23, 2001 RONALD J. CADILLAC, PLS, RS PROFESSIONAL LAND SURVEYOR do REGISTERED SANITARIAN P.O. BOX 258 WEST YARMOUTH, MA 02673 (508) 775-9700 2001 BY R.J. CADILLAC RELD COPY BUILDING ' PERMIT Town of Yarmouth DATE August �—1 L01 PERMIT NO. B-02-152 - APPLICANTCCU= D]Vi. Ruildorn ADDRESS 9 NEW Venture Dove S-Dennin 056130 (NO.) (STREET) (CONTR'S LICENSE) , i 'ERMITTO additinn 1 1 STORY NUMBER OF •i nwrl I INr IINITC ITYPE OF IMPROVEMENT) NO. (PROPOSED USE) 1` AT (LOCATION) 53 Lewin Bay Blvd- DIO TING RICT $ 25 i ^./ (NO.) (STREET) •\ e BETWEEN '� AND m (CROSS STREETI )CROSS STREET) LOT m SUBDIVISION 16147 LOT. X3_ BLOCK M.'Ip 12 SIZE fit U Om BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION O iTO TYPE 5$ USE GROUP R 4 BASEMENT WALLS OR FOUNDATION (TYPE) O LL REMARKS: # j} tchen AREA OR VOLUME / (CUBIC/SQUARE FEET) OWNER ADDRESS ESTIMATED COST $ 8S-500 00 FEEMIT $ lEQ3.00 BUILDING DEPT. Z41 , INSPECTION RECORD DATE NOTE PROGRESS - CORRECTIONS AND REMARKS INSPECTOR q !� Z 10 m y'°� •YAk'r C M11lTM Ml[{1Nv� ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Deparunent 1146 Route 28 - Yarmouth, NIA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-2365 Office Use Only Permit No-5e Permit Fee $ , I123 �r�)) Deposit Rec'd. $ A54ate Net Due $ (Sg• Planning Board Information Plan Type Endorsement Date Recording Date Plan No. Assessors Department Information: map Lot Map Lot 2 b H1 Old New 1.4 Property Dimensions: 9.7 a o . 2 Lot Area (so .G2 Frontage (ft) . Lot Coverage Other This Section for Office Use Only Building Permit Number: I Date Issued: Signature: 31A Certificate of Occupancy Is Is not V required Building Official Date Section 1 - Site Information I Use Group: R-4 Type: 5-B 1.1 Property Address: �3 �5 Play %LVO. 1.2 Zoning Information: V--2S Zoning District Proposed Use I /. VA9A1 by-A� . f) to 1.3 Building Setbacks (it) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided + S� /S 22' GS } 1.4 Water Supply (M.G.L. c. 40. S 54) Public 0( Private 1.5 Flood Zone Information: Comments: Zone: v1-%'FE: Section 2 - Property Ownership/Authorized Agent 2.1 Owner of Record: NX2. 7oc D' -:��o PO• C'xot Lit JADlAen t14 Name (print) Mailing Address O7 S--- D Soe) 1329-2033 Signature Telephone 2.2 Authorized Agent: D GEORGE DAVIS BUILDI;S Name (priin_t)fD1 9 New Venture Drive, # 7 Mailing Address �.Gillr�--- mennls—M.A 02R60 (Ka$I �a- 4 W59 Sig lure Telephone / Section 3 - Construction Services 3.1 Licensed Construction Supervisor. ❑ Not ApplicableGEORGE DAVIS ILL.LI\ 9 New Venture Drive, # 7 Number 5 613 Address ennis, ' pira 1 ate Signature Telephone 3.2 Registered Home Improvement Contractor: Company Name GEORGE DAVIS BUILDERS 9 New Venture Drive, # 7 Not Applicable ❑ Address f S.DA 02660 (508) 394-0832 .� l Signature Telephone License Number ( 3 Expiration Date —) 31 p'Z 9- 15-99 1of2 OVER / n Section 4 - Workers' Compensation Insurance Affidavit (M.G.L c. 152 S 25C (6) r+• , Workers Compensation Insurance affidavit must be completed and submitted with this application. Failurd' to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes . ..... No .......... Section 5 -, Description of Proposed Work (check all applicable) New Construction ❑ I No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition Accessory Bldg. ❑ Type Demolition fA&M)Jii. S�r,rraa�n Other Specify: Brief Description of Proposed Work: S.r r. err^ Costs Section 6 - Estimated Construction Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Fling (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) 1. Building ,--- 2. Electrical 3..so o — 3. Plumbing / Gas 3. 5W — 4. Mechanical (HVAC) 500 — 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 8 5 a o 7.Total Square Ft. (new houses& additions) ZZ Section 7a - Owner Authorization - Owner's Agent or Contractor Applies To be Completed When 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. Signature of Owner Date Section 7b - Owner/Authorized Agent Declaration I, (nza , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. 