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38B-211 (2) BP-2024-0857 218 SOUTH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38B-211-001 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-2024-0857 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: DIPIETRO HOME ENERGY SOLUTIONS DBA REVISE DBA Est.Cost: 2161 DIPIETRO HEATING &COOLING 104464 Const.Class: Exp.Date: 03/06/2026 Use Group: Owner: SWERSEY WAGENHEIM JEFF &SARAH Lot Size(sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: URB Applicant: REVISE DBA DIPIETRO HEATING&COOLING Applicant Address Phone: Insurance: 32 MIDDLESEX ST 978-270-0063 WC100142003 HAVERHILL,MA 01835 ISSUED ON: 07/08/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ER I 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 Driceway 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: 77.2_ Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner / / r The Commonwealth of Massa uset • JU� `5 Board of Building Regulations a St• s 2024 FaR Massachusetts State Building Co e;7.({0>ywllo„„ TN. kbN� I` ISPE LITY Building Permit Application To Construct,Repair,Renova - Revi.•-d Mar 2011 One-or Two-Family Dwelling 4 oroe 0 /� J'This tion For Official Use Only Building Permit Number: f ?`7 . 657 Date Applied: 07/02/2024 470 / /72— 7- -2ozy Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 218 South St Northampton,MA 01060 1.1 a Is this an accepted street?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) 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 1 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Sarah Swersey Northampton,MA 01060 Name(Print) City,State,ZIP 218 South Street (413) 262-5797 sarah@swersey.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 ❑ Repairs(s) 0 Alteration(s) 0 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) I.Building $2161.77 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $0 ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $0 2. Other Fees: $ 4.Mechanical (HVAC) S 0 List: 5.Mechanical (Fire Suppression) $0 Total All Check No.l heck Amount: U Cash Amount: 6.Total Project Cost: $2 1 6 1 .77 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-104464 03/06/2026 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 l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering ��— WS Window and Siding SF Solid Fuel Burning Appliances 351-588-0362 wx-permitting@callrevise.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC 185083 04/24/2026 Dipietro Home Energy Solutions dba Revise HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 32 Middlesex St wx-permitting@callrevise.com No.and Street 351-588-0362 Email address Haverhill.MA 01835 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 of perjury that all of the information contained in this applicati is true and accurate to the best of my knowledge and understanding. 07/02/2024 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 Ed 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 Office of Investigations =�1= Lafayette City Center =_ty= �� , 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#:351-588-0362 Are you an employer?Check the appropriate box: Type of project(required): 1.E I am a employer with 180 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El 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 g. ❑Demolition workingfor me in anycapacity. employees and have workers' insurance.: 9. El Building addition [No workers' comp. insurance comp. 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.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t 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. t Homeowners 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 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.#:WCI00142003 Expiration Date:04/20/2025 Job Site Address: 218 South Street 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. /do hereby certify under the pa' and p nalties of perjury that the information provided above is true and correct. Signature:_ �-p—` Date: 07/02/2024 Phone#: 351-588-0362 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): 1❑Board of Health 20 Building Department 3❑City/fown Clerk 4.0 Electrical Inspector 501'lumhing Inspector 6.0Other Contact Person: Phone#: - / IN DIPIEHO-01 NFOWLER ACORU CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDMVYY) `----- 4/18/2024 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(,). PRODUCER License ft 1780862 1 C CT Anya Toteanu HUB International New England PHONE I FAX 300 Ballardvale Street A/c No,F�nl: (MC.No) Wilmington,MA 01887 s,,,;anya.toteanuahubinternational.com NSURER/S)AFFORDING COVERAGE NAtC I INSURERA:Inde ndence Casualty Insurance Company 11984 _ INSURED INSURER 8: Dipletro Home Energy Solutions,Inc.,Joseph A.Dipletro INS Rc Heating&Cooling,Inc.,Revise,Inc. +_� — 32 Middlesex Street INSURER0: _ Haverhill,MA 01835 I INSURER E: t 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 liADDL MAR POLICY EFF POLICY jjilli TYPE OF INSURANCE INS MG POLICY NUMBER