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25A-049 (3) BP-2022-1621 12 CROSBY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25A-049-001 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-2022-1621 PERMISSION IS HEREBY GRANTED TO: Project# insulation 2022 Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 9000 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date: 03/06/2024 Use Group: Owner: J KELLY JOHN R&DOROTHY Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: URB Applicant: REVISE Applicant Address Phone: Insurance: 32 MIDDLESEX ST (978)203-6736 WC100142000 HAVERHILL,MA 01835 ISSUED ON: 12/20/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/WE ATH ERI 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 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: I 4 V .52 . 5997r Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 1.feeo 14..-'T 1l-PFt041/4.)1r j�,`` EM c=,4�cU IZ-1a j'� 1 � c):( u Qrn n) ,i_r Iqj ;. The Commonwealth of Massachusetts/ 0EC 1 1 Board of Building Regulations and Standards 4 20�2 FOR Massachusetts State Building Code, 780 CNIRRv1LTNI USE IPALITY ;, 2.08D,,, U Building Permit Application To Construct, Repair, Renovate t-D.efo ,....: Revised Mar 2011 One- or Two-Family Dwelling °j(,,:o°''" This Section For Official Use Only Building' � 'K Permit Number: to A). - 1Ga I Date Applied: KEVi moss �(// 12-Z6 ZVzz Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Addr s: 1.2 Assessors Map& Parcel Numbe s /9 C4 Is k a&cA Y7 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) d 1 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 OWNERSHIP1 2.1 OwneM of R' A in P i er, 1 /veil S` Y\ Al talvt r 1 44 0 (( (F U Name(Print) City,State,Z la Crtgilti - . 6,03 75'(-j)(pit( McNot_ kb rtvs-kok Q oldiI No. and Street Telephone Email Address ; U4114 SECTION 3:DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building 0 Owner-Occupied FP Repairs(s) 0 Alteration(s) 9E1 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units / Other 0 Specify: Brief Description of Proposed�Work2: _ 1 p t G�cy�` 1 c CY,' f c A-u «l_lt a( VA SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 9oc o w 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ 0 Standard City/Town Application Fee 0 Total Project Costa (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: /' Check No.()a heck Amount: J Cash Amount: 6. Total Project Cost: $ qo 6 w 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) CS I O�� 3 / 44 JOJAQ s ( ,M h1 3 License Number Expiration Date Name of CSL Hol r C�S SeAgo S SAp V Kol List CSL Type(see below) L( No. and Street Type Description 1/41-4),%,kA p� '(� rll cz?r U Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP YV�V� U UJl1 R Restricted t&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding _ SF Solid Fuel Burning Appliances 7 R� (I3 6790 ( D�VVN KOtA10 0 co ft rsii,s2, I Insulation Telephone Emai4 address CZINA D Demolition 5.2 Registered Home Improvement Contractor(HIC) '/ _ ��p I(��3?� , (t( Jar ib.w&e.S l�l 6 p6Ltk,J- "`V'ekb t Ek(?gy S6lui S HIC Registration Number Expiration Date H Company Name or HIC R gistrant Name d t,� 1 Re t j ,3 - MN eselc S —ram M Lima,1 o&c 6.revile . lfily\ No. a d Stree i�1 ilk iA 0 ig 3S 9f g0 3 (03 b Email address 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 V 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 On;,r S I 1 Mo j i - "'vi p kt me_ f"►' v SN . taki to act on my behalf, in all matters relative to work authorized b this building permit application. G000%.. kjs3.Q Ktv aat-t\ QX r ems`{ (^ 1()[i(�3 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER1 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. A0--r.,, ( ,m,)06u of (di et i ''''t Print Owner's or Authori ed Agene4 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 M ��%" f� I °' ttalt4 Massachusetts w= t ' t`_? DEPARTMENT OF BUILDING INSPECTIONS 'i ct ' 212 Main Street • Municipal Building �Oy,,y ��'a: •'---- . ._ Northampton, MA 01060 ,�04 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: Location of Facility: 3.,) IY)001,01 - 4.eackii ( 6 d i le S The debris will be transported by: Name of Hauler: & I Q& F'i v-\ Signature of Applicant: -.''