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23D-112 (12)
BP-2023-1726 584 ELM ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-112-001 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-2023-1726 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION/WEATHERIZATION Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 3712 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date: 03/06/2024 Use Group: Owner: MANNING COHEN JOSHUA &LAURA Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: URB Applicant: REVISE Applicant Address Phone: Insurance: 32 MIDDLESEX ST (978)203-6736 WC100142002 HAVERHILL,MA 01835 ISSUED ON: 01/10/2024 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: ' .).2 I � Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 1K Pc-L-K9 /L+i //l^I=1174,1TT mR de/,/ t3-o r- I Z-I I "1 l R 4-r ii I 2/29/aT XEe Commonwealth of Massachusetts Q Boa d of Building Regulations and Standards FOR _ 8 �023 Mas achusetts State Building Code, 780 CMR MUNICIPALITY USE Building Pe it plication To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 Dear OF�ltlr Mtn One-or Two-Family Dwelling � Fuiv,, lP/3Prc,TioN _`1--- ___-_�.�.4 o1O o S This Section For Official Use Only Building Permit N f 7 073' /7410- Date Applied: 12/04/2023 4,,,,z, /12 i-io-zDZ Y Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 584 Elm St Northampton,MA 01060 l.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 0 Zone: Outside Flood Zone?— Municipal 0 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Joshua Cohen Northampton,MA 01060 Name(Print) City,State,ZIP 584 Elm St 347-307-7309 joshua@theriseandfall.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 $3712.04 1. Building Permit Fee:$ 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:POI Wheck Amount:¶ ashAmount: 6.Total Project Cost: $37 1 2.04 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 Haverhill,MA 01835 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP /-1 M Masonry RC Roofing Covering -��— WS Window and Siding SF Solid Fuel Burning Appliances 351-588-0362 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 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 la 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. 12/04/2023 Print Owner's or Authorized Agent's ame(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 � ._1' Office of Investigations It Lafayette City Center 2Avenue 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 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.❑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. :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.#:WCI00142002 Expiration Date:04/20/2024 Job Site Address: 584 Elm St City/State/Zip:Northampton, MA 01060 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 de hereby certify under the pa' and p nalties of perjury that the information provided above is true and correct. Signature: Date: 12/04/2023 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): 11=1Board of Health 2❑Building Department 30City/Town Clerk 4.0 Electrical Inspector 5.0Plumbing Inspector 6.0Other Contact Person:- Phone#: �� AC^ ® DATE(MM/DDIYYYY) 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 (AHONE EM). (978)374-6352 (A/C,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 INSURERA: 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) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE D CLAIMS-MADE X OCCUR PREMISESO(Ea occ urrence) $ 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 LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X RO LOC 000020 , 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 XHIRED Ne 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 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/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 ,4coR0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `-� 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,Eat): laic,NOWilmington,MA01887 Miss:anya.toteanu@hubinternational.com INSURERS)AFFORDING COVERAGE NAIC N 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 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR,WVD (MM/DO/YYYYI IMM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY jef LOC PRODUCTS-COMP/OP AGO $ OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ _ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS yyN p BODILY INJURY(Per accident) $ _ AUTOS ONLY AUTOS O Y ((Perr accident)AMAGE UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION Xy PER STATUTE ERH AND EMPLOYERS'LIABILITY WC100142002 4/20/2023 4/20/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? N N I A (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 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 ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE ?V..?'47 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 Washingtot}Street- Suite 710 Bostorb Massachusetts 02118 Home Improvement~ConfractorRegistration Type; Individual i:tegi5ttation: 167375 JAMES G.DIMOUOULOs Expiration: 03/11/2021 25 SEVEN SISTER RD HAVERHILL,MA 01830 1 ti.'