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BP-62805
Permit No. BP-62805 BUILDING PERMIT IT GIS#: 4270.00 Commonwealth of Massachusetts Map: 0079 "_ TOWN OF DARTMOUTH Lot: 0048 400 Slocum Road,Dartmouth,MA 02747 Sub-Lot: 0033 - Phone:(508)910-1820 • Fax:(508)910-1838 Category: GARAGE Project# _ JS-2011-002107 PERMISSION IS HEREBY GRANTED TO: . Est.Cost: $30000.00 Contractor: License: Phone#: _ Fee: $390.00 Const.Class: Engineer: License: Phone#: Use Group: R3 Lot Size(sq.ft.) 268615 Applicant: Phone#: Zoning: SRB STEVEN S DAVIS (508)996-8186 Aquifer Zone: ZONE 3 OWNER: Flood Zone: PARTIAL ZONE A DAVIS STEVEN S&GAY E DAV New Const.: 960 sq.ft. ��°' Alt.Const: N/A DATE ISSUED: P I Date Typed: 05-20-2011 i TO PERFORM THE FOLLOWING WORK: Construct a 24'x 4 _arage for residential use only r ;j ct L Lion: 42,,SUNDANCE RI) ,_ may~Approved/Issued By j I,f/tom I7/ ` `1 ,/ t �rF.,ecl. ,i1/,'(-/ . / vt," DAVID BRI'JNETTE,LOCAL;BUILDING INSPECTOR 1 f All work shall comply with 780 CMR 7TH Ed.(MGL Chap.ltio)and any other applicable Mass.Laws or Codes and plans on file. SCHEDULE APPROPRIATE INSPECTIONS AS REQUIRED. UPON COMPLETION OF WORK,FINAL INSPECTION IS REQUIRED. THIS PERMIT WILL EXPIRE PER 780 CMII 5110.9(NOT MORE THAN 3 EXTENSIONS WILL BE GRANTED)OR ON ISSUANCE OF A REGULAR OCCUPANCY PERMIT. I hereby certify that the proposed work is authorized by the owner of record and I have been authorized by the owner to make this application as his agent and to receive this permit, I further derstand other agen 'es mad have reason to STOP WORK if items under their jurisdiction are not met; not withstanding the issuance of this Buildi g/roning Permit >I Signature of Owner/Agent: `l-11 - "Persons contracting with unregistered contractors do not have access to the guaranty fund(as set forth in MGL c.142A)" Inspector of Inspector of D.P.W.Inspector Building Inspector Inspector of Gas Fire Department Plumbing Wiring Water Service#: Footings: Underground: Oil: Underground: Service: Foundation: Rough: Smoke: Rough: Rough: Sewer Service#: Rough Frame: Insulation: Final: Final: Final: Cross Connection Final: Final: Treasury: Board of Health E-911 Additional Comments: Planning Board Prior to issuance of Certificate of Occupancy/Completion,this card must be returned to the Building Department with all necessary inspections signed off. Department phone numbers are listed on the white"Required Inspections"document provided with the issuance of the building permit. POST CARD SO IT IS VISIBLE FROM THE STREET , A TOWN OF DARTMOUTH - BUILDING DEPARTMENT RECEIPT 63274 PHONE: 508-910-1820 FAX: 508-910-1838 \ it 11 , _1 Iiiiic: -t-- ik.---R -..•)---/ Name: ' • 1.--/;"(.'''-i-1 ,,,,,/1/ 1-1/ Property Owner:,----1 Dater' -'- ,44/-.2---) Job Location: a 1 i (7 / t il 7' ,../1 , / --7\ /IA/V/ , ,,,,c,. \ /(--- Map: Lot:, / .)—,1 Description General Ledger#'s Ref. # Amount _--- ' Building & Building Misc. , 01000-44105 i/7 ..4,A......,.....,-,t.....- .Electrical 01000-44106 Plumbing & Gas 01000-44107 Trench Safety 01000-44129 .2 Other Department Revenue 04000-42420 White-Collector's Office Yellow Copy-Customer's Receipt Pink Copy-Building Department Received By,// -14'1 THIS IS NOT A PERMIT/LICENSE FOR BUILDING, ELECTRICAL, PLUMBING OR GAS S •-r n c) n n r, CD E. d rI. rD In Vt N N V1 Vf CD CD CD CD CD o 0 0 v n1 i 'O 7 �. CD CD (D CD CD CD 3 3 3 3 3 • i 3 � 3 7 7 0 i (T i i i ,M m m m rj m c Co c. E. = n Q sZ �! CD C = 7 n' O O i h �, CD d Q`0 DTIv�V CD S ,G ni n Lel co 'n O s n CD co rr O 0 m - 0 G -p 0 0 0 0 0 0 c_ Di F� I— I-1 I-1 F1 I-A cm CA O C O O O O O O CD _ ^ (D E. N O O O O O O • �' O Q. --rY Nrr+ N -P A -P -D. r� 1 n CN0NJhJI-� F� I' Oa A,N N 0 0 0 �l iY_ lO v 01 Ul N" N ' - D C >I _x rD • n 37 k m (D a)(o -a cr 4t '.§, , 2.1 Owner Record: '�' u/vz/e/«�i � Name(print) Contact Address Phone Number 22 Authorized Agent.- Name(print) Contact Address Phone Number 3.1 Licensed Construction Supervisor/Specialty License License Number: ` � Company Name/Contractor Name: C Address: Expiration Date: 0 Signature: Telephone: P �� �2 Registered Home Improvement Contra �� c Not Applicable O 0 Are you o Home Improvement Contractor subject to(7DOCMR.110.RO ? OYen ONo F Are ~ daming from the re quirements? OYoo ONn If Yes, Goto Section 3.3 � CompamFName/ContractbrName: Registration Number(if none, state^nnne"): C Address: � E Signature: Telephone: Expiration Date: rV 3.3 For Residential Remodel Work Only C FIRRSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND: E QUESTIONS OR COMPLAINTS call orwrite: | (S) Home Improvement Contractors Registration, One Ashburton Place'Room 130tBoston, 8&4 02108, 517'727'8508 [] ( 8nla Homeowner performing all the work myself. Owners Name(print): Ad Ago OF Signature: V~ � A ^ 4�N�— � Bydgni ab"v,.me homeowner aoknuw�ugoxmatmemvwnuenoeoyium��moouamm�Fund v*� � Dote: ` � 3.4 Homeowner Exemption'One&Two Family Only FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT mouxa Licensing o«Construction supervisors: Except for those structures governed u'Construction Control m Section 1m4 effective July 1.198e.nomuwuua shall m,engaged m directly supervising persons engaged m construction,reconstruction,an°ratmn.rena/r.mmma/v,uemo/m"nmvo/mn«mevuu"mra/o/omenmofuunmnn or structures,unless he or she is licensed in accordance with the rules and regulations promulgated by the BBRS entitled Rules and Regulations for Licensing Constructioi uu~ / E�,_°pticn: Any Homeowner performing work for which o Building Permit w required shall ueexempt from the provisions of this section;provides that nv*vmeonne ennooe".�j pe=nn(o)for hire muo such work,that such Homeowner shall act aysupervisor � For m&purposes of this section only,o^*"m°o°m°r"is defined=follows: p°=""(s)who owns a parcel of land on which he/she resides o,intends to reside,unvmc �u�is,vr/s/n�nuou�be,a one ormm�m//van°mnn.au""heu"rue�"h"o"t,""ma�="°"=�m such use=um,�m"*mu"m°. Ane�on who constructs more the � one home ma two-year period shall not ue considered oHomeowner | |f you onuo iu nui ow: y V ��� Signature �^^>����'y� ��� 'V ^ Your signature carries certain responsibilities,including but not necessarily limited to,general liability Page ii f . ,,;`, SLt TIGNNN 4^-, 'ORKERS..COMPENSATiQN', NSUt'RA,$CE'A FIDAVtT:(IiGL c,a1;521.25) .z Worker's 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: 0 Yes ❑ No ,_.,,SECTION,';.-"DESCRIPTION.:+E3F;PROi?USEi},°JVOF2K{Cheek aIf appitcable);4 Sk 3r.; ,it`:igi. ,� ':..aL-W' ❑ Deck 0 Pool 0 Repairs 0 Alteration 0 Chimney/Fireplace 0 Woodstove/Pellet Stove ❑ New Construction* ,'Accessory Bldg. 0 Roofing/Siding 0 Other (Energy report required) (Shed/Garage) (Specify below) ❑Addition 0 Replacement window/door 0 Demolition (Energy report required) No. of windows Doors (Specify below) *If new construction, please complete the following: Single Family: No. of Bedrooms No. of Baths Two Family: No of Bedrooms Unit 1 No. of Baths Unit 1 No of Bedrooms Unit 2 No.of Baths Unit 2 ❑Furnace(hot air)-fuel gas(natural or propane),fuel oil,electricity,other(specify): ❑Boiler(heating)-fuel gas(natural or propane),fuel oil,electricity,other(specify): ❑HVAC(combined unit)-primary fuel,natural gas,propane,electricity,other ❑Air conditioning-(separate unit) XNone of the above to be provided ❑ Hot Water: Gas Electric Fuel Oil Other Description of proposed work: I 5 iU(2-Y 21-X4-0 Cri4R .. i SEcTIOM,6 €sTEMATEo C.ONs1Ruc-TION coSrf .. -k i `. Item Estimated Cost($)to be completed by permit applicant 1. Building _ 2. Electrical 3. Plumbing 4. Mechanical (HVAC) g30..c000-00 5 Total (1 +2+3+4) • ka:MIT € SEGTtON :WP* ER -01 .41)01 . ... .,ate 0 '0 j n p : ,- .5 ~(to e car pteted whe> owner s;,agenf,or contractor Tapples-for,bcff it*:ti.tiT t i'.�.;,:; .ei .,. .. * . (Please Print I, I Cii/ S_ .0/91 IS , as Owner of the subject property hereby authorize to act on behalf, in all tters tive to work authorized by this building permit application. 47-14/ 4' - .. .-CIT .‘"----; . 3 /31 Iii Signature of Owner Date .a ..,x d.. '70 SECTION ZB4►NNEE2iA0i=IO1ZtZEO 7 GENT,QECC ARATtONr, .. SF. , . ., .z. ,M. .. I, , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sig ender the pal -nd p=nalties of perjury. / 11A ,/\5 gnature of OJvner/Authorized Agent Dat Page 3 1. Date plan reviewed: MAY 1 9 2011 2. DENIED(see project review worksheet): Date: 3. HOLD Reason: Date: 4. HOLD subject to Zoning Board of Appeals action: Date: Comments: 011 Inspector's Signature: Date:MAY cp -- . . .: 44,, . 