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22D-037
BP-2023-0777 22 CLARK ST COMMONWEALTH OF ASSACHUSETTS Map:Block:Lot: 22D-037-001 CITY OF NORTH MPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0777 PERMISSIO IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: DIPIETRO HOME E RGY Est. Cost: 4030 SOLUTIONS DBA EVISE 104464 Const.Class: Exp.Date: 03/06/20 4 Use Group: Owner: MANUEL VARGAS, MICHAEL Lot Size (sq.ft.) Zoning: WSP Applicant: MANUEL VARGAS, MICHAEL Applicant Address Phone: Insurance: 22 CLARK ST FLORENCE, MA 01062 ISSUED ON: 06/13/2023 TO PERFORM THE FOLLOWING WORK: INSULATION AND WEATHERIZATION 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: )2 Qs- • , . ( II Fees Paid: $69.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissi.ner C � WILT I q26 The Commonwealth of Mass. uset !/1 • i Board of Building Regulations . d St. dards140 , / FOR . Massachusetts State Building o. , ":.� . R 0 elt E LITY Building Permit Application To Construct,Repair, t c Demol'W a Revised Mar 2011 One-or Two-Family Dwelling 4,r�N, Cal. Nsp , This Section For Official Use Only QagoCp- Buildin Pen-nit Number: f`2ia'vj�-' 7 7 Date Applied: 06/07/2023 ��°�S ,� �'s /�& _ G- /3-2023 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 22 Clark St Florence,MA 01062 1.1 a Is this an accepted street?yes V 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) 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 El Zone: — Outside Flood Zone'? Municipal 0 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Mike Vargas Florence, MA 01062 Name(Print) City,State,ZIP 22 Clark St 413-584-315� mikevargasmusic©gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2:Insulation,Weatherization,and Air Sealing SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $4030.71 1. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $0 ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $0 2. Other Fees: $ 4.Mechanical (HVAC) $0 List:_ 5.Mechanical (Fire Suppression) $0 Total All Fees:$ di Check No. 0I41 Check Amount: 040 Cash Amount: 6.Total Project Cost: $4030.71 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-104464 03/06/24 James Dimopoulos License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 32 Middlesex St No.and Street Type Description Haverhill,MA 01835 U Unrestricted(Buildings up to 35,000 cu._ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering \WS Window and Siding SF Solid Fuel Burning Appliances 978-203-6736 melissat@callrevise.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC-167375 03/11/24 James Dimopoulos Dipietro Home Energy Solutions dba Revise HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 32 Middlesex St melissat@callrevise.com No.and Street Email address Haverhill,MA 01835 978-203-6736 City/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 0 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 to act on my behalf,in all matters relative to work authorized by this building permit application. See attached authorization Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties o f perjury that all of the information contained in this applicati n is true and accurate to the best of my knowledge and understanding. 06/07/2023 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or at 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.G.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 be 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 Numbe-of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts .74,a Department of Industrial Accidents _. Office of Investigations 7. =.. Lafayette City Center "IL=t' 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Dipietro Home Energy Solutions dba Revise 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in anycapacity. employees and have worke .' P tY 9. ❑Building addition [No workers' comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and it 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised thei 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MG 12.0 Roof repairs insurance required.] t c. 152,§1(4),and we have o Weatherization employees. [No workers' 13.❑■ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'comp nsation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside co ractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-con . ors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy mber. I am an employer that is providing workers'compensation insurance for my e ployees. Below is the policy and job site information. Insurance Company Name: HUB International New England Policy#or Self-ins.Lic.