6adr1C 1iArvt S Print name Signature of Owner Agent Date 9-15-99 2of 2 TOWN OF YARMOUTH �6�7 0 • r � .y;�� BUILDING DEPARTMENT BUILDING PERMIT APPLICATION SIGN OFF Applicant: Sb.e D 44-- k 4-0 Building Permit No.: Address: Cx2- N 000542 t 11 A Tel. No.: e2q'2033 Date Filed: 3)5-101 Bldg. Site Location: S3 X-ewn'7 RE-*j NVP Map No.: 16 Lot No.: 41 The following information outlines the procedural steps required to obtain a permit to build, alter, or add to a structure within the Town of Yarmouth. The Building Department will determine compliance to the following: (A) Zoning Requirements (B) Historical Districts (C) Flood Zones. The Building Department will be responsible for assisting the applicant through the following departments: RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability. (applicant to obtain) ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION CON91ISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc. HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements for Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal ---------------------------------------- Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. The following Departments must sign off, in the respective order, prior to building inspector issuing the required building permit: REVIEWED BY: 1. WATER DEPARTMENT: DATE: In I N/A: 2. ENGINEERING DEPARTAI ot ATE: N/A: 3. CONSERVATION. DATE: N/A: 4. HEALTH DEPARTMENT: DATE: �iN/A: 5. WIRING INSPECTOR: _ 6. PLUMBING INSPECTOR: 7. FIRE DEPARTMENT: _ PLEASE NOTE All stumps and/or brush must be disposed ofat an approved site. COMMENTS: ,C,.,ta , S,_ 7-a DATE: N/A: DATE: N/A: DATE: N/A: u) Q-6 N8CA.." A/� -, -y M&<7 5a 1-116 et.SA%S7yJc (�rs�ti. 8/99 Applicant Signature J— �/ l/ Date The Commonwealth of Massachusetts Department of Industrial Accidents exceollarestlysdiis 600 Washington Street Boston, Mass. 02111 --4� Workers' Compensation Insurance Affidavit Applicant information: PleasePRiIVTTedihFtr name b:L 502 ill i�rt1 l s-l7 location:,, `�3 Lt-w►� i3� j g�Vb city VA o-4r,\ phone M sa& O 1 am a homeowner performing all work myself. I am a sole proprietor and ha%e no one working in any capacity 64 1 am an employer pro%iding workers' compensation for my employees working on this job. GEORGE DAVIS BUILDERS 9 New venture Drive, # 7 address: S.Dennis, MA 02ern (5018) 394 0682 insures ice Co. &tiAem C., .,INN policy V \.JC V 3DObls1 5 I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below w ho have the following worker' compensation polices: company name: address, city phone H: insurance co. policy N Failure to secure coverage as required under Section 25A of MGL I52 can lead to the imposition of erimlaal penalties ofa Doe up to SI�WQAY andfor one years' Imprisonment as sell as civil penalties in the form of a STOP WORK ORDER and a Doe of S100.00 a day against me. I onderstaad that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify paint an penalties ojperjury llsal the lnjormation provided above is true and correct _Date Print name 6.P&1q it h4Js/I -J Phone N 34 y— U P� 3 oRcial use only do not %rite in this area to be completed by city or Iowa official city or town: YARMODTIi p check if Immediate response is required contact person: permit/license 0 n8uildiog Department p1.1censing Board .261 ❑Selectmen's Office ❑11ealth Department phone ll: _ (508) 398-2231 ext. n0thcr u"„ea s,os Pu) It I Information and Instructions 1. Massachusetts General Laws chapter I52 section 25 requires all employers to provide workers' compensation for their employ ees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An entplot-er is defined as an individual. partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual . partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein: or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the `_rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. %lG1_ chapter 152 section also states that even• state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionall%. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha%e been presented to the contracting authority. Applicants Please till in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial .accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affdavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents office It Imstlletleo! 