RC-0546-2022 �\ Office Use Only
ADDITION/ALTERATION PERMIT Permit#: 1VC. ZZ
Torn of uccn`sbii APPLICATION ,p
2 n' er
Permit Fee:$ " l5
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.ciueensbury.net Invoice#: C ,
Flood Zone? Y �N Reviewed B�
Project Location: ,MC V�A I I !z) nk 1%
Tax Map ID#: � ) 1 Subdivision4
0 6
PROJECT INFORMATION: SEP 2022
TOWN OF QUEENSBURY
BUILDING&CODES
TYPE: , Residential ❑ Commercial, Proposed Use:
�LSingle-Family ❑ Two-Family ❑ Multi-Family(#of units_) ❑ Townhouse
❑ Business Office ❑ Retail ❑ Industrial/Warehouse ❑ Garage (#of cars )
❑ Other(describe )
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor:
2nd floor: 2nd floor:
3rd floor: 0 3rd floor:
,Basement(habitable space): tJ Basement(habitable space):
Total sq ft: 3, (D Total sq ft:
Scope of work to be done: Fin -' .5 14) X QD p��,9i) rl nA
Addition/Alteration Application Revised June 2022
A
`ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ (�, �Y In
2. Source of Heat(circle one): 5 Gas ❑ Oil ❑ Propane ❑ Solar ❑ Other:
Fireplaces/inserts need a separate Fuel Burning Appliances &Chimney Application
3. Are there any structures not shown on the plot plan? ❑ YES IA NO Explain:
4. Are there any easements on the property? ❑ YES 11. NO
SITE INFORMATION:
• Is this a corner lot? ❑ YES .NO
• Will the grade be changed as a result of the construction? ❑ YES 0,NO
• What is the water source? PUBLIC ❑ PRIVATE WELL
• What type of wastewater system is on the parcel? ❑ SEWER $,PRIVATE SEPTIC
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans prior to/during construction will require
the submittal of amended plans,additional reviews and re-approval.
2. If,for any reason,the building permit application is withdrawn,30%of the fee is retained by theTown of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. Ifthework is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. 1 certify that the application, plans and supporting materials are a true and a complete statement and/or description
of the work proposed,that all work will be performed in accordance with the NYS Building Codes,local building laws
and ordinances, and in conformance with local zoning regulations.
5. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. 1 also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: CEO,d
SIGNATURE: DATE:
Addition/Alteration Application Revised June 2022
'CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): k- t�t'n (' S!AeLN
Mailing Address, C/S/Z:
Cell Phone: ( 22q) q2g1- Ayaa Land Line:
Email:
• Primary Owner(s):
Name(s):
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line: �)
Email:
❑ Check if all work will be performed by property owner only
• Contractor(s): (List all additional contractors on the back of this form)
Contact Name(s): &-Ire.0 u sol 1 I f
Contractor Trade: ('inAJwh)-V-)y
Mailing Address, C/S/Z: L1 i QYo Pki Guf eyiA-J i% kl%
Cell Phone: io"W) ) LlInJ 1?12 Land Line:
Email: da" C.9 r-3 1�—'
"Workers' Comp documentation must be submitted with this application"
• Architect(s)/Eneineer(s):
Business Name: (r1n
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone:_( ) Land Line:
Email:
Contact Person for Compliance in regards to this project: l, s i d dr ilAt)&
Cell Phone:_( 61f0 ) !tb 1713 Land Line:
Email: d0riff ;P bQ 2r ('177 wx
—AAAa&- d
Addition/Alteration Application Revised June 2022
Office Use Only
Permit M
Permit Fee:$
742 Bay Road,Queensbury, NY 12804
P:518-761-8256 Invoice#:
FUEL BURNING APPLIANCE &
CHIMNEY APPLICATION
**ONE APPLICATION PER APPLIANCE**
Project Location: J AAi sd z,! Qy. Tax Map ID #: A-11 --r3h
Room of Instali:— rrA,,i - 1 _Planned Install Date:n=;�^
FUEL BURNING APPLIANCE INFORMATION:
TYPE OF DEVICE:
Stove ,Fireplace Insert Fireplace
Fuel Fired Equipment(Garage Only, 18" clearance per IMC 304.3)
Fireplace,factory built"
(**Manufacturer's name: 8a�k Model
SOURCE OF HEAT:
Wood Coal Pellet Gas
CHIMNEY INFORMATION:
Masonry (require plans to be submitted):
block brick stone 00,6A c-)V,A wow �
Flue:
tile steel size, in inches
Material*:
double-wall triple-wall _insulated
(*Manufacturer's name: Model#: )
Principle Structure Packet Revised March 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
❑ Check if all work will be performed by property owner only
• Installer/Builder: Workers' Comp documentation must be submitted with this application
Contact Name(s): I,nx�. f,,V0Inr,( _- b n)e. .