#:WC100142002 Expiration Date:04/20/2024 Job Site Address: 22 Clark St ity/State/Zip:Florence, MA 01062 Attach a copy of the workers' compensation policy declaration page(showi 1 g the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can le.d to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in he 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 DIA for insurance coverage verification. I do hereby certify under the pa' and p nalties of perjmy that the information provided above is true and correct. Signature: �--� _ pate: 06/07/2023 Phone#: (978) 203-6736 Official use only. Do not write in this area,to he completed by city or town fftcial. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 3.0City/Town Clerk 4.0 Electrical Inspector 5FlPlumbing Inspector 6.0Other Contact Person: Phone#: ACCPRO0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/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 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). PRODUCER CONTACT Emily Costello NAME: Costello Insurance Group (AHCO.NNo,Eat): (978)374-6352 FAX No): (978)521-5127 2 S.Kimball St. E-MAIL ecostello@costelloinsurance.com ADDRESS: PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC# Bradford MA 01835 INSURERA: Colony Argo Insurance INSURED INSURER B: Commerce Insurance Co. 34754 Dipietro Home Energy Solutions,Inc. INSURER C: DBA Revise INSURER D: 32 Middlesex Street INSURER E: Bradford MA 01835 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2241402385 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP 'TYPE OF INSURANCE LTRINSD WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2023 04/25/2024 PERSONAL 8,ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO LOC 00000PRODUCTS-COMP/OPAGG $ 2 OTHER: pollution $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED �/ SCHEDULED HS6326 05/09/2023 05/09/2024 BODILY INJURY(Per accident) $ _ AUTOS ONLY /'s AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY -(Per accident) Medical payments $ 10,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB ^ CLAIMS-MADE EXC4245322 04/25/2023 04/25/2024 AGGREGATE $ 3,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 210 Main Street THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Northampton, MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I I, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DIPIEHO-01 CWOODSIDE ,d►coRL7 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD YYYY) 4/19/2023 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). PRODUCER License#1780862 I CONTACT NAME: Anya Toteanu HUB International New England PHONE 300 Ballardvale Street (A/C,No,Ext): (A/C,A No): Wilmington, MA 01887 E-MAIL anya.toteanu@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Independence Casualty Insurance Company 11984 INSURED INSURER B: Dipietro Home Energy Solutions,Inc.,Joseph A.Dipietro INSURER C: Heating&Cooling,Inc 32 Middlesex Street INSURER D: Haverhill,MA 01835 INSURERE: 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WYD IMM/DDIYYYYI IMM/DDIYYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY Tef LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OAUTOS EONS ONLY SCHEDULEDNWtIE BODILYO INJURY(Per accident) $ AUTOS ONLY AeTO ONL9 _(Perr accident)!DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE OTH- ER WC100142002 4/20/2023 4/20/2024 1,000,000 ANYI PROPRIETOR EXRTNERE ECUTIVE N NIA E.L.EACH ACCIDENTE $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under - 1000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ ' DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 210 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE 77 T ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington-Street - Suite 710 Boston, Massachusetts 02118 Home Improvemerit:Contractor-Registration Typo; Individual egistration. 167375 JAMES G.DIMOUOULOS Expiration: 03/11/202=1 25 SEVEN SISTER RD HAVERHILL, MA 01830 y ', Update Address and Return Cant. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affafrs&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 Rosiness Regulation Rogi treliert Expiration 1000 Washington Street -Suite 710 167375 03/11/202,1 Boston,MA 02118 JAMES G.DIMOUOULOS, JAMES DIMOUOULOS 25 SEVEN SISTER RD ;/,.,.ter!;.