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone th (617) 7274900 ext. 406, 409 or 375 TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARDIOUTH NL SSACHUSETTS0266"451 Telephone (508) 398.2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS 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 5'3 1tom.( Vsk v0 Work Address is to be disposed of at the following location: �A�- Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Permit No. Date °`Yqk TOWN OF YARMOUTH 3e BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLFASE PRINT: Job Location: ' 3 21�y P.1\ `/ b W. yAVn 6AA--, Number Street Village Owner of Property: �� kri `c O Construction Supervisor: Address: GEORGE Name V New Venture Drive, � 7Z''ccnse No. S.Dennis, MA 02660 (508) 3"32 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: L. License No. Phone No. 2.15.1 The license holder shall be fully and completely responsible for all wort: for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes Ul No ❑ If you have checked M, 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 152 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 Signature: — /--- Building Official Approval: For Office Use Only Permit No. Date TOWN OF YARMOUTH AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142A requires that the 'reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition or construction of an addition to any pre-existing owner -occupied building containing at least one but not more than four dwelling units or structures which are adjacent to such residence or building' be done by registered contractors, with certain exceptions, along with other requirements. Type of Work: Est. Costt13S, Address of Work S3 V 0 Owner Name: V Arn t c p Date of Permit Application: -4slt'` I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under $1,000 Building not owner occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: 3�51c>1 Date Contracto Name Registration No. Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name APPENDIX J COMPLIANCE REPORT March 12, 2001 To: Town of Yarmouth Building Department From: George Davis — Builders Unit 7; 9 New Venture Road South Dennis, MA 02660 (508) 394-0832 Fax 394-5460 Re: D'Amico Addition 53 Lewis Bay Blvd West Yarmouth, MA Please be advised that for the purposes of Appendix J Compliance, we intend to satisfy the requirements by meeting the conditions of Section J1.1.2.3.1, paragraph 3, utilizing the prescriptive requirements of Table J1.1.2.3.1. Our calculations are as follows: Ceiling, Wall & Glazed Areas Gross Ceiling Area 480 sq. ft. Gross Wall Area 585 sq. ft 40% of Above 426 sq. ft. Gross Area of Glazed Fenestration 141 sq. ft. Does the Gross Fenestration Exceed 40% of No Gross {Nall Area? Product U-Valucs Windows and Glass Doors U-.33 Insulated Fiberglass Door U-.28 Are the U-Yalues within the Prescriptive Yes Allowed Values? Component R-Values Roof R-30 Wall R-13 Floor R-19 Are the ComponentR-Yalues within the Yes PrescriptiveAllowed Values? Prepared By: George Davis, Builder MAR-07—OI 01:06 PM JOSEPH.DAMICO.OD Wlt! iKESM-40 508 829 6732 ��r�. It. P.01 March 7, 1001 building Dr,partment .'-wn aF ;'t�lrulitl' Sirret 1 annt,it;,. '.L*, "20 morn Dr. ke V AMICO 53 Lewis Hty Ulvd Ye.mv;nTh, MA R'. A:rrm AuthuriLl6on Ptojr:t Address Siroa To whim tt 11;a%, cvncrlr . Please tie. Advised thtit iiv)rde Dais, tsuilde:, 1s authonzed to act as agent on my hthalf with rtyeld to the projwa undtr rvicFv in this building depannrant r `•-1—%,� '�'N _ u � Urtc trch'1�;,;hj, Dr .lot D'Amiw -- p�C��DdC� 2001 I Sc� I"�'.ZD Zbol j P�-o'er ?1,14� _ FvQ.- - - - - - I i1Qs Tof- VPrrttct;y SLY 6 Y"WDO"A Ink 0 5POSAMMc_" 11�(::�Jj 8uru{ �w�5 PU vok- Lim;is B#r`I S 3��c 3 F------------ YAR/ABLE WX07W _ 770,,,," ,�,,yy ; Z E wl s 31,q Y o P 92.45. C.G3. FNd • y 3A 2 7, 0 0 0 f �* s 4A 28, Oooff 43 1 I 41 .ti JA� I y PL A/V of L A/VO WEST Y�1 R MO UTy Miss. FAR 2 U T H H. kVEL L. S 945//16 o T� RE C oBDED ��/ 7.yE BA�NSTA 5Z, COUNTY REG/SrRY OF OEEOS /N f�lA/V Boom /.s ,SAGE /S" SCALE: /"= '¢D' OECEMBEf� 4, /77 O io POao dfo.So ,00 geor-ge G OW CX/7CY CO. S UR1/EYaRS A/v.0 ENG/VEER S I 1 - SHED PEAK VM SOFFIT SHEp P EAK WRHOUT. SOFFIT U Y SHED ROOF AT WALL SHED PEAK: NO OVERHANG SAYE WR}iOUT SOFFIT EAVE WITH SOFFIT 45 APPLICANT- Geo. Davis Bui�ders� N PERMIT TO REPAIRS (_) STORY (TYPE OF IMPROVEMENT) NO. jBUILDING PERMIT FIELD COPY 