0.. .t . itti,sFc tOt ,ARP;t1CAtlT IOTIFICA,TtONAN , i*...�:.,. .. ` >g Applicant informed of above: Date: Time: Clerk: Comments: dto r�" as '�'tr ,�,�s � '." '� r_:.� ,. . . a: _. ,' .. SKTla,f, O oP FlgEltNsPtgTOzVIoT$1' WSV. �z r- Less Application Fee:$25.00 Remaining Balance: $ 366 Total Permit Fee: $ „� � b Other$Amount$ TOTAL FEE: 3 ?' Gross Area-New Construction total sq. ft. Gross Area-Alteration total sq. ft. Permit Issued to: —471/4 - br ` .z , ` S;ECTI©s ;f ADDITI01" COM irgiSKETCHES Mz-z-4- 96 0, 2 /62-4-7-‘, ( "A;)u- - 1��' Page 4 permit No. BP-62805 Project Location: 42 SUNDANCE RD Commonwealth of Massachusetts GIS#: 4270.00 TOWN OF DARTMOUTH Map: 0079 400 Slocum Road,Dartmouth,MA 02747 Lot: 0048 Phone: (508)910-1820 • Fax: (508)910-1838 Sublot: 0033 BUILDING PERMIT Prove t# GA AGE 2Est. ° FIELD INSPECTION Fee;C°st $39000° Const.Class: Use Group: ro(9 ) R3 Contractor: License: Phone#: Lot Sizes .ft. 268615 Zoning: ,... SRB Engineer: License' Phone#: Aquifer Zone: ZONE 3' Applicant: Phone#: Flood Zone: PARTIAL ZONE STEVEN S DAVIS (508) 996-8186 A OWNER: New Const.: 960 sq.ft. DAVIS STEVEN S&GAYL E D S. Alt.Const.: N/A rq ;r-.1r\,E DATE ISSUED: 5 I � • TO PERFORM THE FOLLOWING WORK: Construct a 24'x 40' garage for residential use only DATE TIME I OF INSPECTION&REMARKS INITIAL �t , 6 vii M1:7/ f'''' '-'1Z' 3/6 „'',i-iii<}4,-0.' ...41,,Lx.)P" --". _"/ /.„...___) aal__.- iff? I'4') t r-ir,...311, , c \i„.; ,__.,_ P//1/TYPE Apr 01 2011 16: 13 LE DARTMOUTH BOARD OF HEAL TH 15089101893 p. 2 RESIDENTIAL • 0 Approval in Part{Per 780 Ch9R.5111.13) $ s.00 APPI.t[C nON 1�E ISNON A 3B�1E�7N PL>i L I1i?;N-T�tEt:'YS AB ovsr�; DATE RECENED DARTMOUTH BUJLD1N DEPARTMENT , rr'� + 400 Slocum Road, P.O. Box 79399 • ' " Dartmouth, MA 02747 y Phone: 50&910-1820 Fax: 508-910-1838 www.t own.dartm out ti.m a,us APPLICATION TO CONSTRUCT",REPAIR,RENOVATE OR DEMOLISH A ONE OR i O FAMILY DWEi LING r �- '3� 1W}d67 "�� -_, A ilk .':6,...t. - , � ��! Fy 7y„seay `�)siA���� � � err . W fl�,m ! i3 r e{d} ��h r ,. � ....1 s3 1 'el i. t M1 .5 , - t r •i Y i { r"yf�} "'t .S} -7�F'G.If" -- ' :- • ra i�-:' --- - !r _ r • --3l LK1' !,-(:4,'. '1 S.;:--114--- �1-47,7"t,-�., '4 - I ji i r'� i j�a+��3s Znnin -eview Signature: late: • Report Signature: Date: • ire, ref Signature: Date: 1 11 i Signature: r Conservation Commission: - Signature: /4' Date: �"i('�� ` •, Signature: _ Date: Briefr descriplon of work being performed: .. _ ,,r }i / / i • 1 1 1 Property Address:"T� S�N� J I._ t,2 Assessors ap&Lot Number ` y 7- ' • Lot Area(sf.) Frontage Map ict _ ii ri v, l;i Required • Provided Front Yard fi • Side Yard • 1.3 Historical District ❑Yes ,L' No r'f Rear Yard Year Built 0 Altering more than 25%per side of building 1 1,4 Water Supply(MGL c40 s54}: 1.5 Sewage Disposal System: Has application been submitted to the Historic Commission? ;!. ❑Municipal 'Private Well U Municipal ,�On Site Disposal System CI Yee ❑No Date: rI I • • ED t CONSTRUCTION ��.� � 0 SITE CLAN i� ENERGY ���� �- `I Page 1 i! RESIDENTIAL ❑Approval in Part(Per 780 CMR.5111.13) S''3„5.)o APPLICATION FEE IS NON HE-FUNDABLE &NON-TILE NSEEF,A L foc.T_,� DATE RECEIVED /`" "�LI D 1 Tip fll9T�i BUILDING DEPARTMENT T GI, '_ ,t= 400 Slocum Road, P.O. Box 79399 :Z '' Dartmouth, MA 02747 • - 4` Phone: 508-910-1820 Fax: 508-910-1838 www.town.dartmouth.ma.us APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING - , fi,, 1 2 • a{ p, THIS SECTION€:FOR OFFICIAL USE ONLil t ,T �-,:5 x: ; _- ��:.., t 2. $ s'i�. �" .t. k ."�J',t``,, ' ++« z -d ,c a, oil`',.$R. '' -",i'," Y:�`•r' '1` -5�. '-'S f� .R�j -�r na^4-- k"- -ARE. ���` �,�'�F,> " �n� c��� `��,'��� .a*% t:� 5� �a� � -� Y-�, � ��� r; �` � >,�` �.s CEI`lED BYitTS � - i ,'' p �- � l BUILDING PERh�ITzNUMBEFt .� t�'f�*e �`� �.z�- �a��.-�"��...�z �''°fi '�, '� r"c-.'r� L. �-�r`3�?, k �T� x ��. ,f�,s,x �,'�,� `TL z� :..e �:key� `�-,s .tea z r '� e ?'Sv"• F - ',,' ay^ 4 ,., r ".�' -, pia :DATE SENT'FOR REV 1lVS t zz u� l .A^ h � • f• ; t x � RA . , _ �� . . - QATEgISS ED . . . S .,a -+==' �� s,- 3k«' .�, " $.-y-.z' g Via" a,EN't h>�-. ,may *': ` . , m . - `mod ' ,,, a k�- ,�,-e::r' '� ...-„? a'fi -. "^ ,,,i '*s 5 . �..y .. '' a,..x ,m. "'.'' :�`6 ^' . c.▪ � .,„,,'--F,i K.,' "r` „°£.� Q ff T� ISSUE. _SIGNATI_fRE 4 • n t ' �fi: _ ' In fir. I �rE. Ex . R, - � v � .:,, � ATE . 0 r . r. to S ors �'• Fz �a g,- .07.-k� • � � ,,a 'a i.- $� y�x;- _ Sri ", 4-�`. ZOrlin��District����,�:� ��� -�� 114 s�.°l � ��5� �`� -g�� � °.'��'e�a�-s. ��� �� �` �A� <:t- e g 'Atli ` .,. p oposed'US y.-#4,fr7 - r ZOrt a�7"y,,,:-E:MB I�,A»® Vaa ulfesc2ArT �" -.,� ,,« ,�:..��3S�R:': `�� �_��: x�-- .x' adt"�:R7 *�: � .4� �ki� ;� �:-.�",�,.. ° ��?�,�,;�,,-���f�s -_▪�, ~' �-�`.��:e frs xc.� r » ,r'' .�'�:,r a t� " �,�. �s";, ,�'�.� .�" S ' '.�� - a t„, S' `c' - . s ram "" r:, ; ...� .;��'� �� ^" i.�-..� �i:., '� �c� � �-�.. -.>� dux �� �.�'"�� �=k� �:,�'�-,���.s � ��..,-t- � :a�`fit-�. a ��- - T E FOLLOWING GEN SHOD B OFp S.... k'r Y" s x :,"5��'�?;��r� - ,y ziF `i�-i� -'� *,: ��d�` �`sF 3� u�-`°�-. "`i - ,<z"",`�£'``` �.. � � ``r'�.-�3 �, :. s�'c,�` ,� .��,^ � sag ,�� � _ �w?�"� -� �r t� ���y `r ❑Board of s:❑Board-Of El Cons. ..i„ k bemor. ` - ,.� - ys ry s_ar ,,,q,„y..•a pt � ❑i}PW'�- � � ' '7 A eal5.�,,k �g,,,,,r� .-' v -_�� sue^ . ..t, rt;. .., € .: 5 4„v„i Ietgf epoti. "'" �s pp Health Commission 3 _ -,M,., _ �;� �� ° � ��.� ��, � �S�Affidaui ��' � kCard�Sent ,��� � ��COff � a ��'�-� Foltow-u �`"' .��n s -f ▪ a a �;.. y ea' ':.., • -.fit" • - �,,, ' ray -' ,. 't�.a ` A. p -_°» '_ ❑fxe* Q.Gas,,' ° arming--�,.-'t` ❑.Sewer Card p Water Card `. *QT on n.- �, t-' Ghief . Cut Orf r Board; _ J.e *, 9 ��., „�`,' �taj� �• � gym, �`. �.�, rx '`� fP � 4 G .Off3 . . � �«»a. �'���� h �,�,. �dX ��. �b .e K»x�<ne ,# C�t•,:09 � 1.Tv�C. k�.. 'S�..�,y'�'. F"^ .t 4 �``� _4,t�s�*'��• E S S` ` S NGE©F ERMET�. .,,� - *RQUIRES 1NSPECTOR, kREVFAJ BE .c RE j Zonin eview: Signature: at . _. En rgy Report: Signature: Date: ire ief. Signature: Date: Nd � /3 <,/jj B rd of Health: Signature: j� ;'d Date: Conservation Commission:- - Signature: Date: Other:. Signature: Date: r Brief description of work being performed: ()5/1---e,,,—iel,__ • . ::- r� x 4 ..J.� - =SECTIQh1 Siz IINFORIVIATEON ril' :__.•: � ,4e ..a,, A,. .; �r 1 1.1 Property Address:¢Z SO/N/ I' 12.0 1.2 Assessors Map& of Number: Lot Area(sf.) • Frontage Map Lot -.3 C I • Required Provided • Front Yard 1.3 Historical District ❑Yes A.No Side Yard Rear Yard Year Built 0 Altering more than 25%per side of building • • 1.4 Water Supply(MGL c40 s54): 1.5 Sewage Disposal System: Has application been submitted to the Historic Commission? 0 Municipal XPrivate Well Cl Municipal XOn Site Disposal System ❑Yes 0 No Date: CONSTRUCTION PLANS 12 SITE PLAN ,r3 ENERGY RE-PORT • Page 1 I S , 1W p Rd. • SIL.. .14110 • ni,SSW _-(-- 411kligOIX iik ar-itt4,.. a li T. i fnilINN itsp4-fki I MN 11111::7111:111bNrall. "11111‘ I i L'L,1 v 3,3 ir ..`.4%karniP 4/404 " lo t * vo 0 4 The Commonwealth of Massachusetts I`.)r Department of IndustrialAccidents Office of Investigations 600 Washington Street ,tlj, Boston, MA 02111 4.-, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly . ,Name (Business/Organization/Individual): 1V F/v s s DIINIS Address: 4fZ solo c4 ,f@D .. C fl ` 62717 Phone #: SOS rq ` eg t Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction listed on the attached sheet. 7. ❑ Remodeling 2.n I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.t 9. n Building addition [No workers' comp. insurance required.] 5. ElWe are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11.❑ Plumbing repairs or additions 3. ( I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.n Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: rtm Policy# or Self-ins.Lic.