.— Date: t) (t ()a 27- The Commonwealth of Massachusetts 'r \, Department of industrial Accidents 1 —; ' Office of investigations ► �7 Lafayette City Center c:;te\ 2 Avenue de Lafayette, Boston, MA 02111-1750 ? www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business c rQanivauon/Individua►):Dipietro Home Energy 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): LEI i am a employer with 30 4. ❑ I am a general contractor and 1 New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑ Remodeling 2.❑ i am a sole proprietor or partner- ship and have no employees These sub-contractors have R. ❑ Demolition working for me in anycapacity. employees and have workers' 9. 0 Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 100 Electrical repairs or additions officers have exercised their 1 1.❑ Plumbing repairs or additions 3.❑ 1 am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL I2 ❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no WeatheriZation employees. [No workers' 1.3.©Other comp. insurance required.] *Any applicant that checks box++l must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they arc 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 NE Policy#or Self-ins. Lie. #:WCA005734001 Expiration Date:04/20/2023 Job Site Address:_ Cil�5'�(Al, Yl City/State/Zip: Afirit#146t I"t(r oak 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 crimina 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 O DER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the ffice of investigations of the D1A for insurance coverage verification. I do hereby certify under the pain. nit(, enalties of perjury that the information provided above is true and correct. Signature: Date: / i`ii4-- Phone#: 978-203- 36 J_ 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): (❑Board of Health 20 Building Department 30Cite/Town Clerk 4.0 Electrical Inspector 59'lumbing inspector 6.0Other Contact Person: Phone#: ' r��l---11 DIPIEHO-01 CWOOD$1D A C.-�I?L) DATE(MMOD'YYYYi �.- CERTIFICATE OF LIABILITY INSURANCE a,arzazz 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 endorsements). PRODUCER License 4 1780862 I-NC NTACT Anya Toteanu HUB International New England PHONE FAX 300 Ballardvale Street .(gA�[,No.Eet}_ (A1C.Not Wilmington,MA 01887 AQ INS:anya.toteanu T hubinternationalcom INSURERISI AFFORDING COVERAGE �- I NAIC II INSURER A:Atlantic Charter Insurance Company 44326 INSURED INSURER B: Joseph A.Dipletro Heating&Cooling,Inc-,Dipietro Home INSURER c: _ Energy Solutions,Inc.,Revise,Inc. 32 Middlesex Street INSURER D: 1 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. iLT RDIS TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP INN D POLICY NUMBER IMMIDQ)YYYYI I IMIADDNYYYI((I LIMITS COMMERCIAL GENERAL LIABILITY I Ea ii OC_ RF£NCE INS -- CLAIMS-MADE I—I OCCUR 'PREMISES Ea RRENTEDl mamma) S MED EXP(Any one Denson) $ -.. ms.QNA�_6MV INJURY' ;: p.... GEHL AGGRer_TEppLIII��MpI.APPLIES PER. GENERAL AGGREGATE 4 POLICY ACT LOC PRODUCTS-COMP[OP AGO $ OTHER s AUTOMOBILE LIABILITY [EEA exden SINGLE GIST $ —ANY AUTO BODILY INJURY IPe+Damon) 'IS OWNED SCHEDULED AUTOS ONLY AUTOS �[ ,peQQ[?ILY INJURY tPor $ _.AUTOS ONLY _ALITC�SONI L9( [PerQaodrCayi[} MACE ; $ — UMBRELLAUAB _ OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE .. DED 1 RETENTION: $ A WORKERS COMPENSATION PER }OTH- AND EMPLOYERS'LIABILITY X STATUTE ?ER !ANY PROPRIF1QR,PARTNER'FftECUTIVE Y!N WCA00573401 4120/2022 4/20/2023 1,000,000 11ROIfFICERAfEIMEH7 EXCLUDED? III N[A E.L EACH ACCIDENT ; 1 r000,000 IMendalory In lloord E.L DISEASE-EA EMPLOYEE IS rppG%,describe order cr IDESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $ 1.000,000 DESCRIPTION OF OPERATIONS[LOCATIONS[VEHICLES(ACORD 101,Additional Remarks Schedule.may be enacted it more space is required) CERTIFICATE HOLDER CANCELLATION 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 7 ",-�i ACORD 25(2016/03) 198E-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �Ir•""Il DATE IMMvoavrvY) ACc."