HomeMy WebLinkAbout52320-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 52320 Date: 10/06/2025
Permission is hereby granted to:
Polenas Farm LLC
57 Westgate Blvd
Manhasset, NY 11030
To:
Construct a two-story,single-family dwelling to include an unfinished full basement and HVAC system
as applied for perSCHD approval.
Premises Located at:
1981 August Ln, Greenport, NY 11944
SCTM#53.-6-46.10
Pursuant to application dated 07/07/2025 and approved by the Building Inspector.
To expire on 10/06/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling-NEW $3,017.00
CO Single Family Dwelling-New $100.00
Total $3,117.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax(631) 765-9502 https://www.sotitholdtownti.y.gory
Date Received
BUILDINGAPPLICATION FOR
1 � For Office Use Only
PERMIT NO.c.J a)aC) Building Inspector:
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an lquilcling Department
Owner's Authorization form(Page 2)shall be completed. Town, Of SOUthold
Date:
OWNER(S)OF PROPERTY:
Name: Pdlenas FcLr-rn LL C _ SCTM#1000- 053 .00-o(4.60- o o(o
Project Address: I90o f A u us4 Lone Green o r-I- N-I . 1l4 y
Phone#: Email:
Mailing Address: Srl Wtx- i31Vd Manh0s5Cf l iy. 11030
CONTACT PERSON:
Name: Skcxn no n
Mailing Address: Cove Sd 04\(xm P+t�r1 ki�/ I Iq (9 g
15 C I I
Phone#: (p31 - .5(a Co - rT(o Lo rl Email: ,L1 s 1 p e rt4 mai l. ConrN
DESIGN PROFESSIONAL INFORMATION:
Name: Funk LC rn6o-rdo
Mailing Address:
Phone#: Email: . I
CONTRACTOR FORMATION: 35q —143$
Name: ICI or-S ke. -rn C .
Mailing Address: M.I.
Phone#: (931 - 23(a ` '192_9 ham,
Email: nomv,-wnc . Corn
DESCRIPTION OF PROPOSED CONSTRUCTION
QfIew Structure ❑Addition ❑Alter Lion ❑ 7pair emolition Estimated Cost of Project:
El other •� 'I` $
Will the lot be re-graded? Yes ❑No Will excess fill be removed from premises? ❑Yes No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes ❑No IF YES, PROVIDE A COPY.
❑ Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildktgs,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
housing code and rnguladons and to admit auttrorized Inspectors on premises and in bultding(s)for necessary inspections.False statements made herein are
punishable as a Gass A misdemeanor pursuant to Section 210.45 of the New York State Penal law.
Application Submitted By(print name): j do�v__ To Le(`f qL ❑Authorized Agent DO n-er
Signature of Applicant: Date: 4 1 3 l zo 2r'
STATE OF NEW YORK)
SS:
COUNTY OF )
s &T ` iz- being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the V% a I'
(Contractor,Agent, Corporate Officer,etc.)
of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this
application;that all statements contained in this application are true to the best of his/her knowledge and belief; and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
'30 day of,
Notary Public
MICHAEL W MALIK
NOTARY PUBLIC-STATE OF NEW YORK
PROPERTY OWNER AUTHORIZATION No.01 MA6279262
Qualified in Nassau County
(Where the applicant is not the owner) My Commission Expires 04-06-2029
I, .S(0 l 1), ?01,trfj R- residing at 57 �J(�1rSrG(���' DUO 1'i A N�t/>}�1 C�F
y UQ,30 do hereby authorize Sq i4 14a L,Cfy to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
wner's Signature Date
Print Owner's Name
2
FRANK A LOMBARDO ARCHITECT
P.O. Box 128,Westhampton, N.Y. 11977-0128 A.., u ... f,,1,'
tel.: 631-357-1438 email: FrankLombardo@yahoo.com
September 10, 2025
Ms. Tracey Dwyer
Town of Southold
Building Department
54375 NY-25
Southold, N,Y. 11971
Reference: 1981 August Lane, Greenport,N.Y.
