25 BUFFUM ST - BPA-16-1064 10
The Commonwealth of Massachusetts 1' TY OF
Board of Building Regulations and Standards z l r SALEM
Massachusetts State Building Code,780 CMR -RewimdMar2011
Building Permit Application To Construct,Repair,RenovagMr%ib14h P 1
Jt One-or Two-Family Dwelling
N This Serdbon Por O�oi�; e
BuildingeaIDitNomber Date bed:
}3aldingOffcialfPrnm e)" aige
Dais
( >IECITON 1,SITE TI�11I OR i1TION
1.1 Pro rty Address: 1.2 Assessors Map&Parcel Numbers
l.la Is this an accepted street?yes /� no Map Number Parcel Number .
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use �, Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Pmvided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal 13 On site disposal system 13
Public Private Check if yes❑ _ . .
lsECTION 2 PROPER3 YUWI`1E1tSi�'t
2.1 Owgerr fRecord: S4LEP1 01A 0/ 9W -
J7I t E�9At 6 A LL.o
Name(print) city,state,ZIP
�Q
2 S I>tlr 1't/w/ S 7L Pa R Q IIO lv
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK$(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Addition ❑
Demolition �1 Accessory Bldg.O Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work': e m E' t r f „ n Z
roes�� r o jo
SECTION 4:ESTIIIlATED CONSTRUCTION COSTS
Estimated Costs: Official Use Only
Item Estimated
and Materials
1, Bulldiag Permit Feel$Z Indicate hoiv fee is determined
1.Building $ 06 V 13.Standard City/Town A"ication.Fee
2.Electrical $ P 60 VO Total Project Cost'(Item 6)x multiplier x _
3.Plumbing $ /S00019 2. Other Fees: 5
4.Mechanical (HVAC) $ Lam'
5.Mechanical (Fire $ Total All Fees:$
S ression Check No. Cheek Amount: Cash Ammmt:
$
6.Total Project Cost: � =000p Paid in Full p Outstgn Balance tire: .
Sm pt-r�tv S �m-e-t��
G ci.�ZS�
SECTION S. CCINSTRUMOA SERVICES
5.1 Construction Supervisor License(CSL) O 3 4 g £Lj �� g l
�, djAR At � Licensee Umber uati Date
Name of CSL Hol " r . .
/Sr �Q2�S *rte f-- List CSL Type(see below)
No.and Street Type De4�Ptico '
ISA `►'1 /mom U l`t '7 0 U Unrestricted(Mdings m 35 two cu.ft.
R I Restricted l&2 Family Dwellinglime
61y/I•own,State,ZIP M
RC Roofing Covenn
WS Wmdow,and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) ( 74, 412 9 BIZV17
-J,e,F:76e1A1L-`-2wt L HIC Reipshation N Efcpnub&Date
HIC C ao Name or HIC Re ' t Nam
n
NSQ L f!" ri/'4 D OEM 67372ZJ p Email address
Ci /Town State ZIP Telephone
SECTION 6:WORKERS'compIfmATION HOURANCE AFFIDAVIT(ALG.L c:152.§25Q6))
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 .........IBJ No...........❑
7a:OWNER AUTHORIZA TO BE COASPLETED®6'MN
OWNER'S AG FNT Og CQ : TQR TOR D _. *9 rXRMT
I,as Owner of the subject property,hereby authorize 62l ArA E!" L--
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) rte
SECTION 7b-6*TIMW OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this a tion is true and accurate4o the best of my knowledge and understanding.
er' or Autho d g®t's Name(Electronic Signature) Date
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.eov/oca Information on the Construction Supervisor License can be found at wwMmass.eov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The CemmortweAm ofMasBarJeuseds
DeparbneW oflrr<das[rralAar denfs
I Congress,Sbwg Supe 100
Bosoolr,Af4 02114-2017
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Workers,Compensation h waranee Affidavit Boffdera/Contradora/FlaOiciana/Phtmbem
TO BEFHW WITH1HliFMA fffMNGAVMOBITY.
An�icantLdormtition PkasePa7at IAdbh�
Name(saam
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InsmmocCompany Name
Policy#Orself-ins.I.;c:#QOy-/ 0 4 QQ rJ(o E m.�;.
Job Site Address• Z S-P� 4f-'j C�)Z lSljd3tete/ZiP: 6A4 l'!
Attach a copy of the workers,eompemdon ptdie7 dedamoon page(showhrg rye policy opmbw and moradon date).
