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29-258 (7) BP-2021-2190 391 BROOKSIDE CIR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-258-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair I PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-2190 PERMISSION'S HEREBY GRANTED TO: Project# INSULATION Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 5500 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date:03/06/2022 Use Group: Owner: DRISCOLL-HORTON TRACY Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: WSP Applicant: REVISE Applicant Address Phone: Insurance: 32 MIDDLESEX ST (978)203-6736 WC100142000 HAVERHILL, MA 01835 ISSUED ON:11/17/2021 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZTION 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 144.9 4.4,, )9 . • I Fees Paid: $65.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner NO luILT )(Wf 14/0ANam,p The Commonwealth of Massacht sett' s ' C El V E JIre Board of Building Regulations and San ds jOR / Massachusetts State Building Code, 80 C mi ) IPALITY 3 5 2021 USE Building Permit Application To Construct,Repair, Reno ate Or Demolish a evis d Mar 2011 One-or Two-Family Dwelling „r PT OF nt w DINC Ild3pcG,i NS This Section For Official Use Only"22RTHAMPTON MA 01060 Building Permit Number: p- A l- 4IgoDate Applied: 4iiu /tcoss ii-/6-ZOL1 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 PropertyAddr ss: 1.2 Assess rs Map& Parcel Numbers R1 ,�roulCsiole C4r .21 a5e- ! 1.1 a Is this an accepted street?yes p no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq fI) Frontage(ft) 1.5 Building Setbacks(ft) 0 A Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: D Name(Print) City,State,ZIP 3°t k ' BrOOk-- i4. Q CI( 413 (o87 7)70 +adhitl9hofmaaIl 4wt No. and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building It Owner-Occupied 90 Repairs(s) 0 Alteration(s) Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units ( Other ❑ Specify: Brief Description of Proposed Work2: I3{Vva... M\( Sh51AIOt;ir''e'l £ A ail 1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ S f(Y0 w 1. Building Permit Fee: S Indicate how fee is determined: 2.Electrical $ CIStandard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fe Check No. l2heck Amount: 06 Cash Amount: 6. Total Project Cost: $� �� 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS 111MoY 3{ I2a JOJ'v\QS ( ,MC•1�6403 License Number Z Expiration Date Name of CSL Hol r List CSL Type(see below) (AC)S LTeUPo No.an( Street Type Description i , , _ I. 1 p a t n ono Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,yC�State,l\ZIP1 9V'T\ U UJIl R Restricted l&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding _ SF Solid Fuel Burning Appliances "17 6a63 la?30' I O�v1/4 0 Q fl ies-ks2. I Insulation Telephone Ema' address 'Y D Demolition 5.2 Registered Home Improvement Contractor� (HIC) 7375 3(i, !�� ` p'�Y Solute` S HIC Registration Number Expiration Date H Company Name or HIC Registrant Name +b� i2e Ijj s- 3a M�d e3eic S ar&hl t)guilt-e�4Q . (,m No. Street iftzkiEmail address a d 111 ihlet 01S3S Cfl 3 (Q?36 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 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 JJ - to act on my behalf,in all matters relative to work authorized b this building permit application. Oteco- 3,Q 1-ra nsul 4-ra# 111361 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 application is true and accurate to the best of my knowledge and understanding. A04-1•ctei- ( ,rn o f ail., o l 1 1 3 I . r Print Owner's or Authori d Agent' Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.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.R.) (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 `5 St `', t Massachusetts �wS �. cfto ` `•r. DEPARTMENT OF BUILDING INSPECT IONS ''• s, .j„ xf 212 Main Street • Municipal Building yJ6.'- Cb* ', Northampton, MA 01060 sy ‘'‘� CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: .1/ , Location of Facility: :3) ff it r�l��ejo — ' 1il'll iik. Y} 616'3 5 The debris will be transported by: Name of Hauler: U hi)di0 ' Signature of Applicant: .. Date: / 1 i!3 /d The Commonwealth of Massachusetts _,:t= Department of Industrial Accidents _ 1-- 1 Congress Street, Suite 100 1• Boston MA 02I14-2017 wrs'w.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business Organization/Individual): Dipietro Home Energy Solutions Inc dba Revise Address: 32 Middlesex St City/State/Zip: Bradford, MA 01835 Phone #: 978-203-6736 Are you an employer?Check the appropriate box: Type of project(required): I.0 I am a employer with 30+ employees(full and/or part-time).