#: Fitr, Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER.and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c if under th ains a penalties of perjury that the information provided abo e is true and correct. Signature: %li L,-,i, Date: .3/31 ii Phone#: SO ,2 ` q76 - 21 2 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. AIso be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference.number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do no t hesitate' to give us a call. The Department's address,telephone and fax number: ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia A WC Gnide to ood Construction in High Hind Areas: 110 mph tf'ind Zone Massachusetts Checklist for Compliance(780 m530 2J • FAQ*: WFCM Checklist Question: I understand if a new home is built in a town in a 110 mph wind zone then the American Forest and Paper Association (AF&PA) Wood Frame Construction Manual can be used to prescriptively design it. I also understand that in some cases the home can be framed per the WFCMloo mph Guide, if it meets certain requirements including but not limited to aspect ratio, roof height, number of stories, and exposure category (B). I have heard that Massachusetts has a "modified" checklist that can be used instead of the checklist at the end of the Guide. Is this true and what can you tell me about this "modified" checklist? Answer: You are correct on the items that you have noted. MA has modified the checklist in several important ways. The MA version allows a roof with a pitch up to and including 8 in 12 to not be "counted" as a story. Further it does not require steel hold downs and straps in many locations if full height sheathing is used as defined in the MA checklist. Further, if the building will have furring strips installed in the ceiling abutting the gable wall then 2 x 4s installed on top of the ceiling joists are not required. There are other changes as well that were not isnoted here. The MA version of the checklist was formulated in recognition of the highly regarded framing methods used in MA for many years and wood framing that has been used in North Carolina over the past 10 to 15 years which has performed well in severe hurricane weather in that state. *Answers to FAQs are opinions of the BBRS Staff and do not reflect official positions or code interpretations of the BBRS. Ate,u-e Th clig►f we- 1 S it P fig-S 1 I SW 0,e etoOric- I-/lovV, A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CM R 5301.2.1.1)1 El Check • Compliance 1.1 SCOPE Wind Speed(3-sec.gust) 110 mph t Wind Exposure Category B �C 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) a stories 5 2 stories i/ Roof Pitch (Fig 2) _____fi5 12:12 _ Mean Roof Height (Fig 2) ft <_33' _AG Building Width,W (Fig 3) 2.41 ft <_80' :i Building Length, L (Fig 3) c; ft 5 80' is Building Aspect Ratio(L W) (Fig 4) /_;.Ise <_3:1 ;.---- Nominal Height of Tallest Opening2 (Fig 4) .2' 5 6'8" ✓ 1.3 FRAMING CONNECTIONS General compliance with framing connections (Table 2) !/` 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete Concrete Masonry ,...c9-- 2.2 ANCHORAGE TO FOUNDATION" 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general (Table 4) 2 1 in. '---- Bolt Spacing from end/joint of plate (Fig 5) 6-1 7_in.<_6"—12" +/ Bolt Embedment—concrete (Fig 5) -7 in. a 7" 4.--- Bolt Embedment—masonry (Fig 5) in. >_ 15" Plate Washer (Fig 5) >_3"x 3"x'/<" _Lc— • 3.1 FLOORS Floor framing member spans checked (per 780 CMR Chapter 55) Maximum Floor Opening Dimension (Fig 6) _ft<_ 12' 0 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6) (-. Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall (Fig 7) _ft <_d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall (Fig 8) _ft 5 d .,e. Floor Bracing at Endwalls (Fig 9) Floor Sheathing Type (per 780 CMR Chapter 55) -,S)-- Floor Sheathing Thickness (per 780 CMR Chapter 55) in. xD- Floor Sheathing Fastening (Table 2).._d nails at in edge/_in field 4.1 WALLS Wall Height Loadbearing walls (Fig 10 and Table 5) /10 ft 5 10' i"----- Non-Loadbearing walls (Fig 10 and Table 5) r to ft 5 20' it Wall Stud Spacing (Fig 10 and Table 5) it, in.<_24"o.c. L Wall Story Offsets (Figs 7&8) 0 ft 5 d _� 4.2 EXTERIOR WALLS3 � '-4' Wood Studs COPY Loadbearing walls (Table 5) 2x�I - i G ft_in. w/ Non-Loadbearing walls (Table 5) 2x 'i - io ft_in. Gable End Wall Bracing Full Height Endwall Studs (Fig 10) :.---- WSP Attic Floor Length (Fig 11) ft>_W/3 �C Gypsum Ceiling Length(if WSP not used) (Fig 11) ft z 0.9W • Double Top and 2 x 4 Continuous Lateral Brace @ 6 ft. o.c. .. (Fig 11) ;� or 1 xl 3tPlate ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays 1/ Splice Length (Fig 13 and Table 6) ft Splice Connection(no.of 16d common nails) (Table 6) j t i/ A WC Guide to Wood construction in High Wind Areas: 110 mph Wind one Massachusetts list for Compliance (784)c 1R 530 ,2.1.1)f Loadbearing Wall Connections 4Lateral (no. of 16d common nails) (Tables 7) 2 Non-Loadbearing Wall Connections Lateral(no.of 16d common nails) (Table 8) . 1,-- Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans (Table 9) /l ft 41 in. <_ 11' Sill Plate Spans (Table 9) 1 I ft er in. 5 11' Y Full Height Studs (no. of studs) (Table 9) f_---- Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans (Table 9) ft .64' in.5 12' ✓ Sill Plate Spans (Table 9) ft Lr in. 5 12" Y' Full Height Studs(no.of studs) (Table 9) _3_ C Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 , Minimum Building Dimension,W ` Nominal Height of Tallest Opening2 (-5''1.5 6'8" Sheathing Type (note 4) L✓ S f' 1/ Edge Nail Spacing (Table 10 or note 4 if less) t fi,in. _j Field Nail Spacing (Table 10) 12 in. Shear Connection (no.of 16d common nails)(Table 10) -/F( i---- Percent Full-Height Sheathing (Table 10) #--L%o 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts) ✓--- Maximum Building Dimension, L /4 Nominal Height of Tallest Opening2 -<6'8" Sheathing Type (note 4) c.. P a,- Edge Nail Spacing (Table 11 or note 4 if less) & in. -__1G Field Nail Spacing (Table 11) 1'L in. 1i Shear Connection (no.of 16d common nails)(Table 11) 7 frT Percent Full-Height Sheathing (Table 11) % �/. 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts) Wall Cladding Rated for Wind Speed? • 5.1 ROOFS Roof framing member spans checked? (For Rafters use AWC Span Tool, see BBRS Website) V Roof Overhang (Figure 19) 1 ft<_smaller of 2'or U3 _iG-- Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift (Table 12) U=Z1 7 plf Lateral (Table 12) L=17 L>plf Shear (Table 12) S= -/ 7 plf 4---- Ridge Strap Connections, if collar ties not used per page 21... (Table 13) T='2z. plf Gable Rake Outlooker (Figure 20) 5 ft<_smaller of 2'or U2 t/ Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift (Table 14) U= LI17lb. c---- Lateral (no.of 16d common nails)...(Table 14) L Llb. _� Roof Sheathing Type (per 780 CMR Chapters 58 and 59) ..-- Roof Sheathing Thickness y7 jn. >_7/16"WSP Roof Sheathing Fastening (Table 2) , — Notes: — 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception: Opening heights of up to 8 ft. shall be permitted when 5% is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 0 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade. A WC Guide to Wood construction in High Wind Areas: 11 mph Wind Zone Massachusetts list for Compliance(780 CMR 5301,2.1.01 t 1 • 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio, determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment • WHEN THE EDGE RESTS ON FRAMING USE811 NAi1 S AT6no A�fibs. --'-------=- _ __ , 11 ; 1 . IF 1 I 11 1 1 u l- it I I 1 tl I I I I I 1 1 11 1 1 II 1 H 1- 1 1 I! I 1 1 11 I�(( I 1 N Y• 1! 1 i 1 F. O II '- 'I"' Il 1 1 11 1 I 0. . 1 1 i D h I 1 Z II p4 1 1 2 1 $ I 1 IIZ 1 g R 1 I u1 0 1 1 14 W 1. 1 U �' i 1 4r I !! a. i 1 11 I! 1 i d i i I" 2f.. 1 p i i 3 ii n1 I f' iii 1} mime et)et tIA}IESPACING � i C PANEL_ .