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1987-170 i +CERTIFICATE �] +D+ + UI'AN+ TOWN OF QUEENSSURY WARREN COUNTY. NEW YORK AlAq a$ 001 AugiYst 283 8 Date 19 'This is to certify that work requested to be done as shown by F�e�rrnic No. F37-170 has been cc+mPleted. V t "'-. ONE FP141LY DWELLING 'This structure May be occupiedas L � 2 x xsii xAc T . bOx BEDFQhP Ixxation � � �"l �'' '�" �cT I WINIG � ROBERT AND JANET Owner J By Order Town Board ,roV4rN OF QUEENSSSURY Building +!�' Zoning lnspectcfr BUILDING PERMIT TOWN OF QUEENSSURY No. 87- 20 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Robert: and Janet Winig Lot 122 Brookshire Trace ( St . #9 ) Street, Road or Ave. OWNER of property located at rb rt One—Family Dwelling rt in the Town of Queensbury, To Construct or place a co at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. u w (D t . OWNER'S Address is 43 East Blvd . {'* Gloversville , NY 12078 r+- r- 00 2. CONTRACTOR or BUILIDER'S Name Anthony Marciano 3. CONTRACTOR or BUILDER 'S Address Brookshire Trace r Queensbury , NY 12801 a rt I—• N N d, ARCHITECT'S Name oti rf 0 a 5>r' ua 5. ARCHITECT'S Address w fD r[+ H rf Ps 6_ TYPE of Construction — (Please indicate by X) r' 3' to I ?-Wood Frame I 1 Masonry { ) Steel { 1 Enrt ANS an 7. PLANS Specifications z 4 No 108 ' x48 ' per plot plan , specifications and application submitted including sewage system and two—car attached garage . s. Proposed Use One-Family Dwelling I $5400 CIO 87 269 , 00 Nov . 1 PERMIT FEE PAID — THIS PERMIT EXPIRES 1s (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Qusensbury before the expiration date_! ro 8 7 I—' Dated at the Town of Queensbury this loth Day of April 19 F. SIGNED BY / / ► Zfar the Town of Queensbury Building and Zoning Inspector ���TOWN OF QUEE3NSBURY TO BE COMPLETED BY BLDG, DEPT . N M N j Application No . 'u{'` �` APR 15 1987 OWIt t7l� B[ If S !!ll' Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 4 8UIj DiMr'a & CODE DEFT. Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury. New York 12801 'Variance No . Site Plan Review No . T G+ c�? - *2. -Z. Approved b APPLICATION FOR 71 EUILDING AND ZONING PERM IT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING , The undersigned 'hereby applies for a Building Permit to do the following work which will be done in accordance with the description , plans and specifications submitted, and such special conditions as may be indicated on the Permit . __ --------------- _- ............ t ; The owner of this property is : � Address rs' V_ / rat t -P . O , Tel . Ma Property Location : fob Gi c ^' C Tax Map Street number or building lot number Subdivision name (if applicable) s to THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : �r tiLA�w Ci. i69 yk p S1atInc i624wa�frl�l�rYi�� r 0+ 7 p 3 ""7 /FAO' 0. Na- mmer;P P . O. Address Tel . No . Name of builder 4.4t. i+6:ek &P Address relookay Tei : _ 1 � Name of plumber Name of mason Address Tel .M NATURE OF PROPOSED WORK : ZONING INFORMATIONI construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED , _Addition to a building * drawn reasonably to scale and attached heretor Alteration to a building showing clearly and distinctly all buildings , � (no change to exterior dimensions ) whether existing or proposed and indicate all Other work (describe) set-back dimensions from property