43-065 (8) BP- 022-1435
56 DUNPHY DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
43-065-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-1435 PERMISSION IS HEREBY GRANT I TO:
Project# INSULATION Contractor: License:
DIPIETRO HOME ENERGY
Est. Cost: 4000 SOLUTIONS DBA REVISE 104464
Const.Class: Exp.Date: 03/06/2024
Use Group: Owner: D KOTEL AMY
Lot Size (sq.ft.)
DIPIETRO HOME ENERGY SOLUTION' DBA
Zoning: WSP Applicant: REVISE
Applicant Address Phone: Insurance:
32 MIDDLESEX ST (978)203-6736 WC100142000
HAVERHILL,MA 01835
ISSUED ON: 11/02/2022
TO PERFORM THE FOLLOWING WORK:
INSULATION/WEATH ERI ZATI ON
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: Footings:
Rough: Rough: House# Foundation:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIO ATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: ( l
1
Fees Paid: $65.00
•
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
F /i ' ; AUJL Ig76 9J�! aM p
he Commonwealth of Massachusetts
Boa#d of building Regulations and Standards FOR
I NOV MUNICIPALITY
Z 2022 '1as achu(setts State Building Code, 780 CMR
i USE
Building Permit A plic tion To Construct, Repair, Renovate Or Demolish a Revised Mar,2011
oFar OF euitnirvr ih jsPFcrioN� One- or Two-Family Dwelling
1 NnRTNe
Mrrory MA 0i050 This Section For Official Use Only
Building Permit Number: ,?i -/q A5- Date Applied: j
/EV k) 1055 / 2' /1-2-2,022
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
5(o h eh AO 6,S- I
1.1a Is this an accepted stret?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) N
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:
Public 0 Private 0 Zone: Outside Flood Zone?
— Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owned of Record:
Name(Print) City,State,ZIP
5U) l-, j ,r , • 41 3°I 3 ass-y owA.K-zab c 0 i ;I , Low
No.and Street Telephone Email A&-ess
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building ill Owner-Occupied!ff Repairs(s) 0 Alteration(s) II Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units ( Other 0 Specify:
Brief Description of Proposed Work2: WQ IA A e h?.t J- tyr i 11 Sujit 44('l7
oktf k. )
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ `Z)L W 1. Building Permit Fee: $ Indicate how fee is determined:
2. Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost3 (Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees:
Check No Check Amouhk: Cash Amount:_
6. Total Project Cost: $ 1100-b 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS- i d ti ,v y 3 l W .
lake S ( f). fle64OS License Number Expiration Date
Name of CSL Hol r I
Ors rkvROt List CSL Type(see below) V
No.an Street 111\)))i Type Description
I �� ^„ (\2' U Unrestricted(Buildings up to 35,000 cti.ft.)
0� 1 l' " U R Restricted L&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
°1-169-63673(o TO.Pn M v9caLt�V-i,, I Insulation
Telephone 3 Emaif address SOY\ D Demolition
5.2 Registered Home Improvement Contractor
(MC) - 'b'1 3'15 3�L 1 1
Di 8�{1M J V6ilt,a.s_ 7)'10-q-31C) 4 a�rel f SOf,�fttks HIC Registration Number Expiration Date
H Company Name or HIC Registrant Name A t f ie vi s.Q
3a IN Aolt �G S otp&m imcky 6 OC.titre rite . (OMNo.aria Str t1_l\ Ak lotO 13S Cflg 13 (Q�3 b Email address
OakfaeCity/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 10 No 0
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 3,4Pe,.S i MOpRila..) -�i.p►CSk,1`o ` 'd
•
to act on my behalf,in all matters relative to work authorized b this building permit application. Cities-
4/1 ( I o,a��aa
Print Owner's Nam (Electronic Signature) Date 1
SECTION 7b:OWNER1 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 application is true and accurate to the best of my knowledge and understanding.
Aa_Pat . ,mdpau 0f 1tilaZ 2a-
Print Owner's or Authori ed Agent' 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.C.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can he found at www.mass.gov/dps,
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. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton
Massachusetts �� "?
