HomeMy WebLinkAboutBLD-22-006823 ONE & TWO FAMILY ONLY- BUILDING PERMIT
Town of Yarmouth Building Department
1146 Route 28, South Yarmouth,MA 02664-4492
508-398-2231 ext. 1261 Fax 508-398-0836 ,I , .
% -'1,
RECEIVED Massachusetts State Building Code, 780 CMR
ii 'ng Permit Application To Construct, Repair, Renovate Or Demolish _ _
MAY 2 4 2022 a One-or Two-Family Dwelling
This Section For Official Use Only
B U I L T�uiuiQ M �2Z �. Date Appli
By_ Permit um Der:
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1 1.1 Propety Address: 1.2 Assessors Map&Parcel Numbers
l I xe y ktoHot 'veit,u e y 0
1 1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number
j 1.3 Zoning Information: 1.4 Pro er -Dimensions:
1
R-40 S„ /e ,.,;l7 /2,
Zoning District Prop sed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
30' 29, 8' .2-o' l •• 3 ' 2a' 5
1.6 Water upply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private 0 Zone: Outside Flood Zo e? /
Check if yestl" Municipal 0 On site disposal system E7
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Te-Acrey i 7- r4'1/arnt. St. Weu-w,� i / D2�s
Name(Print) )
City,State,ZIP
4ci -4Z - 3(o4 i eageticti
•
No.and Street Telephone Emai Address'
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building NI/ Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition IBA
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2:
GohSltuC+ /2 'x ldZf .Ci fib 0 � of exi r7 k s
JUL 2 0 2322
SECTION 4: ESTIMATED CONSTRUCTION COSTS.
Estimated Costs: T
Item BUII. 1' r
(Labor and Materials) Official Use Only sY
1.Building $ 1. Building Permit Fee:S 66 _Indicate how fee is determined:
2.Electrical $ /0 �� Standard City/Town Application Fee
0 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ /0/ 2. 35 Ci 3S-�/ V `'t�/
U-� Other Fees: $ \
4. Mechanical (HVAC) $ srj'CTO-e). - List:
A\N�
5.Mechanical (Fire
Suppression) $ Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ ( D—
0 Paid in Full Outstanding Balance Due: cA J
is .
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
her Vi o95b $ �,
CAns License Number Expiration ate
Name of CSL Holder
/ 7 SifIle�k �Q Q List CSL Type(see below) (i(-
No. and Street '`�u�— Type Description
tS Y� OL> /t 4 O2&/ ,/ U Unrestricted(Buildings up to 35,000 Cu.ft.)
City/Town,State,ZIP (O`t_ R I Restricted I&2 Family Dwellinti
M Masonry
•
RC Roofing Covering
WS Window and Siding
7-4_.2,-2 /'� SF Solid Fuel Burning Appliances
Telephone p /o.ac i)C�viN Lon' I 1 Insulation
Email address D ' Demolition
5.2 Registered Home Improvement Contractor(HIC) 2-01
�
HICc '4p �/'/lleetrt' /1'1C' HIC gistr umber Exxiati" Da
t' �"Corn
�/�e o�P1�3/�C tr I�,EL•e
�+° Street /�Cv �iU/!�I�iir� (�Q�
' / /�2/4 C%�1��1 ¢_2�2_6�ty6 Email address
z `�'o-ll
City/Town, State,ZIP Telephone
SECTION 6: WORKERS' COMPENSATION LNSURANCE AFFIDAVIT(M.G.L. c. 152.§ 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 Issuance of the building permit.
Signed Affidavit Attached? Yes IV No 0
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR^APPLIES FOR BUILDING PERMIT
1.
I, as Owner of the subject property,hereby authorize •A • V hGe.41( inc.
to act on my behalf, in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature)
Date
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
l n s*ier A • Wileep f 57 Vas
Print Owner's or Authorized Agent's Name(Electronic Signature)
` Date
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 not have access to the arbitration
program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program can be found at
www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.uov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) II bg50 (including arage, finished basement/attics, decks or porch)
Gross living area(sq.ft.) g p )
�� �0+ Habitable room count $'
Number of fireplaces / Number of bedrooms 3
Number of bathrooms a Number of half/baths 0'
Type of heating system Qti.S A ol—A.i r Number of decks/porches
Type of cooling system Enclosed Open ✓
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
N
:, • The Commonwealth of Massachusetts
� � Department of Industrial Accidents
E"—' 1 Congress Street, Suite 100
i Iv` Boston, MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
A licant Information
Please Print Le ibl
Name (Business/Organization/Individual): C. . V% cetell hie
Address: / shit ,B,k Rat .
