IN. CONST CONT DOC, 1/7/19 Initial Construction Control Document
To be submitted with the building permit application by a
`y Registered Design Professional
for work per the ninth edition of the
�''��• Massachusetts State Building Code, 780 CMR, Section 107
Project Title:Structrual Design of Roof Modifications Date:1/7/2019
Property Address: 204 Highland Avenue Salem,MA
Project: Check (x) one or both as applicable: New construction X Existing Construction
Project description:Structural design of roof modifications to remove interior bearing walls and other
supports to open up the clinic spaces.
I Paul F.Kirby MA Registration Number:35313 Expiration date:6/30/2020,am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans,computations and specifications
concerningl:
Architectural X Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information, and belief such plans,
computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780
CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my
designee) shall perform the necessary professional services and be present on the construction site on a regular
and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the
progress and quality of the work and to determine if the work is being performed in a manner consistent
with the approved construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official.
Upon completion of the work,I shall submit to the building official a'Final Construction '' ' • . ent'.
Enter in the space to the right a"wet" or e
lectronic signature and seal: KtRBY H
c-' STRUCTURAL
Phone number:781-305-9419 Email:pkirby@allenmajor.com NO.35313 cc
t. T e \�/ .
Building Official Use Only FSsi t 6
•
Building Official Name: Permit No.: Date:
Nutel.Iudtcale with an piled.design}Jhans,computations and spedfnatiuns that you yiepaied u y s 'other'is
chosen,provide a description.
Version Ol O1 2018