8-66t 84,3 &5. - ce • 9l;l05 S/51m 15• 2000 PERM T NO. B-00-863 ,,)Yeture Dr. S. MA (NO.) (STREET) 05 0 (CONTR'S LICENSE) NUMBER OF DWELLING UNITS IPROPOSED USE) 53 Lewis Bay Blvd. W. ;Y. ZONINGR-25 AT (LOCATION) DISTRICT (NO.) (STq EET) 1 1 a BETWEEN AND m m (CROSS STREET) (CROSS STREET) am SUBDIVISION 16/47 � X 3 12 LOT BLOCklaLOT SIZE Om BUILDING IS TO BE FT. WIDE BY FT. LON� BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION 5-B R-4 z f TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION C (TYPE) O ` REMARKS; Replace existing windows w/new anderson •Tilt -wash" TW 3056-3 AREA OR VOLUME ESTIMATED COST $ (CUBIC/SQUARE FEET) OWNER 7Ahellg n#Am4C0 ADDRESS P O_Bow 41. HoIAeII,M"02520 5000.00 FEEMIT $ 35.00 BUILDING DEPT. BY INSPECTION RECORD DATE NOTE PROGRESS CORRECTIONS AND REMARKS INSPECTOR ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR AO FAMILY DWELLING Town of Yarmouth Building Department 1146 Route 28 - Yarmouth, NIA 026644492 t Tel: (508) 398-2231 x261 • Fax: (508) 398-2365 Office Use Only , Permit No.P?i D`s �5ate �. Permit Fee $ 3� Deposit Rec'd. $ -- Date Net Due $�T / Planning Board Information Plan Type Endorsement Date Recording Date Plan No. Other Assessors Department Information: map nor Mep Iw )a Ib old New 1.4 Property Dimensions: Lot Area (sf) Frontage (ft) Lot Coverage This Section for Office Use Only Building Permit Number: Date Issued: Signature: O'a Buil0bg Official Date Certificate of Occupancy is is not -7-- required Section 1 - Site Information I Use Group: R-4 Type: 5-B 1.1 Property Address: S3 ttln-� Btu P1,VD 1.2 Zoning Information: -iI�-- Zoning District Proposed Use W. Y44lt•-1. 1.3 Building Setbacks (it) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided D .r 1.4 Water Supply (M.G.L. c. 40. S 54) Public Private 1.5 Flood Zone Information: Comments: Zone: BFE: Section 2 - Property Ownership/Authorized Agent 2.1 Owner of Record: 2p 1c- U'�r1�Lo PQ ?b)L 1t • .AbVk r t1A bZS2t:) Name (print) Mailing Address Signature Telephone 2.2 Authorized Agent: GEORGE DAVIS BUILDERS G� Name print) /`—S.De"is, MA 02660 (508) 394-08g2Mailing Address D I gignp&re Telephone 15 Section 3 - Construction Services 3.1 Licensed Construction Supervisor. B GEORGE DAVIS BUILDERS N ' 9 New Venture Drive, # 7 S.Dennis, MA 02660 (508) 394-OR19 License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor. Company Name GEORGE DAVIS BUILDERS 9 N -w Venture Drive, #-i Not Applicable ❑ License Number Address S.Dennis, MA _02660 (508) 394-0832 _ lr Signature Telephone Expiration Date -7 %/SOD 9 - 15 - 99 1 of 2 OVER Section'4 - Wol(ers' Compensation Insurance Affidavit (M.G.L c. 152 S 25C (6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this iffidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes ..D..... No .........: Section 5'= Description of Proposed Work (check all applicable) New Construction I No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ Repair(s) @ Alterations ❑ I Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: h,(� G�.ex.lurit'1.�a WJa.D ar�hl� hur\ �.,•.�cSa� -Man► vllro�5 w 2w Section 6 - Estimated Construction Costs Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Fling (if applicable) ❑ Old Kings Highway & Historical Commission approval . (if applicable) 1. Building -Sion o "" 2. Electrical 3. Plumbing / Gas 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) S, o uu 7. Total Square Ft. (new houses S additions) Section 7a - Owner Authorization - To be Completed When Owner's Agent or Contractor Applies for Building Permit I, 1Zfa.occtL 0'Ar- %et o , as owner of the subject property hereby authorize 6°ot!$1 D:'-u(S to act on my behalf, In all matters relat' It work authorized by this building permit application. Signature of Owner Date Section 7b - Owner/Authorized Agent Declaration 1, N'Vi S , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed underthepains and penalties of perjury. Print name Signature of Owner/Agent Date 2of 2 SUBMITTAL REQUIREMENTS/CHECK LIST FOR BUILDING PERMITS New Structures 1. Application signed by the owner and owners authorized npresentativelconstructton supervisor. Application shall include: Construction Supesvisois license, Workers Comp. Affidavit/Certificates, Home Improvement Affidavit. ? Four certified site , lansstamped by a Mass. Registered Professional Land Surveyor, showing all boundaries, proposed P �p OSed location of ftfue(s), Paddng, curb cuts, drainage, impervious setbacks. cutting &proposed �ades/contotrrs, prof cover calculations (whey applicable), flood zone and Title V design and any other zoning related dezaris deemed necessary.. 