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17A-158 (17) BP-2023-1507 53 FOX FARMS RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-158-001 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-2023-1507 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: DIPIETRO HOME ENERGY Est.Cost: 5571 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date: 03/06/2024 Use Group: Owner: S RONDEAU PATRICK D&KRISTA Lot Size (sq.ft.) Zoning: URA Applicant: S RONDEAU PATRICK D&KRISTA Applicant Address Phone: Insurance: 53 FOX FARMS RD FLORENCE, MA01062 ISSUED ON: 10/25/2023 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: iv O TO Fees Paid: S65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEI V 1q55 oc, 2 T e Commonwealth of Massachusetts / )4. Q 2023 oar of Building Regulations and Standards FOR ass chusetts State Building Code, 780 CMR MUNICIPALITY �Fna t city,- USE ^ a"Ia t A lication To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 `'-- One-or Two-Family Dwelling This Section For Official Use Only Building ermit Number: 15a.)3-/)'b 7 Date A lied: 10/18/2023 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 53 Fox Farms Rd Florence MA 01062 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) 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 yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Patrick Rondeau Florence MA 01062 Name(Print) City,State,ZIP 53 Fox Farms Rd (413)727-5396 pdrmedia@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 $5571.85 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $0 ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $0 2. Other Fees: $ 4.Mechanical (HVAC) $0 List: 5.Mechanical (Fire Suppression) $0 Total All Fees: Check No:7111 Check Amount: Cash Amount: 6.Total Project Cost: $557 1 .85 ❑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 Haverhill,MA 01835 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonr y RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 978 891 0163 wx-permitting@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 wx-permitting@callrevise.com No.and Street Email address Haverhill,MA 01835 978 891 0163 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 James Dimopoulos to act on my behalf,in all matters relative to work authorized by this building permit application. See attached authorization 10/18/2023 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. 10/18/2023 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" NThe Commonwealth of Massachusetts Department of Industrial Accidents ,' `— Office of Investigations F. Lafayette City Center 2 Avenue de Lafayette, Boston, MA 02111-1750 "' 41 I www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers 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 #: (413) 727-5396 Are you an employer? Check the appropriate box: Type of project(required): I.❑■ I am a employer with 180 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. El New construction listed on the attached sheet. 7. ❑ Remodeling 2.El I am a sole proprietor or partner- 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. ❑ 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 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no Weatherization employees. [No workers' 13.0 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. :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 Policy#or Self-ins. Lic. #:WCI00142002 Expiration Date:4/20/24 Job Site Address: 53 Fox Farms Rd 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 pains and penalties of perjury that the information provided above is true and correct. Signature: 514414,2Date: .1 0/1 8/23 Phone#: 978-372-4111 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): 1❑Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: ACR le OF LIABILITY INSURANCE DATE(MMDDIVYYY) 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 PHO N,E■t): (978)374-6352 FAX c No): (978)521-5127 INC,2 S.Kimball St. E-MAIL ecostello©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. 1LTR TYPE OF INSURANCE NSD MD POLICY EFF POLICY EXP POLICY NUMBER (MMIDDIYYYY) (MM/DDlYYYY) UMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGEIO REN I ED 50,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2023 04/25/2024 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY X PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: pollution $ 2,000,000 AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED v 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 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (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/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 212 Main St THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Northampton, MA 01060 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 DIPIEHO-01 CWOODSIDE AC-ORE) CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `-� 4/19/2023 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 CONTACT Anya Toteanu HUB International New England PHONE FAX - 300 Ballardvale Street (A/C,No,Ext): (A/C,No): Wilmington,MA 01887 joisonya.toteanu@hubintemational.com