% ,rGG•r / __"�, ...x -"'� '� IIAVERHItL,MA 01830 Undersecretary i /� N k--lid without signature 1117 Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards Ir Constx, tots Srvisor CS-104464 a' Expires:03/06/2024 JAMES G DIMOPOULOS 25 SEVEN SISTER RD HAVERHILL MA 01830 „Y i`)/iA :t r� 04 Commissioner ,;? f; $...1 t.7c 'al, DocuSign Envelope ID: 1A5B021F-AA4C-4F1A-A8B5-050B73CD7864 Page 1 of 2 0 REVISE ENERGY 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:Mike Vargas Email:Not provided Phone:413-584-3156 Premise Address:22 Clark St,Northampton,MA 01062 Mailing Address:22 Clark St,Northampton,MA 01062 Project ID:4837683 Date:May 10,2023 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour 4 hr $377.32 $0.00 Hatch -2"Thermal Barrier Polyiso 1 each $47.37 $11.84 Walls -Wood Shingle-4" Dense Pack Cellulose 920 SF $2,272.40 $568.10 Attic Floor- 11"Open Blow Cellulose 468 SF $1,015.56 $253.89 Install Aluminum Soffit Vent 4 each $140.24 $35.06 Propavent 4 each $16.52 $4.13 Damming 44 each $107.80 $26.95 Bath Fan Hose 1 each $28.00 $7.00 Vapor Barrier- 6 mil Polyethylene (with AS hrs) 25 SF $25.50 $0.00 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -A non-refundable Deposit by credit card(Mastercard,Visa,or Discover card)or check is due at the 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:$ -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 Fial Invoice.If this credit card charge is declined for any reason,upon notice from REVISE ENERGY you will be responsible for providing valid alternative credit card information necessary to complete payment. /—DocuSigned by: �DocuSigned by: 5/10/2023 Itl.tctuid, 5/10/2023 7�� BA117331D15243F... Date R EVIN—D4784CBB9E1D490... Dale Michael E madden Name cf RE\SE ENERGY ReCteser1atiae 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 DocuSign Envelope ID: 1A5B021F-AA4C-4F1A-A8B5-050B73CD7864 Page 2 of 2 0 REVISE ENERGY rik 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:Mike Vargas Email:Not provided Phone:413-584-3156 Premise Address:22 Clark St,Northampton,MA 01062 Mailing Address:22 Clark St, Northampton,MA 01062 Project ID:4837683 Date:May 10,2023 Project Total $4,030.71 Weatherization incentive ($2,720.92) Air sealing incentive ($402.82) Total Program Incentive -$3,123.74 Customer Total $906.97 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -A non-refundable Deposit by credit card(Mastercard,Visa,or Discover card)or check is due at the 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:$ -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 Firal Invoice.If this credit card charge is declined for any reason,upon notice from REVISE ENERGY you will be responsible for providing valid alternative credit card information necessary to complete payment. DocuSigned by: r—Docusigned by: 5/10/2023 5/10/2023VaroaS tIGU.A. , Dust—BA117331D15243F.. Date R E1 D4784CBB9E1D490... Dale Michael E Madden Name of REVISE ENERGY Represertalive The Terms of this Agreement are contained on both sides of this page Revise Energy-5 South Simmer St Haverhill,MA 01835.800-885-SAVE-hello@ReviseEnergy.com-ReviseEnergy.com DocuSign Envelope ID 1A5B021F-AA4C-4F1A-A8B5-050B73CD7864 1R � t,. the way save 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 Mike vargas 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. --DocuSrgned by: Owner Signature: Uarroal.s BA117331D15243F._. Date: 5/10/2023 Revise Energy Planview Diagram Customer: Mx t(-C J t V"`h) Advisor Name: Ashen Address: 47 I Any limitations to access by truck? Y,C N) Town: C-r'Liv Site ID: K 48 '7 *Use the greater of the two BAS it's when calculating for MVR if of stories 1 1.5 2 2.5 3 BAS 1: 15 cfrr X ft 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 CFMSO> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS)>final CFM50 Is this part of a multi-unit workscope?Y o(N) A/S Multiplier?(it) >6"Lbose Insulation Cross-Batt >6"Mix Loose/x-batt Truss Workscope: P\..A 't-L 4 f tAd 5 w ii"VCL ,.)-o0 F -' s�- 1 Anc t o *6c? c, 1,-- 1 N.3`7 i Aso i;n r Ip a v✓` 1 Any work scoped outside of best practices/approved by? CS) `C-2) C9EA.6\11\ 1.lop ,r6 .71 Page__of,__ 4eit WEATHERIZATION mass save BARRIER INCENTIVES Savings through energy efficiency Based on your Energy Specialist's recommendations,your home can benefit from program-eligible insulation and/or air sealing improvements.Before moving forward,please follow all the instructions below to remediate your weatherization barriers. CUSTOMER INSTRUCTIONS 1. Hire a qualified, licensed contractor to evaluate and/or remediate the weatherization barrier(s). 