Dear Ms Dwyer,
This letter shall serve as certification that all construction for the work proposed at 1981 August
Lanve, Greenport, N.Y. complies with the 2020 Residential Code of New York State, This
certification applies to the primary residence as well as the accessory structures (Pool House,
Swimming Pool, and Tennis Court).
Plese feel free to contact me with any questions you may have regarding this certification.
Very truly yours,
Frank A. Lombardo Architect '
,k
k Joe*
ANK A- LOMBARDO
N.Y.S. LICENSE NO. 1542-
m w nµ
Town Hall Annex Telephone(631)765-1802
54375 Mak,Road Fax(631)765-9502
P.O. Box 1179 w
Southold, NY 11971-0959 � uu
it
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED
WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION
Date: o'
Owner: TOlenoas F-rfnn LL.C.
Location of Property: fflus4- Lane. 6ree_nt,,,j+ . N'-V- LLqAA_
Please take notice that the (check applicable line):
✓ New commercial or residential structure
Addition to existing commercial or residential structure
Rehabilitation to an existing commercial or residential structure
to be constructed or performed at the subject property reference above will utilize
(check applicable line):
Truss type construction (TT)
Pre-engineered wood construction (PW)
. Timber construction (TC)
in the following location(s) (check applicable line):
Floor framing, including girders and beams (F)
Roof framing (R)
Floor and roof framing (FR)
Signature:
Name (person submitting this form):
Capacity(check applicable line):
Owner
Owner representative
TrussRegMdocx Effective 1/1/2015
1
Albert J. Krupski, Jr. STORlMMATIER,
SUPERVISOR IMIANA�G]EN11EINT
SOUTHOLD TOWN HALL-P.O.Box 1179 4
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of So u th o l d
CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM
( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. )
APPLICANT; (Property Owner, Design Professional, Agent, Contractor, Other)
NAME: Date:
rya. ,
Contact Information: I�
(E-Nlad&Telephone Number)
Lo
Property Address / Location of Construction Site:
L ol u 54- LU"w S.C.T.M. #: _1000
District
�... ��..-.. W_ 3 ��0l
DE C Section Block Lot
J U L - 7 2025
TO BE COMPLETED BY SOUTHOLD TOWN part m I DEPARTMENT
Building
ENGINEERING
Town of Southold
❑ - Area of Disturbance is less than I Acre, No S.P.D.E.S. Permit is Required I
Project does Not Discharge to Waters of the State„ No S.P.D.E.S. Permit is Re uired f
❑ - Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Discharges Directly
to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit
DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Building Permit.
❑ - Area of Disturbance is Greater than 1 Acre & Storm-water Runoff Flows Through Southold
Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN
a S.P.D.E.S. Permit through the Southold To%,\n EagineeriEz Department
Prior to Issuance of a Buildin Permit.
r » �
Reviewed B�: I/�/2�fG � Date: �S
FORM SMCP-TOS December 2024 A e c el V e 77 /� c�
b
CGenerated by REScheck b Software
�(J Compliance Certificate
Project 1981 August Lane
Energy Code: 2018 IECC
Location: Westhampton, New York
Construction Type: Single-family
Project Type: New Construction
Project SubType: None
Conditioned Floor Area: 2,659 ft2
Glazing Area 30%
Climate Zone: 4 (5331 HDD)
Permit Date:
Permit Number:
All Electric false
Is Renewable false
Has Charger false
Has Battery: false
Has Heat Pump: false
Construction Site: Owner/Agent: Designer/Contractor:
1981 August Lane Norske Inc Frank Lombardo
Greenport, NY 11944 P.O.BOX 42 P.O. BOX 128
Westhampton, NY 11977 Westhampton, NY 11977
631-236-7929 631-357-1438
franklombardo@yahoo.com
Compliance: 4.4%Better Than Code Maximum UA: 476 Your UA: 455 Maximum SHGC: 0.40 Your SHGC: 0.40
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.
s m no k mn,w u� or peer uwrn��a i n e corn G:nMian e I�ui;nth iin 1�1"S i�uu ck, li�s�:Ih:>iuu)n oirn.. rod
��mi�.-�nr� um�nu~a!n" 1f�ran�la��n�l �nu�, r,�u a ��.uu�n nu�u icu rt� iurvu �Ihi�:�: ilD
aukse nni~ y In the specified dfir ate,zirm µ rinust r neE.lt the mir0irnuuirnu r!:n°eirg r codE� uo~UmwuUII iflorn IRvallue and durlpin llh irn quiwelnmien ts.