lines . Give * street and number or lot number and indicate whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND , * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED . * of septic disposal area . * * COMPLETE INFORMATION REQUIRED BELOW . Size of property 'z j7 f t X 240 ' ' _ f t . Existing building ( s) Size ft X ft . PROPOSED BUILDING AND USE : Existing building ( s ) Use size of new structure Z ft X� ft Foundation-pier/slab/crawl/partial * Proposed building , distance from property line (circle one ) * ft No . of stories (habitable space} * Front yard GrO ft Rear yard ft Side yards i ft and " Height (grade to ridge ) _ +�3 - t ' ,� If on corner , setback from side streetrf�ft If residential , no . of families ; No . of rooms ( excluding baths ) j Z OCCUPANCY INFORMATION Nom of bedrooms & * PRIMARY $UILDING - No , of bathrooms_ �' * ^ One family dwelling Primary heating system_ �►�� * Two family dwelling Type of fuel_ If�G * Multiple dwelling / Number of units No . of fireplaces to be installed Will a wood stove be installed? / 14 * Permanent occupancy Transient occupancy Central Air conditioning? AtI2 * Business BUILDING STYLE, PRIMARY STRUCTURE Industrial Ranch Contemporary Log cabin * Other * If addition , what will use be? Raised ranch Mansion Duplex Split level Old style Bungalow Cape Cod Cottage Other * ACCESSORY BUILDING- olonial Row Town Souse Detached garage/one car,/ two car/ car ( CIRCLE ONE PLEASE Attached garage/one car/ wo ca car * x x * * * * * * * * * * * * * _Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION $ L140 700 * d � INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDI Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : / Type of construction , wood frame , fire safe , etc . 6aksol- C Will any second-hand or ungraded lumber be used? If so , for what ? ,,,, Foundation wall material �'p�* fire r Thickness /(} 40 Depth of foundation below grade (to bottom of footing ) es Will there be a cellar? ,b H�� or unheated?dyjgFloor sq. footage ��/ sq ft Will there be a basement? Will any portion be used as living space ( If so, what portion? sq . ft . - - Type of use? Type of roof - o e let/shed/other Material of roof &JJ Size , wood stus3s_ �"� •XT spacing "o . c , length � ft . joists ( floor beams ) 1st . floor `,Z "x spacing / '"o . c . span ft . Joists ( floor beams ) 2nd . floor ""X '" _-,Z' _ _ spacing IE^s "o . c _ span , fit . Overlays ( ceiling beams ) ? "X , spacing /j,.2 Flowc _ span e t . Roof rafters -_ "X_J(0 spacing o . c . ssp-aah l�' ft . Roof trusses (pre-engineered) spacxng - "'o . c . span .J7; ft . Exterior wall finish � Of what material ? Interior all finish . If a gar a !a is to be a tathea , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? = If so will a Fire-rated door , enclosure , and self-closing device be , prov .ded? da Will a flue-lined chimney be installed? kk 5 Height above roof o"oZo £t � ,r �� Depth of chimney foundation below grade_.�ft . Depth of fireplace hearth Z_ ft . Q.in . / Water supply - ,Municipal or private well Aft2nro � `t?