24C-161 BP-2024-1208
10 ARLINGTON ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24C-161-001 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-2024-1208 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2024 Contractor: License:
DIPIETRO HOME ENERGY
SOLUTIONS DBA REVISE DBA
Est. Cost: 1084 DIPIETRO HEATING &COOLING 104464
Const.Class: Exp.Date: 03/06/2026
Use Group: Owner: DELL SHYCON ROBERT D & LINDA D
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: 09/17/2024
TO PERFORM THE FOLLOWING WORK:
INSULATION/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: 772.
Fees Paid: $75.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Buildinc Commissioner
iq00 RECEIVED
S E P 1 7 2024 The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Macc chusetts State Building Code,780 CMR MUNICIPALITYUSE
FPT OF BUILDING INSPECTIONS
NoBliil+dit1WrieAondtAtplicatiQn To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
+� This Sec ' n For Official Use Only
Building Permit Number: b/ ( /�6 Date Applied: 09/12/2024
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
10 Arlington St Northampton MA 01060
1.1a 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 la Private❑ Zone: _ Outside Flood Zone'? Municipal la On site disposal system 0
Check if yesla
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Robert Shycon Northampton,MA 01060
Name(Print) City,State,ZIP
10 Arlington St (413) 586-1855 rshycon@yahoo.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) ❑ Alteration(s) 13 Addition 0
Demolition 0 Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work:Insulation.Weatherization,and Air Sealing
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $1084.45 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost (Item 6)x multiplier x
3.Plumbing S 0 2. Other Fees: $
4.Mechanical (HVAC) $0 List:
5.Mechanical (Fire
Suppression) $0 Total All Fees:
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $1 084.45 0 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
U Unrestricted(Buildings up to 35,000 cu.ft.)
Haverhill,MA 01835
Haverhill,
City/Town,State,01ZIP R Restricted I&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
351-588-0362 wx-perrmitting@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 n is true and accurate to the best of my knowledge and understanding.
09/12/2024
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 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"
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111 , S 150A.
Address of the work: 10 Arlington St Northampton MA 01060
The debris will be transported by: Dipietro Home Energy Solutions dba Revise
The debris will be received by: Dipietro Home Energy Solutions dba Revise
Building permit number:
Name of Permit Applicant James Dimopoulos
09/12/2024 9cand2.4- T7 e u.�ee-
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
IA a Department of Industrial Accidents
Office of Investigations
_><,.. Lafayette City Center
1�►�!�. 2 Avenue de Lafayette,Boston,MA 02111-1750
www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
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.❑� 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. ❑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'
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 12.12 Roof repairs
insurance required.] t c. 152,§1(4),and we have no Weatherization
employees. [No workers' 13.11 Other
comp. insurance required.]
*Any applicant that checks box#I 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: 10 Arlington 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 certify under the pa' and p nalties of perjury that the information provided above is true and correct.
Signature: �-d- Date: 09/12/2024
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):
I❑Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5E1'Iunthing
Inspector 6.DOther
Contact Person: Phone#:
DIPIEHO-01 NFOWLER
ACORU CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YVYY)
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(s).
PRooucER License#1780862 NAAcT Anya Toteanu
HUB International New England PHONE FAX
300 Ballardvale Street (NC,No,Eat: (NC,(A/C,Nol:
Wilmington,MA 01887 Liss,anya.toteanuehubinternational.com
•
INSURERS)AFFORDING COVERAGE NAIL
INSURER A:Independence Casualty Insurance Company 11984
INSURED INSURER B:
Dipletro Home Energy Solutions,Inc.,Joseph A.Dipletro LIISgURERC:.,______
Heating&Cooling,Inc.,Revise,Inc.
32 Middlesex Street INSURER0:
Haverhill,MA 01835 INSURER E:
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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCEDpp BY PAID CLAIMS.
wy
ILTp TYPE OF INSURANCE I POLICY NUMBER n F LIMITS
COMMERCIAL GENERAL LIABILITY II EACH OCCURRENCE s
CLAIMS-MADE I OCCUR DAMAGE TO RENTED .._�
.pREMISESfFi LSOrorce) S
_ _ ._._ - MED EXP(M Ors
on)one Os n) S
PERSONAL&ADV INJURY $
SILAGG .IMrr APPLES PER: GENERAL AGGREGATE ;
POLICY ricIf LOC PRODUCTS•COMP/OP AGO $
- -
OTHER: S
AUTOMOBILE LIABILITY j OMBINEDISINGLE LIMIT I$
ANY AUTO BODILY INJURY(Per person) 5
OWNED ----'SCHEDULED
AUTOS� ONLY AUTOS
pBROpDIILY INJURY(Per accident) $
AUT, OSp UTO CNLY AS ONEp LY (PN ICCkmd!AMAG S
S
UMBRELLAUAB ^ OCCUR EA9HOCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
OED RETENTIONS
A WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN �( PES7AT1lIB. FRH
ANY PROPRIETOR/PARTNER/EXECUTNE WCI00142003 4/20/2024 4/2012025 El EACH ACCIDENT ; 1,000,000
CFFICERA.t�MBER EXCLUDED' N I N/A
(Mandatory'^N ) E.L.DISEASE-EA EMPLOYEES 1,000,000
yes,descrbe Jade, 1,000,000
DESCRIPTION OF OPERATIONS belt* El.DISEASE•POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached H more space Is required)
Part 1 Workers Compensation State:Massachusetts
CERTIFICATE HOLDER CANCELLATION
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 PO-ICY PROVISIONS.
