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BP-2023-1786 172 OVERLOOK DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-572-001 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-2023-1786 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 4134 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date:03/06/2024 BRADLEY-GILBERT BRUCE G&MARYELLEN F Use Group: Owner: BRADLEY-GILBERT Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: WSP Applicant: REVISE Applicant Address Phone: Insurance: 32 MIDDLESEX ST (978)203-6736 WC100142002 HAVERHILL,MA 01835 ISSUED ON: 12/26/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATI 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. cria Signature: I 444., ,,c I ,,,,, Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massa uset DEC 2 i 20 OR Board of Building Regulations an Sta •ards Massachusetts State Building Co ,781 CMR 23 fUSE Building Permit Application To Construct,Rep ' Rene+,�• . '_• . Revi d Mar 2011 One-or Two-Family Dwelling HAamTON,MA o7°ri°A s _ This Section For Official Use Only Building Permit Number: / 7b Date Applied: 12/19/2023 , 4. Building Official(Print Name) Signature Dat SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 172 Overlook Dr Florence,MA 01062 1.1 a 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 la 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: Maryellen Bradly Florence,MA 01062 Name(Print) City,State,ZIP 172 Overlook Dr 413-584-9570 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction❑ 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 $4134.50 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 Fees; 41 6 Check No.111 Check Amount. " Cash Amount: 6.Total Project Cost: S 41 34.50 ❑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.) Restricted 1&2 Family Dwelling City/Town,State,ZIF `—� M Masonry RC Roofing Covering —"1— WS Window and Siding SF Solid Fuel Burning Appliances 351-588-0362 wx-permitting@callrevise.com 1 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 351-588-0362 Email address Haverhill,MA 01835 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 C3 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. 12/19/2023 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 % t.= Lafayette City Center 19 ! . 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/Organization/Individual): Dipietro Home Energy Solutions dba Revise Address:32 Middlesex St City/State/Zip: Haverhill, MA 01835 Phone #:351-588-0362 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 and I 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 h 9. ❑ Building addition [No workers' comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.111 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑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. :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 New England Policy#or Self-ins.Lic.#:WC100142002 Expiration Date:04/20/2024 Job Site Address: 172 Overlook Dr 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 c•erti/j•under the pa' and p nalties of perjury that the information provided above is true and correct. Signature: Date: 12/19/2023 Phone#: 351-588-0362 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): 10 Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: ® DATE(MM/DD/YYYY) ACC) CERTIFICATE OF LIABILITY INSURANCE 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/CONN Ext): (978)374-6352 FAXC,No): (978)521-5127 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE 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 GEM_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: pollution $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED HS6326 05/09/2023 05/09/2024 BODILY INJURY(Per accident) $ AUTOS ONLY /.. AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ 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 YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A 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/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 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 AcoRO CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) 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 NAME: HUB International New England PHONENo,Ext): , FA(A/X,No): Wil300mington, ingardvale Street EMAIL an a.toteanu hubinternational.com Wilmington,MA 01887 ADDRESS; Y INSURER(S)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 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI (MM/DDIYYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE L OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ - PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 1.7t8T LOC PRODUCTS-COMP/OP AGG $ - OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ -- ANY AUTO BODILY INJURY(Per person) $ - OWNED SCHEDULED AUTOS ONLY _ AUTOS yy�E BODILY INJURY(Per accident) $ AUTOS ONLY _ AUT P��ac eMpAMAGE UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED I RETENTIONS $ A WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE OTH- ER WC100142002 4/20/2023 4/20/2024 1,000,000 ANY FFICER/MEM ER/EXCLUDED ECUTIVE PI N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes describe under 1,000 000 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 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- 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 Washington Street- Suite 710 Bostor2, Massachusetts 02118 Home lmprovement~CanfractorRegistrativn Type: Individual ileglal ation: 167375 JAMES G.DIMOUOULOS Expiration: 03/11/2024 25 SEVEN SISTER RD HAVERHILL,MA 01830 1 ...