3. Three tar of complete construction tion plant, including a complete structural cross section, floor plans, rue ofrooms, dimensions, window & door schedule, HVAC details- electrical+ Plumbing & mechanical plans are also requited for commercial & muld-family (3 units or more) structures. 4. Flood zone applicability -Compliance with Section d 107 of the State Building Cod"Elevadi n orflaad proofnng certificates (whichever is applicable), shall he submitted prior to the issuance of a Certificate of occupamry. S. Plans shall be reviewed by the following departments: Health, En&gi' Fue & Conservation (when applicable). The Building Deparaneat will forward. 6.Old Kings Highway & Historical Commission (when applicable). 7.:dass. DPW approval for State FTighway curb cut and access ways, 8. Construction control affidavits for all projects to be constructed or altered under the provisions of section 116 of the St= Building Code. Buildings mntmning 3S,000 cubic feet or morn One & two family sauctures arc ezemPt, except, Ctrtitied designs may be required for unusual snucttual circums==. Section 3107 of the Building Code requires wed plans for new and substantially improved structures in flood zones. Addition.* 1. Same as above, except the blank generic "Plot Plan" available from the Building Dept., may be used for one & two family ractures, when setbacks are not marginal. . Flood zone app4cabtlityZ-When the value of improvements equals or exceeds 50% of the structure's value (substantial aproverztexas)• Alterations _ Same as above, except existing & proposed conditions shall also be shown on the plant. -- - - - _ - --E BUILDING PERMIT HAS PEEN ISSUED. Filing a building permit 0 BUILDING TOWN OF Y A R M O U T H ELECTRICAL GAS 1146ROUTE28 SOUTHYARIIIOUTH hiASSACHUSETTS02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 PLUMBING SIGNS 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 151 4,0Awb5� P °j N Va Work Address is to be disposed of at the following location: A94--l-44iV, b='"D Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. gnaturc of Applicant Permit No. S/>l0-) Date 2�eY^ke TOWN OF YARMOUTH 00 �: .�.....y�y BUILDING DEPARTMENT BUILDING PERMIT APPLICATION SIGN Applicant:y oe1 Ct:� Building Permit No.: OFF Address: S5 Vs" V3..dD Tel.No.:'50' t--Xi VS313ateFiled: 5114c,u Bldg. Site Location: '-A4nt Map No.: l b Lot No.: "-I The following information outlines the procedural steps required to obtain a permit to build, alter, or add to a structure within the Town of Yarmouth. The Building Department will determine compliance to the following: (A) Zoning Requirements (B) Historical Districts (C) Flood Zones. The Building Department will be responsible for assisting the applicant through the following departments: RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability. (applicant to obtain) ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc. HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements for Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. ---------------------------------------- 77re following Departments must sign off, in the respective order, prior to building inspector issuing the required building permit: REVIEWED BY: 1. WATER DEPARTMENT: DATE: 2. ENGINEERING DEPARTMENT: DATE: 3. CONSERVATION: DATE: 4. HEALTH DEPARTMENT: DATE: INDUSTRIAL AND/OR COMMERCIAL PERMITS 5. WIRING INSPECTOR: DATE: 6. PLUMBING INSPECTOR: DATE: 7. FIRE DEPARTMENT: DATE: PLEASE NOTE All stumps and/or brush must be disposed of at an approved site. COMMENTS: N/A: N/A: N/A: N/A. - N/A: N/A: N/A: 8/99 Applicant Signature Date 3i°;Ak4C TOWN OF YARMOUTH 00 �r.K.,S,�y BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRIM: Job Location: yl4J� �`'`'�� Number Street Village Owner of Property Dt 4n t e-p Construction Supervisor: 0''6l3Z0 NMORGE DAVIScense No. Phone No. 9 New Venture 11i5 WILi��i.�,"�. Address: 7+►t3, MA 02660 (508) 394-0832 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes � No ❑ If you have checked =, 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 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: S g cure @ OwKer or Owner's Agent Owner ❑ Agent I � Signature: building Official Approval: The Commonwealth of Massachusetts Department of Industrial Accidents OfAce oJlsivesdpstlsss 600 Washington Street Boston, Mass. 02111, Workers' Compensation Insurance Affidavit Applicant information: FleasePRIIVTIeihFc namr7 location:_ lCX3 sS ?'J O 1 am a homeowner performing all work myself. O 1 "am a sole proprietor and hase no one syorkine in any capacity I am an employer pros iding workers' compensation for my employees working on this job. company name: GEORGE DAVIS BUILDERb 9 New Venture Drive, # 7 address: ,,,,,,,, ' city 1� phone q• insurance co. �(e-.�tnY� r^�-��6��1 y typ WGv3bo191S I am a sole proprietor. general contractor, or homeowner (circle one) and have hired the contractors listed below ssho ha%e the follossin_ ssorkerscompensation polices: Failure to secure coverage as required under Section 25A of MGL 152 as lead to the lopositioa of erisaisal penalties of a fiat up to S1,5W.00 and/or one years' Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. t do herehy certify under pains and penalties of perjury that the information provided above is true and correct Date S�rr/y`� Print name G��� t�F�'V) 'S Phone 0 3`�`�—U� 3 Z official use only do not write in this area to be completed by city or town official city or town: YARMOUT11 ❑ check irImmediate response is required contact person: permit/license 0 nBuilding Department ❑uceosiog Board 261 ❑Selectmea's Omce (508) 398-2231 eat. ❑Htalth Department phone M; _ _ nOther Ue.ned 3,95 %AI Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their etaaplo%ees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written.. An e►►►phi i-er is defined as an individual, partnership, association. corporation or other legal entity, or. any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dw elline house of another %%ho employs persons to do maintenance , construction or repair work on such dwelling house or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an emplo%er. MGL chapter I _ _' section =5 also states that even- state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any :applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionall%. neither the common\\ealth nor any of its political subdivisions shall enter into any contract for the performance of public aork until acceptable evidence of compliance with the insurance requirements of this chapter ha\ e been presented to the contracting authority. Applicants Please till in the workers' compensation affidavit completely, by checking the box that applies to your situation and stippl%ink_ company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affida\ it should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial accidents. Should you have any questions regarding the "law' or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The aMdavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents office of IevestUtllUeos 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 ug;estc i. a%it for ome mprove For omce rx only NAME OF CI Y,TOWN Persnu \d Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application .MGt-c. 14ZArceutrestlut the'reconstructton. alteration. renovation. reoatr. mnae^moon. cnnvers+nn +. ^rrn rmer.t. r- �wa�. �e "^"•+ran nrcon.Rmctinnnfanaddmontoanvere•ettstin nwner-r+ccumedhuddmecnntjtm^catirastnnerutnnrmnrernintnuraµrn+r.cc-+}+ 'r to strt:aares µntch are sancent to sucn rester -ice nr nttldmg' ve 00ne w mr1slema Contractors. µin certain eruptions. jinn[ usln cane: rsgwmacnts Type of Work: ()J��do� at. cost Address of Work Owner ;Fame: 1 l Lb Date of Permit Application: S 1 ti ( 00 I hereby certify that: Rccistration is not required for the following rcason(s): _Work excluded by law _Job under S1.000 _Building not owncr-occupied Owner pulling own permit _Other (specify) Notic.- is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMFRO EMENTWORKDONOTHAVE ACCESS TO THE ARBITRATION PROGRAM OR Gi:ARANn' FUND UNDER .