2.Submit signed and completed copies of this form and a copy of the paid contractor invoice(s)within 60 days of your Home Energy Assessment to:Submit signed and completed copies of this Contractor Evaluation Report and a copy of the dated and itemized Contractor Invoice to the Participating Home Performance Contractor that completed your Home Energy Assessment. 3.The weatherization incentive will be deducted from the customer co-payment amount of the weatherization work.A rebate check will be issued in the event the amount exceeds the customer's co-payment amount. 4.Complete the recommended weatherization improvements. CUSTOMER INFORMATION Customer Name: Mike Vargas Client#or Site ID: 4833228 Site Address: 22 Clark st City: Florence State: MA ZIP: 01062 Phone Number (413)584-3156 Email: mikevargasmusic@gmail.com Customer/Homeowner Signature: }4,,.aE, Yak aS Date: 06/08/23 KNOB AND TUBE WIRING To determine if there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save` weatherization recommendations have been made: •Attic Floor It Attic Wall III Attic Slope ®Exterior Wall II Basement U Other: ❑Other: • I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below. ®Attic Floor U Attic Wall ®Attic Slope IN Exterior Wall U Basement U Other: ❑Other: ❑ I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: Jeff Bagge Address: 37 Cheshire Dr City: Longmeadow State: MA ZIP: 01106 Company Name: JRB Services 54886-b License Number: Contractor Signature: it1 f 4 13 1 I I .f../ Date: 06/08/23 / / MECHANICAL SYSTEM BARRIERS(To be filled out by licensed contractor.) High Carbon Monoxide:Contractor is to service and re-evaluate the selected mechanical system(s)and reduce the carbon monoxide level, as measured in the undiluted flue gas,to below 100 parts per million(ppm). Draft Failure:Contractor is to correct the draft in the selected flue(s).Refer to table on reverse for acceptable draft ranges. High Carbon Monoxide Draft Failure Existing CO ppm: Revised CO ppm: . I Existing Draft Pa: I Revised Draft Pa: Heating System Hot Water Heater I Other: Spillage:Contractor is to correct the spillage of flue gases in the selected mechanical system(s).Must not spill after 60 seconds of operation. ❑ Heating System 0 Hot Water Heater 0 Other: ❑ I have performed my inspection and have corrected the items noted in the areas selected above. ❑ I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: _ Address: City: State: ZIP: Company Name: License Number: Contractor Signature: Date: Continued on back (page 1 of 2) VENTILATION Exhaust Fan for Fresh Air:Contractor to install exhaust fan to provide measured,continuous or intermittent whole building ventilation. The required rate of flow must be capable of providing CFM(measured at fan). Dryer Vent Evaluation:Contractor to ensure the dryer vent is exhausted to the exteric r through hard metal ductwork. ❑ I have installed an exhaust fan to the specifications noted above. ❑ I have evaluated and/or repaired the dryer vent fan to the specifications noted above. ❑ I have read and agree to the Terms and Conditions on this form. Contractor Name: Address: City: State: ZIP: Company Name: License Number: Contractor Signature: Date: TERMS AND CONDITIONS Eligibility Requirements:Applicant must be a residential customer of a participating Mass Save Sponsor.Customer must participate in the Mass Save Home Energy Services Program(must reside in a 1-4 family home).The qualifying barrier must e identified at the time of the Home Energy Assessment as a barrier preventing the installation of proposed weatherization improvements.Customer must omplete the recommended weatherization improvements to receive the applicable incentive.Customer must submit the completed Contractor Evaluation Report including a copy of the dated and itemized invoice from the licensed contractor on company letterhead within 60 days(postmarked)of the Home nergy Assessment.If contractor invoice is not provided within 60 days,the eligible weatherization barrier incentive may be forfeited.Customer particip tion does not guarantee the barrier will be cleared. Contractor Responsibilities and Acknowledgement:In performing any work in connection with the Weatherization Barrier