City/State/Zip: S. / , . hl t/4 b ,. - Phone #: ¢-.2./,Z.e 3
Are you an employer?Check the appropriate box:
1. [am a employerType of project(required):
C with employees(full and/or part-time).*
2.0 I am a sole proprietor or partnership and have no employees working for me in 7. C ReW Jelin construction
any capacity.[No workers'comp. insurance required.] 8. [ Remodeling
3.[I am a homeowner doing all work myself. [No workers'comp. insurance required.]t 9. C Demolition
4.[I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 wilding addition
ensure that all contractors either have workers'compensation insurance or are sole
11.[ Electrical repairs or additions
proprietors with no employees.
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.0 Plumbing repairs or additions
T ese sub-contractors have employees and have workers'comp. insurance.t
13.[I]Roof repairs
6. - e are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other
152,§1(4),and we have no employees. [No workers'comp. insurance required.]
*Any applicant that checks box'l 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.
tContractors 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:
Policy r or Self-ins.Lic.#:
Expiration Date;
Job Site Address:
Attach a copy of the workers' compensation policy declaration page(showing thetate/Zip:policy number and expiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
•
Signature: C�'V
Date: :S ? 22
Phone#: ¢' 424,--0/31
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#:
„ ,o�YgR
40:` TOWN OF YARMOUTH
o C BUILDING DEPARTMENT
�' MAT7A . 1146 Route 28,South Yarmouth,MA 02664
508-398-2231 ext. 1261 Fax 508-398-0836
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at I?
Work Address
Is to be disposed of at the following location: lu- a ) t9
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
Signature of Application
Date
Permit No.
AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone
Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1
Q Check
Compliance
1.1 SCOPE
Wind Speed(3-sec.gust) 110 mph ✓i
Wind Exposure Category B
1,7
1.2 APPLICABILITY
Number of Stories (Fig 2) / stories <2 stories ✓
Roof Pitch (Fig 2) ja <_12:12
'
�
Mean Roof Height (Fig 2) ft 5 33' �
Building Width,W (Fig 3) ft 5 80' t/
Building Length,L (Fig 3) &ift <80' t/-
Building Aspect Ratio(L/W) (Fig 4) <3:1 ►/
Nominal Height of Tallest Opening2 (Fig 4) b °k 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
V .
Concrete
Concrete Masonry......
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) t7---in. ✓`
Bolt Spacing from end/joint of plate (Fig 5) in.<6"-12" _i----""v
Bolt Embedment-concrete (Fig 5) in.z 7"
Bolt Embedment-masonry (Fig 5) in.>_15" A,'.
Plate Washer (Fig 5) >3"x 3"x 1/4
3.1 FLOORS
Floor framing member spans checked (per 780.CMR Chapter 55)
Maximum Floor Opening Dimension (Fig 6) [eft<_12'or U2 or W/2
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6) r
Maximum Floor Joist Setbacks
Supporting Loadbearing Walls or Shearwall (Fig 7) 9 ft <_d
Maximum Cantilevered Floor Joists j
Supporting Loadbearing Walls or Shearwall (Fig 8) "fft 5 d
Floor Bracing at Endwalls (Fig 9 _
Floor Sheathing Type (per 780 CMR Chapter 55) g#yyam�,, 76 .O$
IVFloor Sheathing Thickness (per 780 CMR Chapter 55) sif..T.4.E7 in.
Floor Sheathing Fastening (Table 2).. 3d nails at G in edge/ LZi field -
4.1 WALLS
Wall Height
Loadbearing walls (Fig 10 and Table 5) <_10' v
Non-Loadbearing walls (Fig 10 and Table 5) i-ft <20'
Wall Stud Spacing (Fig 10 and Table 5) lja in.5 4"o.c.
Wall Story Offsets (Figs 7&8) ft <d
4.2 EXTERIOR WALLS3
Wood Studs
Loadbearing walls (Table 5) 2x'- -ht in.
Non-Loadbearing walls (Table 5) 2x - 7 ft 9 in.