1, .Xi. 1 C•x $A DEPARTMENT OF BUILDING INSPECTIONS
,. y. 212 Main Street • Municipal Building vb. •. a
\ „os+Y�✓�,' Northampton, MA 01060 s �ti'
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: 3� �i di-p,�� !vflili a 6 di e3 5
The debris will be transported by:
Name of Hauler: G- mdlo I1(\
Signature of Applicant: -�',— Date: ILAD7\ )-
The Commonwealth of Massachusetts
f1 Department of Industrial Accidents
Office of Investigations
600 Washington ashington Street
Boston, MA 02111
rvWW.mass. ov/dia
1Vorkers' Compensation insurance Affidavit: Builders/Contractors/Electrician' /Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Dipietro Home Energy Solutions dba Revise 1
Address: 32 Middlesex St
City/State/Zip: Haverhill, MA 01835 Phone #: 978-203-6736
Are you an employer? Check the appropriate box: Type of project(required):
1.0 I am a employer with 30 4. ❑ i am a general contractor and I 6 New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ i am a sole proprietor o partner- listed on the attached sheet. 7. El Remodeling
ship and have no employees These sub-contractors have H. ❑Demolition
working for me in anycapacity. employees and have workers' d g
P" y• ). ❑ Building a dition
[No workers' comp. insurance comp. insurance.*
required.] 5. ❑ We arc a corporation and its I0.❑ Electrical r pairs or additions
❑ officers have exercised their 11. Plumbing r pairs or additions
3. i am a homeowner doing all work
myself. [No workers'comp. right of exemption per MGL 12.❑ Roof rcpai
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' I3.®Other Weatherization
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy inlhtnration.
t I lonteowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached tut additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. It the sub-contractors have employees.they must provide their workers'comp.policy number.
I ace an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: HUB international New England
Policy#or Self-ins. Lie.#: WCA00573401 Expiration Date: 04/20/2 23
Job Site Address: Dllh P h (N ' City State/Zip: r V a(ubc)
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties ail
tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the IAA for insurance coverage verification.
I do hereby certifi'under the pctit s i dpe::a/ties of perjury that the information provided above is true and correct.
Signature: • • -,•t :. yam Date:
Phone#: c/ 7 S '703 L'/X
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority (circle nne):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#:
,---� DIPIEHO-01 CWOODSI E
ACORO DATE(AIWDD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 4/4/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
IPRooucEn License 0 1780862 c TACT Anya Toteanu
J HUB International New England PHONE FAx —
300 Ballardvaie Street i- ' ram(arc,NR !b•Ext3 _ lNC )-
'Wilmington,MA 01887 11p ;anya.toteanu@hubinternational.com
•
{ e1SLIRER[S)AFFORDWG COVERAGE • NAIC N
INSURER A;Atlantic Charter Insurance Com_pany 44326
i INSURED j INSURER B: i
Joseph A.Dipietro Heating&Cooling,Inc.,Dipietro Home 1 wsuRER c:
Energy Solutions,Inc.,Revise,Inc. 1
32 Middlesex Street INSURER o.
Haverhill,MA 01835 i 1.loiSliFtER ..i
[INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
{ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED7- BY PAID CLAIMS.
i sesR TYPE Of INSURANCE IADDL,SUBR4 POLICY NUMBER POLICY EFF 1 POLICY EXP LIMITS ——
i!l t l fl ral(MIIYDWYYYY)..
COMMERCIAL GENERAL LIABRJTY I
FAcH OCC.1RAfNCE_..,— •-$---
Ci.AIMSUADE OCCUR j DAMAGE TO RENTED
�, I Pf�EU15 [Eir&f.aferor) f
WO EXPLMpallorq toe pallor I i _
t!-- PERSQNAL.¢ADv ekAJRY .1.
{
GEM.AGGREGATE la
APPLIES PER: ! GENERAL AGGREGATE S
PoucY► II JECT 1 1 LOC PRUOIX:TS_C(N,,P.'CP AGG :i
..___�_ _
AUTON ISILE LIABILITY r _-._ ..-__ __:'Eaa Nid i'Il SINGLE UAKT !S _.—a
—I
I ANY AUTO i 90OILY INJURY IPer parson) 1 S
,OWNED ~SCHEDULED
,AUTOS ONLY _ AA�UOTTOS pp 6OOI1V*MVRv.IP ^L,_t.
