20 COLONIAL DRIVE - AFFIDAVIT Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the ninth edition of the
Massachusetts State Building Code, 78o CMR,Section logy
Project Title: 20 Colonial Road Date:4 August 2020
Property Address: 20 Colonial Road, Salem, MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description: Remove and properly dispose of existing roof down to the gypsum deck. Furnish
and install(1)new layer of 3"polyiso insulation (R-17.4)and one layer of 2" polyiso insulation(R-
11.4)mechanically attach using polymer fasteners to the 2" min. gypsum deck(R-1.2) .For a total R-
Value of R-30. Then furnish and install .060 Black EPDM fully adhered to the new insulation.
I,Philip Hresko MA Registration Number: 4403 Expiration date: 8/31/20,am a registered designArchitect,and I
have prepared or directly supervised the preparation of all design plans,computations and specifications
concerning,:
X Architectural 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, (78o
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 78o 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 78o 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 Control Document'.
I IM(kl61Mk H F TT--
Phone number: 617-350-7666 Email: phil@archusa.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is
chosen,provide a description.
Version 01 01 2018