s enya.toteanu@hubintemational.com INSURER(S)AFFORDING COVERAGE NAIC N INSURER :Independence Casualty Insurance Company 11984 INSURED INSURER B: Dipietro Home Energy Solutions,Inc.,Joseph A.Dipietro INSURERC: Heating&Cooling,Inc — 32 Middlesex Street INSURER D_ 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. ADDLSUBR INSR TYPE OF INSURANCE NSD WVD POLICY NUMBER (MM/DDY LTR /YYYYI (MMIDD/YYYYI LIMITS COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO(El oc at PREMISES(Ea 000unarloe) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEM AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ga LOC PRODUCTS-COMP/OP AGG $ OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _(E4accident) ---- S ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSO ONLY AUTOS _BODILY INJURY(Per accident) $ AUTO ONLY AUTOS ONL� tIVI EaOCIdenU GE $ UMBRELLA LIAB i OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ! WC100142002 4/20/2023 4/20/2024 X TEE ER OTH 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ �FFICER/MEMBER EXCLUDED? ,LN J NIA - illandatory in NH) E.L.DISEASE-EA EMPLOYEE,$ 1,000,000 It yes describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT f DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) ciageft f4Stbanipton CANCELLATION 212 Main St Northampton, MA 01060 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingtar>_Street - Suite 710 Boston,Massachusetts 02118 Home Improvement-Contractor-Registration Type: Individual :Registuition: 167375 JAMES G.i7IM000UI OS Expiration: 03/11/2021 25 SEVEN SISTER RD HAVERHILL, MA 01830 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTr Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE Individual Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 167;176 03/11/2021 Boston,MA 02118 JAMES G.DIMOUOULOS JAMES DIMOUOULOS 25 SEVEN SIS 1 ER RD „�-o/w�•+� �^"r IAUFRHILL,MA 111830 Undersecretary C.--%' N, G1id without signature ® Commonwealth it Massachusetts Division of Occupational Licensure Board of Building Regultations and Standards Con1tfCL�0 11 Slirvisot � CS-104464 6pires:03/06/2024 JAMES G DIM,OPOULOS 25 SEVEN SISTER R.t. HAVERHILL MA 01830 :: nr_. • ;i .) Conlmissionef ,,'[6erGu I •i•ri i't... Customer: (ti �� Address: - Advisor Name: an v� �1 Town: o J. -�-- _ Any limitations to access by truck? Y/(t�j Site ID: •Use the greater of the two BAS N's when calculating for MVR #of stories ®©® 3 BAS 1: 15 cfm X U occupants X n-factor n-factor 19 16 an 13.7 BAS 2: .00S83 X area X height X n-factor = Mechanical Ventilation Recommended:BAS>final CFM50> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS)>final CIM50 Is this part of a multi-unit workscope7 Y ot'Fi� A/S Multiplied / >6"Loose Insulation Cross-Batt >6"Mix Loose/x-batt Truss Workscope: Aic o7-7C i6320 C4 47aa (x) 06 Any work scoped outside of best practices/approved by? G77 est) C9 6 a- � ® page�of CP \ DocuSign Envelope ID:24DC64B6-FEA5-4883-A187-887EFBBB27C3 Revise Energy -, REVISE Home Performance Contractor the way you save 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CLIENT# WORK ORDER Patrick Rondeau (413) 272-8626 05/22/2023 806576 76201 SERVICE STREET BILLING STREET PROPOSED BY: 53 Fox Farms Road 53 Fox Farms Rd Revise Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 12 $1,131.96 $1,131.96 Seal areas of your home against wasteful, excessive air leakage. Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics, basements, attached garages and other unheated areas (windows are not generally addressed.) DAMMING 149 $365.05 $273.79 $91.26 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLOOR OPEN BLOW CELLULOSE 11" 1,638 $3,554.46 $2,665.85 $888.61 Provide labor and materials to install a 11"layer of R-40 Class I Cellulose to open attic space. DocuSlgned by: r—DocuSigned by: eektvi& rok 5/23/2023 hithAtt, f n 5/22/2023 —4E88D3549098443 04784CBB9E 1 D490. .. Michael E Madden DocuSign Envelope ID:24DC64B6-FEA5-4883-A187-887EFBBB27C3 Revise Energy REVISE Home Performance Contractor i the way you save 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CLIENT N WORK ORDER Patrick Rondeau (413) 272-8626 05/22/2023 806576 76201 SERVICE STREET BILLING STREET PROPOSED BY: 53 Fox Farms Road 53 Fox Farms Rd Revise Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence,MA 01062 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL PROPAVENT 2' OR 4' 126 $520.38 $390.29 $130.09 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. Total: $5,571.85 Program Incentive: $4,461.89 Customer Total: $1,109.96 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Thousand One Hundred Nine& 96/100 Dollars $1,109.96 DocuSigned by: f--DocuSigned by: A� ��,, A^111I 5/23/2023 itt,j , f ,�, Michael E Madden Paflnrlc f`�A1 ^�" -D4784C8B9E 1D490... —'COI�FRAO�t�ATIVE CUSTOMER SIGNATURE 5/22/2023 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. DocuSign Envelope ID:24DC64B6-FEA5-4883-A187-887EFBBB27C3 REV the way you s46,` 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 Patrick Rondeau 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: Patrick IeaU itau. Date: 5/23 B/202493 8D35098443..