Fat7ure m aeaue covmage as ia4aired imdc 1vIGI c: 152;¢25A is a criminal vioLtiein pwwhpbh bys fine up to 51,500.00
and/or ane-year impaieomxml u wcfl as orvt7 penalties in the farm ala."UP`$YORK ORIM and a fine ofap p 3251).00 a
. . .
day agamst the Wolataf.A copy oiois etaimt�y hE fottiverded t0 flee Office ofltived issfions:orifi DIA Amos mance
coverage veri5cetioa:
Ido hereby uen&ander airs and;,mahfes ofpajwy that the information p vWded aboaw is orae and oorreat
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O�eW ase only. Do nd wrpe In OW area,to be eaypfeted by dry or rows o,B1elal
City or Town: P 0
Issuing Authority(circle ane):
1.Board of Bean 2.Banding Department 3.Chy/Ibwn Clerk 4.Eleehical Inspector 5.PlombinglnapedOr
6.Other
Coned Person• Phone B:
OW CFSALEA4 MASSAa-AWn
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ffi!®BRIFY�t�L Fi1Y 740 9
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Construction Debris Disposa/Affjdavit
(required for all demolition and,renovation workj
in Bawrdenoe with the shM edition of the State BUROW Code, 7M MR. Seddon 111.5 Debris,
and the provis M of MGL OW.S 54; Buffi ft Permit B is Issued with the
condition that the debris resuf ft from this work shah be disposed of in a properly Ikensed
waste deposit facility as defined by MGL c 111,S isik
The debris will be transported by.-
(name
y:(name ofhauler)
The debris will be disposed of in:
+ �IZ-T2i
(narne of fadllty)
(l�c ero
,^n
,S�e r
(address of facility)
S o applicant
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ate
®Boise Cascade Triple 1-3/4" x 11-7/8" VERSA-LAMO 2.0 3100 SP Floor Beam\FB01
Dry 11 span I No cantilevers 10/12 slope September 19, 2016 13:45:27
BC CALC®Design Report
Build 4516 File Name: BC CALC Project
Job Name: Description: Designs\FBO1
Address: Specifier:
City, State, Zip: , Designer:
Customer: Company:
Code reports: ESR-1040 Misc:
3
2 j
3
14-00-00
BO 131
Total of Horizontal Design Spans= 14-00-00
Reaction Summary (Down / Uplift) (lbs)
Bearing Live Dead Snow Wind Roof Live
BO 1,960/0 2,786/0 4,200/0
B1 1,96010 2,786/0 4,200/0
Live Dead Snow Wind Roof Live TO b.
Load Summary
Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125%
1 Standard Load Unf. Area (Ib/ftA2) L 00-00-00 14-00-00 15 60 04-00-00
2 Unf. Area (Ib/ftA2) L 00-00-00 14-00-00 30 10 04-00-00
3 Unf. Lin. (Ib/ft) L 00-00-00 14-00-00 0 80 n/a
4 Unf. Area (Ib/ftA2) L 00-00-00 14-00-00 20 10 08-00-00
5 Unf. Area (Ib/ftA2) L 00-00-00 14-00-00 15 45 08-00-00
Controls Summary value %Allowable Duration case Location
Pos. Moment 25,922 ft-lbs 70.6% 115% 3 07-00-00
End Shear 6,282 lbs 46.1% 115% 3 01-00-12
Total Load Defl. L/269 (0.624") 89.2% n/a 3 07-00-00
Live Load Defl. L/431 (0.389") 83.4% n/a 6 07-00-00
Max Defl. 0.624" 62.4% n/a 3 07-00-00
Span/ Depth 14.1 n/a n/a 0 00-00-00
Notes
Entered/Displayed Horizontal Span Length(s) = Clear Span + 1/2 min. end bearing +
1/2 intermediate bearing
Design meets Code minimum (L/240)Total load deflection criteria.
Design meets Code minimum (L/360) Live load deflection criteria.
Design meets arbitrary (1") Maximum total load deflection criteria.
Minimum bearing length for BO is 1-7/8".
Minimum bearing length for B1 is 1-7/8".
Calculations assume Member is Fully Braced.
Design based on Dry Service Condition.
Deflections less than 1/8"were ignored in the results.
®Boise Cascade Triple 1-3/4" x 11-718" VERSA-LAM® 2.0 3100 SP Floor Beam\FB01
Dry 1 span No cantilevers 10/12 slope September 19, 2016 13:45:27
BC CALC®Design Report
Build 4516 File Name: BC CALC Project
Job Name: Description: Designs\FB01
Address: Specifier:
City, State, Zip: , Designer:
Customer: Company:
Code reports: ESR-1040 Misc:
Connection Diagram Disclosure
Completeness and accuracy of input must
b d be verified by anyone who would rely on
a output as evidence of suitability for
• • o • particular application.Output here based
o
C on building code-accepted design
properties and analysis methods.
• ] _• Installation of Boise Cascade engineered
e o 0 0 wood products must be in accordance with
current Installation Guide and applicable
building codes.To obtain Installation Guide
or ask questions,please call
a minimum = 2" c =6-7/8" (800)232-0788 before installation.
b minimum = 3" d = 24"
e minimum = 3" BC CALC®, BC FRAMER®,AJST
ALLJOISTO, BC RIM BOARD TM,BCI®,
Nailing schedule applies to both sides of the member. BOISE GLULAMT" SIMPLE FRAMING
Member has no side loads. SYSTEM®,VERSA-LAM®,VERSA-RIM
Connectors are: 16d Sinker Nails PLUS®,VERSA-RIM®,
VERSA-STRAND®,VERSA-STUD®are
trademarks of Boise Cascade Wood
Products L.L.C.
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