9 FOREST AVE - BPA 11-258 + The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
Massachusetts State Building Code, 780 CMR. 70 edition OF SALEMI
t ReviseJJunusvy
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or wu-Fumily Dwelling
Thiti SkctionForO.fficial VM Only
Building Permit 4U,mmber: Due lied:
Signature: `
Building Commissi d Inspector a nIp V Data
SECT O 1: SITE INFORMATION
A Proper Address: 1.2 Assessors Map At Parcel Numbers
1- Z,Cw4 ✓ w e S o.\ern
I.la Is this an accepted street°yes v no Map Number Parcel Number
IJ Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Ld Ares(sq 11) Frontage(it)
1.5 Building Setbacks(R)
From Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public O Private O Zone: _ Outside Flood Zone? Municipal O On site disposal system O
Check if yesO
SECTION 2: PROPERTY OWNERSHIP'
2.1 ner'of ord:
� I
c rt:r. 0\,.KA is 9 t 1- Atee_.
l.Q,t
Nup(Print).� SIX
Address for Service:
�L V\ ,.X1L. q-7fr--T4\ <37k(oV, 01-7A -%T-6—OO Z
Signuu Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK"(cheek aU that apply)
J6Total
Construction O Existing Building O Owner-Occupied O Repairs(s) C) Alteration(s) O Addition O
lition O Accessory Bldg. Cl Number of Unit_ Other O Speci&:
Description of Proposed Work': ���;,,...._ �o✓„� �,.�,,\\e or �a� «_o..,� �\ooc-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs: OlDelal Use Only
Labor and Materials
ding S I. Building Permit Fee: f Indicate how fee is determined:
trical f O Standard City/Town Application Fee
O Total Project Cost'(item 6).s multiplier x
J. bing S 2. Other Fees: S �
anical (HVAC) S List:
anical (Fire S
sion Total All Fees:S
Check No. Check Amount: Cash Amount:
l Project Cost: S \2 pp O O Paid in Full O Outstanding Balance Due:
SECTION 3: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
License Number F%pirotiun Wit:
Name tat CSI.-I lulder 1.ist CSL Type(see below)
f Ikscri ion
Address U unrestricted to)3.0W Cu.Ft.
R Restricted IS2 FamilyDwellin
Signature M M onl
MD
Residential RoutineCovering
felcphone Residential Window and Sidin
Residential Sulid Fuel Bumin A Rance Installation
Residential Demolition
s.2 RegIstered Home Improvement Contractor(HIC)
f tIC Company Name or IIIC Registrant Name Registration Number
Address Expiration Date
Signature 'telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. ISL f 23C(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..........a No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
WNER'S AGENT OR CONTRACTOR((APPLIES FOR BUILDING PERMIT
1 <o _ � S `\eS , as Owner of the subject property hereby
authorize to act on my behalf,in all matters
reluiv w authorized
�4—this�uil rtnit application. //��
/( A !9I I bl ? bl
Si tare of ner Dale
SECTION 7b:OWNERt OR AUTHORIZED AGENT DECLARATION
1 as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and
behalf.
Print Name
Signature of Owner or Authorized Agent Date _
(Sistred under the pains and penalties of 'u
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 no have access to the arbitration
program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 1 IO.R6 and 110.1113,respectively.
substantial work is planned,provide the information below:
Total floors area ISq. Ft.) (including garage, finished basemenUanics,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
J. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY OF SALEM
Y 4 PUBLIC PROPRERTY
DEPAR"I'MENT
Construction Debris Disposal ,affidavit
(rcquired lur all demolition and rcnovatiun work)
In accordance wth the sixth edition of the State Building Code, 780 C141R section 1 11.5
Debris, and the provisions of NIGL c 40, S 54;
Building Permit 4 is issued with the condition that the debris resulting from
this work shall he disposed of in a properly licensed waste disposal facility as defined by NIGL c
I 11. S 150A.
The debris will be transported by: 1
��v� SAic_ c1rv1_.4c
(name(1(hauler)
The debris will be disposed of in
(name W aci ity)
l address ul Ianlity)
c 1 A
,icna ure cif I>.nnit epphcant
'late
CITY OF S.UL E.NI
PUBLIC PROPERTY
DEPARTtiiENT
ufouu.Y n...-n.
MAVOR 130WMNDWTCN Swat 9 S LM MAUAOa'scm 019-0
TEL V..e•74S-9S"0 FAA.9711.74&994
HOMEOWNER LICENSE EXEIMMON
Please Print
Date 0-112 01,
Job Location qF �^e s� �•1e r
Home Owner Address 9 z e-&V lam �t
Home Owner Telephone g-7 x - -7 q1 -3-1 Sto
Present Mailing Address 5 N=o,�A A-je .._c-
The current exemption of"Homeowners"was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who does not possess a license,provided that the owner acts as supervisor.
DEFINMON OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on
which there is, or is intended to be, a one or two family dwelling, attached or detached
structures accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official, on a form acceptable to the Building
Official, that hdshe be responsible for all such work performed under the Building
Permit.
The undersigned "homeowner"assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations.
The undersigned "homeowner"certifies that he/she understands the City of Salem
Building Department minimum inspection procedures res and requirements and that he/she
will comply with said procedures and ro uirements
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING INSPECTOR
See other side for state code
LA" (OvLu1vx,3S
_-..._ .
_r
1
i
' J
i�m
t 0 U►Jl���d0/�'
�I1JC1� eLtj50A)
E3n5�' rn�/vT 9 �nnci
I
(O
it
41
� � 4
' I
i
n �I
i
, I
I { �
I i'N
I
jiff
`b C r Ll
Vr
� 1
cJ
r
r �
CIO
P I
55��€fGtQ4
O/C
e
l
�aolse Cascade Triple 1-3/4" x 14" VERSA-LAM® 2.0 3100 SP Floor Beam\FB01
BBC'CALC®3.0 Design Report- US 1 span I No cantilevers 1 0/12 slope Monday, August 30, 2010
Build 440
File Name: BC CALC Project
Job Name: Description: F801
Address: 9 forest st Specifier:
City, State,Zip:Salem, MA Designer: Adam Pisano
Customer: Gilbert and Cole Company: Boise
Code reports: ESR-1040 Misc:
C<_- -_Ltd
16-00-00
So Bi
LL 3,840 lbs ILL 3,840 lbs
DL 1,126 lbs DL 1,126 lbs
Total of Horizontal Design Spans=16-00-00
Live Dead Snow Wind Roof Live Trib.(In.)
Load Summary
Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125%
1 Standard Load Unf. Area(psf) L 00-00-00 16-00-00 40 10 12-00-00
Controls Summary value %Allowable Duration case span Disclosure
Pos. Moment 19,862 ft-lbs 45.6% 1000/6 1 1 - Internal Completeness and accuracy of input must
End Shear 4,196 lbs 30.0% 100% 1 1 - Left be verified by anyone who would rely on
Total Load Defl. L/504 (0.381") 47.6% 1 1 output as evidence of suitability for
Live Load Dail. U651 (0.295") 55.3% 1 1 particular application.Output here based
Max Dail. 0.381" 38.1% 1 1 on building code-accepted design
properties and analysis methods.
Span/Depth 13.7 n/a 1 Installation of BOISE engineered wood
products must be in accordance with
Notes current Installation Guide and applicable
Design meets Code minimum U240 Total load deflection criteria. building codes. , obtain Installation Guide
9 ( ) or ask questions,please call
Design meets Code minimum (U360) Live load deflection criteria. (800)232-0788 before installation.
Design meets arbitrary(1") Maximum load deflection criteria.
Minimum bearing length for B0 is 1-1/2". BC CALC®,BC FRAMER®,AJSTM,
Minimum bearing length for B1 is 1-1/2". ALLJOIST®,BC RIM BOARDTM BCI®,
Entered/Displayed Horizontal Span Length(s)=Clear Span+ 1/2 min. end bearing+ BOISE GLULAMT SIMPLE FRAMING
1/2 intermediate bearing SYSTEM®,VERSA-LAM®,VERSA-RIM
9 PLUS®,VERSA-RIM®,
Fastener Manufacturer: Simpson Strong-Tie, Inc. VERSA-STRAND®,VERSA-STUDS are
trademarks of Boise Cascade,L.L.C.
Connection Diagram
y- b d —
te�
c
a minimum = 1-1/2"c= 11"
b minimum =4" d=24"
e minimum = 1"
Install screws from both sides, staggering screws by 1/2 of the spacing to avoid splitting.
Member has no side loads.
Connectors'are:SDS 1/4 x 3-1/2
Page 1 of 1
i