21 AMANDA WAY - BUILDING INSPECTION (3) The Commonwealth of N4assachusetts
i OF
Board of Building Regulations and Standards CITY M
assac Mhusetts State Building Code 780 CNIR Sd Mar g Revised Lfnr 2011
W Building Permit Application To Construct, Repair, ne-Oatr olish a
One- or Two-Family Dwe1 ng
This Section For Officia e0
Building Pe rmitNumberr.- Da[e p '
Building Official(Print Namz) Stgnaturi; . Data
SECTION I: SITE INFORNIATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
l.la Is this an accepted street?yes_ no Map Number Parcel Number
1.3�Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(it)
1.5 Building Setbacks (ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone?
Public Private[3M
Check if yes❑ unicipal On site disposal system ❑
qQ SECTION 2:; PROPERTY OWNERSHIP" '
2.1 ACennraeeird� e`
's'� 1,N!
Name(Print) City,State,ZI
2 I /' [OCLP " 'INQyi 72E- 66-/yRQ
No. and Street Telephone Tmail Address
SECTION 3: DESCRIPTION OF PROPOSED WORK''(check all that apply),
New Construction ❑ Existing Building Owner-Occupied CO: Repairs(s) ❑ Alteration(s) El Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Descript{ion.of Proposed Work': t� U va=r 1S r l :c S re <ra( C'h
SECTION 4: ESTIMATED CONSTRUCTION COSTS
[rem �d
Estimated Costs:
Official Use Only
Labor and Materials)
!. Building $ AV�CI I Building1. Pit Fee:S C rr�iicate how fee is determined: I b
❑Standard City/Town Application Fee /
2. Electrical S -j QG O ,
❑"Coral Protect Cost (Item b)x multiplier. x
3. Plumbing S DzfU 2. Other Fees: S
1. Mechanical (11VAC) S %S `J List:
5. %leehanical (Fire S
5uP cession) Total All Fees: .S
Check No. Check Amount:__Cash AIttOLatC
6 I'Mat I'rnject Cost: S2 J " 13 Paid in Full ❑ _)utstmtding Balance Dua:
-
A
}
SECTION 5: CONs'ritucr[ON SERVICES
5.1 Constructio Supervisor License (CSL) 0-00,Y6 3
ek C7� License Number Expiration Date
Name of CSLI[Oldcr I_ _ U
List CSL Type(sea below)
Type Description
No. and Street
�C, O �6 U Unrestricted2 Fin(Buildings u el ing cu. ft.)
!1 R l2cstrictcd 1,4c2 Famil Dwelling
City/Town, State,ZIP MI \•lasonr
RC Roofing Covering
NS Window and Siding
^� SF SOIid Fuel Burning Appliances
Insulation
Telephone Email address D Demolition
5.21tegistered Fjome 19rpravement Contractor(H[C) j��L/� Y- 7 / 1,7
�'�1C,-C. -)CCU//T'/YL FIIC Registration Number Expir ion Date
?"I IC col any [���!!�Or I Ilp Registra It Name
It7 06 C /� OLD
N and fv etpiL -"r O �_97i_GG6 6 Email address
Ct /Town,State, ZIP Telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE 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 .......... No........... ❑
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 IClUI Q Yi l-e VLF
to act on my behalf, in all matters relative to work authorized by this building permit application.
` -� / lq ll3
XPrint Owner's Vine(Electronic Signature) Date
SECTION 7h: OWNEW 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 ap lication is true and accurate to the best of my knowledge and understanding.
