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HomeMy WebLinkAboutBLDR-23-12899 lU I // ei'Y1Q./r) l°1 Q./}t.S I ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 7 of y 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 tit .•.`� Massachusetts State Building Code,780 CMR „7„.s.• " . Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only gt -2. -. 2 � �f` RECEIVED BuildingPermit Number: Date A p th ed: \ 1 uxc-- / - 7'03 SEP 06 2023 Building Official(Print Name) Signature DaCe SECTION 1:SITE INFORMATION BUILDING DEPARTMENT By._ — . LProperty Address `j���_� 1.2gessors Map&Parcel Numbers en hc1 . U.tl"YY�(JL O('" )2 i t ,, I fl 1.l a Is this an acceloted street?yes no Map Number Parcel Number 1.3 o ir Informatia 1.4 Properly Dimensions: -, V.P(-1 c m/L i-I a,i 1-7,1e-is tuoli, i\AD Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard (iXi'41( Side Yards Rear Yard Required Provided Required Provided Required Provided "50 44 ,E 3(0 i'L- SO L-Fq t 0 1.6 Water Supply: (M.G.L c.40,§54) 1.7 F od Zone Information: 1.8 Sewage Disposal System: Public Private© Zone: — Outside Flood Z9ne? / Check if yes Municipal 0 On site disposal system t SECTION 2: PROPERTY OWNERSHIP` �„ Owner'oLRe ord: aLtiti C( gitLITIT)Utt I(Matt.r+ 9 -thibaca4, -. `ictrenati-1,-P(v-,- ktt-0a(015 Name(Print) City,State,ZIP No.and Street j Telephone Email Address v l SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ I Existing Building El/ Owner-Occupied Piet Repairs(s) Cl Alteration(s) 4 Addition i Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: (;C italeir) ►-ernCCU` SECTION 4: ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Off cialUse Only (Labor and Materials) 1.Building $ )(4,0, p co 1. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee f2.Electrical $ /2i 6-00 I ❑Total Project Cost(Item 6)x multiplier x 3.Plumbing $ /3/ S'0 0 2. Other Fees: $ 4.Mechanical (HVAC) $ /Zr o O O List: 1.90.00 el4 3// `7 5.Mechanical (Fire Suppression) $ 0 Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ A8i 6 0 0 0 Paid in Full — ©Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5,1 Construction Supervisor 'cense(CSL) 19 License Number Expiration Date Name of CSL Holder List CSL Type(see below) r No,and Street Type I Description U 1 Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted l&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Cractor(HIC) HIC Company Name or HIC Registr Name HIC Registration Number Expiration Date No.and Street Email address City/Town, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(iVI.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 Ne No El SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize 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. C/ cr/cs j": \J i 1 ! c.orT (/ /3 .3 Print Owner's or Authorized Agent's Name(Electronic Signature) Dat•2 NOTES: I. 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 RIC Program can be found at www.mass.sov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,_provide the information below: Total floor area(sq,ft.) /"7 C .i (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft,) 060 of Habitable room count � ' Number of fireplaces _ Number of bedrooms 3 Number of bathrooms ' % Number of half/baths a Type of heating system! • _1t4' c a e d e t4 umber of decks/porches 4.. Type of cooling system(s`r HUH( f et h;y/ ''�0- t'� er>:' Enclosed Open 4,/� j t�'<'�`m 1'�.4i e 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts 0 Department of Industrial Accidents si taw t 1 Congress Street, Suite 100 ler Boston, MA 02114-2017 w„ www,mass,gov/dia 104 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Y t, y Name (Business/Organization/Individual): C v.,4'rL1•es- Z" AA I f)114 I D Uv^'/ Address: lv... lot/5-5 Z City/State/Zip: QtrGti.hu-/-L( i4 r Phone #: 5-0 01 9 g 3 Are you an employer?Cheek the appropriate box: - Type of project (required): I.E 1 am a employer with employees(full and/or part-time)." 