- 4 See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment • A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 CMR 5301.2.1.01 • • tu CI a cc Z ci' 111 " Z4 ---------- • z • C215 I I Z I I r I I ! ! FRAMING MEMBERS EDGE DITERMEDIATElL , "la g 3fr 1.3"MIN.1 --- • • • STAGGERED / r MIN. NAIL PATTERN PANEL PANEL EDGE t DOUBLE NA&EDGE SPACING DEFAL • • Detail Vertical and Horizontal Nailing for Panel Attachment • • • WARNING Failure to Follow Could Cause Property Damage or Personal Inju ILE c ,; IMPORTANT NOTES These notes pertain to the attached truss designs and placement plans The following trusses are designed at the request and specification of the customer as an individual building component,in a vertical plane, to be incorporated into the building design at the specification of the building designer. Bracing requirements shown is for lateral support of individual truss members only. Additional temporary bracing to insure stability during construction is the responsibility of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. Design and materials are in substantial accordance with state building code's referenced edition of NDS and/or TPI/ANSI specifications. For general guidance regarding design responsibility,storage,erection and bracing,consult"Building Component Safety Information BCSI 2006 Guide to Good Practice For Handling,Installing,Restraining and Bracing of Metal Plate Connected Wood Trusses," available from the Structural Building Component Association(SBCA)www.scbindustrv.com and the code referenced edition of the"National Design Standard for Metal Plate Connected Wood Truss Construction ANSI/TPI 1" 1. Provide copies of truss designs to the building designer and 11. Contractor or building designer responsible to assure that erection supervisor. load bearing walls and foundations is adequate to support the loads imposed by the trusses. 2. Top chords must be sheathed throughout or purlins provided at spacing prescribed on the individual truss designs. 12. Camber is a non-structural consideration. Trusses are not cambered except as specified by the customer and noted on the 3. Bottom chords require lateral restraints(or alternate)as individual truss design. shown on the individual truss designs if no ceiling is installed. Anchorage and/or tie-in components are the responsibility of 13.The effect of lateral thrust/horizontal displacement of others. supports for scissors type trusses is not a consideration of these designs. The design of the truss supports must accommodate 4.®Designates the location for a lateral restraint(or alternate) the lateral thrust/horizontal displacement of the truss. for lateral support of individual truss members only. Subject to review and approval by the building designer,this is a 2x4 14. Mitek Connector Plate Code Approval: ESR-1311, ESR- continuous lateral restraint fastened to each member with two(2) 1988, ESR-1352&ESR-2362. 12d or 16d nails or alternately,a Simpson Strong-Drive Truss Spacer Bracer or Mitek Stabilizer. 15. For additional information refer to Reliable Trusses': Order Paperwork &Proposal 5. Do not stack construction materials on floor or roof that Placement Diagram&Notes. induce loading on truss greater than designated loads. Individual Truss Designs Other Detail Sheets as Provided 6. Except as noted on the attached designs,do not cut or alter truss without prior written approval of Reliable Truss or a 16. Reliable Truss and it's vendors reserve the right to upgrade registered design professional. the specified truss material to facilitate manufacturing without customer approval. 7. Building designer is responsible to insure that loading shown hereon is applicable to building and use. Additional Notes for Floor Trusses Only 8. Care should be exercised in handling,erection,and 17. Refer Reliable Trusses"2x6 Strongback Bracing installation of trusses. Recommendations"for additional performance related notes 9. Provide adequate drainage for all trusses with shallow top 18. Maximum allowable gap between the inside of bearing and chord slopes. end web for top chord bearing floor trusses is W. 10. Building designer to determine and transfer all gravity,uplift, = wind,seismic and other lateral loads from trusses to building �Z� foundation. �� /Z MAX GAP BEARING REFER TO ATTACHED WTCAITPI BCSI-B1 & B3 FOR IMPORTANT HANDLING INSTALLATION AND RESTRAINING SUMMARY INFORMATION ISSUE DATE TITLE SHEET# RELIABLE TRUSS 4-26-10 STANDARD TRUSS NOTES RT-2 AND COMPONENTS ENTS.IN; RT-002 4-26-10 TLL-0455619 1103281 R-xxxxx INSTALL MA 3-24-11 Job Truss Truss Type Qty Ply 261 WINTER ST/FALL RIVER,MA 1103281R T001 FINK 42 1 Job Reference(optional) RELIABLE TRItISS CO.,NEW BEDFORD MA,02745,TLL 7.250 s Sep 1 2010 MiTek Industries,Inc. Thu Mar 24 17:13:07 2011 Page 1 ID:X3ySVr2BbYd ftdEYSMPUKzXhu7-x1 HMtykT?nRWZamiv65fEznWj n46Ybef31Rhp3zXgM0 -1-0-0 6-6-5 a 12-0-0 17-5-11 24-0-0 25-0-0 1-0-0 6-6-5 5-5-11 5-5-11 6-6-5 1-0-0 Scale=1:43.7 3x6= , 5 /1 388% 3x8 8 5.00 12000 1.5x3\\ 1.5x3// 3 7 iiiiiii...... iiiiii , 2 i , 30 PSF STORAGE LOAD „ T 8 l % 61 IN gi `" az Q., 91$ �3:48---- 12 n 10 _4 3.4= 4x6= 3x4= 3x 16" O.C. i 7-7-10 i 16-4-6 24-0-0 7-7-10 8-8-12 7-7-10 Plate Offsets(X,Y): (2:03-1,0-1-81,15:0-3-0,Edgel,18:0- ,0-1-81 LOADING(psf) SPACING 1-4-0 CSI DEFL in (loc) I/deft Lid PLATES GRIP TOLL 30.0 Plates Increase 1.15 TC 0.50 Vert(LL) 0.28 10-12 >999 240 MT20 197/144 TCDL 15.0 Lumber Increase 1.15 BC 0.48 Vert(TL) -0.34 10-12 >842 180 BCLL 0.0 Rep Stress Ina NO WB 0.78 Horz(TL) 0.05 8 Na n/a BCDL 10.0 Code IRC2003/TPI2002 (Matrix) Weight:90lb FT=20% LUMBER BRACING TOP CHORD 2 X 4 SPF No.2 TOP CHORD Structural wood sheathing directly applied or 3-6-5 oc purtins. BOT CHORD 2 X 6 SPF 1650F 1.5E BOT CHORD Rigid ceiling directly applied or 7-6-6 oc bracing. WEBS 2 X 3 SPF No.2*Except" W1:2X3SPFStud REACTIONS (lb/size) 2=1113/0-3-8(min.0-1-12),8=1113/0-3-8 (min.0-1-12) Max Horz 2=-48(LC 6) Max Uplift2=-347(LC 8),8=-347(LC 8) FORCES (lb)-Maximum Compression/Maximum Tension TOP CHORD 1-2=0/26,23=-2267/1573,3-4=-2114/1578,4-5=-268/126,5-6=-268/126,6-7=-2114/1578,7-8=-2267/1573,8-9=0/26 BOT CHORD 2-12=-1371/2022,11-12=-1061/1620,10-11=-1061/1620,8-10=-1371/2022 WEBS 3-12=-357/157,4-12=-578/662,6-10=-578/662,7-10=-357/157,4-6=-1387/1117 NOTES 1)Unbalanced roof like loads have been considered for this design. 2)Wind:ASCE 7-02;110mph;TCDL=6.0psf;BCDL=6.0psf;h=25ft;B=48ft;L=24ft;eave=4ft;Cat.II;Exp B;enclosed;MWFRS(all heights)and C-C Eiderior(2)zone;cantilever left and right exposed;end vertical left and right exposed;porch left and right exposed;C-C for members and forces& MWFRS for reactions shown;Lumber DOL=1.60 plate grip DOL=1.60 3)This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. 4)One H2.5A Simpson Strong-Tie connectors recommended to connect truss to bearing walls due to uplift at jt(s)2 and 8. 5)This truss is designed in accordance with the 2003 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSI/TPI 1. 6)"Semi-rigid pitchbreaks including heels"Member end fixity model was used in the analysis and design of this truss. LOAD CASE(S) Standard 1)Regular Lumber lncnease=1.15,Plate Increase=1.15 Uniform Loads(plt) Vert:2-12=-13,10-12=-53,8-10=-13,1-5=-60,5-9=-60 l o TIMOTHY L. G g LaCHAPELLE o CIVIL 1 o.30 t iih,t.,446.446/opt ' 24/11 Warning!, —Verify design parameters and READ NOTES ON THIS AND ;- ' ` - INCLUDED RELIABLE TRUSS REFERENCE PAGE RT-2 L2.., , RELIABLE TRUSS AND COMPONENTS,INC. I LL-U4bbb22 11 U3231 It-xxxxx INS I ALL MA 3-24-11 RT-901 3-13-07 r August 20, 2003 Standard Gable End Detail ST-GE110-002 I II I Page 1 OF 1 flF1 iIII1LII? Ty2xPiVe_ca L-Brace Nailed To 2x Verticals Wrace Nails,6"o.c. Vertical Stud 1 1 J Vertical Stud (4)-16d Common . Wire Nails DIAGONAL aBRACE MiTek Industries, Inc. '_, 16d Common SECTION B-B .404 Wire Nails DIAGONAL BRACE �____® Spaced 6"O.C. 4'-0"O.C.MAX . (2)-10d Common 2x6 Stud or Wire Nails into 2x6 2x4 No.2 of better -� TRUSS GEOMETRY AND CONDITIONS SHOWN ARE FOR ILLUSTRATION ONLY. �Typicel Horizontal Brace ill01.1111.°111 Nailed To 2x Verticals iiii,- 12 SECTION A-A w/(4)-10d Common Nails • Varies to Common Truss 2x4 Stud %%/ /!%% !%%/ /%%/ /i: SEE INDIVIDUAL MITEK ENGINEERING iii DRAWINGS FOR DESIGN CRITERIA �Y h....... ; ci ; ; ; ; 3x4= *-Diagonal Bracing ** -L-Bracing Refer Refer to Section A-A to Section B-B 24"Max. NOTE: 1.MINIMUM GRADE OF#2 MATERIAL IN THE TOP AND BOTTOM CHORDS. 2.CONNECTION BETWEEN BOTTOM CHORD OF GABLE END TRUSS AND WALL TO BE PROVIDED BY PROJECT ENGINEER OR ARCHITECT. 3.BRACING SHOWN IS FOR INDIVIDUAL TRUSS ONLY.CONSULT BLDG. ARCHITECT OR ENGINEER FOR TEMPORARY AND PERMANENT BRACING OF ROOF SYSTEM. 4."L"BRACES SPECIFIED ARE TO BE FULL LENGTH. GRADES:1x4 SRB OR 2x4 STUD OR BETTER WITH ONE ROW OF 10d NAILS SPACED 6"O.C. PROVIDE 2x4 BLOCKING BETWEEN THE FIRST 5.DIAGONAL BRACE TO BE APPROXIMATELY 45 DEGREES TO ROOF TWO TRUSSES AS NOTED. TOENAIL BLOCKING DIAPHRAM AT 4'-0"O.C. TO TRUSSES WITH(2)-10d NAILS AT EACH END. 6.CONSTRUCT HORIZONTAL BRACE CONNECTING A 2x6 STUD(or 2X4 No.2 ATTACH DIAGONAL BRACE TO BLOCKING WITH OR BETTER)AND A 2x4 STUD AS SHOWN WITH 16d NAILS SPACED 6"O.C.HORIZONTAL (5)-10d COMMON WIRE NAILS. j/ BRACE TO BE LOCATED AT THE MIDSPAN OF THE LONGEST STUD. ATTACH TO VERTICAL STUDS WITH(4)10d NAILS THROUGH 2x4. (REFER TO SECTION A-A) (4)-8d NAILS MINIMUM,PLYWOOD 7. GABLE STUD DEFLECTION MEETS OR EXCEEDS U240. SHEATHING TO 2x4 STD SPF BLOCK 8. THIS DETAIL DOES NOT APPLY TO STRUCTURAL GABLES. 