07-012 (18) ENERGY CONSERVATION APPLICATION FORM FOR
LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS
780 CMR Appendix 7
Applicant Name: WEtL NomstP-A' Site Address: 402. ♦• it t-.
Applicant Address: ,ICRC AI02nf fAesS k'r City/Town: r1.OPPTAJC6=, 0(4 _
F_Lv2-ex2Ce • Use Group:
Date of Application: /O- f/ - -& •
Applicant Phone: (4r'S}S8'4-Oq Sfr Applicant Signature: 77.0
Compliance Path(check one):
] Prescriptive Package(Limited to I-or 2-family wood frame buildings heated with fossil fuels only)
Package(A through KK from Table 75.2.1b): Heating Degree Days(1-IDD6,)from Table 75.2.1a:
(For items d. through i.,fill in all values that apply from.Table 35.2,11y)
a. Gross Wall Area f 4 70 sq.ft f. Wall R-value R- R 9'
b. Glazing Area' 3 2 1 sq.ft. g. Floor R-value R- I ?
e. Glazing%(ion xb-a) 2(. $ % h. Basement wall R- S'
d. Glazing U-value U- O,2 a i. Slab Perimeter R- JA-
e. Ceiling R-value Jt- 38 j. Heating AFUE 4n_..t
❑ Component Performance: "Manual Trade-Off"(Limited to wood or metal framed buildings only)
Climate Zone(from Figure 16.2.2) ❑ Zone 12 E Zone 13 Zone 14
Attach Trade-Off Worksheet from Appendix 1, [and HVAC Traria-Off Worksheet,if applicable]
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❑ MAScheck Software
Attach Compliance Report and Inspection Checklist printouts
❑ Home Energy Rating System Evaluation .^< '
Attach Home Energy Rating Certificate (HERS rating score must be 83 or higher)
❑ Systems Analysis OR E Renewable Energy Sources
Attach Mass Registered Architect or Engineer Analysis _
ALTERNATIVE FOR ADDITIONS ONLY:
a Gross Wall-r Ceding Area sq.ft. b. Glazing Area sq.ft. c. Glazing%(100 x b-a)
] ADDITION with Glazing%(c.) up to 40%may use 780 CMR Table 31.1.2,3.1 below:
MAXIMUM U-value MINIMUM R-Values
Fenestradoa Ceiling' Wall Floor Basement Wall Slab Perimeter,Depth
0.39' R-37 R-13 R-19 R-IO R-30,4 ft
1 Glazing Area may be either Rough Opening or Unit dimensions.
2 Based on NFRC listing. Applies either to every unit,or to area-weighted.average of all units.
3 R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R:value over the entire ceiling area
(i.e.-not compressed over exterior walls,and including any access openings.)
]
"SUN-ROOM"addition (greater than 40%glazing-to-wall and ceiling gross area)
Attach`Consumer Information Form"from 780 CMR Appendix B.
Official's Name: Official's Signature:
Application Approved ❑ Denied ❑ Date of Approval/Denial:
Reason(s)for Denial: (provide additional details as needed on back side)
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