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for roe in anycapacity. 8. [ i Remodeling ap [No workers'comp. insurance required.] 9. 3.[E I am a homeowner doing all work myself. (No workers'comp. insurance required.]r ❑(Demolition 4. l am a homeowner and will be hiring contractors to conduct all work on my property. I will I O lYCJ Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.7 Plumbing repairs or additions S. I am a general contractor and I have hired the sub-contractors listed on the attached sheet, These sub-contractors have employees and have workers'comp. insurance.' 1 Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per,MGL C. 14. Other 152,§1(4),and we have no employees.[No workers'comp. insurance required.] *Any applicant that checks box#.1 must also fill out the section below showing their workers'compensation policy information. I.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. .1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy Ai or Self-ins.Lic.4: 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 MGL c. 152, §25A is a criminal violation punishable by a fine up to 51,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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. 1 do hereby certify under the pomp ai d enalties of perjury that the information provided above is true and correct. Signature: el1,v,,-- Date: 1 Gti, �� J / 3 9 F Phone#: / 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'f TOWN � ` YARMOUTH $ BUILDING DEPARTMENT Y H� �=Kr,VB 1146 Route 28, South Yarmouth,MA 02664 508-398-2231 ext. 1261 HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: DATE: JOB LOCATION: Ci�iDI 1 . 01 I t il)(a I-=( �fi( i,I! t (I, /61 i 1'i r-4. P, .. NAME STREET ADDRESSSECTION OF TOWN "HOMFOWNER I;-,� ' (�`I'Y-aa ; C)Z - NAME HOME PHONE WORK PHONE PRESENT MAILING ADDRESS MAILING /1 E'1 , 1+..,�,.��L� -F V�C(l li fl A it)i21_t- ,' f fh 0? (z- CITY OR TOWN STATE ZIP CODE The current exemption for `Homeowner' was extended to include owner—occupied dwellings of one or two units and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such homeowner shall act as supervisor, (State Building Code Section 110 R5.1.3.1) Definition of Homeowner: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to be, a one or two family attached or detached structure assessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall submit to the building official, on a form acceptable to the building official,that he/she shall be responsible for all such work performed under the building permit. (Section 110 R5.1.3.1) The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned 'homeowner' certifies that he / she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements. HOMEOWNER"S SIGNATURE di-,.1"- / i' • • ti APPROVAL OF BUILDING OFHCIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch.142. Yes No If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent h:homeownriicexemp §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-223!l ext. 1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be • conducted at l \ LAI* Cif-kPOY-E Work Address Is to be disposed of oat the following location: �rn"1, L.'r n(4 Atrillo4eiC I ai ididt(Y) Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Ili/ 1r: th 1/ 3 / 3 Signature of Application Date Permit No. Generated Software r Compliance Certificate Project 9 Embassy Ln. Charles Vaillancourt Energy Code: 2018 IECC Location: Yarmouth Port, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 9 Embassy Ln Charles Vaillancourt Yarmouth Port, MA 02675 9 Embassy Ln 75 Yarmouth Port, MA 026 v�f '''' ss:✓r/ /y:St :4 * ,- ,' i i/� y� / ✓� �fiM i i/�y _,, : re l: - I,;:'''�O///// %i/m",,,,. ,.. H %:., su0////id, yi//60� ;: �� ..,„ ,,�9 /,,✓%%O/. Comb liar ce: 1.4%Better Than Code Maxirnu UA: 144 Your PA: 142 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. .1: .