Gable End Wall Bracing 1
Full Height Endwall Studs (Fig 10) /,
WSP Attic Floor Length (Fig 11) l ft?.W/3 __L-/
Gypsum Ceiling Length(if WSP not used) (Fig 11) ft>_0.9W
2 x 4 Continuous Lateral Brace @ 6 ft.o.c. ..(Fig 11)
Double Top Plate /
Splice Length (Fig 13 and Table 6) 2ft ✓ /
Splice Connection(no.of 16d common nails) (Table 6) ✓
•
AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone
Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1
Loadbearing Wall Connections
Lateral(no.of endnailed 16d common nails) (Table 7) 9---
Non-Loadbearing Wall Connections —
Lateral(no.of endnailed 16d common nails) (Table 8)
Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)
Header Spans (Table 9)
Sill Plate Spans ft•fin.5 11'(Table
t�
Full Height Studs (no.of studs) (Table 9) ft_fin.<_12
Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to able 9)
Header Spans... (Table 9) in.5 12' 1. /
Sill Plate Spans.... (Table 9)
it Full Height Studs(no.of studs) in.s 12" /
Exterior Wall Sheathing to Resist Uplift and Shear Simultaneouslye9) -�G
Minimum Building Dimension,W
Nominal Height of Tallest Opening2 pl�l..�6'8" ,Sheathing Type (note 4) t� vim/
Edge Nail Spacing (Table 10 or note 4 if less) in.. _
Field Nail Spacing (Table 10)
Shear Connection(no.of 16d common nails)(Table 10) tf
inn'
Percent Full-Height Sheathing (Table 10)
5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts) A,��'
Maximum Building Dimension, L ( 44
Nominal Height of Tallest Opening2 fp r 5 6,8"
(note4)............................................ f s V
Sheathing Typei14 Edge Nail Spacing (Table 11 or note 4 if less) (, in.Field Nail Spacing (Table 11)
Shear Connection(no.of 16d common nails)(Table 11) 3
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,San Tool,see BBRS Website)Roof Overhang (Figure 19) 1/7.-ft s smaller of 2'or U3 i/Truss or Rafter Connections at Loadbearing Walls
Proprietary Connectors
Uplift (Table 12) U=I ipplf u/
Lateral (Table 12) L= plf ,�
Shear (Table 12).( S= If —�Ridge Strap Connections,if collar ties not used per page 21.... (Table 13) T= If ./
Gable Rake Outlooker (Figure 20) rft<_smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls
Proprietary Connectors
Uplift (Table 14) U='1 Tlb. ✓
Lateral(no.of 16d common nails)...(Table 14)...
Roof Sheathing Type
Roof Sheathing Thickness (per 780 CMR Chapters 58 a 59).. '!'.Ip ,••• �%�/
Roof Sheathing Fastening in. 7/16"WSP ✓
Notes: (Table 2) t / ,✓
1. This checklist must 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
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.
3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness.pressure treated#2-grade.
Sears, Tim
From: Sears, Tim
Sent: Thursday,June 2, 2022 10:50 AM
To: 'info@cavincent.com'
Subject: 17 Raymond Ave
Chris,
I have reviewed your application for the addition and there are some items needed.
e, The use of sonotubes for a foundation requires plans reviewed and stamped by a Registered Design Professional
Deck footings require a minimum of 12"footings
if 110mph checklist or stamped plans needed
Please submit these items for review
This email is considered a written denial of your permit application per Section 105.3.1 of the Massachusetts
State Building Code. Section 105.3.2 states in part that "an application for a permit for any proposed work
shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been
pursued in good faith"
You may appeal this denial to the Building Code Appeals Board in accordance with M.G.L. c. 143 §100, within 45
days of this notice.
I..imothy Sears CB()
Deputy Building Commissioner
Town of Yarmouth
508-398-2231 Ext. 1259
mailto:tsears@yarmouth.ma.us
1
°`.7ilii,eiro
,": TOWN OF YARMOUTH l� , HEALTH DEFT.
HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: I7 fzeiri(oive Alliefit-u-e_d
Proposed Improvement: A D1.-r HO>'t g-t` •-(>41&Le-S Lac of kbuise
Applicant: C< 4- -Vr/iCZ.Jj I r'1C. Tel. No.: 212�-69.A
Address: 1'- Ali gt P1,)S- YA13, tit t O2 4 Date Filed: Silt 27-2.—
**Ifyou would like e-mail notification of sign off,please provide e-mail address: J kf @CSC.-If l li 4'l . C-0*1
Owner Name: Jr -fi /
Owner Address: 77-4 jug. C.) twit-wick) fel C72e '1 Owner Tel. No.: `, .- j—
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
Please submit three (3) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) —
Note: Floor plans not required for decks, sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: DATE:
S
PLEASE NOTE 1"/C)j--',
COMM COMMENTS/CONDITIONS: NC v / r /, /v0`,-,... c r
TOWN OF YARMOUTH
} o. WATER DEPARTMENT
a y' 99 Buck Island Road
+wR.c Esc / ; West Yarmouth, MA 02673
Telephone: l508 771-7921 • Fax: (5081 771-7998
BUILDING PERMIT APPLICATION FOR
WATER DEPARTMENT SIGN OFF
TRANSMITTAL FORM
BUILDING SITE LOCATION: /7 Attifi-md 7fVeA 2- ___
PROPOSED WORK: aiteti 7',on ._
APPLICANT: C•A - V it , j.?��
ADDRESS: /1' Still6rtelk ievt. Yorkvotat,f ,iih O2 44
TELPHONE: ��4-a-l.Z—D�f � � ' CO GeC,virsC . C4lti^.
RESIDENTIAL AND 'OR COMMERCIAL BUILDING
Water Department: Determines Compliance of Water Availability and or existing location
Engineering Department: Determines Compliance for Parking and Drainage
Conservation Commission: Determines Compliance to Wetlands Act; i.e. It'lot(s)border any type of
wetlands. streams, ponds,rivers, ocean, bogs, boys, marshland, ETC...
Health Department: Determines Compliance to State and Town Regulations, i.e.
requirements for Septage Disposal and other Public Health Activites
Fire Department: Determines Compliance to State and Town Requirements for Personal
Safety, Property Protections, i.e. Smoke Detectors, Sprinkler Systems,etc
‘/2/? —
APPLICANT SIGNATURE DATE
OFFICE USE: COMMENTS ON PERMIT APPROVAL OR DENIAL
2Z
R EWED Y WATER DIVISION(SIGNATURE) DATE
REScheck Software Version 4.6.5
Compliance Certificate
Project Addition
Energy Code: 780 CMR 51.00: Massachusetts Residential Code, 9th Edition, Energy Efficiency
Location: South Yarmouth, Massachusetts
Construction Type: Single-family
Project Type: Addition
Climate Zone: 5 (6137 HDD)
Permit Date:
Permit Number:
Construction Site: Owner/Agent: Designer/Contractor:
17 Raymond Ave Chris Vincent
S Yarmouth, MA 02664 17 Still Brook Rd
S Yarmouth, MA 02664
Compliance:Passes using UA trade-off
Compliance: 5.3%Better Than Code Maximum UA: 38 Your UA: 36
The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
Envelope Assemblies
Gross Area Cavity Cont.
Assembly or R-Value R-Value U-Factor UA
Perimeter
Ceiling 1:Cathedral Ceiling 150 38.0 0.0 0.027 4
Wall 1:Wood Frame, 16"o.c. 310 21.0 0.0 0.057 15
Window 1:Vinyl/Fiberglass Frame:Double Pane with Low-E 27 0.300 8
Door 1: Solid 20 0.270 5
Floor 1:All-Wood joist/Truss:Over Outside Air 135 30.0 0.0 0.033 4
Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other
calculations submitted with the permit application.The proposed building has been designed to meet the 780 CMR 51.00:
Massachusetts Residential Code,9th Edition, Energy Efficiency requirements in REScheck Version 4.6.5 and to comply with the
mandatory requirements listed in the REScheck Inspection Checklist.
Name-Title Signature Date
Project Title: Addition Report date: 05/24/22
Data filename: Untitled.rck Page 1 of10
giREScheck Software Version 4.6.5
, Inspection Checklist
Energy Code: 780 CMR 51.00: Massachusetts Residential Code, 9th Edition,
Requirements: 0.0% were addressed directly in the REScheck software
Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each
requirement,the user certifies that a code requirement will be met and how that is documented, or that an exception
is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided.
,/,!,1,/,;:,ti ;; ,,;:::::::;0,:
103.1, Construction drawings and ❑Complies
103.2 documentation demonstrate • ❑Does Not
[PR1]1 energy code compliance for the
building envelope.Thermal ❑Not Observable
envelope represented on �' % ❑Not Applicable
'construction documents.