9. DO NOT USE FLAT BOTTOM CHORD GABLES NEXT TO SCISSOR TYPE TRUSSES. Roof Sheathing 11111M11111111111 D i lic!�� / 2 DIAGONAL 1'-3" PrIAI Minimum Stud Without 1x4 2x4 DIAGONAL BRACES AT (2)-1 Stud Size Spacing Brace L-Brace L-Brace BRACE 1/3 POINTS Max. �� Species / / �: (2)-10d NAILS and Grade Maximum Stud Length / 40. 2x3 SPF No.3 12"O.C. 4-0-6 5-0-6 7-1-6 8-0-13 12-1-4 $_- ," / 2x3 SPF No.3 16"O.C. 3-7-15 4-4-5 6-1-15 7-3-15 10-11-15 � /-Trus- -s @ 24" O.C. 2x3 SPF No.3 24"O.C. 3-2-6 3-6-11 5-0-6 6-4-13 9-7-4 .. / •_. X Diagonal braces over 6-3"require a 2x4 T-Brace attached to 2'x6 DIAGONAL BRACE SPACED 48"O.C. one edge. Diagonal braces over 12'-6"require 2x4 I-braces Dlag. Brace V ATTACHED TO VERTICAL WITH(4)-16d attached to both edges. Fasten T and I braces to narrow edge at 1/3 point COMMON WIRE NAILS AND ATTACHED of web with 10d common wire nails 8in o.c.,with 3in minimum if needed 0--, TO BLOCKING WITH(5)-10d COMMONS. end distance. Brace must cover 90%of diagonal length. MAXIMUM WIND SPEED=110 MPH I MAX MEAN ROOF HEIGHT=30 FEET APRIL 1,2007 tll End Wall N HORIZONTAL BRACE CATEGORY II BUILDING DETAIL ADEQUATE FOR ASCE 7-02&7-05 =: (SEE SECTION A-A) EXPOSURE B or C ASCE 7-98 STUD DESIGN IS BASED ON COMPONENTS AND CLADDING. DURATION OF LOAD INCREASE:1.60 CONNECTION OF BRACING IS BASED ON MWFRS. __.� \ ISSUE DATE TITLE SHEET# p -- 2-2s-o7 MITEK STANDARD GABLE RT_1 OC RELIABLE TRUSS AND caePoN END DETAIL 1r,wc. 1 of 2 TLL-0455620 1103281 R-XxxXX INSTALL MA 3-24-11 RT-10c1 2-26-07 a— Standard Gable End Detail SHEET 2 Page 2 OF 2 I II I ® ALTERNATE DIAGONAL BRACING TO THE BOTTOM CHORD U OD Trusses @ 24" o.c. HORIZONTAL BRACE 2x6 DIAGONAL BRACE SPACED 48"O.C. (� a (SEE SECTION A-A) ATTACHED TO VERTICAL WITH(4)-16d COMMON WIRE NAILS AND ATTACHED MiTek Industries, Inc. Roof Sheathing TO BLOCKING WITH(5)-10d COMMONS. D4 X X \ X X 1'-3" Max. . IT IS THE RESPONSIBILITY OF THE BLDG DESIGNER OR NAIL DIAGONAL BRACE TO THE PROJECT ENGINEER/ARCHTECT TO DESIGN THE PURLIN WITH TWO 16d NAILS CEILING DIAPHRAGM AND ITS ATTACHMENT TO THE TRUSSES TO RESIST ALL OUT OF PLANE LOADS THAT MAY RESULT FROM THE BRACING OF THE GABLE ENDS vJ 2X 4 PURLIN FASTENED TO FOUR TRUSSES WITH TWO 16d NAILS EACH.FASTEN PURLIN TO BLOCKING W/TWO 16d NAILS(MIN) Diag. Brace •���� PROVIDE 2x4 BLOCKING BETWEEN THE TRUSSES at 1/3 points � SUPPORTING THE BRACE AND THE TWO TRUSSES if needed \ 4� ON EITHER SIDE AS NOTED. TOENAIL BLOCKING \ �. \ TO TRUSSES WITH(2)-10d NAILS AT EACH END. \ ATTACH DIAGONAL BRACE TO BLOCKING WITH 4. (5)-10d COMMON WIRE NAILS. End Wall ' CEILING SHEATHING BRACING REQUIREMENTS FOR STRUCTURAL GABLE TRUSSES STRUCTURAL GABLE TRUSSES MAY BE BRACED AS NOTED: STRUCTURAL METHOD 1:ATTACH A MATCHING GABLE TRUSS TO THE INSIDE GABLE TRUSS FACE OF THE STRUCTURAL GABLE AND FASTEN PER THE FOLLOWING NAILING SCHEDULE. METHOD 2:ATTACH 2X SCABS TO THE FACE OF EACH VERTICAL SCAB ALONG • MEMBER ON THE STRUCTURAL GABLE PER THE FOLLOWING VERTICAL `1 NAILING SCHEDULE.SCABS ARE TO BE OF THE SAME SIZE,GRADE AND SPECIES AS THE TRUSS VERTICALS NAILING SCHEDULE: I -FOR WIND SPEEDS 120 MPH OR LESS,NAIL ALL MEMBERS WITH ONE ROW OF 10d(.131"X 3")NAILS SPACED 6"O.C. -FOR WIND SPEEDS GREATER 120 MPH NAIL ALL MEMBERS WITH TWO ROWS OF 10d(.131"X 3")NAILS SPACED 6"O.C.(2X 4 STUDS MINIMUM) MAXIMUM STUD LENGTHS ARE LISTED ON PAGE 1. 1rN ALL BRACING METHODS SHOWN ON PAGE 1 ARE / VALID AND ARE TO BE FASTENED TO THE SCABS OR INLAYED STUD VERTICAL STUDS OF THE STANDARD GABLE TRUSS ON THE INTERIOR SIDE OF THE STRUCTURE. STRUCTURAL AN ADEQUATE DIAPHRAGM OR OTHER METHOD OF BRACING MUST GABLE TRUSS / BE PRESENT TO PROVIDE FULL LATERAL SUPPORT OF THE BOTTOM CHORD TO RESIST ALL OUT OF PLANE LOADS.THE BRACING SHOWN IN THIS DETAIL IS FOR THE VERTICAL/STUDS ONLY. NOTE:THIS DETAIL IS TO BE USED ONLY FOR / STRUCTURAL GABLES WITH INLAYED STUDS.TRUSSES WITHOUT INLAYED STUDS ARE NOT ADDRESSED HERE. / STANDARD / GABLE TRUSS April 27,2004 ISSUE DATE TITLE SHEET# 2-26-07 MITEK STANDARD GABLE RT_1 OC RELIABLE TRUSS END DETAIL L AND�aowErTs,IYC. 2 of 2 TLL-0455621 1103281 R-xxxxx INSTALL MA 3-24-11 RT-10c2 2-26-07 0. oo_ a - r „S9 k _ - - N j o G o.- c, .. _ _ - N_ x fiN ....,6 „__ ,,N ,..., _t G7.., , r i c,J. - ,0,N.,1 i� ct 0 _.> 0 N I " r. W d O a = ‘ >c atten. a m Z. 'r) � 0 1 1 G r a Z 1 l I 7 4__________3 z 1 > J . I l 1 -----__ ) ,2_,, 1 F.:, _ � � � I Cr) o I 0 UN 10 9, -� 1 , I 1 I ' I �C�QQ } i i 4 4 ... T-- . ZJ°ad� „AoQNrM olAot i ,aN T � Q .. 'Xit C-61`7 l 0 1 T i r‘: H tiC o (< cxj • O G 2x5 WI N00 vJ ). f 2- 9' Ff �R k i f- r is I , -----r--- . { t' e ' ! k S II • E O 4 , i {f ! s I E ' - i is Z I 1 vT O 0 fi . z J y t ., 1 7i U Y 1 / __._._.,,......._ ..=; ----- --- • .. M _ i 3 J . 4 I > s v, _A1- J t-• ° { 1 ..Ai °��, _ _a 1� d G . =' 0 �e N l 1p 5 C d 0' T c� E' e} 1,1 r r 01 �J c .+ 1 d -tie i — --- `I• ! I' s , l tSS S 3ld' ! d - __ � .. s o 0 vim ' � e- a 3+ `a � s 'is �. \ , ,1 1 ----ti' . 4 41 k r ...................0,...............:ti, , ...A s e� r z 3 j o t ! F 4 9/41 3 D A R 1 M O V 1 H / - ' Qui, -7,1\ M A S S AC HU::SET 1l S CONSERVATION COMMISSION _ _ =e !\ z t MICHAEL O'REILLY • c: 400 Slocum Road •P.O. BOX 79399 ' s �'� n`"/ Environmental Affairs Coordinator Dartmouth,MA 02747 '.• - c,}.. TEL: 508-910-1822 FAX: 508 910-1897 ...Ihh4 ',.•' http://www.town.dartmouth.ma.us January 13, 2011 TO: Building Department riLP • - Department of public works Planning Board Board of Health FROM: Dartmouth Conservation Commission SUBJECT: Request for review and written comments on the accompanying Notice of Intent and plan(s) from Steven Davis re: Map 79 Lot 48-33 on 42 Sundance Road . Please review the attached Notice of Intent and plan(s). If you have any comments, please submit them to the Conservation Commission office by January 24, 2011. Thank you for your cooperation and assistance in this matter. DF:df Steven Davis 3 42 Sundance Road - Dartmouth, MA 02747 Prime Engineering, Inc . c/o Richard Rheaume P.O. Box 1088 = Lakeville, MA 02347 rrheaume@primeengineering.org i ouy;� DARTMO,TT:T`H a� \�E_ob�C,9N:.` . MASSACHUS .TTS CONSERVATION COMMISSION • _ c MICHAEL O'REILLY 400 Slocum Road •P.O.BOX 79399 =® ,�1 Environmental.,affair~Coordinator Dartmouth,1\11027.47 •:p.� yy' TEL: 308-910-1822 FAX: 508 910-1897 16........... http://www.town.dartmouth.ma.us • January 13, 2011 The Chronicle P.O. Box 80268 Dartmouth, MA 0274'8` news@chroniclenewsonline.com chroniclenewsonline.com LEGAL AD: Please run the following legal ad once in your issue of January 19, 2011 Advertiser#300329 PRE-PAYMENT CHECK TO FOLLOW DARTMOUTH CONSERVATION COMMISSION NOTICE OF PUBLIC HEARING Notice is hereby given in accordance with the provisions of the Dartmouth Wetlands Protection Bylaw and M.G.L:, Ch. 131, §40, the Wetlands Protection Actjthat,a hearing will be held on the Notice of Intent of Steven Davis who wishes to construct a garage and driveway on land located at map 79 lot 48-33 on Sundance Road in Dartmouth. The hearing will be held on Tuesday, January 25, 2011,at 7:00.p,m., in Room 103 at the Dartmouth.Tawn-Hall, 400 Slocumn.Road in Dartmouth and all interested parties should be present at that time. Jacquelyn McDonald,Chair CC: Chronicle D.E.P. Dartmouth Board of Health Dartmouth Building Dept. Dartmouth Planning Board Dartmouth D.P.W. Owner Applicant Applicant's representative(s) 4 Massachusetts Department of Environmental Protection Provided by iasspN ,, NA Bureau of Resource Protection -Wetlands t4-6sl f ember ,to WPA Form 3 - Notice of Intent t�ocumertt it'artsa',fion Nuitrb ' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Dartmouth City/Town Important: A. General Information When filling out forms on the computer,use 1. Project Location (Note: electronic filers will click on button to locate project site): only the tab key to move your 42 Sundance Road North Dartmouth 02747 cursor do not a.Street Address b.City/Town c.Zip Code