�tl )r s': a i€° , (lf. Irl� _ _ :_'',1,,, , ( .f,_' t�E, t.._.. i �,� , ,_... ' / }-'{�:t I ,.l is ii`f /,�! t(7i ,,. s ,.Yl e` ...`, _.., � t ,a,.FCOI I t. .� Envelope Assemblies Gross Area Cavity Cont. Prop. Req. Prop, Req. Assembly or R-value R-Value U-Factor U-factor vA UA' .. Perimeter 50 15.0 0.0 0.PerimeterCeiling: Cathedral Ceiling 980 38.0 0.0 0.027 0.026 26 25 Wall: Wood Frame, 16" o.c. 077 21.0 0.0 0.057 0.060 4 3 Wall 1: Wood Frame, 16" o.c. 20 0.270 1,250 0.060 63 66 Door: Solid Door(under 50% glazing) 0.300 5 6 Window: Vinyl Frame 132 0.300 0.300 40 40 Floor: All Wood Joist/Truss 110 30.0 0.0 0.033 0.033 4 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 2018 IECC requirements in REScheck Version : REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name Title Signature Date Report date: 06/16/23 Project Title: 9 Embassy Ln. Charles Vaillancourt Data filename: Page 1 of 9 REScheck Software Version ESche k-Web Inspection Checklist Energy Code: 2018 IECC 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. Section Flans Verified Field Verified # I Pre-Inspection/Plan Review Value Value Complies? Cor ments/Assumptions &Req.la I 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 Systems serving multiple ❑Not Applicable dwelling units must demonstrate compliance with the IECC Commercial Provisions. 302.1, Heating and cooling equipment is. Heating: Heating: :❑Complies 403.7 sized per ACCA Manual S based Btu/hr Btu/hr ElDoes Not [PR2]2 on loads calculated per ACCA Cooling: Cooling: Manual J or other methods Btu/hr Btu/hr ❑Not Observable approved by the code official. ❑Not Applicable { Additional Comments/Assumptions: 1 High Impact (Tier 1) 2 Medium Impact(Tier 2) i 3 Low Impact(Tier 3) Project Title: 9 Embassy Ln. Charles Vaillancourt Report date: 06/16/23 Data filename: Page 2 of 9 Section Foa ridation inspection Complies"? Cornalen sfAS & Rect,ID 303.2.1 A protective covering is installed to ❑Complies F[F011]2 protect exposed exterior insulation ❑Does Not and extends a minimum of 6 in. below grade. ['Not Observable ❑Not Applicable 403.9 Snow-and ice-melting system controls ❑Complies [FO12]' installed. ❑Does Not ❑Not Observable' DNot Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) ; 3 ILow Impact(Tier 3) 1 Project Title: 9 Embassy Ln. Charles Vaillancourt Report date: 06/16/23 Data filename: Page 3 of 9 Section Plans Verified Reid Verified:.. -. `` # FramingI Rough-In i s ectlo m t rat /Assclrrlpfions Vegas Value: .- 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 402.1.1, Glazing U-factor(area-weighted U- : U- ❑Complies :See the Envelope Assemblies 402.3.1, average). 3❑Does Not :table for values. 402.3.3, ❑ 402.5 Not Observable [FR2)1 ❑Not Applicable 303.1.3 U-factors of fenestration products�, &;�;N.::,, ❑Complies (FR4]1 are determined in accordance ❑Does Not fi with the NFRC test procedure or , . ° taken from the default table. ❑Not Observable <� -% ❑Not Applicable 402.4.1.1 'Air barrier and thermal barrier k_ :-: .❑Complies [FR23]1 .installed per manufacturer's ❑Does Not instructions. ['Not Observable ❑Not Applicable is,Tugawaligiefenaiinaragiggigai,ii: 402.4.3 , Fenestration that is not site built ` " _".,;. ❑Complies [FR2011 is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440 0. or has infiltration rates per NFRC :. .,, ❑Not Observable 400 that do not exceed code ❑Not Applicable limits. 