Northampton, MA 01060
AUTHORIZED/REPRESENTATIVE
�
ACORD 25(2016/03) C 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
A�Roy CERTIFICATE OF LIABILITY INSURANCE DATE(MM'DDIYYYYI
_
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 CONTACT Emily Costello
NAME:
Costello Insurance Group Aoel ten. (978)374-6352 FAX No): (978)521-5127
2 S.Kimball St. &MAIL ecosleto@costetoinsurance.com
ADDRESS.
PO BOX 5248 INSURER(S)AFFORDING COVERAGE NA;C s
Bradford MA 01835 INSURERA Colony Argo Insurance
INSURED INSURERS: Arbella Protection Ins Company 41360
Op otro Home Energy SOIuIons,Inc. INSURER C. _
32 Middlesex Street INSURER(): �.
INSURER E:
Bradford MA 01835 INSURER F:
COVERAGES CERTIFICATE NUMBER: CI2441303422 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. 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.
ILTR TYPE OF INSURANCE IN
BNND POLICY NUMBER IrUM e MiDO/YCY EYYY) (NN.'ODIFF POLICYY) LIMITS
XI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
MA TO RNTED
CIMMS-MADE X OCC:,R pRE'IISFS fE occurrencet S 50,000
HIED EXP(Any one person) S 10.000
A PACEP308383 04/25/2024 C4/25/2025 PERSONAL a ADVIN URY 3 1,000.000
GEN-_AGGREGATE LMITADPJESPER GENERAL AGGREGATE s 2,000,000
X POLICY a 7,-. Ti LOC PRODUCTS-COMP/OP AGG S 2.000,000
OTHER. Pollution S 1,000,000
AUTOMOBILELIABILITY COMBWED SINGLE LIMIT S 1,000,000
1ga acGdent)
ANYAUTO BODILY INJURY O'er Person) $
B OWNED SCHEDULED 1020128852 05/09/2024 05/09/2025 BOOtY INJURY(Per accrdert) 3
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE S
AUTOS ONLY ^1 AUTOS ONLY iPy a;cidern
3
XI UMBRELLA LIAR X OCC.,R EACH OCCURRENCE S 3,000,000
A I IM
EXCESS LIAB CLANS-MADE EXC4245322 04/25/2024 04/25/2025 AGGREGATE S 3,000,000
I
I DEO XI RETENTION 3 10,000 S
WORKERS COMPENSATOR PER OTH-
AND EMPLOYERS'LIABILITY YIN STATUTE ER
ANY PROPRIETOR/PARTNER/EXECGTIVE i / E.L.EACH ACCIDENT S
OFFICERiMEMBER EXCLUDED? N A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S
If yes,describe under
DESCRIPTION OF OPERATIONS Delon E L.DISEASE-PO'_ICY LIMIT S
DESCRIPTION OF OPERATIONS/LOCATIONS 1 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
AUTHORIZED REPRESENTATIVE
I /
J 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
=, Commonwealth of Massachusetts
k. 0Division of Occupational Licensure
e,w.' Board of Building Re ulations and Standards
�T
Cons atn rvisor
4*Ic :�. :, , dr
CS-I 04464 ' , �a ires : 03/06/2026
JAM E S G DI • PO I O . �� ; ,.-.' ,
x
25 SEVEN S - TER RD - AD 1--1
clk
HAVERHILL 01830 . i . .,,
,� ,' { M
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.4:iri" 4>'
te
41.19.-1 _ CO • i
wilvaiA -
i .
Commissioner .
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 AL 17 :..• Business Regulation
1000 Washing .; ..;•� -Suite 710
Bosto --.••
-- - .._ . .. ' 118
Home Im•row" ,r.w. u•..-•...- = istration
v
� "sa� t' Irawwfrs� �
' ;i Type: Corporation
DIPIETRO HOME ENERGY SOLUTIONS INC ; tion: 185083
E lion: 04/24/2026
D/B/A REVISE '— -
iIIIIIIIIII
32 MIDDLESEX ST. �di MRiiti
i�Mar
IHAVERHILL,MA 01835 Mil
v
OS
IMO Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer A • &Business Regulation Registration valid for individual use only before the
HOME IMPRO -y -. ONTRACTOR expiration date. If found return to:
«.•,.,•, ,.,, Office of Consumer Affairs and Business Regulation
^„ 1000 Washington Street -Suits 710
r-7" 'o Y =7;;; Boston,MA 02118
DIPIETRO HOME EN;-".i g- •
DBIA REVISE _im: E=1
JOSEPH DIPIETRO -- -7=_ .i;'
32 MIDDLESEX ST. !- ' -``'f%, el* „..-
HAVERHILL,MA 01835 '�: 4 ► .? Undersecretary H ature
Virtual „ -. >re One , w
Revise Energy Planview Diagram
Customer } � Advisor Name �
Address: ) Aran � Sfi Any limitations to act' ss by truck? Y
Town:
Site ID: a+ Use the greater of the two 8A5 q's when calculating for MVR
I p of stories 1 1 5 ..62 2 5 3 I BAS 1: 1S cfm X a occupants X n-factor = 5
n-factor 19 16 14.4 1 13 7 I BAS 2: .00583 X area X height X n-factor =
Mechanical Ventilation Recommended:BAS>final CVM50> (07 X BAS) Mechanical Ventilation Required:(0 7 X BAS)>final CFMS°
Is this partof a multi-unit workscope?Y . as Multiplier? rA >6"Loose Insulation Cross-Batt >6'Mix Loose/x-batt Truss
Workscope:
I R/5 I
Z''�► y,S Utz,
3 2 Poky dcc,r z
`+ i i-+/s Weep
Any work scoped outside of best practices/approved by?