Enveloije-Assemblies
Ceiling: Flat Ceiling or Scissor Truss 1,354 38.0 0.0 0.030 0.026 41 35
Above grade walls: Wood Frame, 16"o.c. 2,527 21.0 0.0 0.057 0.060 97 103
Front door:Solid Door(under 50%glazing) 28 0.350 0.320 10 9
Above grade windows:Wood Frame SHGC: 0.40 789 0.320 0.320 252 252
Garage wall:Wood Frame, 16"o.c. 128 21.0 0.0 0.057 0.060 6 6
Garage door: Solid Door(under 50%glazing) 21 0.200 0.320 4 7
Floor above basement:All-Wood joist/Truss 1,305 30.0 0.0 0.033 0.047 43 61
Floor above ambient:All-Wood joist/Truss 44 30.0 0.0 0.033 0.047 1 2
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 1 of10
Floor above garage:All-Wood joist/Truss 23 30.0 0.0 0.033 0.047 1 1
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 2018 IECC requirements in
REScheck'Version:REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Gerson Rubio, P.E. 7/3/2025
Name-Title Signature 61 Date
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 2 of10
CREScheck Software Version : REScheck-Web
�(J Inspection Checklist
Energy Code: 2018 IECC
Requirements: 97.0% were addressed directly in the REScheck software
Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each
requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception
is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided.
Section# Plans Verified Field Verified Value
Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions
& Re .ID
g 1"❑Do spNot Requirement will b me
103.1, ;Construction drawings and a met.
103.2 documentation demonstrate
[PRI]i energy code compliance for the ❑Not Observable
41 building envelope.Thermal ,,
°envelope represented on ❑Not Applicable
construction documents. %
103.1, Construction drawings and CiCOmplies Requirement will be met.
103.2, documentation demonstrate ❑Does Not
403.7 energy code compliance for ❑Not Observable
[P R3]i :lighting and mechanical systems. ""
Systems serving multiple ❑Not Applicable
dwelling units must demonstrate
compliance with the IECC
:Commercial Provisions.
Y
302.1, Heating and cooling equipment is Heating: Heating. f❑Complies Requirement will be met.
403.7 sized per ACCA Manual S based Rtu/hr Btu/hr ❑Does Not
[PR2]2 on loads calculated per ACCA Cooling; j Cooling:
Manual J or other methods Btu,/hr Btu/hr ❑Not Observable
approved by the code official.
;❑Not Applicable ;
Additional Comments/Assumptions:
1 High Impact(Tier l) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 3 of10
Section
# Foundation Inspection Compiles? Comments/Assumptions
&Req.ID
303,.2.1 A protective covering is installed to '❑Cpm pbies "Exception: Requirement is not applicable.
IF01112 protect exposed exterior insulation ;❑Does Not
1011 and extends a minimum of 6 in. below
❑
grade. Not Observable:
_ ;❑Not Applicable
403.9 Snow-and ice-melting system controls 10complles Exception: Requirement is not applicable.
jrO121 installed. ❑Does Not
❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
11 High Impact(Tier 1) 2 Medium impact(Tier 2) 3 Low Impact(Tier 3) �
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 4 of10
Section min9/ Rough-in Inspection 9 p Plans Verified Field Verified
# Fra Value Value Complies? Comments/Assumptions
_
402.1.1, :Door U-factor. U- U- ❑Complies See the Envelope Assemblies� I lies
402.3.4 ❑Does Not table for values.