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: TYPE:individual Office of Consumer Affairs and Business Regulation gogiptltetlQn ExotratIgn 1000 Washington Street -Suite T10 167$T.5 03/11/2024 Boston,MA 02118 JAMES G.DIMOUOULbS. JAMES DIMOUOULOS f 25 SEVEN SISTER RD f,/„�..n:= .i''.a .F Gr f _—•�"""f IIAVERHILL.MA 01830 Undersecretary _r/ tki0Q3(id without signature ® Commonwealth of Massachusetts Division of Occupational Licensure Board of Building R ulations and Standards it' Cons ton Srvisor a CS-104464 I spires:03/06/2024 JAMES G DIMOPOUL.OS 25 SEVEN SISTER RO HAVERHILL MA 01830 t 44t'4l;.t t ', 1 Commissioner . /; , ,,,x... DocuSign Envelope ID: FFF347B3-3997-40E1-AC42-248467562006 � 1, _ REVISE „ 6 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 Joshua Cohen 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. r—DocuSigned by: Owner Signature: jeSLua. C �59CBDF49A45D... Date: 11/1D43/1023B DocuSign Envelope ID:FFF347B3-3997-40E1-AC42-248467562006 Revise Energy r'4, 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 Joshua Cohen (347) 307-7309 11/13/2023 812675 76201 SERVICE STREET BILLING STREET PROPOSED BY: 584 Elm Street 584 Elm St Revise Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 1 $106.59 $106.59 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 1 $36.32 $36.32 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 1 $29.66 $29.66 Provide labor and materials to install a doorsweep to restrict air leakage. DocuSigned by: 11/13/2023 DocuSigned by: 1- •/^`S/ A �� t t et chael E Madden 11/13/2023 D4784CBB9E1D490_ \--559DD4CCBBDF49A45D_ DocuSign Envelope ID:FFF347B3-3997-40E1-AC42-248467562006 Revise Energy tNIi 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 H WORK ORDER Joshua Cohen (347) 307-7309 11/13/2023 812675 76201 SERVICE STREET BILLING STREET PROPOSED BY: 584 Elm Street 584 Elm St Revise Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton,MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL HATCH:THERMAL BARRIER POLYISO 2 INCH (ATTIC) 2 $107.92 $107.92 Provide labor and materials to insulate the back of an attic hatch with 211 rigid insulation board at R-10. Total: $280.49 Program Incentive: $280.49 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/Dollars $0.00 DocuSigned by: f—DocuSigned by: LiOSLA/4 Ct 11/13/2023 I�A( f � Michael E Madden ... - —D4784CBB9E1D490.. 59D4CBBDF49A45D . _.....4 BDF4__........ IYJ I VMGrt JIV IVN I WIG 11/13/2023 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. Page 1 of 2 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 adjustments in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed. Customer Name:Josh Cohen Email:Not provided Phone:347-307-7309 Premise Address:584 Elm St,#2,Northampton,MA 01060 Mailing Address:584 Elm St,#2,Northampton,MA 01060 Project ID:5042304 Date:Nov. 13,2023 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour 8 hr $852.72 $0.00 Vent Bath Fan to Roof or Other 1 each $166.53 $0.00 Damming 32 each $88.96 $0.00 Hatch -2"Thermal Barrier Polyiso 1 each $53.96 $0.00 Attic Floor-9" Open Blow Cellulose 410 SF $926.60 $0.00 Attic Floor-6" Dense Pack Cellulose 448 SF $1,276.80 $0.00 Door Sweep (with AS hrs) 1 each $29.66 $0.00 Exterior Door Weather Stripping (with AS hrs) 1 each $36.32 $0.00 Project Total $3,431.55 2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows: Payment#1(Deposit):$ -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 Firal 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. Shin, yk 11/13/23 Nlkh to 11/13/23 :ustomerSignaire v v Date Ft EVISE ENERGY Rep'esentanve Signature Date Name ct REVISE ENERGY Regreserlalrve The Terms of this Agreement are contained on both sides of this page Revise Energy.5 South SUrner St.Haverhill,MA 01835=800-885-SAVE hello@ReviseEnergy.cam=ReviseEnergy.com Page 2 of 2 %, REVISE ENERGY r. 