38A-103 (16) ENERGY CONSERVATION MANDATORY CHECKLIST FOR NEW CONSTRUCTION —
(OTHER THAN LOW-RISE RESIDENTIAL) 780 CMR, 1301.8.1
Owner/Agent Name: /4 X�CJ��� Phone:
Owner/Agent Address: / <fel w e 15;'
City/State/Zip: 1'/f�j� /aJ�f(�i �t�, 01-112,7
Project Name: yC � G
Site Address: 0! C:AgLt5 City/Town
Applicant's Name: Signature:
Applicant's Phone: Date of Application:
I. Envelope Compliance Option (check ONE)
❑ Trade-Off (1304.5)-Attach software Compliance Report(COMcheck-EZ)
❑ Appendix J(1301.2-For buildings up to 10,000 sf only)-Attach Appendix J compliance documentation
❑ Systems Analysis(1309)-Attach Registered Architect's or Engineer's report
Prescriptive(1304.2)-Complete this section,and attach copy of applicable Table(1304.2.1 through 13.4.2.12)
Climate Zone(from Table 1303.1) ❑ Zone 12a ❑ Zone 13a 54 Zone 14a
a. Gross above-grade wall area I2. q (P _sq.ft.
b. Total window&glass door area _ � 2s sq.. t.
c. Glazing%(100 x b=a) _ �/a Table#utilized: I -2. q
II. HVAC (check ONE)
❑ Simple Systems&Equipment(1305.2) ❑Complex Systems&Equipment(1305.3)
❑ Systems Analysis(1309)-Attach Registered Architect's or Engineer's report
Ill. Lighting(check ONE)
❑ Building Area Method(1308.6.2.1)
}Attach Compliance Documentation(COMcheck-EZ or other)
❑ Space-by-Space Method(1308.6.2.2)
❑ Systems Analysis(1309)-Attach Registered Architect's or Engineer's report
IV. Approval & Acceptance Constructiom e*ts.(13A1.8.4.1)
0900
Attach a narrative report describing the HVAC,Lighting,and Eleckc Disci@l>t7ibri t�rlis lit Iddting:
For Official Use ONLY: r
❑ I. Design Intent
IV
❑ 2. Basis of Design ;
Building Official ❑ 3. Sequence of operation/systems inter'c �
check off
4. Description of the systems ca acitie�e
completed ❑ P Y' ( P
sections of report ❑ 5.Testing requirements/criteria acceptance- -
❑ 6. Requirement for submittal of operation manuals and maintenance manuals
❑ 7.Requirement for submittal of record drawings and control documents
TABLE 1304.29
BUILDING ENVELOPE REQUIREMENTS
Climate Zone 14a
Glazini r Area 10% or less of Above Grade Wall Area
Above-Grade Walls: Continuous Insulation(or Metal Framingd Framing
Woo
Framed or Masonry<35 ps£ R-7 R-1 I +R-3 c.i. R-1 I
Masonry>=35 psf. R-5 R-1 I +R-3 c.i. R-11
Window Assemblies: SHGC(maximum) U-Value(maximum)
PF<0.25 Any 0.7
0.25<=PF<0.50 Any 0.7
PF>-0.50 Any 0.7
Skylights-U-Value X 4,8
Roof Assemblies: (either/or) Insulation Between Framing Continuous Insulation
All-Wood Joist/Truss T R-19 R-17
Non-wood Joist/Truss R-25 R-18
Concrete Slab or Deck NA R-17
Metal Purlin with Thermal Break R-30 R-18
Metal Purlin w/o Thermal Break X R-18
Floor Assemblies: (either/or) Insulation Between Framing Continuous Insulation
All-Wood Joist/Truss R-25 R-18
Non-wood Joist/Truss R-25 R-19
Concrete Slab or Deck NA R-19
Slab,Perimeter,and Below-Grade R-5
wall
* For masonry walls,average R-value shall be calculated based on the assumption of isothermal planes,
using methodology in 1997 ASHRAE Fundamentals Handbook,Chapter 22.
{
Draft Copy for Educational Purposes Only January 1,2001
This Side For Use by Building Department Only
Official's Name: Title:
I. Plans Review
Date Application Received:
❑ Complete Narrative Report Received(1301.8.4.1)
❑ Design and Specification Documents prepared by legally recognized professional(1301.8.4.3)
Application is: Approved ❑ Date: Signature:
Denied ❑ Date:
Reason(s)for Denial: (provide additional details as needed on separate sheet)
11. Acceptance(1301.8.4.4)
❑ Successful system tests witnessed by Building Official,OR ❑satisfactory test report received(check one)
❑ Certification by Registered Professional(per 780 CMR 116.2)that systems are installed in accordance with
construction documents
❑ Confirmation by owner(or their authorized representative)that they have received record drawings,
reviewed for reasonable accuracy
❑ Confirmation by owner(or their authorized representative)that they have received reports,controls
documentation,operations manual(s),maintenance manual(s),and other documents specified in 1301.8.4.1
Building Official's Signature:
SIEGFRIED PORTH
ARCHITECT
116 PLEASANT STREET SUITE 331
EASTHAMPTON, MA 01027
413-529-9434
BUILDING DEPARTMENT
CITY OF NORTHAMPTON
IN ACCORDANCE WITH SECTION 116.2 OF THE MASSACHUSETTS STATE BUILDING CODE,
1 , SIEGFRIED PORTH ,BEING A PROFESSIONAL ARCHITECT,CERTIFY THAT THE PLANS
FOR: VCA INC. EARLE STREET NORTHAMPTON,MA
HAVE BEEN PREPARED UNDER MY SUPERVISION AND TO THE BEST OF MY KNOWLEDGE,
SUCH PLANS CONFORM TO THE PROVISIONS OF SAID CODE,ALL ACCEPTABLE
ENGINEERING PRACTICES AND ALL APPLICABLE LAWS AND ORDINANCES.
AND, FURTHER,THAT I WILL COMPLY WITH THE REQUIREMENTS OF SECTION 116.2 FOR
THE STRUCTURAL PORTION OF THE BUILDING AND SUBMIT REPORTS TO THE BUILDING
DEPARTMENT AS REQUIRED BY SECTION 1 HE CODE.
'C�REs�qqc
FPy�
SIGNATURE ;,� ` Q I�D p 0 C�
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SIEGFRIED PORT o N
NORTHAMPTON,
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�F9`Th U E M PSSPG�
SUBSCRIBED AND SWORN TO BEFORE ME THIS a� DAY �0-lua,'Zf 20 .
NOTARY PUBLIC 12'wt
MY COMMISSION EXPIRES �E'C ��� ,?el d
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$007 0 C 1"V
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