Contractor Trade: ,'; rl ce= T4 k I 1
Mailing Address, C/S/Z: 11_j-qI-)rg1a1rry7,r_ i;�"--)ia1-�'
Cell Phone:_( ) land Line: f3o-9;17�
Email:
Contact Person for any questions regarding this project: )1'r(1Zy Ntz4 r in v
Cell Phone:_L Land Line: 1 ► �)
Email: /`lrlr)C_ CB GnC _E- c row\
ADDITIONAL INFORMATION:
1. Two (2) inspections are required.A rough-in inspection, prior to installation and a final inspection, after
installation.
2. Manufacturer's installation manual must be available at the time of inspection.
3. Masonry fireplaces&chimneys require plans to be submitted.
4. Twenty-four(24)hour notification is required for inspections.
5. Workers'Comp insurance information is required with this application.
Declaration: Construction/installation must conform to NYS Fire Prevention &Building Code and/or
manufacturer requirements.The applicant or owner agrees to comply with all applicable laws,ordinances,
regulations and all conditions that are part of these requirements and also will allow the inspector to enter the
premises to perform the required inspections.
I have read and agree to the above:
PRINT NAME: P
SIGNATURE: DATE: P, '-
Principle Structure Packet Revised March 2022
Residential Plan Review: 1- and 2- Family Dwellings
Y/N/NA (1 of 2)
Two (2) full sets of plans
Over 1,500 sq. ft. requires engineering stamp
Design loads on plans: 115 Wind Floor Loads 40 psf
(North of Rte. 149 60) 50 Ground Snow Load Sleeping Areas &Attics 30 psf
Calculations Decks 40 psf
Wind design for lake front properties
f 4 Window schedule with glass size & main doors/Air leakage< .5 cfm for doors, < .3 cfm for
windows/Tempered glass in bathrooms
Door schedule/Main entrance 36" door
Emergency Escape or Bedrooms & Habitable Space
Above-grade: 5.7 sq. ft.
Grade: 5.0 sq. ft.
24" (h) x 20" (w) minimum
44" maximum height above door
Window control devices 24" or less 2"d story or 72" above grade
Egress window from basement 5.0 sq.ft.