AUTOS ONLY !, AUTOY PROPERTY DAMAGE
[Per PER)Y
i 3
ry^_ UMBRELLA LIAR OCCUR F„Ap4 OCCi A ENCE _ I
EXCESS LW CLAIMS-MADE AGGREGATE - 3_
i DED 1 1 RETENTION$ i
A ND EMPLOYKERS ERS''LIABILITY Y!N .NSATION X STARTUTE EEL_ --
;ANY PROPRIETORPARTNF.NEXEcUTIVE WCA00573401 �a2022 �23 E,k, A- __ 1,000,000
O�FFICEA.'IIEMBER EXCL JDEO/ E._.. g4Ipaf r -.3
(Manasory In NH) I III N!A j E.L.DISEASE-EA EMPLOYEE.$ 1,000,000
i B i ex.QescnIM under 1000,000
;OESCRIPTION OF OPERATIONS boo* EL.DISEASE-POLICY L141I T 1 '
DE$CRMT,ON Of OPERATIONS i LOCATIONS(VEHICLES (ACORD 101,Additional Romanis Schedule,may be attached if more space is miaowed)
,
CERTIFICATE HOLDER -CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVENTT
� f,f I _
C
ACORD 25(2016103) 0 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACC.W? CERTIFICATE OF LIABILITY INSURANCE DATE IMM,DU'YYYY)
04;14;2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S).AUTHORIZED
REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poiicy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACf Emily Costello
NAME
Costello Insurance Group PHONE (978)374.6352 " (978)521-5127
fA+c Nye.ExitA1C Nol
2 S.Kimball St. E MAIL eoestello@costelloinsurance.com
ADDRESS:
PO BOX 5248
WSURER(S)AFfOROWG COVERAGE NAIL M
Bradford MA C.1e_S:> INSURER A. ColonyArgolnsurance
INSURED j NtsURER s: Commerce Insurance Co- 34754
Dlpietro Home Energy Solutions,Inc. INSURER C:
DBA Revise INSURER D:
32 Middlesex Street ;INSURER E
Bradford MA 018.35 i INSURER F
COVERAGES CERTIFICATE NUMBER: CL2241472385 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT MALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INgR TYPE OF INSURANCE �LJUW P
POLICY EFF POLICY EC LAWS
POS. POLICY NUMBER (S11WDW IMMi YYYY) DWYYYY)
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
s I.CQO,OC'0
CIAI► &IALIE OCCUR® tk:MA(aE TORtNTtD
E SE$rEa bccumemB s 50,000
MED EAR IAA'or.peraan s 10,000
A PACEP308383 0412512022 04125t2023 PERSONAL d AIYV INJURY s 1,000,000
GENT AGGREGATE LIMIT APPLIES PER'. ITENERAI AGGREGATE $ 2.000,000
POLICY [PJECTRO- t 2.000,0 00
I LOC PRODUCTS••COMPIOPAC,O i
OTHER:
AUTOMOBILE LIAIBUTY COMBINED SINGLE UNIT s 1.000,000
(Fa accabenq `
�_ANY AUTO BODILY INJURY(Pau cersai I S
AUTOS
Otsv X St e( LED HS8326 05;0912022 051C'9;2023 RCOILY NARY $
AUTOS
X HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY /' AUTOS ONLY loaf ar:-lard
Medical payments s 10,000
x UMBRELLA L1A[f X OCCUR ---^ EACH OCCURRENCE s 3.000,000
A EXCESS LIAa CLAIMS DACE EXC4245322 04125)2022 0412512023 AGGREGATE s 3.000,000
_11F11 12j<,kl.TENDON.S 10,000
WORKERS COMPENSATION PER CH-
AND EMPLOYERS'LIABILITY YIN STATUTEEP
ANY PRCPR;ETGRPARTNEREXECUTIVE N/A
E L.EACH ACCIDENT
MB S
Of FICFRt ER EXCLUDED/
fMandsoory M NH) F L DISEASE-EA EMPLOrEE $
It Yes.*sorbs urNrtt
DESCRIPTION OF OPERATIONS bobs C L.OLCFaTF-POLICY LIMIT $
•
DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Addihonai Racoons Schedule,may be attached amen space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION OATS THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AJTHOR:ZEU REPRLSENIAnvE
=_I 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
REVV .:
t` the way you . 4
Permit Authorization Form
Site ID:
Street Address:
City:
To be filled out by Subcontractor (if applicable)
Contractor Name: Dipietro Home Energy Solutions DBA Revise
Contractor Address: 32 Middlesex St Bradford Ma 01835
Amy Kotel
owner of the property listed above hereby authorize Revise Energy or my assigned
subcontractor listed above to act on my behalf and obtain a building permit to
perform insulation and/or weatherization work on my property under the Mass Save
Home Energy Services Program.