Incentive(as set forth in detail below),the contractor shall:(i)abide by all local,state and federal guidelines,applicable laws(including,but not limited to all applicable environmental laws),building codes,regulations(including,but not limited to EPA lead-safe and any and all of ner applicable environmental regulations)and licensing requirements;and(ii)stop work and immediately notify the customer in any case where existing or possible health and/or safety problems exist.The licensed contractor must fill in and sign off on the testing results in the appropriate place on this form.Contractor shall remain solely and fully responsible for their confirmations and notes that they provide on this form and with respect to the Contractor Responsibilities set forth above. Knob&Tube Wiring Evaluation(up to$250 incentive):The knob and tube wiring that has been noted cannot be determined inactive at the time of the Home Energy Assessment performed by the Mass Save Home Energy Service Program.Even if the observed wiring appears to be inactive,there might- still be active circuits located in inaccessible areas of the home(i.e.walls,etc.).The Mass Save Home Energy Services Program requires that a licensed electrician verify the absence or inactivity of the knob and tube wiring in the areas of your home where we are proposing insulation be installed.We advise you to share this form with your electrician before hiring them to inspect your home to ensure they agree to the terms.The Home Energy Services Program will rely on the electrician's certification and will not be liable if inaccurate. Mechanical System Evaluation(up to$250 Incentive):Combustion safety testing has been conducted on all the heating and hot water systems in this home.These tests are conducted with all the exhaust equipment running simultaneously,creatirg a"worst-case"depressurization of the building.If a problem was identified,repairs to correct the problem must be completed by a qualified HVAC contractor.The problems and corrections are as follows: 1. Carbon monoxide levels exceed 100 ppm in the undiluted flue gases.After a clean and tune,or other applicable service,the measurement(s)of undiluted flue gas of carbon monoxide are to be recorded on the front of this Contractor Evaluation Report where program rules state the maximum allowable concentration is 100 ppm. 2. During your Home Energy Assessment it was discovered that the identified mechanical system(s)was continuously spilling exhaust gases into the home. This condition is also known as back draft and should end within 60 seconds of system operation in order to be considered acceptable.The contractor must service the system(s)to correct the spillage problem in the selected flue(s),and certify by signature on the front of this form that the spillage condition has ceased after 60 seconds of operation. 3. During your Home Energy Assessment it was discovered that the identified mechanical system(s)are not creating sufficient DRAFT.This condition is where exhaust gases are not moving through the chimney at a fast enough rate.The contrac or must service the system(s)to correct the draft problem in the selected flue(s).New draft results must be provided on the front of this form and within acceptable draft ranges as described in Table 1. Outside Temp('F) Minimum Draft Pressure(Pa) <10 -2.5 Table 1-Acceptable 10-90 (outside Temp/40)-2.75 Draft Test Ranges >90 -0.5 Exhaust Fan installation(up to$250 incentive):The results of the completed blower door test at the time of your Home Energy Assessment or scheduled weatherization installation with a Participating Contractor,determined that your home will need an increase in fresh air flow before undertaking any program eligible weatherization work.Mass Save provides a Weatherization incentive for the installation of an exhaust fan to provide additional fresh air to the home.Your energy specialist can help determine the necessary flow rate and provide recommendations.This incentive is only available in limited situations and not all customers will receive a blower door test at the time of the Home Energy Assessment. Brought to you by: BLGICKSTONE "9h` ColumI a Gas Comp act BERKSHIRE GAS COMPANY of Massachusetts GAS A Nisourc.compnr EVERS=URCE _ Liberty Utilities nationalgrid 1t11 HERE WITH YOU.HERE FOR YOU. O:" "f,:r life FOR ADDITIONAL INFORMATION, PLEASE CALL YOUR ENERGY SPECIALIST. (page 2 of 2)