Floor system sizing per table 502.3.1
Residential check ERI or Prescriptive method
Driveway length: 300' or more-12' width required/500' or more,turnaround required
Foundation drainage on plans, if required
6" drop in 10' exterior grade
4le;e Framing cross section for each roof line, vertical fire stopping every 10' where
required/joist spans pg. 127
Ice &snow shield—24"from exterior wall
Platforms at exterior doors
Stairway headroom 6'8"; all stairs 36" width
Stair run and rise
,4 Winder run and rise
Spiral stairs meet requirements J ��
Smoke detectors—battery backup & proper location, interconnected tart
Bathroom fixtures—proper clearance
Hall width-36" width
Handrails more than four risers on open sides
/�- Railing &guards >30"/basement stairs included/closed risers more than 4" in height
MA Safety glazing notes for required areas
Garage fire separation: %" gable end/5/8" under living space &%Z" on walls/20 min. door
and closer
{�f Garage floor sloped
Attic access: gasket seal & R-value equal to roof insulation kC�
Roof over 30"—22"x 30"/Crawl spaces 18" x 24" access
Continued on back 4 4
Residential Plan Review Revised October 2021
Residential Plan Review: 1- and 2- Family Dwellings
Y/N/NA (2 of 2)
Carbon Monoxide detector outside lowest sleeping area, on every level & interconnected
within 15' of sleeping area p
Soil test results, if required
AAA Septic to well or water line separation
AAll paperwork signed
Note on plans energy saving light bulbs 90%
O} Blower door test agency paperwork
Floodplain Permit required -check map: 2 feet above flood elevation
Hurricane clips required
Floors less than 2 x 10 covered by%" gypsum or 5/8" wood panel
--Manuals S &J required for heating system. Cold air return hard piped
Separate room for draft HVAC or hot water heater with fresh air
HRV shown and calculations
Baffles at eaves for insulations and knee walls !!�I
Makeup air for range hood >400 cfm
Continuous header for garage doors to end wall
Chimney rain cap shown for fireplaces -69-
Deck hold down shown not less than 4 lags and bolts per table 507.2
Residential Plan Review Revised October 2021
Generated by REScheck-Web Software n o 0
Compliance Certificate FILE CO -71
PY 9 ; I"
/1' �J
4 �
Project Monsour Addiiton a a
GC E0V
rr
Energy Code: 2018 IECC
Location: Warren County, New York SEP 0 6 2022
Construction Type: Single-family
Project Type: Addition A
Climate zone: 6 (8499 HOD) TOWN OF QUEENBBURY o
Permit Date: I BUILDING&CODES__J N
Permit Number: 0C1
Construction Site: Owner/Agent: Designer/Contractor: O C
3 Amethyst Drive Mchael Marley N N
Queensbury, NY 12804 REVIEWED FOR 1Concepts&6 Helen Dr
Designs �' N
ENERGY CODE COMPLIANCE 5187448245 NY 12804
maneymi@gmail.com
Compliance: Passes using LIA trade-off
Compliance: 1.5%Better Than Code Maximum UA: 67 Your UA: 66
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.
Slab-on-grade tradeoffs are no longer considered in the LIA or performance compliance path in REScheck. Each slab-on-grade
assembly in the specified climate zone must meet the minimum energy code insulation R-value and depth requirements.
Envelope Assemblies
Prop.Gross Area Cavity Cont.
Assembly or R-Value R-Value
U-Factor U-Factor UA UA
Perimeter
Ceiling: Raised or Energy Truss 256 49.0 0.0 0.020 0.026 5 7
Wall: Wood Frame, 16" o.c. 470 21.0 0.0 0.057 0.045 22 .17
Door: Glass Door(over 50%glazing) 33 0.260 0.300 9 10
Window:Vinyl Frame - 51 0.270 0.300 14 15
Basement Wall: Solid Concrete or Masonry
Wall height: 7.9' 350 0.0 16.0 0.045 0.050 16 18
Depth below grade:7.2'
Insulation depth: 7.5'
Compliance Statement: The proposed building design described IsGfns t building plans, specifications,and other
calculate ns submitt d with the permit application.The propos fd ned to meet the 2018 IECC requirements in
RE 7eVerron : ESchec -Web and to comply with them rl f n the REScheck Inspection heck'st.
- ��1aPa
Name-Title rSi tur
,s 083 6 86
�FESSIONi'�
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 1 of 9
fZREScheck Software Version : REScheck-Web
Inspection Checklist
Energy Code: 2018 IECC
Requirements: 0.0% were addressed directly in the REScheck software
Text in the asComments/Assumptions'column-is;—' ided by,.th`e user in the REScheck Requirements screen. For each
requirement, the user certifies that a code'requirement:will-be'm'et and how that is documented, or that an exception
is being claimed. Where compliance iis,itemized in a separate table, a reference to that table is provided.
ii
Section 'Plans�-Verified Field Verified
# Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions
&Req.ID
103.1, ;Construction drawings and ❑Complies
103.2 (documentation demonstrate r ❑Does Not
[PRl]1 ;energy code compliance for the
Q ;building envelope.Thermal ❑Not Observable
envelope represented on ❑Not Applicable
construction documents.