103.1, Construction drawings and ❑Complies
103.2, documentation demonstrate ❑Does Not
403.7 energy code compliance for
[PR3]1 lighting and mechanical systems. ❑Not Observable
Ak Systems serving multiple , ,r, ❑Not Applicable
dwelling units must demonstrate ;2,/,/,
compliance with the IECC i
Commercial Provisions. a % �.
302.1, 'Heating and cooling equipment is Heating: Heating: ❑Complies
403.7 ;sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not
[PR2]z on loads calculated per ACCA
46 Manual J or other methods Cooling: Cooling: DNot Observable
approved by the code official. Btu/hr ^ Btu/hr ❑Not Applicable
❑Com
103.11 Solar-Ready Roof: New detached ���/ ''%ice! j P
lies
[PR4] one-and two-family dwellings, DDoes Not
and multiple siily
dwellings(townhousesngle-fam)with>_ ❑Not Observable
600 ft2(55.74 m2)of roof area ❑Not Applicable
oriented between 110 degrees
and 270 degrees of true north
comply with sections AU103.2
through AU103.8(RB103.2
through RB103.8).
Additional Comments/Assumptions:
I 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title:Addition
Data filename: Untitled.rck Report date: 05/24/22
Page 2 of10
r, � .�//,,ice A / ,.,
303.2.1 A�protective covering is installed to i❑Complies
(FO1112 protect exposed exterior insulation !❑Does Not
and extends a minimum of 6 in. below ❑Not Observable
grade. ❑Not Applicable
403.9 Snow-and ice-melting system controls'❑Complies
[FO1212 installed. ?❑Does Not
❑Not Observable:
❑Not Applicable
Additional Comments/Assumptions:
II High Impact(Tier 1) ; 2'1Medium Impact(Tier 2) 13 1Low Impact(Tier 3)
Report date: 05/24/22
Project Title:Addition Page 3 of10
Data filename: Untitled.rck
golgoutopoolnolgaincolloomplk
ect n
303.1.3 1 U-factors�of fenestration products ❑Complies
[FR4]1 :are determined in accordance ij,
❑Does Not
with the NFRC test procedure or ❑Not Observable
taken from the default table. /❑Not Applicable
402.1.1, :Glazing U-factor(area-weighted ; U- U- :❑Complies :See the Envelope Assemblies
402.3.1, :average).
❑Does Not table for values.
402.3.3, ❑Not Observable
[402.5FR2] `❑Not Applicable
FR2]1
402.1.1, Glazing SHGC value(area- SHGC: : SHGC: :❑Complies 'See the Envelope Assemblies
402.3.2, weighted average). ❑Does Not table for values.
402.3.3, ❑Not Observable
(FR3]1 ❑Not Applicable
FR3]
a
402.1.1, Door U-factor. U- U- !❑Complies See the Envelope Assemblies
402.3.4 ❑Does Not table for values.
(FR1]1 ❑Not Observable
❑Not Applicable
402.4.1.1 'Air barrier and thermal barrier r , /.❑Complies
[FR23]1 installed per manufacturer's �%/❑Does Not —
instructions. % ['Not Observable i
❑Not Applicable
402.4.3 Fenestration that is not site built ❑Complies
[FR20]1 is listed and labeled as meeting ❑Does Not
AAMA/WDMA/CSA 101/I.S.2/A440 ❑Not Observable
or has infiltration rates per NFRC : ❑Not Applicable
400 that do not exceed code
limits. ,,
r° ❑Com lies
402,4.5 IC-rated recessed lighting fixtures p
[ER16rz sealed at housing/interior finish ?❑Does Not
and labeled to indicate 52.0 cfm ❑Not Observable
leakage at 75 Pa. %DNot Applicable
403.3.1 ',Supply and return ducts in attics ,/7 ❑Complies
[FR12]1 ;insulated>=R-8 where duct is ❑Does Not
>=3 inches in diameter and>= ❑Not Observable
R-6 where<3 inches.Supply and Lin Applicable
return ducts in other portions of
the building insulated >=R-6 for
diameter>=3 inches and R-4.2
for< 3 inches in diameter. ,,,,,,�, ,u• x • //.