_ �g
1' [it 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 FIIC Program can be found at
a w'w.nlass.,,ov/oca Information on the Construction Supervisor License can be found at ivw•w.ln:mss.ao�dL
2. When substantial work is planned, provide the information below:
'Total floor area(sq. ft.)-_ _(including garage, finished basement/attics, decks or porch)
Gross living area(sq. 11.) Habitable room count
Numberoffireplaces_ — Numberofbedrooms --- ---- --
Number of badlrooms Number of halGb:ulis
Type of heating iysfcnl - --- _ _- —_- Number of decks/porches --
I'}peofcooling .iy;tcnl ..----__-- ---_-- Enclosed- _- - _-Open _ —_-_--
). I JLII Ploj,CCt ltltrlrc 11111Y lie illbstitli(C,d fol fl dal PI ojed Cot"
CITY OF siuEm, j%LNs&kcHL'SETTS
BUILDING DEPART.%t&NT
120 WASHNGTON STREET, 3'°FLOOR
TEL (973) 745-9595
F.kX(973) Tao-9sa6
KI\fBERLBY DRISCOfl
MAYOR Trio61AS ST.PiE.Q1t8
DIRECTOR OF PUBLIC PROPERTY/BVI DING COSISIISSIONER
Workers' Compensation insurance Affidavit: Builders/ContractorrlElectr(cf:i"Plumbers
Anolicant Information Picase Print Leeibly
Nairc(nusioess.Organiratiomindividual):
Address:/6 f C� / /
City/State/Zip: �4 �M. /"'� , SIC PhoneN: hI2 — /Z1 1 (7 G
Are you an employer?Check the appropriate boxi Type of project(required):
1.0 [am a employer with 4. 0 I an a gcncral contractor and 1
e d.s
mployees(ILII and/or part-time)." have hired the sub-contractor 6. IC] -construction
2. l am a sole proprietor or Partner• listed on the attacheheet.t 1. emodeling
ship and have no employees These sub-contractors have a. 0 Demolition
working for me In any capacity. workers'camp. insurance. 9, 0 Building addition
(No workers'comp. insurance 5. 0 We are a corporation and its
required.)
officers have exercised their 10.0 Electrical repairs or additions
3.0 1 am a homeowner doing all work right of exemption per MOIL I LCI Plumbing repairs or additions
myself.(No workers'cump. C. 152,41(4),and we have no 12.0 Roof repairs
insurance required.] t amplayees.(No workers'
cump,insurance required.) 13.0 Other
•Any applic:ve riot cheeks iwx st murk also nil out the action bcluw ahawing their wwkan'mmpanndon pogey ineurmallon,
'Mweawners who submit this alf davit indicating they an doing all workand then him mosidscantntcton mint mhrnh a new afndavil indleadng tuck
�Cuntmcton that cheek ibis box must anachod art addillund+hots showing IN none ariho rub.ontracton and thalt workers'comp pulley Infortnaaae.
/urn on employer that is provfding workers'compearadon hesaranee for my etnplayees: Below lx the policy and fob site
injonnuUon. e
Insurance Company Name: /r�j/.
Policy a ur Sclf--irv. Lac. n:V C 6o/y3S201221Z Expiration Date:
12_/7 2
Job Site Address:o21 Amu]-del, VKY CitylStatr/2ip: J° � f/'r 4 O J 9 G
Attack a copy of the workers'compensation policy declaration page(Showing the policy number and expiration date).
Failure to sccuru coverage as required under Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S 1,500.00 and/or one-year imprisonmenk as well as civil penalties in the form of it STOP WORK ORDER and a tine
of up to S230.00 a Joy against the violator. Ile advfscd that a copy of this stalcmunt may be forwarded to the Office of
investigations of the DIA for iosuranee coverage verification.
/du h trehy c,rrrlfy rr r r s mrJ pmmltles of perjury thal rho lajunnatlan provided above is true and c orrect
Si,. . t / / Data•
U/J(c•ial use way. Da nat write in thls area;to be caurp/eted by city of town ayJlt'lat
i
City or Town: __. PefmittLlcenseA
Issuing Authority(circle one).-
1.
❑uard of tiealth 2.Iluildinq Department .i.City/fown Clerk J. Electrical Inspector 5. Plumbing Inspector
6.Other
i
Contact Person: ... __.. __ Phone B:
,
F-' 1
t, -n
' 1 r CITY OF SiU ENI) NfL-1SSACHUSETI'S
BU'MLNG DEP-AIUME.VT
120� C4:ISHCYGTOV 'h . STREET, 3 FLOOR
TEL (978) 745-9595
KI.'tBHRE Y DRISCOLL FAX(978) 740-9346
,`+LAYOR Tnosus ST.PtERRE
DIRECTOR OF PUBLIC PROPERTY/SUMnLNr,COALMISSIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition ofthe State Building Code, 780 CMR section 111.5
Debris, and the provisions of tNIGL c 40, S 54;
Building Permit # is issued with the condition that the debris resulting from
this work shall be disposed ofinerly licensed waste disposal facility as defined by MGL c
111. S 150A.
The debris will be transported by:
(name of hauler)
The debris
will
be disposed of in
(name of facility) ---�
4 ywc( tIA �-/ /M 5�n Met
aJdres.s of tacility)
signature of permit applicant
ate
ddm>.I( I•x
I
f�
,�- De artment of Public Safety
1 Massachusetts.- P
Regulations and St�drd._s
Board of Building `
Constroctinn Supf Nor f
License: CS.009.463 a
DANA DSALEM
to SALTONSTAL'L PI<�Vr
SALEM MA 01990
Expiration
e..