DocuSigned by:
Owner Signature: Q��1 4jcj
Date:
9/29/2022 cgase
vuuuoiyIi C irvciUpc IV. I IUC IOUL-/L03-4r 01-c�03-`JL`JNU I r4`JL 10 ayc I u
C2 REVISE ENERGY - 1
mass save
5 South Summer St.Haverhill. MA 01835
PARTNER
1 DESCRIPTION OF WORK TO BE PERFORMED
REVISE ENERGY will perform or cause to be performed the following work on the customer's address below,in a professional manner and in accordance with the terms of this
Contract,including the attached recommendations/work order describing the work in detail(the Work")which are incorporated herein by reference.Pricing reflected below may be
subject to adjustments in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed
Customer Name:Amy Kotel
Email: Not provided
Phone:413-923-2554
Premise Address: 56 Dunphy Dr,Northampton, MA 01062
Mailing Address:56 Dunphy Dr, Northampton,MA 01062
Project ID:4602421
Date:Sept.29, 2022
Job Description
Measure Description Location Quantity Unit Total Cost Customer Cost
Air Sealing at Estimated 62.5 CFM50 Per Hour 8 hr $754.64 $0.00
Door Sweep (with AS hrs) 2 each $52.22 $0.00
Exterior Door Weather Stripping (with AS hrs) 2 each $63.62 $0.00
Attic Floor - 9" Open Blow Cellulose 960 SF $1,910.40 $477.61
Hatch - 2" Thermal Barrier Polyiso 1 each $47.37 $11.84
Vent Bath Fan to Roof or Other 1 each $146.78 $36.69
Propavent 60 each $247.80 $61.95
Damming 25 each $61.25 $15.31
Project Total $3,284.08
2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows:
Payment#1(Deposit):$
-A non-refundable Deposit by credit card(Mastercard.Visa,or Discover card)or check is due at the time the Work is scheduled.Required payment information will be collected at
the tine of scheduling.Deposit is not to exceed 1/3 of the total contract cost.
Additional Payments and Final Invoice:$
-Additional payments for the Work shall be due upon completion of the Work and will be invoiced to the customer for payment by check or charged to the card on file within 24
hours of delivery of the Final Invoice.If this credit card charge is declined for any reason,upon notice from REVISE ENERGY you will be responsible fort r vi ing valid alternative
credit card information necessary to complete payment.