403.3.5 `Building cavities are not used as ❑Complies
[FR15]3 ducts or plenums. ['Does Not
',/, ❑Not Observable
❑Not Applicable
403.4 :HVAC piping conveying fluids `. R-_ R- :❑Complies
[FR17]2 :',above 105 QF or chilled fluids ❑Does Not
below 55 QF are insulated to zR- ;❑Not Observable
3. ❑Not Applicable i
403.4.1 Protection of insulation on HVAC ❑Complies
[FR24]1 piping. Oboes Not
❑Not Observable i
[Not Applicable
1
1 1 1 High Impact(Tier 1) 12 1 Medium Impact(Tier 2) 13 I Low Impact(Tier 3)
Report date: 05/24/22
Project Title: Addition Page 4 of10
Data filename: Untitled.rck
E Aei, n Fga �� *aim ��IG� ►� , , '
403.5.3 Hot water pipes are insulated to ; R-_ R ❑Complies
[FR18]2 aR-3.
❑Does Not
❑Not Observable
❑Not Applicable
403.6 Each dwelling unit of a residential r/4% /❑Complies
[FRIO -building provided with ❑Does Not
continuously operating exhaust, i❑Not Observable
supply or balanced mechanical ❑Not Applicable
=ventilation that has been site
verified to meet a minimum
!airflow per Section N1103.6.
Additional Comments/Assumptions:
I 1 I High Impact(Tier 1) 12-'Medium Impact(Tier 2) 13 I Low Impact(Tier 3) I
Report date: 05/24/22
Project Title:Addition Page 5 of10
Data filename: Untitled.rck
;
fir. i.,,✓ % i,,, ,,. e,
303.1 All installed insulation is labeled %❑Complies
(IN13]2 or the installed R-values ❑Does Not
provided. ❑Not Observable
❑Not Applicable ;
303.2 Wall insulation is installed per
�1,,' ,;�// i❑Complies
[IN4]1 manufacturer's instructions. ❑Does Not
JJ# DNObservable
ot
�❑Not Applicable
,, ,,�W� ❑Complies
303.2, '
Floor insulation installed per p
402 2 7 :manufacturer's instructions and Oi ❑Does Not
[IN2]1 in substantial contact with the ❑Not Observable
underside of the subfloor,or floor ❑Not Applicable
'framing cavity insulation is in
contact with the top side of �,
sheathing,or continuous , `
insulation is installed on the
underside of floor framing and
extends from the bottom to the
top of all perimeter floor framing
members.
402.1.1, Wall insulation R-value. If this is a R- ` R-_ ,❑Complies See the Envelope Assemblies
402.2.5, mass wall with at least 1/2 of the ❑ Wood ❑ Wood ❑Does Not table for values.
402.2.6 wall insulation on the wall I❑ Mass ;❑ Mass ❑Not Observable
[IN3]1 exterior,the exterior insulation '❑ Steel El Steel ❑Not Applicable
,I requirement applies(FR10).
402.1.1, "Floor insulation R-value. ' R- R- ❑Complies :See the Envelope Assemblies
402.2.E ❑ Wood ❑
Wood DDoes Not table for values.
[IN1]1 E Steel I❑ Steel '❑Not Observable
DNot Applicable
Additional Comments/Assumptions:
1 1'High Impact(Tier 1) ,,2''!Medium Impact(Tier 2) 13 ILow Impact(Tier 3)
Report date: 05/24/22
Project Title:Addition Page 6 of10
Data filename: Untitled.rck
Nn
; i is
303.1.1.1, Ceiling insulation installed per ❑Complies
' ❑Does Not
303.2 manufacturer's instructions. //
[FI2]'i Blown insulation marked every
la ❑Not Observable
300 ft2. d ❑Not Applicable
303.3 Manufacturer manuals for 4/4/`0 ( y'xl� ❑Complies
[F118]3 mechanical and water heating ❑Does Not
systems have been provided. ❑Not Observable
, j
/_.��a.. � ��,� � /�/❑Not Applicable :
❑Com lies
401.3 , Compliance certificate posted. ��� p
[F17]x ❑Does Not
Observable
JDNot
❑Not Applicable
402.1.1, Ceiling insulation R-value. R- R-_ ❑Complies See the Envelope Assemblies
402.2.1, ❑ Wood ❑ Wood ❑Does Not table for values.