4�4. IC rated recessed lighting fixtures "'""T , li :ngliagmivammagnie,b❑Complies [FR1 ,. sealed at housing/interior finish _ ;4❑Does Not and labeled to indicate<_2.0 cfm leakage at 75 Pa. ❑Not Observable r('°' ❑Not Applicable x �. ys;r, 403.3.1 'Supply and return ducts in attics ❑Complies [FR12]1 insulated >= R-8 where duct is d❑Does Not >= 3 inches in diameter and >= R-6 where < 3 inches. Supply and ❑Not Observable return ducts in other portions of _ „ cfa . ❑Not Applicable :the building insulated >= R-6 for diameter>= 3 inches and R-4.2 for< 3 inches in diameter. 403.3.2 'Ducts, air handlers and filter araa �t❑Complies [FR13]1 boxes are sealed with `l❑Does Not joints/seams compliant with ENot Observable International Mechanical Code or International Residential Code,as" ❑Not Applicable applicable. 403.3.5 Building cavities are not used as ❑Complies 1FR1513 ducts or plenums. ❑Does Not ❑Not Observable ❑Not Applicable 403.4 HVAC piping conveying fluids R- R- :❑Complies [Fit1712 above 105°F or chilled fluids ❑Does Not below 55°F are insulated to>_R- =❑Not Observable 3. ❑Not Applicable 403.4.1 Protection of insulation on HVAC i`;. H 1^ • .x ❑Complies [FR24]1 piping. ;� R_E v' I; A ❑Does Not ; A` -rods i,❑Not Observable z. ❑Not Applicable 403.5.3 Hot water pipes are insulated to R- R- '❑Complies [FR1812 _R-3. ;❑Does Not ❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) j 2 Medium Impact(Tier 2) 13 Low Impact(Tier 3) i Project Title: 9 Embassy Ln. Charles Vaillancourt Report date: 06/16/23 Page 4 of 9 Data filename: ecairr Plans VelAlfled Field Framing I of gll-lii Inspection, Conlpli:s, CorrtrinentsfAssurrintions F Itcl, � -lie Value 403.6 Automatic or gravity dampers are ".❑Complies ;[FR19]2 installed on all outdoor air ❑Does Not intakes and exhausts. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2";Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 9 Embassy Ln. Charles Vaillancourt Report date: 06/16/23 Data filename: Page 5 of 9 of ti,m insuiatio lospecti0 Flans s Verified Field 'Verified j Co piles? Comme is/Ass rriptions e l Value Value 303.1 All installed insulation is labeled ❑Complies i[IN13]2 or the installed R-values ❑Does Not <r provided. ❑Not Observable ❑Not Applicable 402.1.1, Floor insulation R-value. R- R- ❑Complies See the Envelope Assemblies 402.2.6 ❑ Wood ❑ Wood :❑Does Not table for values. [IN1]1 i❑ Steel ❑ Steel x ❑Not Observable ONot Applicable 303.2, Floor insulation installed per ❑Complies 402.2.8 manufacturer's instructions and ' =❑Does Not [IN2]1 in substantial contact with the , •underside of the subfloor,or floor '❑Not Observable framing cavity insulation is in >flNot Applicable contact with the top side of sheathing, or continuous t,, 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 [IN3]1 exterior,the exterior insulation ❑ Mass ❑ Mass ❑Not Observable requirement applies(FR10). ❑ Steel ❑ Steel ❑Not Applicable 303.2 Wall insulation is installed per ❑Complies [IN4]i manufacturer's instructions. ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) ' 2 'Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 9 Embassy Ln. Charles Vaillancourt Report date: 06/16/23 Data filename: Page 6 of 9 1 Final fn ecti Provisions ns Plans Verified ,t Field Versfie�! i ValueValue Complies? 9 k,Flle, P ,,skis&.ir4�f.akin, 402.1.1, Ceiling insulation R-value. R- jtI 402.2.1, R- ❑Complies See the Envelope Assemblies 402.2.2, ❑ Wood ❑ Wood ❑Does Not table for values. 402.2.E ❑ Steel ❑ Steel ❑Not Observable [FI1]1 ❑Not Applicable 303 1.1.1, Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions. ❑Does Not [FI2]1 Blown insulation marked every 300 ft2. [Not Observable ❑Not Applicable 402.2.3 Vented attics with air permeable ❑Complies tFI2J2. insulation include baffle adjacent ❑Does Not to soffit and eave vents that extends over insulation. ❑Not Observable ❑Not Applicable 402.2.4 Attic access hatch and door R- R- ❑Complies [FI3]1 insulation >_R-value of the ❑Does Not adjacent assembly. F❑Not Observable ❑Not Applicable 402.4.1.2 Blower door test @ 50 Pa. <=5 ` ACH 50 = ACH 50 = ;❑Complies [F117]1 ach in Climate Zones 1-2, and r❑Does Not <=3 ach in Climate Zones 3-8. ❑Not Observable F❑Not Applicable 403.3.3 Ducts are pressure tested to cfm/100 cfm/100 ❑Complies [FI27]1 determine air leakage with ft2 ft2 j❑Does Not either: Rough-in test:Total leakage measured with a ❑Not Observable pressure differential of 0.1 inch ;❑Not Applicable 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. 