IMmLQD0�1- UMRS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADEI OCCUR PREMISES EAEONCy�prDltiCe� MED E7CP{Arty one wean) S PERSONAL&ADV INJURY S N'LAGG LqMpT.APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER S AUTOMOBILE LIABILITY 1 COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per p.rwn) S AUTOS ONLY �^AAUUTµOS�yyNE�Dp pBOF�DILY INJURY(Per eceident/ $ AUTOS ONLY AUTOS ONLY {P. Ec d1eYni0AMAGE $ 1 S UMBRELLA JAB — OCCUR EACH OCCURRENCE S__ _ ~r EXCESS LIAR CLAIMS-MADE AGGREGATE $ OED RETENTIONS S A WORKERS COMPENSATK)N X 1 PER R � ANO EMPLOYERS'LIABILITY -- ANYPROPRIETOft/PARTNER/ (ECUTIVE YIN WCI00142003 4/20/2024 4/20/2025 E.L.EACH ACCIDENT $ 1,000,000 CFFICER�EMB��EXCLUDED' Li NIA 1 (Mandatory in NH) E.L,QISEASE-EA EMPLOYEE S '000'000 If yes,descrbe under 1,000.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is regained) Part 1 Workers Compensation State:Massachusetts CERTIFICATE HOLDER CANCELLATION City of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POJCY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVENT�, ]E/, ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A C R rO� GATE(MM'DDIYYYY) /1 CERTIFICATE OF LIABILITY INSURANCE 04/13/2024 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 ZrOhTACT Erniy Costello NAME: Costello Insurance Group PHONIC (978)374-6352 FAX (978)521-5127 (AIC WNW); WC,No). 2 S.Kimball St. EMAIL ecostello@costefoinsurance.com ADDRESS, PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC a Bradford MA 01835 INSURE RA: Colony Argo Insurance INSURED INSURERS, Arbella Protection 41360 Dip etro Home Energy Solutions,Inc. INSURERC: 32 Middlesex Street INSJRERO: INSURER E: _ Bradford MA 01835 INSURER F: COVERAGES CERTIFICATE NUMBER: CL 2441303422 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS-ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO-WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAYPERTAIN,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. ILTR ` TYPE OF INSURANCE Ina MD POLICY NUMBER Wit W 0O.'YYYY�, I ahnoDYY ) LIMITS X,COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE TO $ 1,000,000 CLAIMS-MADE A OCCLR PREMISES(Ea cc.D nce) $ 50,000 MED EXP(Arty one oersor? $ 10,000 A PACEP308383 04/2512924 C4/2 512 0 2 5 PERSONAL 3AOV ITc URY g 1.000,000 GEttLAGGRECATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY t'1l JECOT El LOC PRODUCTS-COMP/OP AGG S 2.000,000 OTHER Pollution 3 1.000,000 AUTOMOBILEUABILITY COMBINED SINGLE LIMIT S 1,000,000 1Ea acudent) _ ANYAUTO BODILY INJURY(Per Person) $ B OWNSD ONLY .SCHEDULED 1020128852 05/09/2024 C5/09/2025 BODLY INJURY(Per accident) S X MRED ./I NON-OVIhED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY iPer aecdent� X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAP, -MADE EXC4245322 04/25/2024 04/25/2025 AGGREGATE 5 3,000,000 DED X1 RETENTION$ 10•°°° 13 WORKERS COMPENSATION I PER 0711- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORPARTNER/EXEC,:TIVE ❑ E.L.EACH ACCIDENT S OFFICERAMEMBER EXC_UDED/ N/A (Mandatory in NH) E.L.DISEASE•EA EMPLOYEE S It yes.desaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•PO:ICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCFI I ATION City 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 AJTHORIZED REPRESENTATIVE r,42 Ce ieu. I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD , Commonwealth of Massachusetts 11 Division of Occupational Licensure Board of Building Re ulations and Standards ConsttFón rvisor 4'fic .e , CS-I 04464 -> pires : 03/06/2026 ic4. - - J 4 JAMES G DI r POU LO I g5 25 SEVEN SITER RD 1 HAVERHILL 01830 , ,{ 0 ? - - :... 4-4040) o CommissionerSi„,,j,ev.,,a,:„ Construction Supervisor Unrestricted - Buildings of any use group which contain less than 35,000 cubic feet (991 cubic meters) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call (617) 727-3200 or visit www.mass.gov/dpl THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Aff-,fir' Business Regulation 1000 Washing .'"�_ -Suite 710 Bosto . 118 Home Im•ro K;�••"=•:�=•istration Type: Corporation DIPIETRO HOME ENERGY SOLUTIONS INC -a�1 tion: 185083 DB/A REVISE -_ E ' ation: 04/24/2026 • 32 MIDDLESEX ST. HAVERHILL,MA 01835 r• " S`e Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer A 3 Business Regulation Registration valid for Individual use only before the HOME IMPR• 4 ONTRACTOR expiration date. If found return to: a f• ..,:. Office of Consumer Affairs and Business Regulation 1000 Washington Street -Sults 710 •_, :. Boston.MA 02118 DIPIETRO HOME ENS' OB/A REVISE tti _ JOSEPH DIPIETRO 32 MIDDLESEX ST. 4 HAVERHILL,MA 01835 = r;_• Undersecretary ature DocuSign Envelope ID:6B67479B-6EBD-4747-8CF6-14633BC68BE6 Revise 0 REVISE Home Performance Contractor , ' the way you save 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CLIENT WORK ORDER Jeff Wagenheim (617)782-8211 06/20/2024 820698 76201 SERVICE STREET BILLING STREET PROPOSED BY: 218 South Street 218 South St Revise SERVICE CITY,STATE,ZIP BILLING CITY,STATE.ZIP Northampton, MA 01060 Northampton,MA 01060 Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL KNOB&TUBE WIRING We have identified the potential existence of knob&tube wiring in your (initials) home. The following contract is not valid unless accompanied by the Weatherization Barrier Incentive form, signed by your licensed electrician.Work will not proceed until we receive a copy of this form. PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 4 $426.36 $426.36 Seal areas of your home against wasteful,excessive air leakage. Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics, basements, attached garages and other unheated areas (windows are not generally addressed.) EXTERIOR DOOR WEATHER STRIPPING 3 $108.96 $108.96 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 3 $88.98 $88.98 Provide labor and materials to install a doorsweep to restrict air leakage. DAMMING 26 $72.28 $54.21 $18.07 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLOOR OPEN BLOW CELLULOSE 9" 208 $470.08 $352.56 $117.52 Provide labor and materials to install a 9"layer of R-33 Class Cellulose added to open attic space. INSTALL 2"THERMAL BARRIER POLYISO OPEN GABLE WALL 16 $88.16 $66.12 $22.04 Provide labor and materials to install 2"rigid insulation board to the open gable wall. INSTALL 3" FIBERGLASS BATTING IN OPEN KNEEWALL 16 $35.68 $26.76 $8.92 Provide labor and materials to install 3.5"R-13 faced fiberglass batt insulation to the kneewalls. INSULATE RIM JOIST WITH 2"THERMAL BARRIER POLYISO 152 $839.04 $629.28 $209.76 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. DocuSign Envelope ID:6B67479B-6EBD-4747-8CF6-14633BC68BE6 Revise REVISE Home Performance Contractor '�; the way you save 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CUENTE WORK ORDER Jeff Wagenheim (617) 782-8211 06/20/2024 820698 76201 SERVICE STREET &LUNG STREET PROPOSED BY: 218 South Street 218 South St Revise SERVICE CITY.STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton,MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL REPLACE BATH FAN HOSE 1 $32.23 $24.17 $8.06 Provide labor and materials to install an insulated 4"exhaust hose to existing bathroom fan(s). Total: $2,161.77 Program Incentive: $1,777.40 Deposit: $0.00 Final Total: $384.37 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Three Hundred Eighty-Four&37/100 Dollars $384.37 "--DocuSlyned by: Docu ned by: Mj SLdA 6/20/2024 L/2-;/-�a5 -887A148891AD4FA... CE80A6CA6744419... 6/20/2024 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. DocuSign Envelope ID:6B67479B-6EBD-4747-8CF6-14633BC68BE6 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 i Sarah Swersey 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. Signed under the pains and penalties of perjury. Doeu8ipned by: Owner Signature: 7� hf CE60A6CA6744419... Date: b/20/2024 .:.�.. ra m - y Plainview Diagram ed :vise r�ergY ••� _ ----- Advisor Name: Customer Anylimitations to ace ss by truck? Y N ` _____� Address Z 1� 1. jj''�� __ __ _�.— __ for MVR `�-"• , ~ 'Use thee reater of the two BAS Ws When calculating f o Town. (�fN5 CI IS cfm X p occupants X n•factor — Slte I� e BAS 1 X n-factor =GSc(c=Z q of stories 1 1 5 2 2.5 3 gA51 0O583 X area X heightAS)>final C�M50 n•factor 19 16 14 4 13 7 wired: X 8 bett Truss final CFMSO> (0 7 X BAS) Mechanical Ventilation Req iced (07>e-AS Mix Looms Mechanical Ventilation Recommended.f345 NSA >8-Loose Insulation Cross-Batt Is this part of a multi-unit workscope?Y or N Li- Eve 1 « , 3 G ip�GVa // 2‘ rosy �,S s z, > 5 sty V,i -s Dal z6 6'f(,,itZ " \ wall a-Y work scoped outside of best practices/approved by? 30 S S I t 0 e / 51ef;e Area Yr Boit Heat Yr DHW Yr Ventrattlon SOFT SOFT!300 40%Low/High Existing High Existing Low Rec Vents,N Existing Propervents Required Propervents Soffit vent> Y N R,dge vent? Y N STREET- Gabte vent? Y N Page of ) 9:41 AM Fri Jun 28 ... as LTE 23% K&T Signoff pdf C, U 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 remedwte 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: Sarah Swersey Client u or Site ID: 820698 Site Address: 218 South St City. Northampton State: MA ZIP: 01060 Phone Number 4132625798 Email: Sarah@sWersey.Com Customer/Homeowner Signature: Date: 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: t Attic Floor ■Attic Wall ■Attic Slope ■Exterior Wall ■Basement ■Other:Whole house p Other: 16#1 hpie performed my inspectio nd determined there is no actr knob and tube wiring in the areas selected below. VAttic1l/Floor i ttic Wall Attic Slope ldExtenor Wall sementa U Other: U Other: i I have read and a ne to the Terms and(Conditions on the back of this form. Contractor Name. M'.�i1 J- ,7 d1741 6 51)''_ Address 12 7 S.(- S� City.J + k%J (i MA ZIP V d7s._._. n • BCompany Name: ()� E`G��l License Number: � Cr-- Contractor Signature: Date: _ . r MECHANICAL SYSTEM BARRIERS(To be filled out by Ircensno 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 ra❑ges. High Carbon Monoxide Draft Failure Existing CO ppm: Revised CO ppm: Existing Draft Pa: 1 Revised Draft Pa: Heating System Hot Water Heater_ 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)