103.1, Construction drawings and ❑Complies
103.2, documentation demonstrate �_. F'.{ <`,�{...3(]poes�Not
403.7 :energy code compliance for 4,... ) i t
�� = .=r�•< ,;-....- ❑Nbt-Observable
[PR3]1 ;lighting and mechanical systems. _ �
q� Systems serving multiple ❑Noh'Applicable'` 5
:dwelling units must demonstrate
:compliance with the IECC a
Commercial Provisions.
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]2 ;on loads calculated per ACCA ; Cooling: Cooling:
e !Manual] or other methods
Observable
I ; Btu/hr : Btu/hr :❑Not Applicable
approved by the code official.
Additional Comments/Assumptions:
1 JHigh Impact(Tier 1) '-2=_.Medium Impact(Tier 2) 1 3 Low impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 2 of 9
r'
section Plans Verified Field Verified
#: Foundation Inspection Complies? Comments/Assumptions
&Req.ID Value Value
402.1.1 ;Conditioned basement wall R- R- ;❑Complies ;See the Envelope Assemblies,
[FO4]1 :insulation R-value.Where interior R R_ ❑Does Not ;table for values.
insulation is used,verification ;❑Not Observable
may need to occur during
Insulation Inspection. Not ❑Not Applicable
required in warm-humid locations
in Climate Zone 3.
3012 !,Conditioned basement wall ❑Complies
[FO5]1 :insulation installed per ❑Does Not
manufacturer's instructions. ❑Not Observable
IDNot Applicable
402.2.9• ;Conditioned basement wall ft ft ;❑Complies ;See the Envelope Assemblies
[FO6]1 insulation depth of burial or ;❑Does Not ;table for values.
distance from i top of wall.J ;❑Not Observable
❑Not Applicable
303.2.1 ;A protective covering is installed ❑Complies
[FO11]2 - Ito protect exposed exterior ❑Does Not
!insulation and extends a
i;minimum ❑Not Observable of 6 in. below grade. ❑Not Applicable
i
403.9 Snow-and ice-melting system ❑Complies
[FO12]2 !controls installed. ❑Does Not
43 ; ❑Not Observable
j -❑Not Applicable
Additional Comments/Assumptions:
1 High Impact(Tier 1)- 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 3 of 9
� l
section Plans Verified Field Verified
# Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions
&Req.ID
402.1.1, ;Glazing U-factor(area-weighted U U- .❑Complies ;See the Envelope Assemblies
402.3.1, average). UDoes Not ;table for values.
402.3.3,
402.5 .❑Not Observable
[FR2]1 ;❑Not Applicable
303.1.3 U-factors of fenestration products ❑Complies
[FR4]1 :are determined in accordance ❑Does Not
with the NFRC test procedure or
J ;taken from the default table. ❑Not Observable
I FINot Applicable
402.4.1.1 ;Air barrier and thermal barrier ,❑Complies
[FR23]1 :installed per manufacturer's I❑Does Not
V ;instructions. f ❑Not Observable
(k ❑Not Applicable
402.4.3 Fenestration that is not site built ❑Complies
[FR20]1 is listed and labeled as meeting ❑Does Not
LJ ;AAMA/WDMA/CSA 101/I.S.2/A440 ❑Not Observable
or has infiltration rates per NFRC
.400 that do not exceed code J❑Not Applicable
limits.
402.4.5 ;IC-rated recessed lighting fixtures C ❑Complies
[FR16]2 ;sealed at housing/interior finish f ❑Does Not
and labeled to indicate:52.0 cfm
;leakage at 75 Pa. ❑Not Observable
i ❑Not Applicable
403.3.1 ;Supply and return ducts in attics Complies
[FR12]1 insulated >= R-8 where duct is ❑Does Not
U >= 3 inches in diameter and >_
R-6 where<3 inches.Supply and ❑Not Observable
return ducts in other portions of ❑Not Applicable
;the building insulated >= R-6 for `
diameter>=3 inches and R-4.2 t
.for<3 inches in diameter.
