30C-036 (2) BP-2023-0412
512 BURTS PIT RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30C-036-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0412 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
DIPIETRO HOME ENERGY
Est. Cost: 492 SOLUTIONS DBA REVISE 104464
Const.Class: Exp.Date: 03/06/2024
MOORE WAINWRIGHT JEANE E&ROBERT D
Use Group: Owner: WAINWRIGHT &
Lot Size (sq.ft.)
DIPIETRO HOME ENERGY SOLUTIONS DBA
Zoning: SR Applicant: REVISE
Applicant Address Phone: Insurance:
32 MIDDLESEX ST (978)203-6736 WCA00573401
HAVERHILL,MA 01835
ISSUED ON: 04/07/2023
TO PERFORM THE FOLLOWING WORK:
INSULATION/WEATH ERIZATI 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: (• WY Ti •
•
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
i-�, � /._ ..�
6 �' Di LT 1g6,5
:0 n, , Tye Co ' onwealth of Massachusetts
;�!a�1,--,,,� Board of ilding Regulations and Standards FOR
rcti iNgp MUNICIPALITY
iir` Pc assachusetts State Building Code,780 CMR USE
Building Pe Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: A0°01 3- (Y Date Applied: 04/05/2023
40,A) , -.5-.). // Li'7-702,5
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
512 Burts Pit Rd Florence,MA 01062
1.la 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 0 Private CI Municipal_ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Jean Wainwright Florence, MA 01062
Name(Print) City,State,ZIP
512 Burts Pit Rd 413-210-6702 rjwain@concast.net
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Adcition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work2:Insulation,Weatherization,and Air Sealing
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $492.45 1. Building Permit Fee:$ Indicate how fee is detlermined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $0 2. Other Fees: $
4.Mechanical (HVAC) S 0 List:
5.Mechanical (Fire /�(�
Suppression)
S 0 Total Alle�
Check NoU Check Amount: Cash Amoun:
6.Total Project Cost. S 492.45 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-104464 03/06/24
James Dimopoulos License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
32 Middlesex St
No.and Street Type Description
01835 U Unrestricted(Buildings up to 35,000 Cu.ft.)
Haverhill,hwn,MAS 01835ate, Restricted 1&2 Family Dwelling
City/TM Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
978-203-6736 melissat@callrevise.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC-167375 03/11/24
James Dimopoulos Dipietro Home Energy Solutions dba Revise HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
32 Middlesex St melissat@callrevise.com
No.and Street Email address
Haverhill,MA 01835 978-203-6736
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes 0 No ❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
See attached authorization
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this applicati n is true and accurate to the best of my knowledge and understanding.
this
04/05/2023
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/d DS
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
tOfce of Investigations
Lafayette City Center
2 Avenue de Lafayette, Boston,MA 02111-1750
` www.mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumlers
Applicant Information Please Print Leigibly
Name (Business/Organization/Individual): Dipietro Home Energy Solutions dba Revise
Address:32 Middlesex St
City/State/Zip:Haverhill, MA 01835 Phone#:(978) 203-6736
Are you an employer? Check the appropriate box: Type of project(required):
1.0 I am a employer with 30 4. Q I am a general contractor and 1
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
workingfor me in anycapacity. employees and have workers'
P tY 9. ❑Building addition
[No workers' comp.insurance comp.insurance.:
required.] 5. 0 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 12.1=1 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.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: HUB International New England
Policy#or Self-ins.Lic.#:WCA00573401 Expiration Date:04/20/2023
Job Site Address: 512 Burts Pit Rd City/State/Zip:Florence, MA 01062
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirati n date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal pen lties 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 corre�t.
