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22D-036 (6)
BP-2023-0646 42 CLARK ST COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 22D-036-001 CITY OF NORTHA PTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGI.TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING P RMIT Permit # BP-2023-0646 PERMISSIO IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: DIPIETRO HOME E RGY Est. Cost: 1924 SOLUTIONS DBA R VISE 104464 Const.Class: Exp.Date: 03/06/202 Use Group: Owner: R. ARINSTEIN, STEVEN Lot Size (sq.ft.) Zoning: WSP Applicant: R. ARO STEIN, STEVEN Applicant Address Phone: Insurance: 42 CLARK ST FLORENCE, MA 01062 ISSUED ON: 05/17/2023 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: ' �4 51'1'1 Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (1413)587-1272 Office of the Building Commissioner S4 The Commonwealth of Massachusettsi%oPs W Board of Building Regulations and Stand ti440/4, F,PR Massachusetts State BuildingCode,780 MRe r'�ti iNs, � / )CIPALITY Cr �44 fiCT V USE Building Permit Application To Construct,Repair,Renovate Or Demlrs'6d 610 Revised Mar 2011 One-or Two-Family Dwelling is on For Official Use Only Building ermit Number:6+ —,,I 3 ' Date Applied: 05/10/2023 KEvi,.� l Kos //g2 `j 17 ZDZ5 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 42 Clark St Florence,MA 01062 1.1 a Is this an accepted street?yes V no Map Number 1 Parcel Number 1.3 Zoning Information: 1.4 Property Dmensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard I 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 yes0 SECTION 2: PROPERTY OWNS SHIP' 2.1 Owner'of Record: Steve Aronstein Florence MA 0106 Name(Print) City,State,ZIP 42 Clark St 413-207-5610 saronstein@gmail.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) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2:Insulation,Weatherization,and Air Sealing SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $1924.00 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $0 ❑Total Project Cost3 :Item 6)x multiplier x 3.Plumbing $0 2. Other Fees: $ 4.Mechanical (HVAC) $0 List: 5.Mechanical (Fire — Suppression) $0 Total All Fe Check No 1 ' ' Check Amount: IA 4 Cash Amount: 6.Total Project Cost: $1 924.00 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 — Type Description No.and Street Haverhill,MA 01835 U i Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M 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 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. 05/10/2023 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/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations P Lafayette City Center 2 Avenue de Lafayette, Boston,MA 2111-1750 `�'•`� www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/C ntractors/Electricians/Plumhers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Dipietro Home Energy Solutions dba Revise Address:32 Middlesex St City/State/Zip:Haverhill, MA 01835 Phone#:(978)203-6736 Are you an employer?Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 30 4. ❑ I am a general contractor d I employees(full and/or part-time).* have hired the sub-contract rs 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in anycapacity. employees and have worke s' P h 9. ❑Building addition [No workers' comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and it 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no Weatherization employees. [No workers' 13.■❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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 r umber. 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.#:WC100142002 Expiration Date:04/20/2024 Job Site Address: 42 Clark St City/State/Zip:Florence MA 01062 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: o-L Date: 05/10/2023 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): 10Board of Health 20 Building Department 3E1City/Town Clerk 4.11 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: AC R CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) f�.------ 04/14/2022 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 CONTACT Emily Costello NAME: Costello Insurance Group (A/CO N,Extl: (978),374-6352 FAX No): (978)521-5127 2 S.Kimball St. E-MAIL ecostellb@costelloinsurance.com ADDRESS: PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC# Bradford MA 01835 INSURER A: Colony Argo Insurance INSURED INSURER B: Commerce Insurance Co. 34754 Dipietro Home Energy Solutions,Inc. INSURER C: DBA Revise INSURER D: 32 Middlesex Street INSURER E: Bradford MA 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 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 ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSD WVD (MMIDDIYYYY) (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2023 04/25/2024 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: pollution $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED HS6326 05/09/2023 05/09/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) Medical payments $ 10,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE EXC4245322 04/25/2023 04/25/2024 AGGREGATE $ 3,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) • CERTIFICATE HOLDER CANCELLATION Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 210 Main Street THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Northampton, MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DIPIEHO-01 CWOODSIDE ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE 4/19/2023 VY) 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 NAMEACT Anya Toteanu HUB International New England PHONE FAX 300 Ballardvale Street (A/C,No,Eat): (A/C,No): Wilmington,MA 01887 E-MAIL DRESS:anya.toteanu@hubinternational.com INSURER(S)AFFORDING COVERAGE , NAIC# INSURER A:Independence Casualty Insurance Company 11984 INSURED INSURER B: Dipietro Home Energy Solutions,Inc.,Joseph A. Dipietro INSURERC: Heating&Cooling,Inc 32 Middlesex Street INSURERD: Haverhill, MA 01835 INSURERE: 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 ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYY) (MM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE I OCCUR PREMISES(EaEoccccurrrrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY YE& LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED R � AUTOSE ONLY _ AUTOS BODILYO INJURY(Per accident) $ AUTOS ONLY — A N pUTOS Oyy��NL EpY (Per acEcRldeT DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ _ DED I I RETENTION$ __ $ A WORKERS COMPENSATION v PER Ht AND EMPLOYERS'LIABILITY STATUTE ER WC100142002 4/20/202: 4/20/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FFICERIMEMBER EXCLUDED? N N/A (Mandatory In NH) 1,000,000 E.L.DISEASE-EA EMPLOYEq $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION Town 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 ?9--•?/p's77- ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF fv1ASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington-Street - Suite 710 Boston,Massachusetts 02118 Home Improvemerit-Contractor-Registration Typo: Individual iAogigyntion: 167375 JAMES G.DIMOUOULOS Expiration: 03/11/2024 25 SEVEN SISTER RD HAVERHILL, MA 01830 y •P1 Update Address and Return Card. THE COMMONWEALTH OF NIASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the DOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Individual- Office of Consumer Affairs and Business Regulation Registraltlen Expiration 1000 Washington Street -Suite 710 167370 03/11/2024 Boston,MA 02110 JAMES G.DIb1000ULOS. 1 i JAMES DIMOUOULOS 25 SEVEN SISTER RDr.fil :iGi T I IAVERHILL,MA 01830 Undersecretary N r�Slid without signature Q Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regpulations and Standards 'i ' ConcL[t2'biori lt Srvisor CS-104464 -4. fz`xpires:03/06/2024 JAMES G DIMOPOLILOS -. 25 SEVEN SlitTER RD HAVERHILL MA 01830 > 1 `rat IX :l ',` ~ . Carnmissioner , !� '_ .,, '4., Page 1 of 2 0 REVISE ENERGYAll I lE 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 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:Steve Aronstein Email:Not provided Phone:413-207-5610 Premise Address:42 Clark St,Florence,Northampton,MA 01062 Mailing Address:42 Clark St,Florence,Northampton, MA 01062 Project ID:4837302 Date:May 9,2023 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 Stair Cover(with AS hrs) 1 each $277.33 $0.00 Rim Joist-6" Fiberglass Batting 10 SF $26.90 $6.72 Attic Floor- 10" Open Blow Cellulose 27 SF $56.16 $14.04 Attic Floor- 10" Dense Pack Cellulose 290 SF $919.30 $229.83 Door Sweep (with AS hrs) 3 each $78.33 $0.00 Project Total $1,924.00 Weatherization incentive ($751.77) Air sealing incentive ($921.64) 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -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 Customer Signatue Date REVISE ENERGY Representative Signature Date Name of REVISE ENERGY Reaeserlative The Terms of this Agreement are contained on both sides of this page Revise Energy"5 South Stmner St Haverhill,MA 01835.800-885-SAVE"hello@ReviseEnergy.com ReviseEnergy.com Page 2 of 2 0 REVISE ENERGY 5 South Summer St.Haverhill,MA 01835 mass save PARTNER 1. DESCRIPTION OF WORK TO BEPERFORNED 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:Steve Aronstein Email:Not provided Phone:413-207-5610 Premise Address:42 Clark St, Florence,Northampton,MA 01062 Mailing Address:42 Clark St, Florence,Northampton,MA 01062 Project ID:4837302 Date:May 9,2023 Total Program Incentive -$1,673.41 Customer Total $250.59 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -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. Customer Sigratrre Date R EVISE ENERGY Retresentalwe Signature Dale Name of REVISE ENERGY Representative The Terms of this Agreement are contained on both sides of this page Revise Energy-5 South Sunnier St-Haverhill,MA 01835 800-885-SAVE-hello@ReviseEnergy.cam ReviseEnergy.com DocuSign Envelope ID:0F073725-D966-416F-AB51-7D94B794F176 )J�.� REVISE the way -ou save \*nr Permit Authorization Form Site ID: Street Address: City: To be filled out by Subcontractor (if applicable) Contractor Name: Dipietro Home Energy Solutions DBA Revise Contractor Address: 32 Middlesex St Bradford Ma 01835 I Steve Aronstein 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: S¢ , arowsfc,iw • 3B51C0C2BCA44D0... Date: 5/9/2023 Revise Energy Planview Diagram Customer: ,►A �\� s Pt P D7 N Advisor Name: Adagroweir s'\\ .\4> t..,-Ain) Address: q-a C A',/\,\(.-- 4.2.T Any limitations to access by truck? Y!M Town: c- 6,1l, Site ID: 4 \ \ *Use the greater of the two BAS#'s when calculating for MVR #of stories 1 1.5 2 2.5 3 1 BAS 1: 15 cfm X#occupants X n-factor = 6"1 `) I n-factor 19 I 16 I 15 I14.4 1 13.7 I BAS 2: .00583 X area X height X n-factor g +711 Mechanical Ventilation Recommended:BAS>Final CFMSO> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS)>Final CFMSO Is this part of a multi-unit workscope?Y orC} ]AJS Multiplier? N/A. >6 Loose Insulation Cross-Batt >6"Mix Loose/x-bats Truss Workscope: — �— � C4`A. C L— ti - b tc>ev" s w c.— 3 410,-/t 50c)► E L-6�. ( /�t��UrJJ (%trc,itAc�G fXzl A\c (1wvn. to, Oq. 3--i vs, c cam.. ,bt' )(1 4.903 Any work scoped outside of best ractices/approved by? V • / ._ ! ti (G v (9 y / e 77 7 Ill //7 cam ' AAT I (- (..:?) 0 page of___