[FRI]'
❑Not Observable
❑Not Applicable
402.1.1, Glazing U-factor(area-weighted U- U- ❑Complies see the Envelope assemblies
402.3.1, average). ❑Does Not i table for values.
402.3.3,
402.5 ❑Not Observable
[FR2]1 ❑Not Applicable }
"J
303.1.3 U-factors of fenestration products; ❑Complies Requirement will be met.
[FR4]1 are determined in accordance '❑Does Not
,with the NFRC test procedure or
oaken from the default table. ❑Not Observable
❑Not Applicable
402.4.1.1 'Air barrier and thermal barrier ` ❑Complies Requirement will be met.
[FR23]1 iinstalled per manufacturer's ❑Does Not
instructions.
❑Not Observable
" ❑Not Applicable
402.4.3 Fenestration that is not site built ;[]Complies
[FR20]1 is listed and labeled as meeting " ❑Does Not
AAMA/WDMA/CSA 101/I.S.2/A440 "
or has infiltration rates per NFRC ❑Not Observable
400 that do not exceed code , ❑Not Applicable
limits.
402.4.5 IC-rated recessed lighting fixtures.,:'' 'Complies Requirement will be met.
[FR16]2 sealed at housing/interior finish ;❑Does Not
and labeled to indicate:52.0 cfm
leakage at 75 Pa. ,,❑Not Observable
❑Not Applicable
403.3.1 ;Supply and return ducts in attics - ❑Complies Exception: Ducts located
FR12]1 insulated >= R-8 where duct is ❑Does Not completely inside the
>= 3 inches in diameter and >_
R-6 where < 3 inches.Supply and'
Not Observable j building envelope.
❑
return ducts in other portions of „ `❑Not Applicable
jthe building insulated >= R-6 for
diameter>= 3 inches and R-4.2
Ffor< 3 inches in diameter.
. e
403.3.2 Ducts, air handlers and filter ;❑Complies Requirement will be met.
[FR13]1 (boxes are sealed with ❑Does Not
y joints/seams compliant with
International Mechanical Code or ;❑Not Observable
International Residential Code, as ❑Not Applicable
applicable.
7=_Q111
403.3.5 Building cavities are not used as % ❑Complies Requirement will be met.
[FR15]3 ducts or plenums. %` ❑Does Not
❑Not Observable
T❑Not Applicable
�R HVAC piping conveying fluids R
3.4 R ❑Complies ;Requirement will be met.
17]z above 105°F or chilled fluids ❑Does Not
below 55 °F are insulated to >_R-
3 ❑Not Observable
❑Not Applicable
403.4.1 Protection of insulation on HVAC ❑Complies ;Requirement will be met.
[FR24]1 piping. ❑Does Not
,�❑Not Observable
❑Not Applicable
403.5.3 Hot water pipes are insulated to R-
R- ❑Complies Requirement will be met.
[FR18]2 >_R-3. ❑Does Not
Sri
'❑Not Observable
❑Not Applicable
11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low lmpact(Tier 3)
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 5 of10
ctia Plans Verified Field Verified
�k Framing/Rough-In Inspection Value Value LCorrplies? Comments/Assumptions
Re .ilk _
� 16 Automatic or gravity dampers are �DoespN _me
� p � ies i Requirement will be met.
installed on all outdoor air of
intakes and exhausts.
pNot Observable i
0Not Applicable j
Additional Comments/Assumptions:
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 6 of10
Plans Verified Field Verified
Q. Insulation Inspection Value Value Complies? Comments/Assumptions
&R ID ' _
Section
All installed insulation is labeled
IN13 or the installed R-values ,'E]Do spNot Requirement will be met.
provided. ❑
❑Not Observable
�www� p ❑Not Applicable
402.1.1, Floor insulation R-value. R- R- ❑Complies See the Envelope Assemblies
402.2.6 ❑ Wood Wood ;❑Does Not table for values.
[IN1]1 ❑ Steel Steel:El Steel Observable
❑Not Applicable
303.2, :Floor in ulation installed per � � ❑Co�mpli s Requirement will be met.