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 tens 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:Josh Cohen Email:Not provided Phone:347-307-7309 Premise Address:584 Elm St,#2,Northampton,MA 01060 Mailing Address:584 Elm St,#2,Northampton,MA 01060 Project ID:5042304 Date:Nov. 13,2023 Weatherization incentive ($2,512.85) Air sealing incentive ($918.70) Total Program Incentive -$3,431.55 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 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 Fnal 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 ^/� I n p I n /y Shla, „ yk 11/13/23 1 V ll(!,hN�t�t. 'n" _W th 11/13/23 slomer Signal ire Date REVISE ENERGY Representalve Signature Date Name of REVISE ENERGY ReFreserialae The Terms of this Agreement are contained on both sides of this page Revise Energy=5 South Sumer St=Haverhill,MA 01835'800-885-SAVE'hello@ReviseEnergy.com=ReviseEnergy.com Customer: 30470k I(7--1`-' Advisor Name: 44"c t','t 4v/ 0 ('`' Address: 5 S),41 _51.w1. 5 j,_, Any limitations to access by truck? Y i(.lY/ Town: \-?u-\< <-k- `1> Site ID: ' -i. X 6 s 'Use the greater of the two BAS St s when calculating f r MVR 5$of stories 1 5 2 2.5 3 I @AS 1: 15 cfm X q occupants X n-factor = '"'" ° n-factor _ 19 (1 15 14.4 13.7 I BAS 2: .00583 X area X height X n-factor = 1 -5 / 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)or N A/S Multiplier? N/A >6"Loose Insulation Cross-Batt >6"Mix Loose/x-batt Truss worksc ope \kit-5 CA-A-- &'' 0 'Dooms t %) t✓%w-T 13 A4't N E-81-' 1 a .Alitc E1OL/'— 06c— 9' 1 Any work scoped outside of best practices/approved by? A rt t C �o 9 , / 10 /4 C o .)--Oill 14 , -6 6 0 ,5. 5 D2 1 i") +3 Area HratYt / Heat Yr J I DH W Yr b IJ VenliaNion SOFT SQFT/300 .1 40%Low/High Existing High el 1 Existing Low l!/ Z'. Rec Vents,ft Existing Propervents Required Propervents 10 Ai1k. . ..„,..., .., . Renter Pre-Weatherization incentive Knob Tube andVermiculite Mitigation mass save s ay,,rr,,,, incentive Amount:Up to$5,000 per rental unit 'fats offer is to assist fi ndlordsF of rented properties wittl the cost of knob and tithe endtor rrerat cuttte abateMe.f where it prevents the fettenetron of Mass ";nsulataon or err tmg work A maximum of up to S5.00Li of eiigitrie costs nr rental vol.t�tl br avas�€here before abatement work begors er the form of a two-pa'ty check matte out to the cor=tr ctau are tat ctasf:a-r-::- anct..ondition&. rvf ..>:-o::a, . :•.,,.y form ter a full s9t o>'reran ENERGY SPECIALIST TO COMPLETE-DARRiER$IDENTIFIED A Mass Save weat' raoatron work scope has been developed,but knob and tube wiring onclior vormlcuiite has been observed in the fo'oxdng work arms)and veil need to be removed before the work can be co-notetera(cheek all that aoplyi Knob I Tube Whin _ f . '' 9 Mtn. <. " (,i�xterror Waits i sserr�c+nt Ceding �wispx<e =O Other;_____ `=L}4r-r;. Yemticulite: ".>Attic Y.;Knee WaU s,icw _ ,,,.,,Other; TENANT ACCOUNT FOLDER INFORMATION Residential Electric Provider fi:,:;,Cape L+ ht Compact � / � R' p .,i Evrrsource V t•.z`rtfOt`al(Jae tlnittl Residential Gas Provider , ....8erkstere Gas Eversoome I:berry Mahone!Gad lira:; i Etectr.c Account Number ter w G+ Account Number peter t Qw'ner -Assessment Site ID`' '. -- 1 r i i Tenant Account Holder: ::_. -- � •, ,` �. My Signature co fir ms that I am tenant occupya'sg Ltaas addre, , ... . . . _ _ I. I.'_ , RENTAL PROPERTY OWNER INFORMATION Check Payable To evl; ca YVI,A pre iv.rV ty�_ Pnone Number �j t -7 ')t) -4 2 tn�t+la,ro 9_, „'c -L l k" i�7 `�l Illf,:trit- t"rAhillpr7�C lot,' TVA. P... 0/0 CI Rental Property Owner _....., Gates / / ' My sign.at ve cohfarms tr st 1 Np.ie re,R.I ...:,a owe o a Terms ard KN.c •T BE CONTRACTOR,..t ,,,,: ,F ,T Caxnaany name i}' 14 �, IL r1 rY Li^ fs / O peen t son xf t „ >>h t r:r.r Let.jl• e r 7, ' '''. 4 r.+"1$ ' ''.,w'A c Main Address' ` r ,�,.,/ -r ,r !% 3i-, tt r cc J Cam° t r,y _ /`'a P(5134/! t'I have oar-formed my nSpLrt,oi and tha'te m1r.ed the e ns0' y'� 1. '�c' y tr F ,r da Knob&Tube Whin: , �' Fxter,or Waits c PaSe+� 't L, a, ,'.r, . .r,, r y. Centtactot Signature ,.,,"" .,r�r ,c ^-- Date , A My c.grutture confirms. a t ave oc dn rr_d rely ins, € n 0, '.a e , ,y t s ada arm eve r'A",.d,.-tvd x..�o a-:d too. ,s ,ha ar' ndcatod.My sagr,ature also conarns treat rave rr a,�I an i wo rK to.h, a .c,-id.<,,.5..:aiirscrd.,r,t.e•is wk of errs vrrm. ASBESTOS CONTRACTOR TO COMPLETE AFTERAft.ratista, , r � :••• .: t.?.. r.. ..........' Company Nance: .._ _.... ....� Contact Per,'r;t� Pr rrtaicurlto. ;, S':: i .. t Cot Signature: __ Data; Contractor �__. a it ;iv<•..n ,. r r„i y ..�..:' r•c., •ae,,r.v t., t` , r, t r..a,^_;y ,n,r•,.,.. a r c,, 1 -r•t:.:t r.Jyo'cad and a' r, h r t:.i Terms ilea Pao c.trons orroosri9 o.'r hanu,,,c4 i, -.- emu A,>y_ ._,.. .__>: =z.....,..,� ..... ,,1 �,a:,: ,,t4w 46AteV...w,w..-,-':, ^;a:...:i,— af<— =