3 MALONE DR - BPA (Needs access to jacket) (002) ��S �f �IOiS
'file Commonwealth of Massachusetts CITY OF
Board of Building Regulations and Standards F _CE i FD
/ Massachusetts State Building Code, 780 CMR R6PECTiC "Ase:;E�tuI�E
Revised ti%irr 10/'/
Building Permit Application To Construct, Repair, Renovate Or Demolish a
0 One-or 7ivo-Family Dwelling j015 D C I S A 11* 2
This Section For Oflic' . -se Only
Building Permit Number Date/Applied,
la ' /5
�J' -OailJing Otlicial(Print Name). - - :Signature, - Date
1 SECTION 1 SITE INFOILHATIOW
1� 1.1 Progerty Addressb ' . 11 Assessors r lap&Parcel Numbers
� IV10.I�nt 1�c1JL
t--- 1.1a Is this an ecce ted street9 es no Map Nwnber Parcel Number
IY 1.3 Zoning Information: IA Property Dimensions:
Zoning :P.ropoaedUse. LoCilrea(sgR) - Fronmge(R). .
1.5 Building Setbacks(It)
Front Yard. -: Sine k' ", - - Rear Yard
RegWmd Provided Required - Provided RequiRd` Provided
i.6 Wafer Supply:(M.G.L c.d0,§54) 1.7'Flood Zone Infermation: ' 1.8&Wage Dispose System:
Zonis Outside Flood Zone? Munici O On site du tem' t3
Public O Private O.- -. p�system Cbedrlf : O _.
SECT_1002: PROP6K!'7' b ERS11IPt
kNew
wner'of Record:
(Print) ' City,state,ZI .
RO. L�Crhw SaI44dC ___ 57g 691 90(06 t^c.b.Yi QPYl6601AIL
d street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(cheek all that apply)
onstruction O Eiiisting Building,i'S1 Owner-Occupled O Repairs(s)0 1 Altesation(s) O 1 Addition O
Demolition O Accessory Bldg.C3 Number of Unita. I Other O Speedy
Brief Description of Pro sed Work': e v
IEG r 5 n cdn
SECTION 4:ESTI,•IATED CONSTRUCTION COSTS-
Item
OSTS Item Estimated Costs: Official Use Only
Labor and Materials
1 Building IS jr7 000. .. 1. Building Permit Fee:S Indicate how fee is determined:
2. Electrical s 3l7G7d' OStandard CityrownApplication.Fee
O Toloi Project Cost'(item 6)r multiplier s
3. Plumbing S2 V Qther Fees: S
d.Mechanical (FIVAC) s - List:
5.\lechanical (Fire S Total All Fees:S
Su ression) -
Check NO._Check Amount: Cash Amount:
6.Total Project Cost: S ZZt 000 ❑Paid in Full ❑Outstanding Bakince Due:
i��
I
SECTION 5: CONSTRUCTION SERVICES
5.1 Constructioo�n_S"upervisor+L'icense(CSL)
44t�r cah Asa, N m _ License Number Expiration Date
Name of CSL Holder l i List CSL Type(see below)
i13 �S
m Q`'1 S �T Tye Description .
No.and Street - -
W Avr1/1 �G� � l q Al U Unrestricted(Buildingsu i to 35,000 cu.Il.
R Restricted 1&2 Family Dwellinst
Chymorm,State,ar M Masonry
RC Roolin Covcrin
WS Window and SiJin
SF Solid Fuel Bruning Appliances
978 Gal 906 Cabo�P�C�1GfiIAI� I Insulation
Telephone Email address D Demolition
5.2 Registered home Improvement Contractor(HIC)
C drml3yl L, 14CTYI L k Z HIC Registration Number Expiration Date
MCC ompany Name or HIC Registnuil Name
It3 P /4sit & ,,ef 1t
No.and Street Email address
WAY%ham W 01,A94gvs 6�1 gaio6
Ci /Town State ZIP Tele oae
SECTION 6:WORKERS'COhIPENSATIONINSURAKCEAFFIDAVTI'(MG:Le.152.f 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 Isimince of the building permit
Signed Affidavit Attached? Yes.......... No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED,WHEN'.
OWNER'S AGENT OR CONTRACTOItAPPLIES FOR BUILDING.PERMIT'
1 property. Cctfylan r.rlurf5cD�, W21 yI G K 'J R
I,as Owner of the subject ro hereby authorize _
t9 act on my behalf,in all matters relative to work authorized this buil ing permit applicators.
12) Maim, LLC. - Ran I-Ipn-I,&k a 15
Print Owner's Name(Electronic Sign re) - Date
SECTION 71a:OWNEW OR'AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that oil of the information
contained in this application is true and accurate to the best/of any knowledge understanding.