IZ
2>O
3
Ia)
Area
Yr Built
Heat Yr
DHW Yr
Ventialtion SOFT
SOFT/300
40%Low/High
Existing High
Existing Low
Rec Vents,#
Existing Propervents
Required Propervents
Soffit vent? Y N
Ridge vent? Y N Gable vent? Y N -STREET-
Page 1 Of I
• Docusign Envelope ID:D9A49F4F-2642-4449-848C-18DBCDA4FEB0
REVIS
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
Robert Shycon
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.
Signed by:
Owner Signature: s cc
DAE565eCB3464F.5
Date: 9/11/2024
Docusign Envelope ID:D9A49F4F-2642-4449-848C-18DBCDA4FEBO
Revise
�i-' REVISE Home Performance Contractor
the way you save
5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT
1-800-885-7283
CUSTOMER PHONE DATE CUENT B WORK ORDER
Robert Shycon (413) 586-1855 09/11/2024 823635 76201
SERVICE STREET BILLING STREET PROPOSED BY:
10 Arlington Street 10 Arlington St Revise
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP
Northampton, MA 01060 Northampton, MA 01060 Page 1
DESCRIPTION QTY COST INCENTIVE TOTAL
PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 1 $106.59 $106.59
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 4 $145.28 $145.28
Provide labor and materials to install Q-Ion weatherstripping to
door(s)to restrict air leakage.
DOOR SWEEP 4 $118.64 $118.64
Provide labor and materials to install a doorsweep to restrict air
leakage.
DOOR: THERMAL BARRIER POLYISO 2"(ATTIC) 2 $206.10 $154.58 $51.52
Provide labor and materials to insulate the back of the attic door with
2"rigid insulation board.
Docusign Envelope ID:D9A49F4F-2642-4449-848C-18DBCDA4FEBO
Revise
ri.=
REVISE Home Performance Contractor
the way you save
5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT
1-800-885-7283
CUSTOMER PHONE DATE CUENT 0 WORK ORDER
Robert Shycon (413) 586-1855 09/11/2024 823635 76201
SERVICE STREET BILLING STREET PROPOSED BY:
10 Arlington Street 10 Arlington St Revise
SERVICE CITY.STATE,ZIP BILLING CITY,STATE,ZIP
Northampton, MA 01060 Northampton,MA 01060 Page 2
DESCRIPTION QTY COST INCENTIVE TOTAL
INSULATE RIM JOIST WITH 2"THERMAL BARRIER POLYISO 92 $507.84 $380.88 $126.96
Provide labor and materials to install rigid board insulation to the
perimeter of the basement ceiling at the house sill.
Total: $1,084.45
Program Incentive: $905.97
Deposit: $0.00
Final Total: $178.48
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***One Hundred Seventy-Eight&48/100 Dollars $178.48
rA
DocuSigned by: Signed by:iVita c t,�ct 9/11/2024L1tsJC'
887A148891AD4FA.. 0AE565808346485...
b V MYM1,1 T KCYKCJCK I M I I V C CUSTOMER SIGNATURE
9/11/2024
NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE
SIGN DATE
30 DAYS.
�t„_ ;r City of Northampton
r ,,,. :°'N t5•5 .: Sick.,
/; . .4. Massachusetts A�• �' t.
* :G
N;
ill .4..� i; _!t-'4' DEPARTMENT OF BUILDING INSPECTIONS y.. I' _*�
'r 212 Main Street • Municipal Building J J•.• SOD
' ✓"` Northampton, MA 01060 SPiY-3''50
Property Address: 10 Arlington St, Northampton, MA, 01060
Contractor
Name: Miguel Seda
Address: 32 Middlesex St
City, State: Haverhill , MA 01835
Phone: 978-701-9026
Property Owner
Name: Robert Shycon
Address: 10 Arlington St
City, State: Northampton, MA, 01060
I, Miguel Seda (contractor) attest and affirm that the building I intend to
insulate does not have any open air(knob and tube)wiring in the spaces to be insulated and that I have
provided the property owner with a copy of this affidavit.
by:
Contractor signature rOocuSigned a„ st,
66,
887A148891AD4FA...
Date
9/15/24