-) CERTIFICATE OF LIABILITY INSURANCE c471472022 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 Cost010 NAME: Costello Insurance Group PHONE (978}374-6352 I FAX (978)521-5127 LA,C No,E at: INC.Not: 2 S.Kimball St. oaEss: E-ZZs:ello)ccslelIoinsurance.cvrn PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC M Bradford MA 01835 --_— Colon o IHSURERA- Colony Insurance INSURED INSURER B: Commerce Insurance Co. 34754 Diplelro Home Energy Solutions.Inc, INSURER C: DBA Revise INSURER D: 32 Middlesex Street INSURER E: Bradford I.4A 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.rm.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. ItdR TYPEOFINSURANCE IIDDgSUBR POLICYEFF POLICY EXP IASO wvo POLICY NUMBER TMWDWYYYY) (1IMUDDIYYYY) UNITS X COMMERCIAL GENERAL UABILrY EACH OCCURRENCE S � • Gl AIN.r}11AOE OCCUR DAMAGE TO RENTED e�t� PREMISES iEaaeanrengl ''II lED EXP[Any are persard S 10,000 A PACEP308383 6412512022 0412512023 PERSONAL aADV INJURY 11.000,000 GEN'L AGGREGATE LIMrt APPI TES PER: 2.000.000 1`'� GENERAL AGGREGATE E POLICY rg Ta n LOC PRODUCTS•COMPTOPAGO 12.000.0(X) OTHER: I AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ 1.000,000 ICa dcrkkrui ANY AUTO BODILY INJURY(Per person 1 I B — OWNED SCHEDULED HS4326 05)0912022 0510912023 DC'(IILY INJURY Per acclSenl $AUTOS ONLY X AUTOS ti I X HIRED x NON-0r'ME3 PROPERTY DAMAGE AUTOS ONLY - AUTOS ONLY Lp�aci-dBm) S Medical payments s 10,000 UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 3.000,000 A EXCESS LIAR CLAIMS-MADE a EXC4245322 04125/2022 0412512023 AGGREGATE 13,000,000 _UED RETENTION I 10,000 S WORKERS COMPENSATION - PER OM- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROFRIETORIPARTNETVEXECU n TIVE ELEACH ACCIDENT OF F ICER�NEMBER EXCLUDED? N!A {Mandatory In NHl E L DISEASE-EA EMPLOYEE 6 II yes.iell:rte urclel DESCRIPTION OF OPERATIONS belcrrr EL.DrsASI.POLICY WAIT F" l DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Ad:Sbonal Remarks Schedule.may be attached if more space Is requiredl CERTIFICATE HOLDER CANCELLATION 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 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD City of Northampton Massachusetts A. 4 . # DEPARTMENT OF BUILDING INSPECTIONS 7 M, 41u; 212 Main Street • Municipal Building jsc Northampton, MA 01060 4 "4' Property Address: 12 Crosby St Northampton,MA 01060 Contractor Name: James Dimopoulos Dipietro Home Energy Solutions dba Revise Address: 32 Middlesex St City, State: Haverhill,MA 01835 Phone: 978-203-6736 Property Owner Name: Meredith Borenstein Address: 12 Crosby St City, State: Northampton,MA 01060 e James Dimopoulos Dipietro Home Energy Solutions dba Revise (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. Contractor signature �,/-' Date 12/19/2022 DocuSign Envelope ID:B2FDAB07-752B-4086-A914-C6E801314C7D2 REVISEREVISE (� 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 Meredith Borenstein 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. l DocuSigned by: Owner Signature: —97B71CAD26EE483_. Date: 10/24/2022 DocuSign Envelope ID:B2FDA807-752B-4086-A914-C6E8OB14C7D2 reye i ul 0 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 adjustrnents in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed. Customer Name:Meredith Borenstein Email:Not provided Phone:603-759-2674 Premise Address: 12 Crosby St,Northampton, MA 01060 Mailing Address: 12 Crosby St,Northampton,MA 01060 Project ID:4629824 Date:Oct.24,2022 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour 6 hr $565.98 $0.00 Attic Floor- 10" Open Blow Cellulose 594 SF $1,235.52 $0.00 Rim Joist - 2" Thermal Barrier Polyiso 47 SF $228.89 $0.00 Rim Joist-6" Fiberglass Batting 38 SF $102.22 $0.00 Roof Vent - 12" 2 each $307.14 $0.00 Hatch -2"Thermal Barrier Polyiso 1 each $47.37 $0.00 Damming 34 each $83.30 $0.00 Bath Fan Hose 1 each $28.00 $0.00 Exterior Door Weather Stripping (with AS hrs) 2 each $63.62 $0.00 Door Sweep (with AS hrs) 2 each $52.22 $0.00 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -A non-refundable Deposit by credit card(Mastercard,Visa,or Discover card)or check is due at the tine the Work is scheduled.Required payment information will be collected at the tine of scheduling.Deposit is not to exceed 1/3 of the total contract cost. Additional Payments and Final Invoice:$ -Additional payments for the Work shall be due upon completion of the Work and will be invoiced to the customer for payment by check or charged to the credit card on file within 24 hours of delivery of the 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. ,--DocuSigned by: / DocuSigned by: ��nnr�t��rrk llf26 10/24/2022 10/24/2022 C'4.