* 7. New construction 2.01 am a sole proprietor or partnership and have no employees working for me in t;. Remodeling any capacity.[No workers'comp.insurance required.) 3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.) ' 9. El Demolition 10�]Building addition 4.01 am a homeowner and will be hiring contractors to conduct all work oat my property. 1 will ensure that all contractors either have workers'compensation insurance or arc sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0Plumbing repairs or additions 5.0 i am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.: 13.❑Roof repairs 6.0 We area corporation and its officers have exercised their right of exemption per MCL c. 14.IOther Weatherization 152.§114),and we have no employees.[No workers'comp.insurance rcquired.i *Any applicant that checks box 4.11 must also till out the section below showing their workers'compensation policy inibnnation. .Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. 1Contrrtctors 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. (f 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. Lie.#: WC100142000 Expiration Date: 04/20/2022 Job Site Address: 361 t Ci[, City/State/Zip: i'l'1} \Q ry..p iY\ 6 O1 Attach a copy of the workers'compensation police declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may he forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ins d penalties of perjury that the information provided above is true and correct. Signature: � '�-, Date: IA l ,31 ( Phone#: 978- 3-6736 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: ACORO CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/DD/YYYY) L..� 04/17/2021 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(les)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, d): WC.No): 2 S.Kimball St. ADDRESS:E ecostello@costelloinsurance.com PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC# Bradford MA 01835 INSURERA: Colony Insurance INSURED INSURER B: Commerce Insurance Co. 34754 Dipietro Home Energy Solutions,Inc. INSURER c: 32 Middlesex Street INSURER D: INSURER E: Bradford MA 01835 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2141702077 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 X COMMERCIAL GENERAL UABILITY (MM/DD/YYY1) (MM/DD/YYY1) LIMITS 1 000000 EACH OCCURRENCE $ , DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2021 04/25/2022 PERSONAL&ADV INJURY $ 1,000,000 • GEN'L AGGREGATE LIMIT APPUES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY jEa LOC 2,000,000 PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED HS6326 05/09/2021 05/09/2022 BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY (Per accident) $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE s 3,000,000 A EXCESS UAB CLAIMS-MADE EXC4245322 04/25/2021 04/25/2022 AGGREGATE $ 3,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTNE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD vIrmnv-V r AI V I CAI' A�RL CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/2012021 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 NAME: License#1780862 CONTACT HUB International New England PHONE g78 657-5100 I FAX 978 988-0038 300 Ballardvale Street (NC,No,Ext):( ) IA/C,No):( E-MAIL Wilmington,MA 01887 ADDRESS: INSURER(SI 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 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 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 ADM SUER POLICY NUMBER D/POLICY EFF POLICY EXP LIMBS LIR 1NSD WVD (MM/DYYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILM EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISE TO RENTED S Ea occurrence) $ - MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY , j a LOC PRODUCTS-COMP/OP AGG $ OTHER: $ CO AUTOMOBILE LIABILITY (Ea MN AUTOMOBILEINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED ^ SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ AUR ON EE PROPERTY DAMAGE TOS ONLY _ AUTOS ONNLOY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X STATUTE ERPER H AND EMPLOYERS'DABILrfY WCI00142000 4/20/2021 4/20/2022 1,000,00 AFYIPROPRIEgORJER E RT EPJE ECUTIVE YNN N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under 1,000,00 DESCRIPTION OF OPERATIONS below , E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Whom It May Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c?-9-—7--;.: — ACORD 25(2016/03) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:2F46E44B-76CF-4FFB-8495-702B531F37F4y� REVIS 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: 5 South Summer St Bradford Ma 01835 I Tracy Driscoll-Horton 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: 111at1 '—A86F61CA770E493_. Date: 10/18/2021 Commonwealth of massachusells :VC Division of Professional Ucensvre Board of Building Reg lulations and Standards Co nstrut;t)bnl$iS'pervisor CS-104464 • 1 Expires:03'0612022 JAMES G DIMOPODUOS is SEVENSISTER N AVERNIHILL MA 01B30- C t ,f \` t Commissioner A A•- Qc c69162471./moluo_ecdd ajegAixioaelUedea Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 • Home Improvement_CQntractor Registration " r Type: Individual " _ ; .1 Registration: 167375 JAMES G.DIMOUOULOS Expiration: 03/11/2022 25 SEVEN SISTER RD HAVERHILL,MA 01830 • Update Address and Return Card. SCA 1 !S 20M-05/17 &gel wKv./t/ ac umelA Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE'I3dMdual before the expiration date. if found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 1 _ 03/11/2022 1000 Washington Street -Suite 710 JAMES G.DIMOU � ,--• 1 Boston,MA 02118 JAMES DIMOUOULOk- 25 SEVEN SISTER FiD. -_ met' HAVERHILL,MA o1836- UnderseCreta �'Not va ' out signature ry vuI..u. IyuI r iIvCIupe IU.Gr tocw46-/ol,r'-4r"r o-o4yo-/uL6o3 Ir'3/r-4 rayc I ut 0 REVISE ENERGY Afti- ' ir 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 customers 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:Tracy Driscoll-Horton Email:Not provided Phone:413-687-7272 Premise Address:391 Brookside Cir,Northampton,MA 01062 Mailing Address:391 Brookside Cir,Northampton, MA 01062 Project ID:4335875 Date:Oct.18,2021 Job Description +`a:a ltto* m .e_ P ' . Air Sealing at Estimated 62.5 CFM50 Per Hour 8 hr $740.64 $0.00 Door Sweep (with AS hrs) 2 each $50.62 $0.00 Exterior Door Weather Stripping (with AS hrs) 2 each $60.14 $0.00 Hatch - 2" Thermal Barrier Polyiso 1 each $46.28 $11.57 Bath Fan -Vent to Roof 1 each $141.30 $35.32 Damming 18 each $43.02 $10.76 Rim Joist- 6" Fiberglass Batting 6 SF $16.20 $4.05 Overhang - 9" Fiberglass Batting 222 SF $628.26 $157.07 Overhang - 2"Thermal Barrier Polyiso 222 SF $1,061.16 $265.29 Attic Floor - 10" Open Blow Cellulose 864 SF $1,641.60 $410.40 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -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 Final Invoice.If this credit card charge is declined for any reason,upon notice from REVISE ENERGY you will be responsible for providing valid akemative credit card information necessary to complete payment. DocuSigned by: e—DocuSigned by: -.tt'' 0 II . 10/18/2021 10/18/2021 Gusto r Si r u etrot/ VnualL lkavtaw ` ALt. �t,It Date REVISE E,�RUX,� �ter nature Date A FCA770E493... Eva-n-Tt ieFt"f 5 Name of REVISE ENERGY Represertatrve The Terms of this Agreement are contained on both sides of this page Revise Energy 5 South Simper St Haverhill.MA 01835.800-885-SAVE ohello@ReviseEnergy.corn 'ReviseEnergy.com uul:u. Iyll C I IVCIutIC IV. 4rYUCY40—I Vlor—Yrr O—OYJu—/'J DU.,II-0/r"f 0 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:Tracy Driscoll-Horton Email:Not provided Phone:413-687-7272 Premise Address:391 Brookside Cir, Northampton, MA 01062 Mailing Address:391 Brookside Cir, Northampton, MA 01062 Project ID:4335875 Date:Oct. 18,2021 Project Total $4,429.22 Weatherization incentive ($2,683.36) Air sealing incentive ($851.40) Total Program Incentive -$3,534.76 Customer Total $894.46 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit).$ -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 time 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. Docusrgned by: DocuSigned by: 10/18/2021 A88FB1CA770E493.. /18�Z�21A+ �. Cusla r r 'I 101e R EVI E E --R:Y Rerreseliidi nature Dale Name of REV SE ENERGY Rekreserialive 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 Revise Energy Planview Diagram Customer: r� (�r � — Advisor Name: Evan Rebello Address: �°1 ram, la [,, Any limitations to access by truck? Y/0 Town: ��a �o All A 010 Site ID: Use the greater of the two BAS#'s when calculating for MVR #of stories .1"-C1 1.5 2 2.5 , BAS 1: 15 cfm X#occupants X n-factor = S 70 n-factor 9 16 1 15 3 14.4 13.7 j BAS 2: .00583 X area X height X n-factor = L1 Mechanical Ventilation Recommended:BAS>final CFM50> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS)>final CFM50 this part of a multi-unit workscope? Y or i 1A/s Multiplier? tti >6"Loose Insulation cross-Batt >6"Mix Loose/x-batt Trut orksoope: C)R lYn )c t t j - b >> S4.11r1 h% ( 7) (MYhum 91 () f Poi ) Hai(1, fk1l- )c 4')Ler- VOA( Any work scoped outside of best practices/approved by? Qv4Y hurl / c I Ruse+ ± 12: 7) ao4) l2 61 t7,C $) 2L1 c) 1) 2) bl 3b'