402.2.2, ❑ Steel ❑ Steel :Not Observable
402.2.E[FI1]1 ID Applicable
402.2.3 Vented attics with air permeable % /❑Complies
[F122)2 insulation include baffle adjacent //❑Does Not
to soffit and save vents that ❑Not Observable
extends over insulation. ❑Not Applicable
402.2.4 Attic access hatch and door R- R-_ ❑Complies
[FI3]1 insulation ER-value of the ❑Does Not
adjacent assembly. ❑Not Observable
❑Not Applicable
402.4.1.2 i Blower door test @ 50 Pa. <=5 ACH 50= ACH 50= ❑Complies
[FI17]1 ach in Climate Zones 1-2,and DDoes Not
<=3 ach in Climate Zones 3-8. ❑Not Observable
❑Not Applicable
403.1.1 Programmable thermostats ❑Complies
❑Does Not
[F19]2 installed for control of primary
heating and cooling systems and /❑Not Observable
initially set by manufacturer to /44/,❑Not Applicable
code specifications.
403.1.2 Heat pump thermostat installed / ❑Complies
(F11012 on heat pumps. Ply•x[ ❑Does Not
„�❑Not Observable
/ /❑Not Applicable
403.2 Hot water boilers supplying heat j� ❑Complies
[F126]2 through: one-or two-pipe heating //❑Does Not
systems have outdoor setback :Not Observable
control to lower boiler water ❑Not Applicable
temperature based on outdoor
temperature.
403.3.2.1 Air handler leakage designated /❑Complies
[F124]1 by manufacturer at<=2%of j❑Does Not
design air flow. ❑Not Observable
❑Not Applicable
1 1 High Impact(Tier 1) 1 2 j Medium Impact(Tier 2) 1 3 (Low Impact(Tier 3)
Report date: 05/24/22
Project Title:Addition
Page7of10
Data filename: Untitled.rck
/ice /-1t �V � ###114f
403.3.3 Ducts are pressure tested to cfm/100 cfm/100 ❑Complies
[F127]1 determine air leakage with ft2 ft2 ❑Does Not
either: Rough-in test:Total ❑Not Observable
leakage measured with a ❑Not Applicable
pressure differential of 0.1 inch
w.g.across the system including
the manufacturer's air handler
enclosure if installed at time of
test. Postconstruction test:Total
leakage measured with a
pressure differential of 0.1 inch
w.g.across the entire system
including the manufacturer's air
handler enclosure. Post-
construction or rough-in testing
and verification done by a HERS
Rater, HERS Rating Field
Inspector,or an applicable BPI
Certified Professional.
403.3.4 Duct tightness test result of<=4 cfm/100 cfm/100 DComplies
[FI4]1 cfm/100 ft2 across the system or ft2 ft2 ❑Does Not
<=3 cfm/100 ft2 without air ❑Not Observable
handler @ 25 Pa. For rough-in ❑Not Applicable
tests,verification may need to
occur during Framing Inspection.
403.5.1 Circulating service hot water j / ❑Complies
(FI1112 systems have automatic or �� ❑Does Not
accessible manual controls. a :Not Observable�/❑Not Applicable 403.5.1.1 Heated water circulation systems j❑Complies
[FI28]2 .have a circulation pump.The / ❑Does Not
system return pipe is a dedicated ❑Not Observable
return pipe or a cold water supply ❑Not Applicable
pipe.Gravity and thermos-
syphon circulation systems are j,,,.w 2
not present.Controls for
circulating hot water system ��',
pumps start the pump with signal,
for hot water demand within the j
occupancy.Controls
automatically turn off the pump j
when water is in circulation loop
is at set-point temperature and
_ no demand for hot water exists. �ayy, �, ,.
4t33.5.1.2 '.Electric heat trace systems �O� ❑Complies
[F129]2 comply with IEEE 515.1 or UL �� ❑Does NotY ,
515.Controls automatically ,j❑Not Observable
adjust the energy input to the i ❑Not Applicable
heat tracing to maintain the /�
desired water temperature in the / �j/
piping. /i, /
403.5.2 Water distribution systems that
/❑Complies
(FI30]2 have recirculation pumps that
/❑Does Not
pump water from a heated water w ❑Not Observable
supply pipe back to the heated Applicable
water source through a cold
water supply pipe have a
demand recirculation water
system. Pumps have controls
that manage operation of the lasf
pump and limit the temperatureY
of the water entering the cold //'"/ / • //
water piping to 104°F. /
!1 High Impact(Tier 1) 12 IMedium Impact(Tier 2) 13 ILow Impact(Tier 3)
Report date: 05/24/22
Project Title:Addition
Page 8 of10
Data filename: Untitled.rck
403.5.4 ;Drain water heat recovery unitsJr
❑Complies
[F13132 tested in accordance with CSA ❑Does Not
B55.1. Potable water-side ❑Not Observable
pressure loss of drain water heat ❑Not Applicable
recovery units<3 psi forindividual units connected to oneor two showers. Potable water-side pressure loss of drain waterheat recovery units<2 psi for
individual units connected to
three or more showers.403 61 'All mechanical ventilation system ❑Complies
fF125Jz fans not part of tested and listedj❑Does Not
HVAC equipment meet efficacy ❑Not Observable
and air flow limits. e ❑Not Applicable
,..ry ,?