use the return key. Latitude and Longitude: 41 D 42'04.8"N 71 D 00' 31.85'W d.Latitude e.Longitude virt , 79 48-33 f.Assessors Map/Plat Number g.Parcel/Lot Number 2. Applicant: /NM X\ Steven Davis a.First Name b.Last Name Note: Before c.Organization completing this 42 Sundance Road form consult your local d.Street Address Conservation N Dartmouth MA 02747 Commission e.City/Town f.State g.Zip Code regarding any municipal bylaw 508-996-8186 or ordinance. h.Phone Number i.Fax Number j.Email Address 3. Property owner(required if different from applicant): ❑ Check if more than one owner Same a.First Name b.Last Name c.Organization d.Street Address e.City/Town f.State g.Zip Code h.Phone Number i.Fax Number j.Email address Z g. Representative(if any): ® cn Richard Rheaume > =o a.First Name b.Last Name U o Prime Engineering, Inc. fr t= c.Company LLI o> P.O. Box 1088 Cr — N d.Street Address o Lakeville MA 02347 e.City/Town f.State g.Zip Code 508-947-0050 508-947-2004 rrheaume@primeengineering.org h.Phone Number i.Fax Number j.Email address 5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form): $110 $42.50 $67.50 a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid wpaform3.doc•rev.11/16/09 Page 1 of 8 Massachusetts Department of Environmental Protection Proui,IyMassDEP Bureau of Resource Protection -Wetlands i1ssDEl' iie Number WPA Form 3 - Notice of Intent 1 Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. C. 131, §40 Dartmouth City/Town A. General Information (continued) 6. General Project Description: Proposed construction of garage and driveway approximately 25'from wetlands. 7a. Project Type Checklist: 1. ® Single Family Home 2. ❑ Residential Subdivision 3. ❑ Limited Project Driveway Crossing 4. ❑ Commercial/Industrial 5. ❑ Dock/Pier 6. ❑ Utilities 7. ❑ Coastal Engineering Structure 8. ❑ Agriculture (e.g., cranberries, forestry) 9. ❑ Transportation 10. ❑ Other 7b. Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR 10.24(coastal)or 310 CMR 10.53(inland)? 1. ❑ Yes ® No If yes, describe which limited project applies to this project: 2.Limited Project 8. Property recorded at the Registry of Deeds for: Bristol County(SD) a.County b.Certificate#(if registered land) 9626 281 c.Book d.Page Number B. Buffer Zone & Resource Area Impacts (temporary & permanent) 1. ® Buffer Zone Only—Check if the project is located only in the Buffer Zone of a Bordering Vegetated Wetland, Inland Bank, or Coastal Resource Area. 2. ❑ Inland Resource Areas(see 310 CMR 10.54-10.58; if not applicable, go to Section B.3, Coastal Resource Areas). Check all that apply below.Attach narrative and any supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including standards requiring consideration of alternative project design or location. Resource Area Size of Proposed Alteration Proposed Replacement(if any) For all projects affecting other Resource Areas, a. ❑ Bank 1.linear feet 2.linear feet please attach a b. ® Bordering Vegetated narrative explaining how Wetland 1.square feet 2.square feet the resource area was c. ❑ Land Under 1.square feet 2.square feet delineated. Waterbodies and Waterways 3.cubic yards dredged wpaform3.doc•rev.11/16/09 Page 2 of 8 Massachusetts Department of Environmental Protection Proved bYJ ass EP , t Bureau of Resource Protection -Wetlands { Messl)i,P: 4t�6 fl: WPA Form 3 - Notice of Intent 1 i 11rtreritTransacttort u b Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Dartmouth City/Town B. Buffer Zone & Resource Area Impacts (temporary& permanent) (cont'd) Resource Area Size of Proposed Alteration Proposed Replacement(if any) d. ❑ Bordering Land Subject to Flooding 1.square feet 2.square feet 3.cubic feet of flood storage lost 4.cubic feet replaced e. ❑ Isolated Land Subject to Flooding 1.square feet 2.cubic feet of flood storage lost 3.cubic feet replaced f. ❑ Riverfront Area 1.Name of Waterway(if available) 2.Width of Riverfront Area(check one): ❑ 25 ft. -Designated Densely Developed Areas only ❑ 100 ft. - New agricultural projects only ❑ 200 ft. -All other projects 3.Total area of Riverfront Area on the site of the proposed project: square feet 4. Proposed alteration of the Riverfront Area: a.total square feet b.square feet within 100 ft. c.square feet between 100 ft.and 200 ft. 5. Has an alternatives analysis been done and is it attached to this NOI? ❑ Yes❑ No 6.Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes❑ No 3. ❑ Coastal Resource Areas: (See 310 CMR 10.25-10.35) Check all that apply below. Attach narrative and supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including standards requiring consideration of alternative project design or location. Online Users: Include your Resource Area Size of Proposed Alteration Proposed Replacement(if any) document transaction a. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below number (provided on your receipt page) b. ❑ Land Under the Ocean with all 1.square feet supplementary information you 2.cubic yards dredged submit to the Department. c. ❑ Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes below d. ❑ Coastal Beaches 1.square feet 2.cubic yards beach nourishment e. ❑ Coastal Dunes 1.square feet 2.cubic yards dune nourishment wpaform3.doc•rev. 11/16/09 Page 3 of 8 Massachusetts Department of Environmental Protection P,rov<de�i by MassDEP , . ,. Bureau of Resource Protection -Wetlands a `� � L IA ss�EP File�m f , WPA Form 3 - Notice of Intent l a meat 1 r 0:A5 n Nye ber; Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Dartmouth City/Town -B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd) Size of Proposed Alteration Proposed Replacement(if any) f. ❑ Coastal Banks 1.linear feet g. ❑ Rocky Intertidal Shores 1.square feet h.❑ Salt Marshes 1.square feet 2.sq ft restoration,rehab.,creation i. ❑ Land Under Salt Ponds 1.square feet 2.cubic yards dredged j. ❑ Land Containing Shellfish 1.square feet k.❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above 1.cubic yards dredged I.❑ Land Subject to Coastal Storm Flowage 1.square feet 4. ❑ Restoration/Enhancement If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the square footage that has been entered in Section B.2.b or B.3.h above, please enter the additional amount here. a.square feet of BVW b.square feet of Salt Marsh 5. ❑ Project Involves Stream Crossings a.number of new stream crossings b.number of replacement stream crossings C. Other Applicable Standards and Requirements Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review 1. Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on the most recent Estimated Habitat Map of State-Listed Rare Wetland Wildlife published by the Natural Heritage and Endangered Species Program (NHESP)?To view habitat maps, see the Massachusetts Natural Heritage Atlas or go to htto://www.mass.gov/dfwele/dfw/nheso/regulatory review/priority habitat/online viewer.htm. a. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife 2008 Route 135, North Drive b.Date of map Westborough,MA 01581 wpaform3.doc•rev.11/16/09 Page 4 of 8 Massachusetts Department of Environmental Protection ,.,„„mlow ProVited by Mla �EP iiik---mi Bureau of Resource Protection -Wetlands :,: ,, � its ber WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Do ume ntTran s action NumberDartmouth City/Town C. Other Applicable Standards and Requirements (cont'd) If yes,the project is also subject to Massachusetts Endangered Species Act(MESA) review(321 CMR 10.18).To qualify for a streamlined, 30-day, MESANVetlands Protection Act review, please complete Section C.1.C, and include requested materials with this Notice of Intent(NOI); OR complete Section C.1.d, if applicable. If MESA supplemental information is not included with the NOI, by completing Section 1 of this form, the NHESP will require a separate MESA filing which may take up to 90 days to review(unless noted exceptions in Section 2 apply, see below). 1. c. Submit Supplemental Information for Endangered Species Review" 1. 