Signature: Date: 04/05/2023
Phone#: (978)203-6736
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(check one):
1DBoard of Health 20 Building Department laity/Town Clerk 4.11 Electrical Inspector 5,nPlumbing
Inspector 6.0Other
Contact Person: Phone#:
DIPIEHO.01 _ WQ.QOSIDE
•
AC'URO CERTIFICATE OF LIABILITY INSURANCE DATE(MH.�DD�YYYY)
ram,.- 4/4/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(Ies)must have ADDITIONAL INSURED provisions or be endorsed.
if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER License#1780862 I CZTACT Anya Toteanu
HUB International New England PHONE FAX
300 Ballardvale Street W(nr"SAC,No,EMI.. iA,T,Not
Wilmington,MA 01887 I ass,anya.toteanu@ahubinternational.com
WSURERjsj AFFORDING COVERAGE NAIC R_—.__,
_ — INSURER Atlantic Charter Insurance Company_ ___44326
INSURED !W SURER B
Joseph A.Dipietro Heating b Cooling.Inc.,Dipietro Home !INSURER C:
Energy Solutions,Inc.,Revise.Inc. I '---
32 Middlesex Street INSURER o .,_--_--
Haverhill,MA 01835 *SURER E; _.- _
I_ _ __ INSURER F: ------__----- 11
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 1HE POLICY PERIOD
INDICATED. NOTWI THSTANUING 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 ALA THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
*MR TYPE OF INSURANCE ;ADOL';SUFIRT POLICY NUMBER POLICY EFF ! POLICY EXP
�L3 — ----------._.— a_Z. W_V4. ..LIM�VIY_TYYI.I4M730.17Y1'1 ----_—LIMITS
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AUTOMOBILE LIABIUTY f .- :cometwo 1 a+Cl F IMF $
ANY AUTO SOOILY NARY IPQr shtttM!:� S
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DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (ACORD 101,AOOit:anal Re•na.i,s ScheOute may be attached d.nora$yace.9.vquuad)
CERTIFICATE HOLDER CANCELLATION
Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
212 Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Northampton, MA 01060
AUTHORIZED REPRESENTATIVE
- ,/
ACORD 25(2016/03) ti 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
4C D� CERTIFICATE OF LIABILITY INSURANCE DA�U4'142022 )
cart 4:zor:
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 Enitty Coy'..Ilo
NAME: _ .. ._374.6352 I FAX ;Tin)
.
Costello Insurance Gmup Pii0P__Cm); (978-) !521.5127
L(AIC Ka)
2 5.Kimball St. E44AlESS ecostefiupcostellc n,urance.cco:
ADDR
*'O BOX 5248 INSURER{SI AFFORDING COVERAGE NAIC s -
Bradford MA 01835 (NSURER A. Colony A.-go Insurance - ~�
INSURED INSURER a Commerce Insurance Co_ 34754
Dipo!ro Homo Energy SoluSurs,Inc. INSURER C:
DBA Revise INSURER D.
32 Middlesex Street ;INSURER E
BradfLed MA 01835 :INSURER F:
COVERAGES CERTIFICATE NUMBER: C12241402385 REVISION NUMBER:
tHS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED IC THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
IND GATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO wH1CH THIS
CERTIFICATE MAY BE ISSUED OR MAY PLR TAIN.THE INSURANCE,AtFORDLO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 10 ALL THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
met" A1mt7SUBN -.LTR TYPE OF INSURANCE INS0 WVV POLICY NUMBER IMIWDOfYYYY)I IVMMOWYYYY) OATS
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(� DAAAGe TOR ski ED
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AUTOMOBILE LIABILITY COMBINED SINGLE LAIIT S 1.0O0.000
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ANY AUTO BCOILY Ika!,,PY(Fter:c^start S
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Medical payments t 10,0E0
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A EXCESS LAB CLAIMS-JACE EXC4245322 0412512022 04/2512023 AC,Z EGATE c 3."�,000
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WORICERSCOMPENSATION _.........__.___._ hF-ANTUTE ER L.
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DESCRIPTION OF OPERATIONS i LOCATIONS,VEIUC LES !ACORO 101,Addd,onal Ramarts Schedule,may be attached d moms space Is reovnedt
CERTIFICATE HOLDER CANCELLATION
Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
212 Main St THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Northampton, MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATNE
1
�!'I988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(20161031 The ACORD name and logo are registered marks of ACORD
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 WashingtoQ Street- Suite 710
Bostonh Massachusetts 02118
Home lmgrovement eonfractor-Registration
Type:iitegtStpation: 167375
JAMES G.DIMOUOULOS Exfyitation: 03/11/2024
25 SEVEN SISTER RD •
HAVERHILL,MA 01830 y l
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:
TYPEandividual Office of Consumer Affairs and Business Regulation
gpa(stts ExniratI .n 1000 Washington Street -Suite 710
167$75 03/11/2024 Boston.MA 02118
JAMES G.DIMOUOULOS.