403.3.4 Duct tightness test result of<=4 cfm/100 cfm/100 '❑Complies [FI4]1 cfm/100 ft2 across the system or ' ft2 ft2 ❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in ❑Not Observable tests, verification may need to ` :❑Not Applicable occur during Framing Inspection. 403.3.2.1 .Air handler leakage designated ❑Complies (FI24]1 by manufacturer at <=2%of ❑Does Not design air flow. ❑Not Observable , ❑Not Applicable 403.1.1 Programmable thermostats ❑Com lies (F19) installed for control of primary 4 ` p ❑Does Not heating and cooling systems and initially set by manufacturer to ❑Not Observable code specifications. ❑Not Applicable 403.1.2 Heat pump thermostat installed l[F110]2 on heat pumps. �:=❑Complies ❑Does Not ❑Not Observable ❑Not Applicable 403.5.1. Circulating service hot water CF111.U2 systems have automatic or ❑Complies accessible manual controls. ❑Does Not ❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 'Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 9 Embassy Ln. Charles Vaillancourt Data filename: Report date: 06/16/23 Page 7 of 9 Section i n to ecti rn ov for Plans Verified Fie d Verified '. I Regal) I Value Complies? tcnrxrs; srrpinns P A 403.6.1 All mechanical ventilation system �� Complies [F125]' fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy t., and air flow limits per Table ❑Not Observable R403.6.1. ❑Not Applicable 403.2 Hot water boilers supplying heat ❑Complies f FI2612 through one-or two-pipe heating % ❑Does Not systems have outdoor setback control to lower boiler water ❑Not Observable temperature based on outdoor ❑Not Applicable temperature. 403 5.1.1 Heated water circulation systems °° ❑Complies [F128}% have a circulation pump.The ❑Does Not system return pipe is a dedicated return pipe or a cold water supply ❑Not Observable pipe. Gravity and thermos- ❑Not Applicable syphon circulation systems are not present. Controls for circulating hot water system pumps start the pump with signal for hot water demand within the occupancy. Controls automatically turn off the pump when water is in circulation loop is at set-point temperature and no demand for hot water exists. 1403,5.1.2 Electric heat trace systems ❑Complies [FI29}7 comply with IEEE 515.1 or UL ❑Does Not 515. Controls automatically adjust the energy input to the ❑Not Observable heat tracing to maintain the ❑Not Applicable I desired water temperature in the piping. 403.5.2 Demand recirculation water ` �� ❑Complies __.._._._.____..._.._.__._ ,[F130.]' systems have controls that ❑Does Not manage operation of the pump and limit the temperature of the ❑Not Observable water entering the cold water ❑Not Applicable piping to <= 104°F. 403.5[F13 11 1 Drain water heat recovery units _______.._. _ ❑Coli tested in accordance with CSA es ❑Doesmp Not B55.1. Potable water-side pressure loss of drain water heat ❑Not Observable recovery units < 3 psi for ❑Not Applicable individual units connected to one or two showers. Potable water- side pressure loss of drain water heat recovery units < 2 psi for individual units connected to three or more showers. 