%IGL c. I42A. Signed under penalties of perjury: hercny apply for a permit as the agent of the owncr. GLUJ%r,� _.GEORGE DAVIS BUILDERS 10.133� t�t!✓� w 9 New Vent VPrifliie Datc S.Det�,;tAop�c (508) 39•-0832 Rcrtstrauon Nu. OR: Noiwithstandine the above notice. I hereby appiv fora permit as the owncr of the above propertn: Date Owner Name INSPECTION SCHEDULE NEW CONSTRUCTION, ADDITIONS , & ALTERATIONS The receipt of a building permit is not the end of the permit process. but rather the be -inninM ?lac building permit holder is responsible for am grog the required inspections before proceeding with :additional work. Failure to do so may result in having to exposure concealed work through the partial or complete removal of some building elements. Musing you delay and unnecessary expettse. It is imncrative that you arrange for the following inspections by either calling 308-398 _0-131. =tension 26 1, or make a personal request at our office. at least 48 hours in advance: FOUNDATION • Betbre concrete flour is poured • Before back -fill • Before first deck is crostructcd • Auer darapprooting • Mier perimeter drain has been installed • After certified "as built" site plans have been submitted • Aticr certified flood zone clevadons have been submitted ('when applicable) Note: When proposed plans specify re -enforcement rod installation or other unique design criteria, you are required to call for an inspection prior to pouring the concrete. In some cases, a separate inspection may be required for a strata/soil or footing inspection. FRAME • After rough electrical. plumbing & gas approvals have been made • Before insulation • After being made tight to the weather FIFtEaLAC&CH1MNEY • When smoke chamber is complete • When chimney is complete (may be inspected with frames • Final INSULATION • After building envelope is completely insulated FINAL • After all other inspections have been approved • After electrical, plumbing, gas. S fire inspections have been upprn cd • After all applicable Historical applications have been completed • Ater an applicable flood r c%ation certificate has been submitted PLOT PLAN FOR LOT # Indicate location of garage or accessory building Additions with dashed lines -------------------- Sewerage disposal (cesspool) Well 0 I I(lot................ft. rear) Abuttor I s Name Lot # If this is a corner lot, write in name of street. b SIDE YARD FT. r1 REAR YARD .............ft. HOUSE Q SET BACK SIDE YARD 0------FTO (lot..................ft. frontage) (NAME OF STREET) Information Supplied by b A Abuttor I s Name Lot # If this is corner la write in name of other street. MARK NORTH POINT APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 TOWN OF YARMOUTH (OFFICE USE ONLY) Fee: $ 500 PERMIT NO. E -0�-576 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: r�-1-I- 0 %" To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) S ��' « VS:l(J G1 ENV 17 c� Owner or TenantC. D Telephone Owner's Is this permit in conjunction with a uildiing permit? es 0No (Check Appropriate Box) Purpose of Buildin A l 4 Utility Authorization No. / S Existing Servicc]� Amps D Z� O VoltsV4t OQUvcr eadP0--0- Undgrd Q No. of Meter New Service Amps / Volts Overhead❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed electrical Work:t�NP rmmnlrtinn of thv fi llmrinv iahly may by waived by thr In mertor of tlirot of Recessed Fixtures No, of C6I,-5usp.(PaddIc)Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above n- Swimming Pool rnd. ❑ rnd. ❑ No. o Emergency Lighting Battery Units No. of Receptacle Outlets Z No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Ileat ump Totals: um er ons — — — — No. of Sclf-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Nlumcipal Local ❑ Connection Other No. of Dryers Heating Appliances KW. Security Systems: No. of Devices or Equipvalcnt No. of Water Ileaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent Altacit aaaatonat acme tj aesirea, or as reyuirea vy me inspccior o7 tires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to permit issuing office. CHECK ONE: INSURANCE B BOND OTHERID (Specify:) � (Expiration Date) Estimated Value o Ele rical Work ^��o (When required by municipal policy.) Work to Start: -?- Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under h pains and penalties of perjury, that the information on this application is true and complet . FIRM NAME -A _ E 1Z O 1= L�z �L LIC. NO. Licensee: \(,\(UCH *,Xk-\SfCY7\Cp Stgm (If applicable, enter "exem t" in the license number line.) ✓LIC. NO. Tel. No.SO RV c, Address2)DI 1 � c � \ A V9IV_ O—N V mX ,t J""ff O u It. Tel. No.: OWNER'S INSURA E WAIVER: I am aware tha the Licensee does n& have the liability insurance coverage normally required by law. By my signature below, 1 hereby waive this requirement. I am the (check one) owner owner's agent. Owner/Agent Signature Telephone No. [Rev. 04/001 APPLICATION FOR PERMIT TO DO PLUMBING TOWN OF YARMOUTH (OFFICE USE ONLY) By L f Fee: $ /09 • t6 PERMIT NO. 19— G rt 3 /d / 233-j /Oa'� Date 61111 20 0OOL, Building r Owner's ,ZS44 D�a2 ro AT: Location Jr'3 �CW/ S 3�g /� �U� Name 6d l�✓.a r Type of Occupancy New ❑ Renovation 0?`*� Replacement ❑ Plans Submitted Yes[] No[] jzdot&4"c axk'jfi'^s Wa{ci Inca c✓ Wcn N z Z Y i 9> frf y Y J U) Q V Q ►- 2 M O y acc ui Z y W FQ- W 2_ y O U. Z Z Z O W m N W ? C Q N Z Q Q. Q� M - tt W O a W 3= a N a a z a 3 Y N a 0 0 J z z G G w H v y y W ►W- p v 3 Y g m ai o c g 3 i ra (nn LL a M c a M m o SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name 1��a5 Sl�i`� /%%d2 li ;",_ Check One: 0"Corp. _ ❑ Partnership ❑ Firm/Company Business Telephone '512of Name of Licensed Plumber, INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent. Check One: Yes ❑ No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy 00� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent I hereby certify that all of the details and Information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Check on Owner ❑ Agent ❑ signature of Licensed Plumber Ucense Number Type: Master tic}—" Journeyman ❑ 01/03/1994 20:07 15083945460 PAGE 02 BOISE CASCADE - BC CALC rm 2001 DESIGN REPORT - US Tuesday, August 14, 200112:36 File Double -1 3/4" X 91/2" V-L SP 2900 Name: George Davis d'amimkitchen, BCC (t Job Name DAmlco Customer - George Davis Address Specifier Designer Jay Malaspino City, State, Zip - Yarmouth. Ma, Company: Shepley Wood Products Code Reports - ICBO 5512, BOCA 98-52, SBCCI 9852 Misc: - Eng. Wood (508) 862-6223 Beam A Kitchen area o 12 .. _ �, _ ' — Standard Load - 25 PSF 15 PSF Tribute 07.0a-00 - J. ,.I..__ I so 1078lbs LL 701 The DL General Data Version: US Imperial Member Type: - Roof Beam Number of Spans - 1 Left Cantilever - No RighlCantilever - No Slope 0112 Tributary 07-06-00 Repetitive n/a Construction Type n/a `ive Load tad Load `-Part Load Duration \. 25 PSF 15 PSF 0 PSF 115 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation Of Boise Cascade engineered wood Products must be In accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions, please call (800)232-0788 before beginning product installation. Total Horizontal Length-11.0"o Load Summary ID Description S Standard Controls Summary Control Type Value Load Type Ref. UnLArsa Load Left Moment 5114 ftabs End Shear 153411)3 Total Deflection L1566 (0.243") Live Deflection U935 (0,148') Max. Dell. 0.243-(Limit 1") Span/Depth 14.5 Elearinq SupDorts Name Type Bo Wall/plate at Wall/plate %Allowable 34.1 % 20.7% 31.7% 25.7% 24.3% B1 1078 Ibs; LL 701 Ibs DL Start End Live Dead Trib, Dur. 00400.00 11-06-00 25 PSF ISPSF 07-06.00 115 Duration Loadcase Span Location ®115% 2 1 - Internal ® 115% 2 1 -Left 2 1 2 1 2 1 1 Dim. (L x M Value %Allowed Case Material 3.1/2"x3.1/2- 1779lbs 34.2% 2 Spruce -Pine -Fir 3-1/2"x3-1/2" 1779lbs 34.2% 2 Spruce -Pine -Fir Design meats Code minimum (U180) Total load deflection criteria. Design meets Code minimum (1J240) Live load deflection criteria. Design meets arbitrary (1") Maximum load deflection criteria. Slope = 0, consider drainage. Page 1 of 1 BCI® and Versa -Lam are registered trademarks of Boise Cascade Corp. 5272015 SlipGen- Portal Hone Town of Yarmouth 12 Template [Building Dept] DI Slipsheet Identifier [sg26266] Document Category Building Permits Map -Block Number 016.47 Street Number 0053 Street Name Department Parcel ID Backfile Batch Scan Document? Additional Naming Info Index Operator Date - Time LEWIS BAY BLVD Building 359 [We Operator, Yarmscan 2015-05-27 - 12:13 httpJAaserfiche1215lipGerN 1/1