0 Percentage/acreage of property to be altered: (a)within wetland Resource Area percentage/acreage (b)outside Resource Area percentage/acreage 2. ❑ Assessor's Map or right-of-way plan of site 3. ❑ Project plans for entire project site, including wetland resource areas and areas outside of wetlands jurisdiction, showing existing and proposed conditions, existing and proposed tree/vegetation clearing line, and clearly demarcated limits of work**" (a)❑ Project description(including description of impacts outside of wetland resource area & buffer zone) (b)❑ Photographs representative of the site (c)❑ MESA filing fee(fee information available at: http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/mesa/mesa fee schedule.htm). Make check payable to"Commonwealth of Massachusetts-NHESP"and mail to NHESP at above address Projects altering 10 or more acres of land, also submit: (d)❑ Vegetation cover type map of site (e)❑ Project plans showing Priority& Estimated Habitat boundaries d. OR Check One of the Following 1.❑ Project is exempt from MESA review. Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14, http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/mesa/mesa exemptions.htm; the NOI must still be sent to NHESP if the project is within estimated habitat pursuant to 310 CMR 10.37 and 10.59.) 2.❑ Separate MESA review ongoing. a. NHESP Tracking# b. Date submitted to NHESP * Some projects not in Estimated Habitat may be located in Priority Habitat,and require NHESP review(see http://www.mass.aov/dfwele/dfw/nhesp/nhesp.htm, regulatory review tab). Priority Habitat includes habitat for state-listed plants and strictly upland species not protected by the Wetlands Protection Act. " MESA projects may not be segmented(321 CMR 10.16).The applicant must disclose full development plans even if such plans are not required as part of the Notice of Intent process. wpaform3.doc•rev. 11/16/09 Page 5 of 8 Massachusetts Department of Environmental Protection ProvidedbyMassDEP : Bureau of Resource Protection -Wetlands ,, :a I<FrTI,It3 EY r+va b e: a nit . k : WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, 10 40 __t�9 �nIt rnsac► n�tuml Dartmouth City/Town C. Other Applicable Standards and Requirements (cont'd) 3.❑ Separate MESA review completed. Include copy of NHESP"no Take"determination or valid Conservation & Management Permit with approved plan. 2. For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? a. ® Not applicable—project is in inland resource area only b.El Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to either: South Shore-Cohasset to Rhode North Shore-Hull to New Hampshire: Island,and the Cape&Islands: Division of Marine Fisheries- Division of Marine Fisheries- Southeast Marine Fisheries Station North Shore Office Attn:Environmental Reviewer Attn:Environmental Reviewer 1213 Purchase Street—3rd Floor 30 Emerson Avenue New Bedford, MA 02740-6694 Gloucester, MA 01930 Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region, please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact MassDEP's Southeast Regional Office. 3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? Online Users: a. ❑ Yes ® No If yes, provide name of ACEC(see instructions to WPA Form 3 or MassDEP Include your Website for ACEC locations). Note: electronic filers click on Website. document transaction b.ACEC number (provided on your 4. Is any portion of the proposed project within an area designated as an Outstanding Resource Water receipt page) (ORW)as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00? with all supplementary a. El Yes ® No information you submit to the 5. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Department. Restriction Act(M.G.L. c. 131, §40A)or the Coastal Wetlands Restriction Act(M.G.L. c. 130, § 105)? a. ❑ Yes ® No 6. Is this project subject to provisions of the MassDEP Stormwater Management Standards? a. ❑ Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management Standards per 310 CMR 10.05(6)(k)-(q)and check if: 1.❑ Applying for Low Impact Development(LID)site design credits (as described in Stormwater Management Handbook Vol. 2, Chapter 3) 2.❑ A portion of the site constitutes redevelopment 3.❑ Proprietary BMPs are included in the Stormwater Management System. b.® No. Check why the project is exempt: 1.® Single-family house wpaform3.doc•rev. 11/16/09 Page 6 of 8 Massachusetts Department of Environmental Protection Priect 1y ta;sDEP � Bureau of Resource Protection -Wetlands aleer ' WPA Form 3 - Notice of Intent I3gcum$nt Transaction[ u er Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Dartmouth City/Town C. Other Applicable Standards and Requirements (cont'd) 2.❑ Emergency road repair 3.❑ Small Residential Subdivision(less than or equal to 4 single-family houses or less than or equal to 4 units in multi-family housing project)with no discharge to Critical Areas. D. Additional Information Applicants must include the following with this Notice of Intent(NOI). See instructions for details. Online Users: Attach the document transaction number(provided on your receipt page)for any of the following information you submit to the Department. 1. ® USGS or other map of the area(along with a narrative description, if necessary)containing sufficient information for the Conservation Commission and the Department to locate the site. (Electronic filers may omit this item.) 2. ® Plans identifying the location of proposed activities(including activities proposed to serve as a Bordering Vegetated Wetland [BVW] replication area or other mitigating measure) relative to the boundaries of each affected resource area. 3. ® Identify the method for BVW and other resource area boundary delineations (MassDEP BVW Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.), and attach documentation of the methodology. 4. ® List the titles and dates for all plans and other materials submitted with this NOI. Plan to Accompany a Notice of Intent a.Plan Title Prime Engineering, Inc Richard Rheaume b.Prepared By c.Signed and Stamped by 01/12/2011 1"=20 d.Final Revision Date e.Scale f.Additional Plan or Document Title g.Date 5. ❑ If there is more than one property owner, please attach a list of these property owners not listed on this form. 6.❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed. 7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed. 8. ® Attach NOI Wetland Fee Transmittal Form 9. ❑ Attach Stormwater Report, if needed. wpaform3.doc•rev.11/16/09 Page 7 of 8 Massachusetts Department of Environmental Protection PC;0*1 ,:bYMassD P , a s Bureau of Resource Protection - Wetlands ,,467,„ 1,144 :4_,,,„r,st! � t3 �� WPA Form 3 — Notice of Intent 4 ,, t7�ent lrat3sa thn Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Dartmouth City/Town E. Fees 1. ❑ Fee Exempt: No filing fee shall be assessed for projects of any city, town, county, or district of the Commonwealth,federally recognized Indian tribe housing authority, municipal housing authority, or the Massachusetts Bay Transportation Authority. Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland Fee Transmittal Form)to confirm fee payment: //1� ,//3/ d// 2.Municipal Check Number 3.Che date /Z.-OI 1,rno8 4.State Check Number 5.Check date S-kv .Dc iii.r 6.Payor name on check:First Name 7.Payor name on check:Last Name F. Signatures and Submittal Requirements I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans, documents, and supporting data are true and complete to the best of my knowledge. I understand that the Conservation Commission will place notification of this Notice in a local newspaper at the expense of the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a). I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the requirements of M.G.L. c. 131, §40. Notice must be made by Certificate of Mailing or in writing by hand delivery or certified mail(return receipt requested)to all abutters within 100 feet of the property line of the project to on. cijiii.,../7.. tetii ,ie ( ( 1 3111 1.Signature of Applicant 2.Date 3.Si. . ureo -ro.erty nerdiffe 4.Dat: ' ' .,, '' e of Represen . a 6.