�,/ SEPTIC SYSTEM _ Distance from ANY private well ( incl ding adjoining properties _ft '_.. (A separate application is necessary for Yyany - 7r►epy+air or new installation of septic system) Town of Queencabury A I D .A V 1 T STATE OF NEW YORK County of Warren I swear that to the bestt of my knowledge and belief the statements contained in this application , together with the plans and specifications submitted , are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE , THE ZONING ORDINANCE , and all other laws pertaining to the proposed work shall be complied with , whether specified or not , and that such work is authorized by the owner . SWORN TO BEFORE ME THIS Signatur fawner , owner ' s agen ctyitect , contractor day of Notary Public , Warren County, N . Y . SPECIAL CONDITIONS OF THE PERMIT : e By " TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work , ANSWER ALL of the followingz 1 . Gross floor area '-/ •7� ' G1,.t' C� or++ � (x.rtc.e IrO �Iw+S 2 , Type of heat G^-LE:G . l>A►S��Gd f 3 . Is the building mechanically cooled ? No 4 , Percentage of area of windows and doors A . Over 16 % Only 1. Uo value of gross area of walls , roof/ ceiling and Floors exposed to ambient conditions 2 . Floor over heated spaces YES NO a . Are foundation walls insulated ? YES NO le If YES , what is the R value ? 3 . Slab on grade YES NO a . If YES , what is the R value of insulation around perimeter of floor ? 4 . Is basement heated ? YES NO a . R value of insulation so Type of insulation B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions. 2 . R value of exterior walls ;1W .a'� 3 . R value of glazed area 4 . R value of doors / T • I 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab /1J� 7 . R value of slab insulation - heated slab AIIA__ __�____. S . R value of heated basement / cellar walls ( above grade ) 1111994 9 . R value of heated basement/cellar walls ( below grade ) 100 Type of insulation jig Is C . Controls 1 . Thermostat maximum heat setting 10 D . Duct Systems ,.�,,� 1 . Is duct system installed in unheated spaces ? fYES3 NO a . If YES , R value of duct installation b . R value of duct in other areas E . Piping Insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation JVpllf+� F . Service Water Heating 1 . Performance efficiency_ + 3 2 . Temperature control setting maximum_ . / + " G . For Swimming Pool Only 1 _ Maximum heating Telephong No . ( applicant ' s s,' e ) APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE '"' I? ! LOCATION OF PROPERTY -FOR INSTALLATION 16+1 1.ZoQ s+r' a4d,�,, J&', g.d7r'�v{�(4k�,f� Owner's Name : W#^* a Telephoner 70"4 " , '/' 4 > Address: C6x*s2 d?ZA( e.�s� r" ✓� IG / ' Installer's Name:,✓.► �fnRJrl f Telephone: 7*, I,' aR 3 7 Number of bedrooms (residential only) L _ Total daily flow (compute (,W ISO gal per bedroom) Topography. circle one: Fla Rolling Steep Slope % of slope _ Soil Nature: circle one: CS` � Loam Clay Other / Depth: feet Ground Water: At what depth? /C;? feet Bedrock or Impervious Material: At what depth? feet Percolation test: circle one: of required equired / rate min. inch. Domestic water supply: circle one Municipa Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ feet PROPOSED SYSTEM: Septic Tank f 0047 gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench S�C.5 •• feet / Total system length 2*0GO feet SEEPAGE PITS) : Number of / Size each feet by feet Size of stone to be used # Depth or Thickness Z ! feet IMPORTANT ...Please...LIST NEW EQUIPMENT TO RE INSTAI-T_ED (over) Section II Septic System Inspections: A. All applications for septic system installation, alteration or repair, as required by the Town