1111 012 0 1 4
Commissioner
Clto
,. a�rrchuoelfe .
office of Consumer Affairs&Business Regulation
- FMFM.p!n
IOVEMENT CONTRACTORType:g,stratw 124478 Individual
piration
DP.LEM DESIGNS
Dana Salem Q _
10 Saltonstall Pky
Salem,MA 01970 Undersecretary
The
Hi
Hoon
Specs for Amanda Way, Salem
2x6 Walls: R-21 (unfaced) fiberglass batt.
-TAPE sides & staple TYVEK to exterior surface of wall framing adjacent to attic space.
-On walls adjacent to EXTERIOR WALL ONLY: apply 4 mil. poly to interior surface.
-Bathtubs/shower adjacent to exterior wall needs poly taped to frame at interior side.
Sloped Ceilings:
-Ventilation baffles throughout, SEAL w/ sprayfoam to roof, to Ridge beam, and at
eave to subfloor. SEAL all gaps that exterior air can leak into insulation cavity.
-Insulate w/ R-30 (unfaced) fiberglass batt.
-Attach between sheetrock strapping: 5/8" white "bead" foamboard.
Flat Ceiling:
-Attach between sheetrock strapping 1x3: 5/8" white "bead" foamboard.
-Install R-30 (unfaced) fiberglass batts to be in contact with above foamboard.
Windows, Jack-Studs and bottom plate:
-Seal gaps between framing with canned sprayfoam and/or painter's caulk:
BEFORE sheetrock:
-Staple ''/:-width strips of foundation sill gasket foam to top-plate of ALL exterior and
interior walls (sheetrock is installed to COMPRESS this gasket to seal top-plate gaps to attic).
Ducts: All seams are to be sealed. NEW ducts to be insulated to R-8 and tested for leakage.
-Caulk register boots to sheetrock.
Final Airsealing:
-Caulk recessed lights, electric boxes, and all other penetrations to sheetrock.
-Attic Hatch: insulate and add weatherstripping to seal it. Add weight on top to
compress weatherstripping.
R-21: 765 s.f. R-30: 1405 s.f. TYVEK: 270 s.f. Baffles: 120 4' lengths
4 mil. Poly: 500 s.f. 5/8" white "bead" foamboard: 1400 s.f.
Ian Rex, Principal 978.233.1433
11 Broadway, Suite 3, Beverly, MA 01915
email: Ian@TheEnergyHound.com
www.TheEnergyHound.com
ciGenerated by REScheck-Web Software
Compliance Certificate
Project Title: Salem, Amanda Way
Energy Code: 2009 IECC
Location: Salem, Massachusetts -
Construction Type: Single Family
Project Type: Addition
Glazing Area Percentage: 17%
Heating Degree Days: 6268
Climate Zone: 5
Construction Site: Owner/Agent: Designer/Contractor:
Compliance: Passes using JA trade-off
Compliance: 0.0%Better Than Code Maximum UA:104 Your UA: 104
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 cast relative to a minimum-cotle home.
Gross Cavity Cont- Glazing UA
Assembly Area or R-Value R-Valuc or D••
Perimeter U-Factor
Ceiling: Flat or Scissor Truss 831 30.0 1.8 27
Ceiling:Cathedral 563 30.0 1.8 18
Wall:Wood Frame, 16in.D.C. 591 21.0 0.0 28
Window:Vinyl Frame,2 Pane w/Low-E 98 0.320 31
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 2009 IECC requirements in
REScheck-Web and to Comply with the mandatory requirements listed in the RES pection Checklist. '
Ian Rex, Energy Rater / ��' / z
Name-Title Signature D e -/
Project Notes:
REScheck completed by: Ian Rex,The Energy Hound, 11 Broadway,Beverly MA 01915,978-233-1433
Project Title: Salem,Amanda Way Report date: 01/30/13
Data filename: Page 1 of 4
Generated by REScheck-Web Software
Inspection Checklist
Energy Code: 2009 IECC
Location: Salem, Massachusetts
Construction Type: Single Family
Project Type: Addition
Glazing Area Percentage: 17% -
Heating Degree Days: 6268
Climate Zone: 5
Ceilings:
❑ Ceiling:Flat or Scissor Truss, R-30.0 cavity+R-1.8 continuous insulation
Comments:
❑ Ceiling:Cathedral,R-30.0 cavity+R-1.8 continuous insulation
Comments:
Above-Grade Walls:
❑ Wall:Wood Frame, 16in.o.c.,R-21.0 cavity insulation
Comments:
Windows:
❑ Window:Vinyl Frame,2 Pane w/Low-E, U-factor:0.320
For windows without labeled U-factors,describe features:
#Panes—Frame Type Thermal Break?_Yes_No
Comments:
Air Leakage:
❑ Joints(including rim joist junctions),attic access openings, penetrations,and all other such openings in the building envelope that are
sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or
solid material.
❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between
window/door jambs and framing.
❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk
between the housing and the interior wall or ceiling covering.
❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or
damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed
to maintain insulation application.
❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air.
❑ Automatic or gravity dampers are installed on all outdoor air intakes and exhausts.
Air Sealing and Insulation:
❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7
ACH at 50 pascals OR 2)the following items have been satisfied:
(a)Air barriers and thermal barrier: Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or
repaired.
(b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed.
(c)Above-grade walls: Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier.
(d)Floors:Air barrier is installed at any exposed edge of insulation.
(a)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or
sprayed/blown insulation extends behind piping and wiring.
(f) Corners, headers, narrow framing cavities,and rim joists are insulated.
(9)Shower/tub on exterior wall: Insulation exists between showers/tubs and exterior wall.
Project Title: Salem, Amanda Way Report date: 01/30/13
Data filename: Page 2 of 4
Sunrooms:
El Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum
skylight U-factor of 0.75. New windows and doors separating the sunroom from conditioned space meet the building thermal envelope
requirements.
Materials Identification and Installation:
❑ Materials and equipment are installed in accordance with the manufacturers installation instructions.
Materials and equipment are identified so that compliance can be determined.
Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided.
Q Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications.
Duct Insulation:
(7 Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are
insulated to at least R-6.
Duct Construction and Testing:
Building framing cavities are not used as supply ducts.
All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means
of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or
UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically
fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three
equally spaced sheet-metal screws.
Exceptions:
Joint and seams covered with spray polyurethane foam.
Where a partially inaccessible duct connection exists, mechanical fasteners can be equally spaced on the exposed portion of the
joint so as to prevent a hinge effect.
Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g. (500 Pa).
Q Duct tightness test has been performed and meets one of the following test criteria:
0)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area.
(2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2.
(3)Rough-in total leakage test with air handler installed: Less than or equal to 6 cfm per 100 ft2 of conditioned floor area.
(4)Rough-in total leakage test without air handler installed: Less than or equal to 4 cfm per 106 ft2 of conditioned floor area.
Temperature Controls:
❑ Where the primary heating system is a forced air-furnace,at least one programmable thermostat is installed to control the primary
heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle.
Heat pumps having supplementary electric-resistance heat have controls that prevent supplemental heat operation when the
compressor can meet the heating load.
Heating and Cooling Equipment Sizing:
❑ Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code.
For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial
Building Mechanical and/or Service Water Heating(Sections 503 and 504).
Circulating Service Hot Water Systems:
Circulating service hot water pipes are insulated to R-2.
❑ Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the
system is not in use.
Heating and Cooling Piping Insulation:
Ej HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3.
Swimming Pools:
Heated swimming pools have an on/off heater switch.
Pool heaters operating on natural gas or LPG have an electronic pilot light.
Fi Timer switches on pool heaters and pumps are present.
Exceptions:
Where public health standards require continuous pump operation.
Where pumps operate within solar-and/or waste-heat-recovery systems.
Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a
minimum insulation value of R-12.
Project Title: Salem, Amanda Way Report date: 01/30/13
Data filename: Page 3 of 4
Exceptions:
Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source.
Lighting Requirements:
C1 A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following:
(a)Compact fluorescent
(b)T-8 or smaller diameter linear fluorescent
(c)40 lumens per watt for lamp wattage<=15
(d)50 lumens per watt for lamp wattage> 15 and<=40
(e)60 lumens per watt for lamp wattage>40
Other Requirements:
❑ Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting
off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is
above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement'c').
Certificate:
A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window
U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility
of the circuit directory label,service disconnect label or other required labels.
NOTES TO FIELD:(Building Department Use Only)
Project Title: Salem,Amanda Way Report date: 01/30/13
Data filename: Page 4 of 4
2009 IECC Energy
Efficiency Certificate
Insulation Rating R-Value
Ceiling I Roof 31.80
Wall 21.00
Floor I Foundation 0.00
Ductwork(unconditioned spaces):
Glass & Door Rating U-Factor SHGC
Window 0.32
Door
Heating &Cooling Equipment Efficiency
Heating System:
Cooling System:
Water Heater:
Name: Date:
Comments: