Fillable Insp-15 Building Permit Application - Rev. 11.2019 Model

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Insp-15 Building Permit Application - Rev. 11.2019 Model

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TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
Page 1 of 4 INSP-15 - Rev. 11/2019
Some building permit applications must be accompanied with:
(A)
A plot plan to scale showing the proposed structure in relationship to the
property lines.
(B)
Construction drawings (two sets).
(C)
The attached energy forms only apply to heated structures.
(D)
The following supplemental information may be required. Contact the
following departments for assistance:
Engineering @ 886-6008 Inspectional Services @ 886-6005
Discharge Application Electrical Permit
Dredge & Fill Mechanical Permit
Driveway Plumbing Permit
Sewer Permit Sign Permit
Site Specific Site Plan Applications
Stormwater NOI Special Exceptions
Water Permit Subdivision Applications
Variance Applications
Wetland Special Exception:
The applicant is required to take steps to prevent any intrusion into wetlands areas
or the surrounding buffer. This includes any equipment used in preparation or
construction. If such intrusion is likely, the applicant must request a Wetlands
Special Exception from the Zoning Board of Adjustment. If the applicant is not sure
whether wetlands are present, they may request an opinion from the Town, or
employ a certified wetland expert. If the building plan requires a Wetland Special
Exception, the plan must show the locations of the wetland, the buffer and all
structures. The wetlands must be staked by a certified wetlands expert. Please be
advised it is not always obvious that wetlands are present. In addition to the
evidence of water, specific vegetation may be evidence of a wetland. Failure to
comply with this requirement will result in a stop work order and may lead to
monetary fines being imposed.
TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
Page 2 of 4 INSP-15 - Rev. 11/2015
BUILDING PERMIT APPLICATION – PLEASE PRINT
Address: _________________________________________________ Unit # _______________
Site/Sub Plan: _____________________________________________ HCRD______________
Office use:
Map __________
Lot __________
Zone __________
Permit # ________
Residential
____ Single family detached
____ Modular Homes
____ Duplex
____ 3+ family dwelling (# of units _____)
____ Other ____________________________
Type of Improvement
____ New Building ____ Deck
____ Addition ____ Shed
____ Alteration/Renovation ____ Swim Pool
____ Repair/Replacement ____ Garage
____ Conversion of +/- dwelling units ____ Carport
____ Other ____________________________________________
Commercial
____ Office/Bank/Professional ____ Garage
____ Hospital/Medical ____ School
____ Industrial/Warehouse ____ Store
____ Restaurant ____ Utility
____ Other _____________________________________
Type of Improvement
____ New Building ____ Deck
____ Addition ____ Shed
____ Alteration/Renovation ____ Swim Pool
____ Repair/Replacement ____ Interior Demo
____ Conversion from residential to commercial space
____ Other ____________________________________________
Will the applicant/owner manufacture, assemble or produce any product, regardless of water use?
Yes (Need IDA Form) No (Need IDA Checklist) *Please consult the Town Engineer at 886-6008 with any questions
Total Cost of
Project:
$______________
Square Footage Footprint ____________ Renovated/added __________ Number of stories ________
Living area of new home (exclude unfinished areas and garage) _________ Total area of bldg _________
Principal Type of Frame Masonry (wall bearing) Wood Frame Structural steel
Reinforced concrete Other-Specify _________________________________
Type of Sewage Disposal Town or private company (requires Town permit)
Private (septic tank, etc.)

TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
Page 3 of 4 INSP-15 - Rev. 11/2015
Type of Water Supply Town Type of Heat Source Gas Other _________
Private (well, cistern) Oil Electric
Name Address City/State/Zip Phone
Owner ____________________________ ___________________________ ______________________ __________________
Lessee ____________________________ ___________________________ ______________________ __________________
Contractor ____________________________ ___________________________ ______________________ __________________
Architect ____________________________ ___________________________ ______________________ __________________
Engineer ____________________________ ___________________________ ______________________ __________________
I hereby certify the owner of record authorizes the proposed work and I have been authorized by the owner to make this application as his
agent and to conform to all applicable laws of the Town of Hudson. I hereby attest all statements made on this application are true to the best
of my knowledge. The signature on this building permit authorizes all Code Officials, Building Inspector and Assessor or their Agents to
conduct inspections from time to time during and upon completion of the work for which this permit is issued. If said structure is
commercial or industrial I understand that an as-built plan is required prior to occupancy of the structure.
Signature of applicant ________________________________________________________________________________ Date ____________
Address _________________________________________________________________________________________________________________
Email: ___________________________________________________________ Phone: ______________________________________________
Filing fee $ 30.00 Receipt # _______________ Date _______________
Building permit fee $_______________ Receipt # _______________ Date _______________
THIS BUILDING PERMIT IS
_____ Issued subject to the following condition(s) _____ Denied for the following reason(s)
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Plans received Date ________________
Comments: ___________________________________________________________________
_______________________________________________________________________________
Use group: _________________
Construction type __________
Live loading ________________
Occupancy load ____________
Certificate of Occupancy ____ Required ____ Final Inspection(Building & HFD)
Comments: ___________________________________________________________________
_______________________________________________________________________________
____ Approved
____ Denied _______________________________________________________________ _______________________
Inspectional Services Official or Designee Date
* Electrical Permit, Plumbing Permit, Mechanical Permit, Certificate of Occupancy,
Water, Sewer and Driveway are to be applied for separately, when applicable.
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TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
Page 4 of 4 INSP-15 - Rev. 11/2019
LOT PLAN POLICY
Some building permit applications shall be accompanied by a plot plan prepared by
a registered land surveyor showing existing and proposed structures on the
property with all setbacks shown and be no older than three years from the date of
building permit application. Any wetland within (50) fifty feet of the proposed site
activity shall be shown on the plot plan.
ONLY above ground pools, sheds, and decks are exempt from this policy and
would only be required to submit a “location plan” at the time of building permit
application.
Unique circumstances should be discussed with the Zoning Administrator.
NOTICE TO APPLICANTS:
New Hampshire RSA 676:13 requires the municipality to act on a building permit
within a 30 day time frame for residential and 60 days for non-residential .
The Town of Hudson will notify the applicant by phone or email when the permit is
ready.
TOWN OF HUDSON
12 School Street
Hudson, NH 03051
Rev. Jan. 2012
EC-1 Form page 1
New Hampshire
Residential Energy Code Application
for Certification of Compliance for New Construction, Additions and/or Renovations
(EC-1 Form)
Min
imum Provisions Effective Date: September 15, 2015
Owner/Owner
Builder
: Company Name: (if applicable)
General Contractor:
Company Name:
Name:
Name:
Mail Address:
Mail Address:
Town/City:
State:
Zip:
Town/City:
State:
Zip:
Phone:
Cell:
Phone:
Cell:
E-Mail:
E-Mail:
Location of Proposed Structure:
Tax Map #: Lot #:
Type of Construction:
Residential Small Commercial
New Building Renovation Addition
Thermally Isolated Sunroom
Modular Home: the site contractor must submit this
form detailing supplementary rooms and Floor and/or
Basement insulation unless the floor insulation is installed or
provided by the manufacturer and no heated space is added.
Street:
Town/City:
County:
Zone 5
Cheshire, Hillsborough, Rockingham or
Strafford except the town of Durham
Zone 6 All other counties and the town of Durham
Total New Conditioned* Floor Area:
_________________________ft
2
Heating System:
(if new system is being installed)
Annual Fuel Use Efficiency (AFUE): %
Fuel Type(s): Oil Natural Gas Propane (LP)
Electric Wood Other _______________
Heating System Type: Hot Water Hot Air
Stove Resistance Heat Pump Geothermal
Basement or Crawl Space:
(*a conditioned space is
one being heated or cooled, containing un-insulated ducts or with a
fixed opening into a conditioned space. Walls must be insulated)
Conditioned? Yes (Walls must be insulated) No
Full Basement Walk Out Basement
Slab on Grade Other ____________
Structure is EXEMPT because:
Mobile Home On an historic register
Low energy use (less than 1 watt/ ft
2
)
Form Submitted by:
Owner Builder Designer Other ________
Architects must certify plans meet code; no form required
02/11
I hereby certify that all the information contained in this application is true and correct, and construction shall comply in all respects with the terms and
specifications of the approval given by the Public Utilities Commission and with the New Hampshire Code for Energy Conservation in New Building
Construction.
Signature__________________________ Print Name____________________________ Date_____________
Official Use Only
Date Complete Application Received: Approved by: Date:
Approval Number:
Stamp:
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signature
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EC-1 Form page 2
New Hampshire Energy Code EC-1 Certification No.:
Code effective September 15, 2015
Directions: Complete the “Your Proposed Structure” columns. No measurements or calculations are needed. If you at least meet the
New Hampshire Energy Code requirements, your project will be approved. Write N/A in any section that does not apply to your
project. Submit pages 1 and 2 only. If your planned structure cannot meet these requirements, consider downloading REScheck from
http://www.energycodes.gov/rescheck/download.stm and use trade-offs to prove compliance.
You are encouraged to build with higher R-values and lower U-values than you report here. The “Required R or U Values” are the worst permitted in NH.
Building Section Required R or U Values
YOUR PROPOSED STRUCTURE
Write Planned
R and U Values
Brands / Models / insulation type and
thickness (if known)
Window U
Factor
(lower U is better)
U .35 (maximum) U-.31 (if log walls)
U .50 (Thermally Isolated Sunrooms only)
Write in U-Value
Window Type:
Low-e Low-e Argon
Check if: Sunroom Log Walls
Skylights
U .60
Flat Ceiling
i
or
Flat Ceiling
with Raised or
Energy
Trusses
R-value
R-38 (Zone 5
)
R-49 (Zone 6)
if using the above
construction
technique
R-30 (Zone 5)
R-38 (Zone 6)
if maintaining the
full R value over
the plates
Write in R-Value
→
If using only R-
30 in Zone 5 or
R-38 in Zone 6
you must check
this box
NOTE: R-38 will be deemed to satisfy the
requirement for R-49 if the full R-38
insulation value is maintained over the
outside plates. If using only R-30 (Zone 5)
or R-38 (Zone 6), you must certify that
you’ll maintain R-38 over the plates by
checking the box below.
By checking this box, I certify that this
structure is being built with a raised energy
truss or that the full R-value of the ceiling
insulation will be maintained over the
outside plates.
Sloped or
Cathedral
Ceiling
R-30 or 38 if more than 500 ft sq or
20% of total ceiling area
R-24
(Thermally Isolated Sunrooms only)
Write in R-Value
Check if Sunroom
Above Grade
Wall
ii
R-value
R-20
Cavity Insulation only or
R-13 plus R-5
Cavity plus Continuous Insulation
R-13 (Thermally Isolated Sunrooms only)
Write in R-Value
Log walls must comply with ICC400, have an
average minimum wall thickness of 5” or greater
and must have overall glazing of U-.31 or lower
and heating AFUE of 90% (gas) or 84% (oil) and
meet all other energy code requirements
.
Check if
Sunroom
Log Walls
Door U-Value
U .35 (maximum)
Write in U-Value
Floor R Value
(Basement ceiling)
R-30
or Insulation sufficient to fill joist cavity
Write in R-Value
If conditioning the basement you must
insulate Basement Walls. If not, you may
insulate either Floor or Basement Walls
and/or Slab Edge
Basement or
Crawl Space
Wall R Value
R-13 Cavity Insulation or
R-10 Continuous Insulation (Zone 5)
R-19 Cavity Insulation or
R-15 Continuous Insulation (Zone 6)
Write in R-Value
Slab Edge
iii
R Value
R-10
2’
(Zone 5)
4’
(Zone 6)
(see drawing pg 3)
add R-5 if the Slab is heated
Write in R-Value
Air Sealing
Planned Air Sealing
Test Method →
By checking this box, I certify that I understand
that I have two approaches to demonstrating
compliance with air sealing requirements.
Blower Door
Vi
sual Inspect
The visual inspection certification must be
consistent with the requirements of Table 402.4.2
(page 4) and the method of compliance planned
and approved by the local jurisdiction
Submit pages 1 and 2 to: NH Public Utilities Commission, 21 South Fruit Street Ste 10, Concord NH 03301
Fax: 603.271.3878 e-mail:
energycodes@puc.nh.gov
EC-1 Form page 3
Footnotes to Residential Energy Code Application for Certification of Compliance
i
Ceilings with attic spaces: R-30 in Zone 5 or R-38 in Zone 6 will be deemed to satisfy the
requirement for R-38 or R-49 respectively wherever the full height of uncompressed R-30 or R-38
insulation extends over the wall top plate at the eaves or the full R-value is maintained. This is
accomplished by using a raised heel or energy truss as shown in the diagram below or by using higher
R-value insulation over the plates.
ii
R-13 + R-5 means R-13 cavity insulation plus R-5 insulated sheathing. If structural sheathing
covers 25 percent or less of the exterior, R-5 sheathing is not required where the structural sheathing
is placed. If structural sheathing covers more than 25 percent of exterior, the structural sheathing
must be supplemented with insulated sheathing of at least R-2.
iii
Slab edge insulation must start at the top of the slab edge and extend a total of two (Zone 5) or four
feet (Zone 6). Insulation may go straight down, out at an angle away from the building, or along the
slab edge and then under the slab. A slab is a concrete floor within 1’ of grade level. See diagram
below.
T
he top edge of insulation installed between the exterior wall and the interior slab may be mitered at a
45 degree angle away from the exterior wall.
Allowable Slab Insulation Configurations
A or A+ B must equal two feet in Zone 5 or four feet in Zone 6
M
ODULAR HOMES must be certified by the NH Department of Safety. Unless the floor insulation
is provided by the manufacturer this form must be submitted. This form must also be submitted if the
basement is to be insulated or supplementary heated space is added to the home upon or after it is set.
EC-1 Form page 4
AIR BARRIER AND INSULATION INSPECTION COMPONENT CRITERIA
Required Elements Check List (see page 2 AIR SEALING) IECC Code section 402.4.2
This page must be provided to the building inspector at final inspection.
√ Check here Certification No.:
Air barrier and
thermal barrier
Exterior thermal envelope insulation for framed walls is installed in
substantial contact and continuous alignment with building envelope
air barrier.
Breaks or joints in the air barrier are filled or repaired.
Air-permeable insulation is not used as a sealing material.
Air-permeable insulation is inside of an air barrier.
Ceiling/attic
Air barrier in any dropped ceiling/soffit is substantially aligned with
insulation and any gaps are sealed.
Attic access (except unvented attic), knee wall door, or drop down
stair is sealed.
Walls
Corners and headers are insulated.
Junction of foundation and sill plate is sealed.
Windows and doors
Space between window/door jambs and framing is sealed.
Rim joists
Rim joists are insulated and include an air barrier.
Floors
(including above-garage
and cantilevered floors)
Insulation is installed to maintain permanent contact with underside
of sub floor decking.
Air barrier is installed at any exposed edge of insulation.
Crawl space walls
Insulation is permanently attached to walls.
Exposed earth in unvented crawl spaces is covered with Class I
vapor retarder with overlapping joints taped.
Shafts, penetrations
Duct shafts, utility penetrations, knee walls and flue shafts opening
to exterior or unconditioned space are sealed.
Narrow cavities
Batts in narrow cavities are cut to fit, or narrow cavities are filled by
sprayed/blown.
Garage separation
Air sealing is provided between the garage and conditioned spaces.
Recessed lighting
Recessed light fixtures are air tight, IC rated, and sealed to drywall.
Exception—fixtures in conditioned space.
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.
Shower/tub on
exterior wall
Showers and tubs on exterior walls have insulation and an air barrier
separating them from the exterior wall.
Electrical/phone box
on exterior walls
Air barrier extends behind boxes or air sealed-type boxes are
installed.
Common wall
Air barrier is installed in common wall between dwelling units.
HVAC register boots HVAC register boots that penetrate building
envelope are sealed to sub-floor or drywall.
Fireplace
Fireplace walls include an air barrier.
EC-1 Form page 5
NEW HAMPSHIRE ENERGY CODE
Summary of Basic Requirements See IECC 2015 Code Book for complete details
These 2 pages must be provided to the building inspector at final inspection or retained.
√ Check here Certification No.:
Air Leakage
Code section 402.4
The building thermal
envelope must be durably
sealed to limit infiltration
All joints, seams, penetrations and openings in the thermal envelope including those around
window and door assemblies, utility penetrations, dropped ceilings or chases, knee walls,
behind tubs and showers, separating unheated garages from the thermal envelope, common
walls between dwelling units, attic access, rim joist junction and all other openings in the
building envelope that are sources of air leakage must be caulked, gasketed, weather-stripped
or otherwise sealed.
Air Sealing and Insulation
Code Section 402.4.2
Building envelope air tightness and insulation installation shall be demonstrated to comply with
requirements by Blower Door testing to less than 7 air changes/hr at 50 Pa or a visual
inspection per page 4 of this document. The local Building Official may require an
independent 3
rd
party to conduct the visual inspection. See page 4.
Testing Option
Code Section 402.4.2.1
or
Visual Option
Code Section 402.4.2.1
While the Blower Door Test and/or Visual Option are methods of demonstrating compliance many of the
general requirements as defined by this checklist (pages 5 & 6) must still be met.
Blower Door Test conducted by: _________________________________________
Result (at 50 Pa): __________CFM Interior Volume___________ CF ______________ACH
or
Structure passes Visual Inspection: _____________________signed ______________ date
Fireplaces
Code Section 402.4.3
New wood-burning fireplaces shall have gasketed doors and outdoor combustion air.
Recessed Lighting
Code Section 402.4.5
Recessed lights must be type IC rated and labeled as meeting ASTM E 283 and sealed with a
gasket or caulk between the housing and the interior wall or ceiling covering.
Electrical Power and
Lighting Systems
Code section 404
A minimum of 50% of the lamps in permanently installed lighting fixtures shall be high
efficacy lamps.
High-Efficacy Lamps
Code section 202
Compact fluorescent lamps, T-8 or smaller diameter linear fluorescent lamps, or lamps with
a minimum efficacy of:
1. 60 lumens per watt for lamps over 40 watts,
2.
50 l
umens per watt for lamps over 15 watts to 40 watts, and
3. 40 lumens per watt for lamps 15 watts or less.
Materials and Insulation
Information
Code section 102.1
Materials and equipment must be identified so that code compliance can be determined.
Manufacturer manuals for all installed heating, cooling and service water heating equipment
must be provided. Insulation R-values, glazing and door U-values and heating and cooling
equipment efficiency must be clearly marked on the building plans, drawings or specifications.
Pull-Down Attic Stairs,
Attic Hatch, and Knee
Wall Doors
Code section 402.2.3
Should be insulated to a level equal to the surrounding surfaces and tightly sealed and weather-
stripped at the opening.
EC-1 Form page 6
Full size Attic or
Basement Entry Doors
All doors leading from a conditioned space into an unconditioned attic or enclosed attic or
basement stairwell should be insulated and weather-stripped exterior rated door units. One
door is exempt.
Duct Insulation
Code section 403.2
Supply ducts in attics must be insulated to at least R-8. All other ducts must be insulated to at
least R-6. Exception: Ducts or portions thereof located completely inside the building thermal
envelope.
Duct Construction
Code sections 403.2.2 &.3
Ducts, air handlers, filter boxes, and building cavities used as ducts must be sealed. Joints and
seams must comply with Section M1601.4.1 of the International Residential Code. Building
framing cavities must not be used as supply ducts.
Duct Testing
Code sections 403.2.2 &.3
Duct tightness shall be verified by testing unless the air handler and all ducts are located within
the conditioned space. Test conducted by: _________________________________________
Duct test result at 25 Pa:___________ __Post construction or _______________Rough-in test
Temperature Controls
Code section 403.1 & .1.1
At least one thermostat must be provided for each separate heating and cooling system. Hot air
systems must be equipped with a programmable thermostat.
Heat pumps having supplementary electric-resistance heat must have controls that, except
during defrost, prevent supplemental heat operation when the heat pump compressor can meet
the heating load
Mechanical System Piping
Insulation
Code section 403.3
Mechanical system piping capable of conveying fluids at temperatures above 105°F or below
55°F must be insulated to R-3.
Circulating Hot Water
Systems
Code section 403.4 & NH
a
mendments
Circulating service water systems must include an automatic or readily accessible manual
switch that can turn off the hot water circulating pump when the system is not in use.
Circulating domestic hot water system piping shall be insulated to R-4.
Mechanical Ventilation
Code section 403.5
Outdoor air intakes and exhausts must have automatic or gravity dampers that close when the
ventilation system is not operating.
Equipment Sizing
Code section 403.6
Heating and cooling equipment must be sized in accordance with Section M1401.3 of the
International Residential Code.
Certificate
Code section 401.3
A permanent certificate, completed by the builder or registered design professional, must be
posted on or in the electrical distribution panel. It must list the R-values of insulation installed
in or on the ceiling, walls, foundation, and ducts outside the conditioned spaces; U-factors and
SHGC for fenestration. The certificate must also list the type and efficiency of heating, cooling
and service water heating equipment.
NEW HAMPSHIRE ENERGY CODE Summary of Basic Requirements Page 2
These 2 pages must be provided to the building inspector at final inspection or retained.
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Insp-15 Building Permit Application - Rev. 11.2019 Model

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Completed 13 July 2020

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