of Queensbury Sanitary Sewage Ordinance, shall be submitted to the Building Department at least Z4 hours before start of construction and shall include a plot plan showing: 1 .) the proposed location of the system Z.) location and distance to lot lines 3 .) location and distance to structures 4.) location and distance to any water supply 5.) size and dimensions of all tanks, distribution boxes, the fields and/or drywells B. No system shall be covered before inspection and approval by the building Inspector. Failure to comply with this requirement may result in the uncovering of the system by the installer and a fine of up to $250.00. C. An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system, a new proposal must be submitted to the -Queensbury Building Department before further construction. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage ENsposal Ordinance,� Signature of re ons' a person: r Date : Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 1Z80I (518) 792-583Z SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOOD. PLACE TO LIVE THE NEW YORK BOARD- OF FIRE UNDERWRITERS �7 BUREAU E3 READ OF ELECTRICITY � IfR[1 41 STATE TREET. ALANY, NEWEWYC7RFf 12207 — j f Application No. on file rT �+ ''')Date oCtober n , 1987 f}i 2 4�_,. 7 A 6 J ' 2 8 4 THIS CERTIFIES THAT only the electrical equipnRenc " described bnfasa and intrtwhAeOd by due applivant namsod doss the above appuent4an nTEtnber in the premises of Robert Winig* lxi� t 122 , Brook Shire Trace. , Oucoa3bury . .'Y its thefellowina location; E Basemen[ LIXJat Fl. LixSnd Fl. out JIde Section Block Lot Teas exarrLined on n /237 and foeEnd to be in compliance with the requirements of this Board. y AxruRE pXTURRS RANCM COOK CE M�i DECKS OVENS DISH WASFIERS EkHALRiT SANS = OUTLETS AGUES SWITCt1ES INCANIMSNT F_SENT v AMT, K. W. AMT. — ?; 94 63 £r DRYERS FkMNACE MOTORS RaUM AMIJAMM tTEEWIt SRECIAL RETC't>T 'TIME CLOCKS L UNIT HEATERS SYSTEMS AMT. K. W- OIL H. P. GAS N. P. AMT, ND. A, w. a. AMT. AMP. AMT. AM►S- TRAMS. AMT, M. �. IIIO. Cif IEET ,AMT. WATTS 1 rang; 31#6 SERVICE DISCONNECT No, CW s A E R Y Ir C E NO. OF cc. cONo. A. w. C,, A. W.G. NO. OF NEUTRALS A. w.6. MTT. AMP. TF►E 1 .R' �RW F A' 3w s m ]W 9 X 4W PER I' 4F CC. CONf7. NQ. OF F11-IEG OF N4tiEG OF NEUTRAL O AIrARATM _ e1 r,ctxir heater 4 ? . t3 kw fi A . S ('S Ly� .s- 2 1 . : icw 6 . 75 kw .---�r Crawford E ectrIc Service — 12 Charlton Rd . � BRANCH MANAGER - aallston spa . T:'Y 12020 - Prr This certificate must not be ohered in any manner•- refvrn to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 131JlLD1NG and ZONING DEPARTMENT gay and Havifand Road, R.D, 1 Box 98 C4 s Queensbury, New York 12801 DILDING INSPECTOR ' S REPORT NAME LOCATION ,,77 permit NOA OZ / 7L APPROVED - YES NO Footing/pier Forms Foundation Waterproofing gackfill Framing Roofing Siding Masonry 'Veneer Rough plumbing Relief Valves Ext . porches Fin ,,bed Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete F hors Plbg - Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSUI.ATION Foundation Floors Wa13. s Ceiling FILIAL ELECTRICAL INSPEC'SIC713� DRIVEWAY APPROV survey � Inal Building Next scheduled ir+sp ection (call when ready} Remarks_ Building C3111,11,114, 6f 86 mcI-vl ,pwn v Q"eenshury BUILDING and ZONING DEPARTMENT Bay ©ueensbury. New YO k d Haviland Road, R.D. 98 12801 i3UILDING