404.1 90%or more of permanent ❑Complies [F16j1 fixtures have high efficacy lamps. ❑Does Not ❑Not Observable . ,,_. ❑Not Applicable 404.1.1 :Fuel gas lighting systems have ❑Complies [F12313 no continuous pilot light. ❑Does Not ❑Not Observable ElNot Applicable 401.3 Compliance certificate posted. -❑Complies ❑Does Not IPul ❑Not Observable ❑Not Applicable I 1 !High Impact(Tier 1) 2 [Medium Impact(Tier 2) 3 [Low Impact(Tier 3) I Project Title: 9 Embassy Ln. Charles Vaillancourt Data filename: Report date: 06/16/23 Page 8 of 9 Section . Fi Verified Verified r ctieivisis Complies? CDDrn rents/AssumptionsRetValue Value a303.33 Manufacturer manuals for 3❑Complies [F118) mechanical and water heating t❑Does Not systems have been provided. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 'High Impact(Tier 1) 2 Medium Impact(Tier 2) [3 Low Impact(Tier 3) 1 Project Title: 9 Embassy Ln. Charles Vaillancourt Data filename: Report date: 06/16/23 Page 9 of 9 nc ertificace Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): Window 0.30 Door 0.27 Heating System: Cooling System: Water Heater: Name: Date: Comments JOB VA I 1.3 Cot)LT. 212 Cp SHEET NOCALCULATED By . OF TAYLOR DESIGN, LLC c7Y DATE • .'^ �M «�J'' Gi CHECISED BY f,�i 1 Y,��.�o��.�Q-� Mom.. '�. 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'e, L a a s 3E o h s. c i o weft., - ZZ..f, i " ;33 e, (4 e") = .4Z. colt. gktz.10.4,�� Zt ‘AiIzbe,isi e. 2-I etc- 6x4e•atent.'` t'oo T tWrOf c3A,1:7et it 1k _ F33" G. „ , se,5-0 ;* z 75-4,fs ( % f a x•, TOWN OF YARMOUTHYARMOUTH ' 1146 ROUTE 28,SOUTH YARMOUTH,MA 02664-4451 '' FEB2 l j:15 EC I Telephone(508)398-2231 Ext.1292-Fax(508)398-0836 OLD KI 'S HIGHWAY HISTORIC DISTRICT COMMITTEE JAN 2 72023 APPLICATION FOR .., L r I §SAY CERTIFICATE OF APPROPRIATENESS Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as amended,for proposed work as described below&on plans,drawings,photographs,&other supplemental info accompanying this application. PLEASE SUBMIT 4 copies OF SPEC SHEET(S),ELEVATIONS,PHOTOS,&SUPPLEMENTAL INFORMATION. Check All Categories That Apply: Indicate type of Building: Commercial X Residential 1)Exterior Building Construction: New Building X Addition X Alterations Reroof Garage Shed Solar Panels Other: 2)Exterior Painting: X_Siding X Shutters Doors Trim X Other: 3)Signs/Billboards: New Sign Change to Existing Sign 4)Miscellaneous Structures: Fence , Wall Flagpole Pool Other: Please type or print legibly: Address of proposed work: dtCIV1t3AV14 LAINe. Map/Lot# Vci I4.1 Owner(s): .L.6 9.solk 0490 V4 \t.-.J"i4 C,,.b )e,, ' Phone#: All applications must be submitted by owner or accompanied by letter from owner approving submittal of application, Mailing address: Ck 1>~rv�t; , r L `14:12)PKOO ' 'rci MA- Year built: Rta ,t Email: C1,104M..t�... o4tortk ' ',44Oitim.\t.G Preferred notification method: Phone Email Agent/contractor: t..A1[,,, ) 4 A Ar -Ecr°at IV Phone#: g 31,1-5V5 Mailing Address: 2k4, WN-M1Cc..19 ' 'C , S'C' I./k4.,UttxjC r tM 02-6 4,4 Email:c -'x- ., -"t"cV Gtr\' CCS. C©tJM Preferred notification method: Phone Email Description of Proposed Work: tat �J G,+t`'t US') ' Lov(4Q.":a Q-Nt ,.-r. (,dr VC) b t1 -VC) "F2.1) Signed(Owner or agent): ��� ,. Date: "Z'A"7423 > Owner/contractor/ag av re t t a permit is :L3F ding Department,(Check other departments,also.) Y if application is approved.approve ' a 10-day app:. ad required by the Act, ➢ This certificate is good for one year from appro al date or upon date of expiration of Building Permit,whichever date shall be later, > All new construction will be subject to ins on by OKH.OKH-approved plans MUST be available on-site for framing&final inspections. For Committee use only: Approved Approved with Modifications _ Denied Rcvd Date: II 17 43 Reason for Denial;_ rw Amount Cash/CK#: Z1 Li Cti { Signed: '/why .._ fa 2 Rcvd by: -41.149Ir AO I g ,. Date Signed: 1 APPLICATION#: .2 3-'AO I) 1. � ~ MNNN Oi O g t. CQ cc 2 e c } c~i n Q ZL 0 LT; y A < a a a S O J 8 �. a c g y��Qj Q c� iI il •ia_ Joa 01 N W N Z Oj V! 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