*I" 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: TYPEi individual Office of Consumer Affairs and Business Regulation RogLtttstiorn Exoit tf n 1000 Washington Street -Suite 710 1076 03/11/2024 Boston,MA 02118 JAMES G.DIMOUOULOS. JAMES DIMOUOULOS 'I 25 SEVEN SISTER RO „,.wrt'rs( , I{gVERHILL,MA 01830 Undersecretary _/� Npt 1ki without signature 1117 Commonwealth of Massachusetts Division of Occupational Licensure Board of Building R ulations and Standards ,s t Cons on Srvisor . •s CS-104464 x ,t`pires:03/06/2024 1. JAMES G DIIQOPOULOS .. te 25 SEVEN SISTER RD HAVERHILL !NA 01830 .€ :i if �t"ttttt1v- Ccmmissioner r.;'i /, j'r:Tc ,a. DocuSign Envelope ID:26EF9ACA-8149-4302-B17C-06CB52F74345 Revise Energy 0REVISE 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 Bruce Bradley-gilbert (413) 320-7939 10/23/2023 811872 76201 SERVICE STREET BILLING STREET PROPOSED BY: 172 Overlook Drive 172 Overlook Dr 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 8 $852.72 $852.72 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.) EXTERIOR DOOR WEATHER STRIPPING 2 $72.64 $72.64 Provide labor and materials to install Q-lon weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 2 $59.32 $59.32 Provide labor and materials to install a doorsweep to restrict air leakage. DAMMING 40 $111.20 $83.40 $27.80 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass balls for damming purposes. ATTIC FLOOR OPEN BLOW CELLULOSE 10" 962 $2,270.32 $1,702.74 $567.58 Provide labor and materials to install a 10"layer of R-37 Class I Cellulose to open attic space. HATCH: THERMAL BARRIER POLYISO 2 INCH (ATTIC) 1 $53.96 $40.47 $13.49 Provide labor and materials to insulate the back of an attic hatch with 2" rigid insulation board at R-10. INSTALL 2"THERMAL BARRIER POLYISO ON OPEN BASEMEN 70 $387.80 $290.85 $96.95 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. PROPAVENT 2'OR 4' 56 $262.08 $196.56 $65.52 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. DocuSigned by: 1--DocuSigned by: „• � lea — Gi� '15/2023 k, Au 5t 12/13/2023 7ED9700EED7E432.. "-4403C29D5BD64C8... NI 1 Ke minds L DocuSign Envelope ID:26EF9ACA-8149-4302-B17C-06CB52F74345 Revise Energy REVISE fk. 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# WORK ORDER Bruce Bradley-gilbert (413) 320-7939 10/23/2023 811872 76201 SERVICE STREET BILLING STREET PROPOSED BY: 172 Overlook Drive 172 Overlook Dr Revise Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence,MA 01062 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL REPLACE BATH FAN HOSE 2 $64.46 $48.35 $16.11 Provide labor and materials to install an insulated 4"exhaust hose to existing bathroom fan(s). Total: $4,134.50 Program Incentive: $3,347.05 Customer Total: $787.45 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Seven Hundred Eighty-Seven &45/100 Dollars $787.45 DocuSigned by: by: braiti t ` Gi�u4 15/2°2 3 LtiliL A/QU SI- , 12/13/202 3 7ED9700EED7E432... 4403C29DSBD64C8... NOTE.Imo ram,I mnr ec rr,,nunnrrn er ua it nui cnc,u cu WITHIN M"kre OIMMfr:K1gIpCE SIGN DATE 30 DAYS. DocuSign Envelope ID:26EF9ACA-8149-4302-B17C-06CB52F74345 rI �'`'� 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 Maryellen Bradly - Gilbert owner otf 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: _ ak -7ED9700EED7E432... Date: 12/15/2023 Virtual Circle One In-Home Revise Energy Planview Diagram Customer: ' (v 'gad fet/- ,I bctfr Advisor Name: m on,� Address: I f2 O(Ier!uiC 131. Any limitations to access by truck? Y N Town: F(0((Abe 444 Site 10: at18q-2 Use the greater of the two BAS trs when calculating for MVR I #of stories 1 1.5 7" 2.5 3 I BAS 1: 15 cfm X#occupants X n-factor = �y n-factor 19 16 15 14.4 13.7 BAS 2: .00583 X area X height X n-factor = 9,2o Mechanical Ventilation Recommended:BAS>final CFM50> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BAS)>final CFMSO Is this part of a multi-unit workscope?Y oC IA/s Mult►plie N/ >6•Loose Insulation Cross-Batt >6"Mix Laoseh Batt Truss Workscope: 5. tiftial I h,7 lc 2 �w r to 1-5 /A 6 �"y der 3 0�mrli 47 Flo ` q Ptip> (6 L/ ro'.03c q6.2 a( 6 r3f Host. 2 Any work scoped outside of best practices/approved by? r--_. x r: A+ -IG 13F BF 4 ei.,,„1 ----\2 6 Score El Area Yr Built 3�., Heat Yr J DHW Yr Vontialtion SOFT SOFT/300 40%Low/High Er sri^g High ER..'.ntj Low Rec Vents,I Existing Prcpervents Required Prop rvents Soffit vest' Y N Ridge vent? Y N STREET- Page __ of Gable vent? Y '. -__