403.3.2 :Ducts, air handlers and filter j ❑Complies
[FR13]1 :boxes are sealed with;joints/seams compliant with !❑Does Not
J ;International Mechanical Code or i❑Not Observable
International Residential Code, as I )❑Not Applicable
applicable. I
403.3.5 i Building cavities are not used as i ❑Complies
[FR15]3 "(ducts or plenums. (i ❑Does Not
J ❑Not Observable ;
❑Not Applicable j
403.3.7 ;Ducts declared to be within the ❑Complies
[FR28]3 ;conditioned space are either 1) ❑Does Not
;completely within the continuous
air barrier and within the building ❑Not Observable
,thermal envelope, 2) buried ❑Not Applicable
within ceiling insulation in
accordance with Section
i R403.3.6 and the air handler is
7located completely within the
continuous air barrier and within
ithe building thermal envelope
I and the duct leakage is<= 1.5
cfm/100 square feet of
conditioned floor area served by
;the duct system, or 3)the ceiling
!insulation R-value installed }
against and above the insulated
I duct>=to the proposed ceiling i }
insulation R-value,less the R- {#
;value of the insulation on the
111 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 13 Low Impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 4 of 9
Section
# Framing/Rough-In Inspection Plans Verified Field Verified Complies? Comments/Assumptions
& Req.ID Value Value
403.4 ;HVAC piping conveying.fluids R- R- ;❑Complies ;
[FR17]2 ;above 105 OF or chilled fluids ❑Does Not
below 55 OF are insulated to >_R-
3 ;❑Not Observable
❑Not Applicable
403.4.1 ;Protection of insulation on HVAC ❑Complies
[FR24]1 ;piping. ❑Does Not
QD
❑Not Observable
❑Not Applicable
403.5.3 Hot water pipes are insulated to R- R- ❑Complies
[FR18]z I>_R-3. ❑Does Not
;❑Not Observable
❑Nat Applicable
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:
11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 5 of 9
i
Section Plans Verified Field Verified
*- Insulation Inspection Value Value Complies? Comments/Assumptions
&Req.I D
303.1 ;All installed insulation is labeled ❑Complies
[IN13]2 !or the installed R-values ❑Does Not
JD ;provided. ❑Not Observable
i
❑Not Applicable
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.E ;wall insulation on the wall ;❑ Mass ❑ Mass ;❑Not Observable
[IN3]1 ;exterior,the exterior insulation
requirement applies (FR10). ❑ Steel ;❑ Steel ❑Not Applicable
I
303.2 ;Wall insulation is installed per _ J❑Complies
[IN4]1 manufacturer's instructions. ❑Does Not
❑Not Observable j
IE]Not Applicable
Additional Comments/Assumptions:
11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 6 of 9
Section Plans Verified Field Verified
# Final Inspection Provisions Value Value Complies? Comments/Assumptions
&Req.ID
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
402.2 ;❑Not Observable
E.
(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
[-]Not ft2, r Not Observable
❑Not Applicable
402.2.3 Vented attics with air permeable ❑Complies
[FI22]2 'insulation include baffle adjacent ❑Does Not
Ito soffit and eave vents that
extends over insulation. 9❑Not Observable
i 3❑Not Applicable j
402.2.4 ;Attic access hatch and door R- ; R- ;❑Complies
[FI3]1 "insulation >_R-value of the UDoes Not
adjacent assembly.
'❑Not Observable
❑Not Applicable
402.4.1.2 ;Blower door test @ 50 Pa. <=5 ACH 50 = ACH 50 = :❑Complies
[FI17]1 :ach in Climate Zones 1-2, and ;❑Does Not
<=3 ach in Climate Zones 3-8.