[3at For Conservation Commission: Two copies of the completed Notice of Intent(Form 3), including supporting plans and documents, two copies of the NOI Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation Commission by certified mail or hand delivery. For MassDEP: One copy of the completed Notice of Intent(Form 3), including supporting plans and documents, one copy of the NOI Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP Regional Office(see Instructions)by certified mail or hand delivery. Other: If the applicant has checked the"yes" box in any part of Section C, Item 3, above, refer to that section and the Instructions for additional submittal requirements. The original and copies must be sent simultaneously. Failure by the applicant to send copies in a timely manner may result in dismissal of the Notice of Intent. wpaform3.doc•rev. 11/16/09 Page 8 of 8 F. Massachusetts Department of Environmental Protection LBureau of Resource Protection -Wetlands 1 NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important:When A. Applicant Information filling out forms on the computer, 1. Applicant: use only the tab key to move your Steven Davis cursor-do not a.First Name b.Last Name use the return key. c.Organization ,46 42 Sundance Road d.Mailing Address N Dartmouth MA 02747 t e.City/Town f.State g.Zip Code Xs. 508-996-8186 h.Phone Number i.Fax Number j.Email Address 2. Property Owner(if different): Same a.First Name b.Last Name c.Organization d.Mailing Address e.City/Town f.State g.Zip Code h.Phone Number i.Fax Number j.Email Address 3. Project Location: 42 Sundance Road N Dartmouth a.Street Address b.City/Town To calculate B. Fees filing fees,refer to the category The fee should be calculated usingthe followingsix-stepprocess and worksheet. Please see fee list and examples in the Instructions before filling out worksheet. instructions for filling out WPA Step 1/Type of Activity: Describe each type of activity that will occur in wetland resource area and Form 3(Notice of Intent). buffer zone. Step 2/Number of Activities: Identify the number of each type of activity. Step 3/Individual Activity Fee: Identify each activity fee from the six project categories listed in the instructions. Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2)times the fee per category(identified in Step 3)to reach a subtotal fee amount. Note: If any of these activities are in a Riverfront Area in addition to another Resource Area or the Buffer Zone, the fee per activity should be multiplied by 1.5 and then added to the subtotal amount. Step 5/Total Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4. Step 6/Fee Payments: To calculate the state share of the fee, divide the total fee in half and subtract $12.50.To calculate the city/town share of the fee, divide the total fee in half and add $12.50. Wpaform3.doc•Wetland Fee Transmittal Form•rev.2/21/08 Page 1 of 2 L1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Fees (continued) Step 1/Type of Activity Step 2/Number Step Step 4/Subtotal Activity of Activities 3/Individual Fee Activity Fee la work on single family lot 1 110 110 Step 5/Total Project Fee: 110 Step 61Fee Payments: Total Project Fee: 110 a.Total Fee from Step 5 State share of filing Fee: 42.50 b.1/2 Total Fee less$12.50 City/Town share of filling Fee: 67.50 c.1/2 Total Fee plus$12.50 C. Submittal Requirements a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee, payable to the Commonwealth of Massachusetts. Department of Environmental Protection Box 4062 Boston, MA 02211 b.) To the Conservation Commission:Send the Notice of Intent or Abbreviated Notice of Intent;a copy of this form;and the city/town fee payment. To MassDEP Regional Office(see Instructions):Send a copy of the Notice of Intent or Abbreviated Notice of Intent;a copy of this form;and a copy of the state fee payment.(E-filers of Notices of Intent may submit these electronically.) Wpaform3.doc•Wetland Fee Transmittal Form•rev.2/21/08 Page 2 of 2 • GAYLE E. DAVIS 5-7515/110 STEVEN S. DAVIS 1 42 SUNDANCE ROAD 1 /3 ti NORTH DARTMOUTH, MA 02747-2472 DATE PAY TO THE EnAiyi iii ....) / It:t." ii "V- 1 $ C7,50 / ea. . '' Akft5/"UR.A1Cort . tA - ---DOLLARs .....,..... -- -- 1 Sovereign Bank PART OF THE SANTANDER GROUP MEMO _ IVII I. .0 /0 7 5 1501: 13 200C198 511 2111 1 /qui GAYLE E. DAVIS 5-7515/110 1201 STEVEN S. DAVIS 1 13 1 42 SUNDANCE ROAD - NORTH DARTMOUTH,MA 027472472 DATE Sr0 Sovereign Bank OF11-IE SANTANI)ER GR°U mEmo . 13 c.it jnoc1913 5 I., 2iis 1 20 L '0 L LO 75 150i. GAYLE E. DAVIS 5-7515/110' STEVEN S. DAVIS 1200 42 SUNDANCE ROAD ] NORTH DARTMOUTH, MA 02747-2472 /j j 3/ II DATE j 1 jg 4 et, PAY TO THE `yi ' 1 ORDER OF L/ :.(f'� r i i 0 a - -,&,„, c„..„( i' ��'„454, fkD- f1hC DOLLARS el Sovereign Bank PART OF THE SANTANDER GROUP a. ME1190 r ':O 1 1.0 ? 5 L soi: L 3 200098 54 211' L 200 METHOD FOR BORDERING VEGETATED WETLANDS (BVW) BOUNDARY DELINEATION AT 42 SUNDANCE ROAD,DARTMOUTH, MA Mr. Steven Davis,owner of the property located at 42 Sundance Road,Dartmouth,Massachusetts, filed and had a Wetland Site Inspection(Form A-1) completed by the Town of Dartmouth for the wetlands delineation line shown on the attached plan entitled"Plan to Accompany Notice of Intent" by Prime Engineering, Inc. and dated January 12,2011. ABUTTERS TO ASSESSORS MAP 79,BLOCK 48, LOT 33 STEVEN AND GAYLE DAVIS 42 SUNDANCE ROAD, DARTMOUTH,MA Site Map/Block-Lot Owner Name and Address 79/48-33 Steven S. and Gayle E. Davis 42 Sundance Road North Dartmouth, MA 02747 Map/Block-Lot Name and Address 79/48-48 David F. and Lisa M. Bousquet 37 Sundance Road North Dartmouth,MA 02747 79/48-32 Joseph F. Dawicki III and Joan C .Gertridge 38 Sundance Road North Dartmouth, MA 02747 79/48-34 Michael and Beatriz Smaldone 50 Southwind Way North Dartmouth, MA 02747 79/48-46 Armando R. and Barbara J Pereira 46 Southwind Way North Dartmouth, MA 02747 79/48-47 Jeffrey C. and Suzanne M. Riley 41 Sundance Road North Dartmouth, MA 02747 1 Notification to Abutters Under the Massachusetts Wetlands Protection Act In accordance with the second paragraph of Massachusetts General Laws Chapter 131, Section 40, you are hereby notified of the following. A. The name of the applicant is: Steven Davis B. The applicant has filed a Notice of Intent with the Conservation Commission for the municipality of Dartmouth,Massachusetts seeking permission to remove, fill dredge or alter an Area Subject to Protection Under the Wetlands Protection Act(General Laws Chapter 1331, Section 40). C. The address of the lot where the activity is proposed is 42 Sundance Road, Assessors Map 78/Lot 48-33 D. Copies of the Notice of Intent and plans may be examined at Dartmouth Conservation Commission,400 Slocum Road,Dartmouth MA 02747 between the hours of 9:00 am—10:00 am on Monday—Friday. For more information, call (508) 910-1822. E. Copies of the request and plans may be obtained from the applicant's representative,by calling(508) 947-0050 between the hours of 9:00 am and 3:00 pm on the following days of the week: Monday—Friday. Note: Notice of the public hearing,including its date,time,place,will be published at least five(5)days in advance in the Chronicle Note: Notice of the public hearing,including its date,time,place,will be posted in the Town Hall not less than forty-eight(48)hours in advance. Note: You may also contact your local Conservation Commission or the nearest Department of Environmental Protection Regional Office for more information about this publication or the Wetlands Protection Act. To contact the DEP call Southeast Region: (508)946-2700. Jeffrey C and Suzanne M Riley Jeffrey C and Suzanne M Riley Jeffrey C and Suzanne M Riley 41 Sundance Road 41 Sundance Road 41 Sundance Road North Dartmouth,MA 02747 North Dartmouth,MA 02747 North Dartmouth,MA 02747 Joseph F Dawicki III and Joseph F Dawicki III and Joseph F Dawicki III and Joan C Gertridge Joan C Gertridge Joan C Gertridge 38 Sundance Road 38 Sundance Road 38 Sundance Road N Dartmouth,MA 02747 N Dartmouth,MA 02747 N Dartmouth,MA 02747 Michael and Beatriz Smaldone Michael and Beatriz Smaldone Michael and Beatriz Smaldone 50 Southwind Way 50 Southwind Way 50 Southwind Way N Dartmouth,MA 02747 N Dartmouth,MA 02747 N Dartmouth,MA 02747 Armando R and Barbara J Pereira Armando R and Barbara J Pereira Armando R and Barbara J Pereira 46 Southwind Way 46 Southwind Way 46 Southwind Way N Dartmouth,MA 02747 N Dartmouth,MA 02747 N Dartmouth,MA 02747 David F and Lisa M Bousquet David F and Lisa M Bousquet David F and Lisa M Bousquet 37 Sundance Road 37 Sundance Road 37 Sundance Road N Dartmouth,MA 02747 N Dartmouth,MA 02747 N Dartmouth,MA 02747 ++Pew, • ap s1 at? • 4�� �'..�' . m `� ` �48 �'' 48 M36 65 s . : 44i'' d .1 N 22 4t�;rs' r + ryryry•f �a aa' P.re Ac �• 4 a 48412 0Ft. 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