402.2.8 :manufacturer's instructions and []Does Not
[IN2]1 :In substantial contact with the
underside of the subfloor,or floor '❑Not Observable
framing cavity insulation is in ®Not Applicable
contact with the top side of
.sheathing,or continuous
insulation is installed on the
j underside of floor framing and
extends from the bottom to the
:top of all perimeter floor framing
members.
402.1.1, Wall insulation R-value.If this is a R-
R- mm ® (❑Complies see the Envelope Assemblies
402.2.5, mass wall with at least 1i4 of the `❑ Wood ❑ Wood ❑Does Not table for values.
402.2.6 :wall insulation on the wall ❑ Mass ❑ Mass o❑Not Observable
[IN3]1 ;exterior,the exterior insulation
fad
:requirement applies(FIR ❑ Steel ❑ Steel ❑Not Applicable
303.2 Wall insulation is installed per ❑Oomplles Requirement will be met.
[IN4]1 manufacturer's instructions. ❑Do,es Not
❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 'Low Impact(Tier 3)
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 7 of10
Section Plans Verified Field Verified
# Final Inspection Provisions Value Value Complies? Comments/Assumptions
& Req.ID _
402.1.1, Ceiling insulatione � �...... p 1 �p �R-value. R- R- ❑Com lies See the Envelope Assemblies
402.2.1, ❑ Wood ;❑ Wood °❑Does Not table for values.
402.2.2,
402.2.E ❑ Steel Steel ❑Not Observable
[Fill' '❑Not Applicable
303.1.1.1, Ceiling insulation installed per ❑Complies Requirement will be met.
303.2 manufacturer's instructions. " '[]Does Not
[F12]' Blown insulation marked every
300 ft2. ❑Not Observable '.
°❑Not Applicable
402.2.3 Vented attics with air permeable ;❑Complies Exception: Requirement is
[FI22]2 insulation include baffle adjacent , ❑Does Not not applicable.
to soffit and eave vents that Not Observable i
'extends over insulation. ❑'
❑Not Applicable
402.2.4 Attic access hatch and door R- R- Y❑Complies `'Requirement will be met.
[FI3]' insulation >_R-value of the ❑Does Not
j adjacent assembly.
❑Not Observable .
❑Not Applicable
402.4.1.2 Blower door test @ 50 Pa. <=5 ACH 50 = ACH 50= ;❑Complies Requirement will be met.
[FI17]' ach in Climate Zones 1-2, and ❑Does Not
<=3 ach in Climate Zones 3-8. ❑Not Observable
Not Applicable
403.3.3 :Ducts are pressure tested to cfm/100 cfm/100 [ Complies Exception: Ducts serve heat
[1`I27]' determine air leakage with ft2 ft2 ❑Does Not or energy recovery
either: Rough-in test:Total Observable ventilators not integrated
Not
leakage measured with a ❑ ;with ducts serving
=pressure differential of 0.1 inch ❑Not Applicable heating/cooling systems.
w.g. across the system including
Ahe manufacturer's air handler
enclosure if installed at time of
;test. Postconstruction test:Total j
leakage measured with a
pressure differential of 0.1 inch
w.g.across the entire system
including the manufacturer's air
handler enclosure.
403.3.4 Duct tightness test result of<=4 cfm/100 cfm/100 ❑Complies Exception:All ducts and air
[FI4]' cfm/100 ft2 across the system or ft2 ft2 ❑Does Not handlers are located within
<=3 cfm/100 ft2 without air conditioned space.
handler @ 25 Pa.For rough-in ❑Not Observable
tests,verification may need to ❑Not Applicable ;
occur during Framing:Inspection. 777777,
M .,
403.3.2.1 Air handler leakage designated =❑Complies Requirement will be met.
[FI24]' by manufacturer at<=2%of '❑Does Not
design air flow.