;[-]Not Observable
j❑Not Applicable
403.3.3 ;Ducts are pressure tested to ; cfm/100 cfm/100 I❑Complies
[FI27]1 :determine air leakage with ft2 ft2 :❑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 ,
:handier enclosure.
403.3.4 ;Duct tightness test result of<=4 cfm/100 cfm/100 ;❑Complies
[F14]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 ❑Complies
[FI9]2 I installed for control of primary r ❑Does Not
heating and cooling systems and ❑Not Observable
initially set by manufacturer to ❑Not Applicable
I code specifications.
403.1.2 Heat pump thermostat installed ❑Complies
[FI10]2 on heat pumps. ❑Does Not
:
❑Not Observable ;
❑Not Applicable j
403.5.1 ;Circulating service hot water ❑Complies
[FI11]2 systems have automatic or : ❑Does Not
accessible manual controls.
IDNot Observable
J❑Not Applicable
11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 13 1 Low Impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 7 of 9
section Plans Verified Field Verified
# Final,Inspection Provisions Value Value Complies? Comments/Assumptions,
&Req.lD
403.6.1 lAII mechanical ventilation system ❑Complies
(F125]2 Mans not part of tested and listed ❑Does Not
HVAC equipment meet efficacy
;and airflow limits per Table : ❑Not Observable
R403.6.1. ❑Not Applicable
403.2 ;Hot water boilers supplying heat ❑Complies
[FI26]z 'through one-or two-pipe heating ❑Does Not
.systems have outdoor setback
j control to lower boiler water ❑Not Observable
temperature based on outdoor ❑Not Applicable j
!temperature.
403.5.1.1 !Heated water circulation systems ❑Complies
[FI28]?' :have a circulation pump.The ❑Does Not
;system return pipe is a dedicated
i return pipe or a cold water supply ❑Not Observable
:pipe. Gravity and thermos-
;syphon circulation systems are
not present. Controls for
I 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
i no demand for hot water exists. !
403.5.1.2 !Electric heat trace systems ❑Complies
[FI29]2 ,comply with IEEE 515.1 or UL ❑Does Not
-1515. Controls automatically
adjust the energy input to the [:]Not Observable
i heat tracing to maintain the i _ ❑Not Applicable
j desired water temperature in the s
piping.
403.5.2 ;Demand recirculation water ❑Complies
[F130]2 systems have controls that ❑Does Not
I manage operation of the pump ,
land limit the temperature of the E []Not Observable
;water entering the cold water ❑Not Applicable
'piping to<= 1049F.
403.5.4 !Drain water heat recovery units ❑Complies
[FI31]2 !tested in accordance with CSA ❑Does 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
i individual units connected to
;three or more showers. j
404.1 !90%or more of permanent ❑Complies
[F1611 !fixtures have high efficacy lamps. ❑Does Not
' []Not Observable
❑Not Applicable
404.1.1 J Fuel gas lighting systems have IE]Complies !
[F12313,' no continuous pilot light. ❑Does Not
k 1 I
❑Not Observable
❑Not Applicable
401.3: Compliance certificate posted. ❑Complies
[FI7]2' g❑Does Not
❑Not Observable
❑Not Applicable
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 13"1 Low Impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 8 of 9
8/ 2018 IECC Energy
1 Efficiency Certificate
Insulation Rating R-Value
Above-Grade Wall 21.00
Below-Grade Wall 16.00
Floor 0.00
Ceiling / Roof 49.00
Ductwork (unconditioned spaces):
Glass & D. . ,
Window 0.27
Door 0.26
& Cooling Equipment Efficiency
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments
section Plans Verified Field Verified
# Final Inspection Provisions Value Value Complies? Comments/Assumptions_
& Req.ID
303.3 Manufacturer manuals for f ❑Complies
[FI18]3 )mechanical and water heating } ❑Does Not
(systems have been provided.
$ ❑Not Observable
I k ;❑Not Applicable
Additional Comments/Assumptions:
11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3)
Project Title: Monsour Addiiton Report date: 08/29/22
Data filename: Page 9 of 9