1—DocuSigned by: DocuSigned by:
61LLr L —9/29/2022 ,¢ Vc, , I 9/29/2022
.028cg4ae Cate R Ev; Fn1 _malue Dale
Brandon velasquez
tJainascf REVISE ENERGY Represeriative
The Terms of this Agreement are contained on both sides of this page
Revise Energy 5 South Summer St Haverhill.MA 01835 800-885-SAVE hello@ReviseEnergy.com ReviseEnergy.com
vo•upc IL/. I I VG 1 Vint!LVJ-Y/V 1-JyVJ7LMH0 I r 4MG I O rawer i VI
0 REVISE ENERGY 41'
mass save
5 South Summer St.Haverhill,MA 01835
PARTNER
1. DESCRIPTION OF WORK TO BEPERFORMED
REVISE ENERGY will perform or cause to be performed the following work on the customer's address below,in a professional manner and in accordance with the terms of this
Contract,including the attached recommendations/work order describing the work in detail(the Work')which are incorporated herein by reference.Pricing reflected below may be
subject to adjustments in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed
Customer Name:Amy Kotel
Email: Not provided
Phone:413-923-2554
Premise Address:56 Dunphy Dr, Northampton, MA 01062
Mailing Address:56 Dunphy Dr,Northampton, MA 01062
Project ID:4602421
Date:Sept.29,2022
Weatherization incentive ($1,810.20)
Air sealing incentive ($870.48)
Total Program Incentive -$2,680.68
Customer Total $603.40
2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows:
Payment##1(Deposit):S
-A non-refundable Deposit by credit card(Mastercard,Visa,or Discover card)or check is due at the tine the Work is scheduled-Required payment information will be collected at
the tine of scheduling Deposit is not to exceed 1/3 of the total contract cost.
Additional Payments and Final Invoice:S
-Additional payments for the Work shall be due upon completion of the Work and will be invoiced to the customer for payment by check or charged to the credit card on file within 24
hours of delivery of the Ftial Invoice.If this credit card charge is declined for any reason,upon notice from REVISE ENERGY you will be responsible for pro ing valid alternative
credit card information necessary to complete payment.
DocuSigned by: 1-DocuSigned by:
9/29/2022 b" 9/29/20 2
_air mr;r'1 r Dzecsase._ Date R EI it''i arytaIve SI91- ur? Dale
Brandon velasquez
Name of REvSE ENERGY Represeriarve
The Terms of this Agreement are contained on both sides of this page
Revise Energy 5 South Summer St Haverhill.MA 01835 800-885-SAVE hello@ReviseEnergy,com ReviseEn ergy.corn
Virtual Circle One In-Home
Revise Energy Planview Diagram
Customer: Ail Off Advisor Name: _5{ Cf C3
Address:
Town: Any limitations to access by truc ? Y
Site ID: ( '
b e Q i .Use the greater of the two BAS#'s when calculating for
MVR
I # of stories 1 , 1.5 2 2.5 _ BAS 1: 15 cfm X#occupants X n-factor =
n-factor 19 ✓ 16 15 14.4 13.7 I BAS 2: .00583 X area X height X n-factor
Mechanical Ventilation Recommended:BAS>final SO> (0.7 X BASl-- ch ical Ventilation Required:(0.7 X BAS)>final CFM50
Is this part of a multi-unit workscope? Y o N A/S Multiplie . N/A > Loose Insulation Cross-Batt >6*Mix Looselx-batt Truss
Workscope:
D 9ces tcr`b�c. Co xa Ait/iweeps
a cck1 7
)\,v..41-- 6,.F0-1-\
Any work scoped outside of b ractices/approved by?
2L{
a
(40 �!6
T
Area 1,3 a
Yr Built
DHWHeat Yr (J
Yr `-�
Ventialtion SOFT
SOFT/300
40%Low/High
Existing High
Existing Low
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THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement ConfractorRegistration
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JAMES G.[71M000UL.OS degt5iration: 167375
Expiration: 03/11/2024
25 SEVEN SISTER RD �� ,i•
HAVERHILL, MA 01830 ^ .
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Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE..Individual Office of Consumer Affairs and Business Regulation
Regi_strstien HxQIra tion 1000 Washington Street -Suite 710
167375 03/11/2024 Boston,MA 02118
JAMES G.DIMOUOULOS
JAMES DIMOUOULOS
25 SEVEN SISTER RD /,,,,,,.�, .; G(r•/' JJ .✓` �
11AVERNILL, MA 01830 Undersecretary '� Npt id without signature
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Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Re ulations and Standards
Con.* t ionfSTcrvisor
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CS-104464 x .1cpires:03/06/2024
JAMES G DI4OPOULOS
25 SEVEN SISTER RID
HAVERHILL MA 01030 i
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Commissioner Oar, fi 6,7ciut,