INgpECTgR ' 5W EPORT Al- NAME LOCATION Date perM-it No APPROVED - YES tO Footing/Pier Forms Foundation Waterproofing Sack£ill )(Framing Roofing Siding Masonry veneer is sr j-1 / v gpugh Plumbing 1R Relief Valves Ext . Porches Finished Flours Interior Trim Stairs & Railingsl----� Cellar Drain Tile�� Concrete Floors plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney 11111111 In INSULATION : Foundation Floors Walls Ceiling �.. FINAL ELECTRICAL INSPECTION DRIVEWAY APPROV Final Building survey ction (call when ready* Next scheduled inspe Remarks- Buildin Inspecto 6/86 and-vl gown Of Queenjt ury 13UILDING and ZONING DEPARTMENT Say and Haviland Roadt O128 0BOX 98 Oueensbury. New York SEPTIC DISP O S AL SYSTEM INSPECTION LOCATION DATE PF.PM IT NO . �- 1 O SOIL TYPE - Sand - Loam - clay Percolation Test Required? YES - NO Percolation rate - Min/Inch _ TypF of SYSTEM: Absorption field , total length Length of each trench Dept, of trenches Size of gravel SERFAGE PITS4Number fit, size_ ft. X Gravel size X PIPING SL C L) Bldg . to tan3c 7 ,� Tank to disc . box CG L1J Dist. box to fief NO Partial openings sealed? YES LOCATION/SEPARATIONS : !I t. Foundation to tank Foundation to absorption t ' Absorption to lot line f Separation_- of pits YROPE};t�i`S� ( x • one) TpG'TTC QF, S M OtS side R r t de �_ Front. [` Rear - )Left ig CCMMEN � a , SYSTEM 1L3SE APPROVEk YES NO Bui1 n� Inspector 01/86 and u1 low" 01 +Q"Cenjluiry BUILDING and ZONING DEPARTMENT t� Say and Haviland Road, R. D. I BOX 98 fF{ Queensbury, New York 12801 BUILDING INSPECTrO,Rr ' S REPORT NAME c � V� 1 ► i LOCATION �-�. �I d S4I r � -- Date��/ 7 Permit NO . APPROVED* -* YES* ENO Footing/Pier Forces!_,., Foundation `( watorproofirig aack£ill Framing Roofing Siding Masonry Veneer Rough plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney I N S U T.AT I ON Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION i)RIVFWAY APPROVAL Final Building, Survey 'Pleat scheduled inspection (call when ready Remarks- Building Inspector Y `�/86 and-vl flown o/ Q"eenshury BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R-D- 1 Box 98 Queensburye New York 12801 BUILDING INSPECTOR ' S REPORT NAME K7o 7 U ! rx -+//��j LOCATION + � �p / �. &0j X5-A'i ;o� e P t-ues Date— !° Perms No . L — / '7 0 APPROVED YES NO Footing/pier Forms ][ Foundation 4yLWaterproofing ►� L �? gackfill Framing Roofing Siding Masonry Veneer Rough plumbing Relief Valves Ext . Porches Finished Floors Interior 'Trim Stairs & Failings Cellar Drain Tile _..._� Concrete Floors plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECT CAL INSPECTION DRIVEWAY APPROVAL Final Building Survey _ Next scheduled inspection (call when ready ) Remarks- Cie c /I MCAOA/ �{� 1Y ST fi At`r C a .Ar W Building inspector 6/86 and-vl ,Jo"I" o/ �ueert3heere� BUILDING and ,ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTORS REPORT NAME LOCATION �- C3 � f �-2 /cfl /d I}�S �2I►- � �� . Date g6 / � Permit No o cs APPROVED - YE NO Footing/Pier Forms Foundation Waterproofing 8ackfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION) DRIVEWAY APPROVAL --- Final Building Survey Next scheduled inspection ( call when ready ) Remarks- uo Tt4 4 Building Inspector 6/86 and-vl BUILDING DEPT. COPY OF APPLICATIOW FOR11R a1g.gL, NEW YORK BOARD OF FIRE UNOERWRI FILE TH1S COPY WITH BUILDINGS DEPT. WHEN REQUIRED. TERg, TE1MR # DATE STREET AND MO. OR TOWNSHIP ROAD ANQ POLE NO. �,r COUNTY SETWEEIV WHAT CROSS STRETS PREMI E E ATE ? �UPANT,S . CTI N _J BLOCK : BUILDING OT AMID ADD NAME CUPANCY AMID ADD Fill �I�' BYPPLIEb / 5 TEL. Se t]II BUILDI N(ii IS FROM THEIR 0 ' NEW OFFICE OLD 0 is NEW LIST BELOW NEW ADDITIONAL 0 DDEFECTS ALL EQUIPMENT WHICH Y(]U IAISTALLEp Rfr ED [J NUMBER OF OUTLETS No, of Flxturw & t on LAMP Rees MOTORS HEATERS $RANCH Ceiling 81da Attach,t CIRCUITS OFFICE USE Walt Reemp'ts Swfeph Pendent BreMeet No. T " H.P. a. E ONLY Out l skis Reuw INSPECTION sas rhant tat Ff. 2nd PI. $rd FL REMARKS. LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DID NOT USE THIS SPACE. Tht POIlIcation as Youtarr anthp zed to mak ew o corer the sharp-lislas/ eyuipmerst tp I i SIZE OF the inspection and adjust the fre to carer the nadtf 4abut of at limp of irnpectfan them is found arlditi MA FN8 'a4 pmMt. as prorided by the aPplirynt. anal atluipwnent not abore ti:tpd,x FEEDERS ELECTRIC SIGN CHARACTER LAMPS TOTAL OF WORK EXPOSED GAS T UBE SJGM STARTED WATTS AR TO Be CONCEALED TRANSFORMERS OF ST SERVICECOMPLETED INt/MBERJ VA ENTERS OVERHEAD UNDERGROUNQ SIZE OF SIGN ICAPACJTY1 UIL INO MAKER INSPECTION REGUESTED OF SIGN ON SI AS E NEAR AS 00; �1� ,,��++�� / POSSIBLE gIG'�'.�+'� G— / HYOID DELAY BY GIVfNO FULL AND ACCURATE IIIIFORMATION. ALL SPACES MEw MUST BE FILLED IN OR APPLICATION MAY BE RETURNED, OLD PRINT NAME AND ADDRESS DATE OF NAME OF r APPL+CAIMt APPUCATI r'r. �r .,y 7"" SIGNATURE , STREET ADDRESS OF APPLICCAA�. vc CITY OR POST OFFICE TELEPHONEzp [. �/ � t CIOrOE �Ilae?:_[�LICENSE NO. 66 EL (REV. r/es) A SEPARATE APPLICATION MUST Be FILED FOR EACH SEPARATE BUILDING NEW Y€7RK STATE ENERGY CONSERVATION CONSTRUCTION CODE PART 6 COMPLIANCE - FORM THERMAL RATING METHOD ONE- AND TWO-FAMILY BUILDINGS BUILDING 10 `+EZ46o+nekt L&VII S GROSS FLOOR AREAADDRESS Zit 1013 8ro,"erc. ?racc asa NUMBER OF STORIES ' mj `ocod ' of G?ve .es vt'u DEGREE DAYS! lfe�'G7 CONTRACTOR , ARCHITECT OR ENGINEER _ _ dae''{�. ACP2 8000ft -e.s _ line , TELEPHONE __ _ 00 - 799,- e! C+07 leo..all /*ex4t..'r.�� PRE-QUALIFYING CONDITIONS All pre-qualifying conditions for use of Part 6 have been met . Yes No TOTAL THERMAL RATING The total Thermal Rating for this building design is The Worksheets that developed this Thermal Rating are attached . �A hermal Rating of zero or greater indicates that the building envelope complies with the Energy Code . PRESCRIPTIVE REQUIREMENTS INSULATION : 7815 . 5 Element Required Specified Vapor Barrier - where capable of Yes Pal e 14 J e absorbing moisture Continuity -- at plate lines . sill 540r lines and corners 47 AIR LEAKAGE : 7813 . 5 1 E! F INFILTRATION RATE Element Required Specified Windows . 5 cfm/ linear foot 3 Sliding Glass Doors . 5 cfm/ square foot Swinging Doors 1 . 0 cfm/ square foot tT f k CAULKING . WEATHERSTRIPPING AND SEALANTS Location Required Specified Exterior Joints - Windows � Exterior Joints - Doors Openings at Walls - Roof/ Ceiling Openings at Wall Panels Qcesb Utility Service Protectors FIREPLACE Element Required Specified Outside Combustion Air Yes ' "Jbmt Infiltration Control : ��. .%' aCdocly ia...� 20 cfm flue damper, or ors non-combustible doors 48 HVAC CONTROLS : 7813 . 13 THERMOSTAT Type Required Range Specified Heating Only 45 - 75 degrees min , y�" 447 " Cooling Only 70 - 85 degrees rein . Heating and Cooling 45 - 85 degrees min , HUMIDISTAT Required Specified Type Relative Humidity R . H . Add Moisture 30% maximums Remove Moisture 50% minimum TEMPERATURE ZONING Type Required Specified Thermostat Each System Thermostat Each Dwelling Unit Shut-off Each Zone Shut-off Each Floor CONTROL SETBACK Type Required Specified Switch , or Clack , or Manual Yes 49 HVAC EQUIPMENT PERFORMANCE ' REQUIREMENTS : 7813 . 23 Minimum Specified Equipment Performance Performance Gas Boiler 70% AFUE Gas Furnace 70% AFUE Oil Boiler 75% AFUE Oil Furnace 75% AFUE Heat Pump - Air Source High temp ( 47 deg . ) 2 . 6 COP Low temp ( 17 deg . ) 1 . 8 COP Cooling 805 SEER Heat Pump - Water Source 3 . O COP Cooling 8 . 5 SEER Central Air Conditioner g . 5 SEER. MECHANICAL SYSTEM INSULATION. . 7813 . 19 and 7813 . 20 Hydronic Low Temp . Required Thickness Specified Pipe Size at l " = R4 - R4 . 6 Thickness 1 " and less , 3/ 49" 1 1 /4" to 21' 1 Forced Air Required Specified Duct Temperature R-Value R-Value .^� T of 52 , 5 0eg . F . or less 3 , 5 ( Min . ) --� � T of more than 52 . 5 Deg . F . G T ( De . F . ) ( s . ft . ) 15 btv hr 50 WATER HEATERS ; 7813 . 33 Minimum Energy Specified Type Factor Required Energy Factor Electric Storage . 93 - 00013V 3 Gas a60 - . 0O19V Oil ' 59 - 00019V COMBINATION SERVICE WATER HEATING/SPACE HEATING Maximum Standby Loss Specified 13 . 3 pmd + 400 n CONSERVATION OF HOT WATER: 7813 * 38 Maximum Specified Fixture GPM GPM - Lavatories 3 3 Showers 3 ELECTRICAL POWER : 7813 . 52 Does building comply with National X Yes No Electric Code 5I a ' :r F NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE PART 6 WORKSHEET THERMAL RATING METHOD ONE- AND TWO-FAMILY BUILDINGS BUILDING �a+�► � .�rR..R ssf Le 01"15 GROSS FLOOR AREA 3 &o /' ADDRESS k0e /c l p i+i2 7140- NUMBER OF STORIES 45 " ,. Jwl o/x a&_040 fsiWrj4 DEGREE DAYS 90+0 C> CONTRACTOR , ARCHITECT OR ENGINEER +^✓+ e" g ;r ;j " c La R 0 / TELEPHONE ZQ8 Ore-0, ' 7 If the building does not meet the following pre-qualifying conditions . Part 6 of the Energy Code may not be used . YES NO Building is one- or two-family residential . Building is detached . Building is less than 5 . 000 gross square feet . _ Building is three stories or less in height. 1hC Entrance doors have a storm door or certified U value of . 40 or less . Glazing area / gross wall area is equal to or less than : 24% if 5 , 000 degree days 23% if 6 . 000 degree days 20% if 7 . 000 degree days 18% if 8. 000 degree days 16% if 9 . 000 degree days If all of the above conditions are not met , either PART 3 , PART 4 or PART 5 of the Energy Code must be used . 41 h- S DIRECTIONS : For each component of the proposed building design enter the design information requested such as Areas , "'U" or $'R" Values . Additional lines are provided for designs with more than one component construction type . Obtain thermal ratings for each item by consulting the appropriate Tables . A. ROOF/CEILING Obtain Thermal Ratings from Table 6-1 , 6-2 . 