❑Not Observable
❑Not Applicable
403.1.1 Programmable thermostats ;ElComplies Requirement will be met.
[FI9]2 installed for control of primary ❑Does Not
heating and cooling systems and
initially set by manufacturer to
" '❑Not Observable
code specifications. ,❑Not Applicable
n
403.1.2 Heat pump thermostat installed ❑Complies ;Exception: Requirement is
0]� on heat pumps. ❑Does Not not applicable.
❑Not Observable
❑Not Applicable
403.5.1 g ❑Coplies Requirement will be met.
Circulating service hot water
[FI11]2 ,systems have automatic or ❑Does Not
accessible manual controls. "[-]Not Observable
E]Not Applicable
1 High Impact(Tier 1) 2 'Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 8 of10
Section Plans Verified Field Verified
# Final Inspection Provisions Value Value 77
L-o
mplies? Comments/Assumptions
Req.I D
6i_.H. e�
403.6.1 All mechanical ventilations stem „Y mplies Requirement will be met.
[FI25] fans not part of tested and listed ❑Does Not
HVAC equipment meet efficacy ❑Not Observable
and air flow limits per Table
R403.6.1. ❑Not Applicable
403.2 Hot water boilers supplying heat % ❑Oomplies Requirement will be met.
[FI26]2 through one or two-pipe heating �'������%� ��������� ❑DtkS Not
�,
systems have outdoor setback Not Observable
'control to lower boiler water ❑
temperature based on outdoor s❑Not Applicable
temperature.
403.5.1.1 Heated water circulation systems ❑Complies Requirement will be met.
[FI28]2 have a circulation pump.The ❑Does Not
system return pipe is a dedicated ❑Not Observable i
return pipe or a cold water supply
pipe.Gravity and thermos- ❑Not Applicable
syphon circulation systems are
not present. Controls for
circulating hot water system
pumps start the pump with signal
for hot water demand within the
F
occupancy. Controls
automatically turn off'the pump
when water is in circulation loop
Is at set-point temperature^and
no demand for hot water exists.
.
403.5.1.2 Electric heat trace systems '❑Corptles Exception: Requirement is
403
9]2 comply with IEEE 515.1 or UL ❑Does Not not applicable.
515.Controls automatically "`
" Not Observable ;
adjust the energy input to the �❑
heat tracing to maintain the „, ]Not Applicable
desired water temperature in the
piping.
403.5.2 Demand recirculation water ❑Complies :Requirement will be met.
[F130]2 systems have controls that ❑Does Not
manage operation of the pump
and limit the temperature of the
° °❑Not Observable
water entering the cold water " ❑Not Applicable
e piping to <= 1044F. " "
403.5.4 Drain water heat recovery units ❑Complies Exception: Requirement is
[FI31]2 tested in accordance with CSA ❑Does Not not applicable.
B55.1. Potable water-side
'pressure loss of drain water heat f❑Not Observable
recovery units < 3 psi for ;;',,,; ❑Not Applicable
„o
individual units connected to one
or two showers. Potable water-
side pressure loss of drain water
heat recovery units <2 psi for
individual units connected to
three or more showers.
4.1 90%or more of permanent ❑Complies :Requirement will be met.
611 ;fixtures have high efficacy lamps. ❑Does Not
❑Not Observable
❑Not Applicable
404.1 1 no cl gas out lighting
light.ems �
shave ;❑Complies Requirement will be met.
pilot "Y' ❑Does Not
�❑Not Observable
m ❑Not Applicable
401.3 Compliance certificate posted. ❑Complies Requirement will be met.
[FI7]z
El
Doe�s Not
❑Not Observable
❑Not Applicable j
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 9 of10
ectlr n Plans Verified Field Verified Final Inspection r Provisions Plans
Value Ccswtwpjles� Co�xasrr�en�l+�ssur�pti'orr�s
ll ltD mechanical and water heating I�Oomplies Requirement will be met.
[ j g ODoes Not
systems have been provided.
[]Not Observable
ONot Applicable
Additional Comments/Assumptlons:
1 High lmlaact(Tier 1) Medium Impact(Tier 2) 3 Low Impact(Tler 3)
Project Title: 1981 August Lane Report date: 07/03/25
Data filename: Page 10 of10
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