10 SABLE RD - BUILDING INSPECTION -� 3�C7 GK 9(tat-I tq 1�
a� The Commonwealth of MassachusettSPECTIONAL $ER ICES
Board of Building Regulations and Standardds CITY OF
Massachusetts State Building Code, 780 CMR SALEM
I ?11$ AUG 19 A tAz4&I Mar 201 l
Building Permit Application To Construct, Repair, Renova e r Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building Official('Print Name) Signature IQDate
SECTION I:SITE INFORMATION
I.Ij
ropW d s: 1.2 Ass s [Map& Parcel Numbers
I.1a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use [..or Area(sq It) Frontage(It)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water L,Supply:(M.G. c.4L1,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 3_rS Private❑ Zone: _ Outside Flood Zone'?
Check if yes❑ Municipal 23 On site disposal system ❑
SECTION2: PROPERTYOWNERSI11Pt
2�!/Owner'of Record:
V4 u/_� CN'Tt Tc tX , "A..!
Namo(Pr' t) City,State,ZIP
No.anJ�et � �'.P �/i!� ��d'�337• SPP� a�w P<,-<P��� Inc<�.• ,6 I
"telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building Owner-Occupied 12epairs(s) Ck Alteration(s) ❑ Addition ❑
Demolition Accessory Bldg. ❑ Number ofUnits_ Other ❑ Specify:
Brief Description of Proposed Wo k': /4%1 r,�
SECTION 4: ESTIMATED CONSTRucFION COSTS
Item Estimated Costs:
(Labor and �Nlaterials Official Use Only
L Building S �3 6Q 1. Building Permit Fee: S Indicate how fee is determined:
2. Electrical $ ❑Standard Cityfrown Application Fce
❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S J34,66 2. Other Fees: $
4. Mechanical (I IVAC) $ List: _-----'�--t/�-
5. �blechanical (Fire —
Su n'ession) S 'Total All Fees: $_
G. Total Project Cost: $13 6Q�qV Check No. __Check Amount: Cash Amount:
❑ Paid in Full ❑Outstanding Balance Due:
G� -,o
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL HoIdei.. P ' 'Ills a,-•,
List CSL'rype(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu. ft.)
R Restricted 1&2 Faun it Dwelling
Ciry/•1'mvn,State,ZIP M Mason
ry
RC Roofing Covering
WS Windowand Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or I IIC Registrant Name
No.and Street
Einad address
City/Town, State,ZIP Telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .......... ❑ No...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject property,hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
By enteri ty nam bolo v, I hereby attest under the pains and penalties of perjury that all of the information
coil me this appl io is true and accurate to the best of my knowledge and understanding.
Prit wn is or Aut iorizcd Agenfs Name(E3ectremic Signature) ate
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC) Program), will not have access to the arbitration
program or guaranty fund under M.G.L.e. 142A.Other important information on the HIC Program can be found at
www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq. R.) (including garage, finished basement/attics,(leeks or porch)
Gross living area(sq. R.) _ Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms _ Number of halt/baths
Type of heating system___ Number of decks/porches _
Type of cooling system___ _ Enclosed Open
3. "Total Project Square Footage"may be substituted for"rota) Project Cost"
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AL DENNIS ENGINEERING, LLC, 8 WHEELER PLACE, MARBLEHEAD, MA 01945
ALLANDENNISOcomeast.net, PH: 781-718-2841 FAX: 781-990-5016
General fdotds :
1 ; Construction shall conform to the requirements of the latest Mass. State
Buildinig Code and all other applicablestate and local code requirements.
2. Specified ultimate compressive strength of concrete shall be a minimum of
4000 psi at 28 days. Concrete shall have a slump of 4" a water cement ratio
of 0.40 and have 6% air entraining.
3. Reinforcing steel shall have a minimum yield strength of 60,000 psi
conforming.to ASTM A615; Grade 60. Epoxy coated rebar shall be used in
`structures subject to salt spray.
4. All existing dimensions, conditions and elevations shall be verified by the
contractor:
5. Contractor is responsible for temporary bracing and support during demolition
and new framing erection.
6. Contractor shall field verify all dimensions and elevations prior to placing
concrete.
7. All wood framing shall be 960 psi fiber strength in bending.
8. All framing shall be free from large knots, cracks or other structural defects.
9. Structural timbers, caps, stringers, bracing, blocking and decking shall be
pressure treated southern yellow pine, No. 2 dense or better, surfaced to
nominal dimensions on the drawings.
10.All hardware shall be ASTM A36, hot dipped galvanized in accordance with
ASTM A153.
11.Woist sections shall be as manufactured by the Boise Cascade Corp. or an
Engineer approved equal.
12.All roof sheathing shall be 4' x 8' sheets of 5/8" CDX plywood and shall be
nailed with 8D common nails at 6" o_c. along all edges and 8" o.c. throughout
the remainder of the sheet.
13.In addition to code required nailing rafters in areas with cathedral ceilings
shall be tied to structural ridge members with an LSU sloped hanger as
manufactured by Simpson Strong-Tie Co. or an engineer approved equal.
14.In addition to code required nailing rafters shall be tied to the exterior wall
double plates with Model H2.5 hurricane anchors as manufactured by
Simpson Strong-Tie Co. or an engineer approved equal.
15.Micro-Lam beams, designated as LVL's on design drawings, shall be 2.0E
sections with an allowable bending stress of 3100 psi, as manufactured by
j the Boise Cascade Corp. or an Engineer approved equal.
16.Micro-Lam beams shall be connected together as follows: 2 ply members- 3
per row of 2 7/8" Fastenmaster HeadLok heavy duty wood screws at 24" o.c.
from each side. 3 ply members- 3 per row of 5" Fastenmaster HeadLok heavy
duty wood screws at 24" o.c. from each side.
17.Formwork for new foundations shall be Bigfoot Footing F s as man ctured
by Bigfoot Systems Inc. of Nova Scotia, Canad sh be as
manufactured by Sonoco Sonotubes of South Car specified
otherwise. ^�
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