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18C-113 (4)
BP-2023-1343 186 JACKSON ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18C-113-001 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-2023-1343 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 9939 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date: 03/06/2024 Use Group: Owner: C.JOHNSTON, ADIA Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: URB Applicant: REVISE An licant Address Phone: Insurance: 32 MIDDLESEX ST (978)203-6736 WC100142002 HAVERHILL,MA 01835 ISSUED ON: 09/27/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATI 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: (� b • v. 6 cfri Fees Paid: S64.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner c,...., ,q,z �RECEIVED 2 5 2023 The Commonwealth of Massachusetts ; Board of Building Regulations and Standards FOR `; Massachusetts State Building Code,780 CMR MUNICIPALITY DF Ill f)ING IP1cpFCTIONS USE .-, ':?''�HAMP'oBdillitngTermit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building P rmit Number: 13/� 3' I Date Applied: 09/18/2023 I1ui,—.1 &53 // q- 27-2023 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 186 Jackson St 18C-113-001 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 2 Private❑ Zone: Outside Flood Zone? — Municipal 2 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Adia Johnston Northampton MA 01060 Name(Print) City,State,ZIP 186 Jackson St 4132109463 wx-permitting@callrevise.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) 12 Addition 0 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 $9939.48 1. Building Permit Fee:$ 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 Fees4j Check No.7 3 t / Check Amount: 4` ash Amount: 6.Total Project Cost: $9939.48 ❑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.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 978-203-6736 wx-permitting@callrevise 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 wx-permitting@callrevise 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 ❑ 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 of perjury that all of the information contained in this applicati n is true and accurate to the best of my knowledge and understanding. this --� 09/18/2023 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 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.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 Number 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 Department of Industrial Accidents z ► Office of Investigations sti ��. l— Lafayette City Center 2Avenue 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. ■❑ 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. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in anycapacity. employees and have workers' P tY 9. ❑Building addition [No workers' comp. insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] c. 152,§1(4),and we have no 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'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am 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.Lic.#:WC100142002 Expiration Date:04/20/2024 Job Site Address: 186 Jackson St City/State/Zip:Northampton MA 01060 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 of a fine 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 DIA for insurance coverage verification. I do hereby certiji•under the p and p nalties of perjury that the information provided above is true and correct. Signature: Date: 09/18/2023 Phone#: (978) 203-6736 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 21:1 Building Department 3fCity/Town Clerk 4.0 Electrical Inspector 5Dlumbing Inspector 6.0Other Contact Person: Phone#: A 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/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 PHONE (978)374-6352 FAX (978)521-5127 (A/C,No,Extl: (A/C,No): 2 S.Kimball St. E-MAIL ecostello@costelloinsurance.com ADDRESS: PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC a 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $DAMAGE i REED 1,000,000 CLAIMS-MADE n OCCUR PREMISESO(Ea ooccu ence) $ 50,000 MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2023 04/25/2024 PERSONAL BADVINJURY $ 1,000,000 GEN-'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ��POLICY [ 1 COT I 1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 I JECT OTHER: pollution $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED Ne SCHEDULED HS6326 05/09/2023 05/09/2024 BODILY INJURY(Per accident) $ _ AUTOS ONLY /� 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 I J 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 I LOCATIONS I 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 212 Main St THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Northampton, MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE rinr,(M .-oK,L� 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 ,a►co/Zo 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 CONTACT Anya Toteanu NAME: HUB International New England PHONE FAX 300 Ballardvale Street (A/C,No,Ext): (A/C,No): Wilmington,MA 01887 ADDRESS: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 WVD (MM/DD/YYYYI,(MM/DD/YYYYI 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 JECT PRO- LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY person) $- OWNED SCHEDULED _ AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X OTH- AND EMPLOYERS'LIABILITY STATUTE ER WCI00142002 4/20/2023 4/20/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 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 212 Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE 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.St.reet - Suite 710 Boston?,-Massachusetts 02118 Horne Improvement=Contractor Registration 'Type: Individual JAMES G.DIMOUOULOS :Regi511'ationw 167375 Expiration: 03/11/202.1 25 SEVEN SISTER RD HAVERHILL,MA 01830 .3 • Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8,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 Registr@tivon Ex Iration 1000 Washington Street -Suite 710 167376 03/11/2,,024 Boston,MA 02118 JAMES G.DIMOUOULOS JAMES DIMOUOULOS •' % r/ 25 SEVEN SISTER RD ' : :! I IAVERHItt_,MA 01830 Undersecretary (. N01 '1ki without signature Commonwealth of r.7rssachusetts Division of Occupational Licensure Board of Building Regulations and Standards ,:,�t7 ffH?