COrivi fol F1PnAILIC / �U G ID 1
Print Owner's or Authorized Agent's Name Iccuonic Signature) Date
NOTES:
I. 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 WJ have access to the arbitration
program or guaranty fund under M.G.L.c. IJ2A.t rerimportant n rma t—ion on the H1Cl'rogram anUTOT111Ja — —
www mass.u,uwocia Information on the Construction Supervisor License can be fount at wwsv.nmss.eov:dns .
2. When substantial work is planned,provide the information below:
Tota( floor area(sq. A-) N (including garage,finished basementtattics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/bade
'rype of heating system Number of decks(porches
'rype of cooling system Enclosed Open
1. "Total Project Square Footage"may be substituted for"'total Project Cost" _ _
GENERAL NOTES: N p
W
FRONT 1. CODES: N ~O
MASSACHUSETTS STATE BUILDING CODE, EIGHTH EDITION (780 CMR) o Z Y
N
2.DESIGN LOADS: Q
DEAD LIVE "
PILE #1 PILE #2 10 psf 40 psf FIRST FLOOR* �
10 psf 30 psf BEDROOMS
6'-0" 6'-0" 10 psf 20 psf ATTIC* CD
PILE i/3 10 psf 40 psf ROOF* (GROUND SNOW)
1,000 plf — plf FOUNDATION WALL* � r
* CONTRACTOR TO VERIFY FOUNDATION WALL & FRAMING DIRECTION
IS AS SHOWN.
a�
CRACK LOCATION PILE k4 3.THE CONTRACTOR IS RESPONSIBLE FOR ALL MEANS AND METHODS
DURING CONSTRUCTION. THE ENGINEER IS SPECIFYING THE FINISHED
EXISTING 8' TALL CONDITION ONLY, WITHOUT ASSUMING NEITHER KNOWLEDGE NOR Z
RESPONSIBILITY FOR HOW THE CONTRACTORS WILL ACHIEVE THIS
FOUNDATION WALL o Q
CONTRACTOR TO RESULT. J
N VERIFY (7
PILE NOTES Z
Fo
W
1. PILE LOADS (HELICAL):
wLL PILE LOAD TOROUE* CAPACITY** W
PILE q5 ALL <14,921 Ib 3,600 'Ib 15,300 Ib Z
�C *CONTRACTOR TO USE EARTH CONTACT PRODUCT, TAH-288-60 LL a
EXISTING
10 TORQUE ANCHOR (2-7/8"0 X 0.262") HELICAL PILE O W
_ PILE #6 INSTALLED TO A MINIMUM EMBEDMENT OF 10', USING A
Z3) 2x10 BEAM M 'ESKRIDGE 28B' DRIVER.
**CAPACITY INCLUDES A FACTOR OF SAFETY = 2.0 0_
REPLACE EXISTING LALLY COLUMN wd
W/ LONGER IDENTIAL COLUMN TO PILE 7 2. PILE LOADS (DRIVEN): m U
ACCOUNT FOR THE HIGHER ELEVATION r - PILE LOAD PRESSURE* CAPACITY** O WW
OF THE BEAM IF THE FOUNDATION IS W F ALL <14,921 Ib 3,600 psi 14,992 Ib >_
LIFTED AND THE FLOOR IS LEVELED Z ��
*CONTRACTOR TO USE EARTH CONTACT PRODUCT, 3-1/2"0 X U) O dOQ
Z¢ 0.165" DRIVEN PILE INSTALLED TO A MINIMUM EMBEDMENT OF U) Q OZ2
0 10', USING A 'HYD-350-DC' DRIVER. Q 0 �O�
wLL **CAPACITY INCLUDES A FACTOR OF SAFETY = 2.0 J Z NN¢W
PILE g8 O WRQ
CRACK LOCATION ZH o 3.CONTRACTOR TO USE EARTH CONTACT PRODUCT 'TAB-LUB' Q LL amtq
I BRACKET, W/ 'TAB 288-TV OR A 'TAB 350-77' PIER CAP
4.CEASE PIER INSTALLATION IF STRUCTURE STARTS TO LIFT BEYOND r� k
DESIRED RECOVERY.
5.ENGINEERS STAMP IS FOR PILES ONLY AND WITH CONDITIONS AS
SHOWN ON THIS SHEET CONTRACTOR TO VERIFY FRAMING
6'-0" CONDITIONS Q s
N OF V4 8
PILE #10 PILE q9gN�
Scotty by Sca OdomkL PE
1. ,F Sl; .m= r .ki,RE,o m C�Si ��.�� 9
PILE SUPPORT PLAN ". 01 IC'<�F-- aP�eremee�myll� c�woNk' G�
Orlows = o
SK1 SCALE: 1/4" = 1'-0" P,;yti. t Dat 11:2731
E