-Lar9/SSjeaeD26EE483... _r„r,, R EVb E•r a81*@L7gAtrFl4t17e signature Dale Evan Rebello Name of RENSE ENERGY Represeriative 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:B2FDAB07-752B-4086-A914-C6E80B14C7D2 rdye z ui 0 REVISE ENERGY Aft . 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 adjustments in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed. Customer Name:Meredith Borenstein Email:Not provided Phone:603-759-2674 Premise Address: 12 Crosby St,Northampton,MA 01060 Mailing Address: 12 Crosby St,Northampton, MA 01060 Project ID:4629824 Date:Oct.24,2022 Walls -Aluminum - 4" Dense Pack Cellulose 1806 SF $5,706.96 $0.00 Project Total 8,421.22 Weatherization incentive ( ,739.40) Air sealing incentive $681.82) Total Program Incentive - 8,421.22 Customer Total $0.00 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows. Payment#1(Deposit):$ -A non-refundable Deposit by credit card(Mastercard,Visa,or Discover card)or check is due at the tore the Work is scheduled.Required payment information will be collected at the tine of scheduling.Deposit is not to exceed 1I3 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 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. r DocuSigned by: /—Doc uSigned by: 10/24/2022 � 10/24/2022 CUSI rIQtSM/rreAD26EE483... 'Date R EVitSF—EklEfifi .rse Signature [ar Evan Rebello Name of REVISE ENERGY Represerialive 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 v/tufti Circle►One In-Home Revise Energy Planview Diagram Customer: /rltv k 40XM S t-cov Advisor Name: _ W,, ,61- U 11 Address. 1 Z---_�u 1 _ _Si _ _ . Any limitations to access by truck? Y/ Town /(!t v-i hang ian _ AA__010 60 S►te ID: IA c 70 Sy _ __ .Use the greater of the two BAS Ws when calculating for MVR I of stories 1 1.S 2 2.5 3 1 BAS 1: 15 cfm X#occupants X n-factor = S n factor 19 16 13 14.4 13.7 BAS 2: .00583 X area X height X n-factor = 79. Mechanical Ventilation Recommended:RAS>final CFMS0> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS),Final CFM50 Is this part of a multi-unit workscope?Y o l' Ias Multiplier/9 >6"Loose Insulation Cross-Batt >6"Mix Lobse/x-belt Truss Wolcscxine f`1 ,&r C,e-.4 1Il) /1R -6 Q)HAlth poli • I 2 ^ C -floor- I0 "0 -S 9 y J�4 rrtiwrc"r9 -3�( 3) Ac.,)03-1-�14_y7 0 Rf hose ., ARt� JLAO- ft.• 38 el) o x�ts - 2 5 rtc,r tee.,+ 72 '— Ds /0) M ) walls �ltwrtn�nl Y oPc -te06 Am*worm scoped outside of best practices/approved by? WO II S /Ai icc/A a. eA,Itjrl- 6 -7- 14. id. l' 4) 1 0) l) 21 4) 1) 27 eyr D..2 y) 13 q)Area Yr Suitt Heat Yr DHW Yr Ven ialtion SOFT SOFT/300 40%Low/High Existing High Existing Low Rec Vents,# Existing Propervents Required Propervents Soffit vent? Y N Ridge vent? Y N -STREET- Gable vent? Y N Page of V. Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regulations and Standards Consta^ }iontServisor • CS-104464 4: spires:03/06/2024 JAMES G DIMOPOULOS 25 SEVEN SISTER RD HAVERHILL MA 018'30 a ill, tt �J' Commissioner dtrit 1K. IIfincl A... O 1 THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingtoo.Street- Suite 710 Boston Massachusetts 02118 Home Improvement eonfractor-Registration Type: Individual JAMES G.DIMOUOULOS egtstration: 107375 25 SEVEN SISTER RD Expiration: 03/11/2024 HAVERHILL, MA 01830 `_ Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE; ndividual Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 167375 03/11/2024 Boston,MA 02118 JAMES G.DIMOUOULOS • JAMES DIMOUOULOS 25 SEVEN SISTER RD HAVERHILL,MA 01830 I--. Undersecretary N id without signature