[tOr S�f+,n.-visor CS-104164 expires:03/06/2024 JAMES G DIMOPOULOS 25 SEVEN SISTER RD HAVERHILL MA 01830 • )1e Ccwrnissioner u,:C. ' Revise Energy Planview Diagram Customer: 4 VA A jns - -1-cN Advisor Name J`1 t C 'k /kt,� e re..„ Address: I & -,Ac.,.-sd N_ S 1' Any limitations to access by truck? Y Town: l'o ✓l<U 4Atr'e-t O _ _ _ _ Site 10: -2 _ .‘ 'Use the greater of the two MS Ws when calculating for MVR X of stories 1 1.5 2 2.5 3 1 BAS 1: 15 cfm X q occupants X n-factor = 16/�� , n-factor 19 16 15 14.4 13.7 I BAS 2: .00583 X area X height X n-factor = tr Z Mechanical Ventilation Recommended:BAS>Final CFM50> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS),final JFM50 Is this part of a multi-unit workscope7 Y orINS Multiplier? N/A >6'Loose Insulation Cross-Batt 5' v Loose/x-ban Truss Workscope: �� h•A cr t-./l L %% - () cir)✓1- 'r-t15 3 1( t-too A. 61 o(- c 360 ,16 a west.-) A' -Dec t--54Q 0 0 ko,A5i6 --/\ 1 cz-d(C ( Ioak.4-rcv., tlt(wl vi-{'1JJul. 700 ?ccc\t ( IVY 5 ,(1,,,,, - .s 6" .1-6. (-->v rS ulc_Akt4-( (k/✓1 TcAA-11 i to Jlk,r,. . 2,-',i NI `c/ t 4 Any work scoped outside of best practices/approved by? 0 r Zo ArCt '_, T ik,, 1W '5 �—te Gi\A- 64 0 ict-c(C--wiL, (c)d„,1. -F\-)C C_ -'7&0 pf 31 V 8 6_,(_. ) i 1 6 t. , . 1 r...., e _ _ ®,,,.1 U _c,_ 0_ _.,..A..4.0) 7 t a ,_ 4 I v U U I 1- - - - - ,� �- - Q0 �( - _ 8 9 u U C„ 0 —567 Area Yr Built Heat Yr DHW Yr VentialSOFT ti SOFT 300 _\^\ 40%Low/HighJ ��(/JU 6 , . Existing High Existing Low - Rec Vents,# Existing Propervents Required Propervents Soffit vent? Y N Ridge vent? Y N -S1l EET- Page_of Gable vent? Y N DocuSign Envelope ID:BD848669-4247-4079-8F90-E852EB15F183 r REVISE the way you 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 Adia Johnston 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: L Jia. un. OU. Date: 9 DocuSign Envelope ID:8AD14044-05EE-4515-BC00-F95EAFA2BC63 Page 1 of 2 REVISE ENERGY 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 adjushnents in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed. Customer Name:Adia Johnston Email:Not provided Phone:413-210-9463 Premise Address:186 Jackson St,Northampton,MA 01060 Mailing Address: 186 Jackson St,Northampton,MA 01060 Project ID:4953478 Date:Sept.11,2023 Job Description Measure Description Location Quantity Unit Total Customer Cost Cost Air Sealing at Estimated 62.5 CFM50 Per Hour 4 hr $426.36 $0.00 Attic Floor- 6"Open Blow Cellulose 360 SF $705.60 $176.40 Damming 20 each $55.60 $13.90 Whole House Fan Box-2"Thermal Barrier Polyiso (with AS 1 each $222.03 $0.00 hrs) Hatch -2"Thermal Barrier Polyiso 5 each $269.80 $67.45 Door-2"Thermal Barrier Polyiso 1 each $103.05 $25.76 Door Sweep (with AS hrs) 3 each $88.98 $0.00 Exterior Door Weather Stripping (with AS hrs) 3 each $108.96 $0.00 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -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: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 Frail Invoice.If this credit card charge is declined for any reason,upon notice from REVISE ENERGY you will be responsible for providing valid altemative credit card information necessary to complete payment. r—DocuSigned by: c—Docusigned by: 9/11/2023 aka7 ,, r em 9/11/2023 ki 14 1 l. . _ -rn�rD2�iiJtStl78A46467_. "`� R E"I i-4`,64@Bt3ge lf640..s 3nalure Crolr Michael E Madden Name of RE N SE ENERGY Represeri ative 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:8AD14044-05EE-4515-BCOO-F95EAFA2BC63 Page 2 of 2 REVISE ENERGY 5 South Summer St.Haverhill,MA 01835 mass save 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:Adia Johnston Email:Not provided Phone:413-210-9463 Premise Address:186 Jackson St,Northampton,MA 01060 Mailing Address: 186 Jackson St,Northampton,MA 01060 Project ID:4953478 Date:Sept.11,2023 Walls -Vinyl -4" Dense Pack Cellulose 1348 SF $4,111.40 $1,027.85 Insulation Removal 70 SF $98.70 $98.70 Rim Joist- 6" Fiberglass Batting 120 SF $366.00 $91.50 Rim Joist-2"Thermal Barrier Polyiso 14 SF $77.28 $19.32 Kneewall Wall -2"Thermal Barrier Polyiso 332 SF $1,809.40 $452.35 Transition Air sealing 64 LF $478.72 $0.00 Kneewall Floor-8" Dense Pack Cellulose 320 SF $1,017.60 $254.40 Project Total $9,939.48 Weatherization incentive ($6,386.80) Air sealing incentive ($1,325.05) Total Program Incentive -$7,711.85 Customer Total $2,227.63 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -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 credit 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 for providing valid alternative credit card information necessary to complete payment. �DocuSigneddI by: Aka. �DocuSigned by: a �6UInSfbin 9/11/2023 M.l-I l f 1 1.. 9/11/2023 usi' r�—i ee�enasas�... Date R.0,Z.EE14fic,46e.iissi yeSlsseiuuree Michael E Madden Name of REVISE ENERGY Retreseriahve The Terms of this Agreement are contained on both sides of this page Revise Energy-5 South Summer St Haverhill,MA 01835 B00-885-SAVE-hello@ReviseEnergy.com ReviseEnergy.com