6-1E or 6-2E depending upon degree days and heating type . ! Area : / Q U—Value : .8Z ^ Square Ft . Thermal Rating Area : U—Value : Square Ft . Thermal Rating i B. NET WALLS Obtain Thermal Ratings -from Table 6-1 or 6-1E depending upon heating type. Area : ' i 'Z U—Value: Square Ft. Thermal Rating Area : U—Value: . Square Ft . Thermal Rating Note: Net Wall Area = Gross Wall Area minus Basement/ Cellar Walls, Glazing Areas and Door Areas . C . GLAZING Obtain Thermal Ratings from Table 6-3 or 6-3E depending upon heating type . WINDOWS Area of Glazing : 3 ► U—Value: 6 Q Square Ft . Thermal Rating Area of Glazing : U—Value : Square Ft . Thermal Rating SKYLIGHTS Area of Glazing : U—Value : Square Ft . Thermal Rating 42 • ti . 5 D1 , FLOORS Obtain Thermal Ratings from Table 6-1 . 6-lE or 6-4E depending upon degree days and heating type . Floor Area. : 'Z/ 4> U—Va1ue: r0 1` 30� Sq . Ft. Thermal Rating D2 . BASEMENT/CELLAR WALLS Obtain Thermal Ratings from Table 6-4 . 6-5. 6-6 or 6-5E depending upon degree days and heating type, Wall Perimeter: Linear Feet Exposure Above Grade: Feet U-Value of Wall : Depth of Wall U-Value A ] Below Grade: A Inches Thermal Rating Note: Use the above grade U-Value of the wall . .. The Thermal Rating Tables have been designed to take into account the * insulating effect of the earth , D3 . SLAB INSULATION Obtain Thermal Ratings from Table 6-7 or 6-6E depending upon heating type . Slab Perimeter : Linear Feet Insulation R—Value: ) Thermal Rating 43 E . INFILTRATION CONTROL Obtain Thermal Ratings from Table 6-8 or 6-7E depending upon heating type . r If the building does not meet the following conditions , enter NA ( Nct Applicable ) for Thermal Rating . YES NO _ All windows have an air leakage rate of 0 . 35 cfm or less per linear foot of operable sash crack ; All net wall areas have an infiltration barrier ; and A heat recovery ventilator. which transfers heat between the outgoing airstream and the airstream entering from the outside, is installed . Conditioned Floor Area : MIR ( Shall not include Square Ft. ThermaA Rating basement/ cellar floor area ) F . SOUTH FACING GLAZING Obtain Thermal Ratings from Table 6-9 or 6-BE depending upon heating - type . If the building does not meet the following conditions . enter NA ( Not Applicable ) for Thermal Rating . YES NO The building is no less than 1 . 250 square feet in conditioned floor area ; At least 45 percent of all glazing faces within 30 degrees of true south ; All glazed areas in buildings are no more than i U( glazing ) = 0 . 58; _ South facing glazed areas are free of any site obstructions during the heating season ; and An area of four- ,inch thick concrete or masonry is exposed to direct sunlight from south facing glazing . The area of this concrete or masonry shall be no less than three times the area of south facing glazing . Conditioned South Glass/Total Glass : Z Floor Area : Square Ft. ( See Above ) Glass Area/ Gross Wall Area : % Therm Rating 44 ` Y SUMMARY OF TOTAL THERMAL RATING r If the Total Thermal Rating is zero ( 0 ) or greater , the proposed design for the building envelope complies with the 'Energy Code . THERMAL TABLE AREA U-VALUE RATING USED A , ROOF/ CEILING . Q.�7;!57 B. NET WALLS , . © ^' 3/ 40 Co GLAZING Window Window Skylights D1 . FLOORS 4C7 ► OWS / D2 . BASEMENT/ CELLAR WALLS Wall Perimeter Feet Exposure Above Grade Feet Wall U-Value Depth of Wall U-Value Below Grade Inches D3 _ SLAB INSULATION Slab Perimeter Feet Insulation R—Value E . INFILTRATION CONTROL Conditioned Floor Area Sq . Ft. F . SOUTH FACING GLAZING T� South Glass/ Total Glass Percent G1 . Area/Gross Wall Area Percent Conditioned Floor Area Sq . Ft. TOTAL THERMAL RATING IrcZ 45 or 4p Ift