JAMES DIMOUOULOS
25 SEVEN SISTER RD G;/0,1,440( i/
I IAVERHILL,MA 01830 Undersecretary (_.- Npt id without signature
II Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Regpulations and Standards
'it �
Const }ion lS1rvisor
� s
CS-104464 .Y spires:03/06/2024
JAMES G DIMOPOULOS �'
25 SEVEN SISTER RD
HAVERHILL MA 01830 > }
.... ll ),.
fV5 ,44
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CcinmiSsioner ,: ',(L/ ( . ,ot_„
DocuSign Envelope ID:C2457DAE-05B4-4C58-B2AB-6DFA98A39E1C Page 1 of 1
161REVISE ENERGY
mass save
5 South Summer St.Haverhill,MA 01835
PARTNER
1. DESCRIPTION OF WORK TO BEPERFORMED
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`Worn 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:Jean Wainwright
Email:Not provided
Phone:413-210-6702
Premise Address:512 Burts Pit Rd,Northampton,MA 01062
Mailing Address:512 Burts Pit Rd,Northampton,MA 01062
Project ID:4781536
Date:March 15,2023
Job Description
Measure Description Location Quantity Unit Total Cost Customer Cost
Air Sealing at Estimated 62.5 CFM50 Per Hour 1 hr $94.33 $0.00
Rim Joist-6" Fiberglass Batting 148 SF $398.12 $99.53
Project Total $492.45
Weatherization incentive ($298.59)
Air sealing incentive ($94.33)
Total Program Incentive -$392.92
Customer Total $99.53
2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows:
Payment#1(Deposit):$
-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:
/I'',, 3/15/2023 t&icLat. tuktuA,
3/15/2023
CUE850026909D649C... Dare R D4784CBB9E1 D490... Dale
Michael E Madden
Name of REVISE ENERGY Represerlative
The Terms of this Agreement are contained on both sides of this page
Revise Energy"5 South Srmmer St"Haverhill,MA 01835"800-885-SAVE hello@ReviseEnergy.com a ReviseEnergy.com
DocuSign Envelope ID:C2457DAE-05B4-4C58-B2AB-6DFA98A39E1C
REVgj P
the wa �
wro .
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
Jean wainwright
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.
,-DocuStgned by:
Owner Signature: (Patvort0 E850026909D649C...
Date: 3/15/2023
REVISE _ y= , ,
the way you save
Customer: wAk W ,(l Advisor Name: +l"i‘G -A iek off \A
Address: r) e 1T 6 V) Any limitations to access by truck? Y a
Town: ��✓( t(C
Site ID: 41 6 rj .Use the greater of the two BA5#'s when calculating for MVR
#of stories 1 1.5 2 2.5 3 BAS 1: 15 cfm X#occupants X n-factor =
n-factor 19 16 15 14.4 13.7 I BAS 2: .00583 X area X height X n-factor = 9 5 3
Mechanical Ventilation Recommended:BAS>Final CFMSO> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS)>final CFM50
Is this part of a multi-unit workscope?Y or N A/S Multiplier? N/A >6"Loose Insulation Cross-Batt >6"Mix Loose/x-batt Truss
Workscope: G \ , r
g 6 ,.n TO% P?2Gr- toe i(-
Any work scoped outside of best practices/approved by?
46
C 0 c�
U
Area
Yr Built
Heat Yr
OHW Yr
Ventialtlon SOFT
SOFT/300
40%Low/High
Existing High
Existing Low
Roc Vents,#,
Existing Proponents
• Required Properventi
Soffit vsnt'j 'Y N.
Ridge vent?'Y N + -STREET-
Genieven$? N 7 Page_of