7 / /77 ''.."''
403 6 2 Installed performance of the /� ° / ❑Com plies
[F132]3 mechanical ventilation system ❑Does Not
tested and verified by a HERS 1 ❑Not Observable
Rater,HERS Rating Field � %❑Not Applicable
Inspector,or an applicable BPI j
Certified Professional,and [ %
measured using a flow hood,flow
grid,or other airflow measuring / �j,
device in accordance with either
RESNACCA Standadard rd 5.Chapter 8 or ,����
403.6.3 Ventilation devices and ', /❑Complies
[F133]3 equipment are tested and ❑Does Not
certified by Air Movement and i❑Not Observable
Control Association("AMCA")or 0 ❑Not Applicable
Home Ventilating Institute • ,'
("HVI")and the certification label �'e , /
is afixed to product.Where /
multiple duct sizes and/or ,
j/oNot
exterior hoods are standard /4
options,the minimum size shall �/
not be used. H / iiy �� �/
403.6.4 Sound ratings for fans used for[F134J3 whole building ventilation are /flComplies
❑Does Not
rated at a maximum of one sone. ❑Not Observable
❑Not Applicable
403.6.5 Owner and the occupant of the //❑Complies
[FI35]3 dwelling unit provided withj❑Does Not
information on the ventilation ❑Not Observable
design and systems installed,including instructions on the Applicable
proper operation and
maintenance of the ventilation
systems.Ventilation controls
shall be labeled with regard totheir function.
11 IHigh Impact(Tier 1) 12'l Medium Impact(Tier 2) ( 3 I Low Impact(Tier 3) j
Report date: 05/24/22
Project Title:Addition
Page 9 of10
Data filename: Untitled.rck
ii„ii i,. .i, ,ills ,i i%,/,i.
403.6.6 All ventilation air inlets are ,❑Complies
[FI36]3 `unobstructed and located a ❑Does Not
minimum of 10 feet from other
vent openings that constitute ❑Not Observable
:known contamination sources. " • ❑Not Applicable
Outdoor forced air inlets are
covered with rodent screens..A
;whole house mechanical
'ventilation system does not
extract air from an unconditioned
basement unless approved by a
registered design professional. /
Where wall inlet or exhaust vents /
are<7 feet above finished grade. ;, /
in the area of the venting an �" ��
.identification plate is ��
permanently mounted to the
exterior of the building at a >= 8
:feet above grade directly in line 2 o
with the vent terminal. � j/
404.1 75%of lamps in permanent '� x'r, ❑Complies
[FI6]1 fixtures or 75%of permanent
Not
fixtures have high efficacy lamps. ❑Not Observable -
Does not apply to low-voltage ❑Not Applicable
lighting. ;
'404.1.1 Fuel gas lighting systems have ❑Complies
[FI23]3 =no continuous pilot light. >, •
❑Does Not
❑Not Observable
,,, „1, � r , /❑Not Applicable
r as �/
Additional Comments/Assumptions:
I 1(High Impact(Tier 1) 1 2;IMedium Impact(Tier 2) ( 3 (Low Impact(Tier 3) I
Project Title: Addition Report date: 05/24/22
Page 10 of10
Data filename: Untitled.rck
g, 780 CMR 51 .00:
Massachusetts
Residential Code, 9th
Edition, Energy
Efficiency Energy
Efficiency Certificate
Insulation Rating R-Value
Above-Grade Wall 21.00
Below-Grade Wall 0.00
Floor 30.00
Ceiling/Roof 38.00
Ductwork(unconditioned spaces):
Glass&Door Rating U-Factor SHGC
Window 0.30
Door 0.27
Heating&Cooling Equipment Efficiency
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments