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32A-116 (8) BP-2023-1637 90 MARKET ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-116-001 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-2023-1637 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 2255 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date: 03/06/2024 WHEELER MARY L &MELANY THOMPSON- Use Group: Owner: WHEELER Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: URC 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/W EATH ER I Z ATI 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: • a 2 51-) '1 • Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner t..L. 0 KyT AFr�oAvic C%�f/'1G1 RECEIVED it v NNOV 7 2023 /�ut1,r 1R1� The Commonw alth of Massachu tts FOZ Board of Building Regulations and St ndards MassachusettsState Building Code,7 0 Cl MUNICII ALITY u n g T.OF BUILDING INSPECTIONS US Building Permit Application To Construct,Repair,R newate-UPT n1R.rh t A 0 0A9vised A'tar 2011 One-or Two-Family Dwelling nn This Section For Official Use Only Building Permit Number: 6/—4A,3* /a 7 Date Applied: 11/16/2023 /LfFtl lr.� �3 ���/ L _ I /6-2)2, Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 90 Market St#2 Northampton,MA 01060 1.1a 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 Lone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Mary Wheeler Northampton,MA 01060 Name(Print) City,State,ZIP 90 Market St#2 413-230-6997 mwheeels55@gmail.com No.and Sweet Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(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 $2255.19 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $0 ❑Standard City/Town Application Fee ❑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: Check No? heck Amount:(( Cash Amount: 6.Total Project Cost: $2255.1 9 ❑Paid in Full ❑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 U Unrestricted(Buildings up to 35,000 cu.ft.) Haverhill,MA 01835 Haverhill, City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering —�a— WS Window and Siding SF Solid Fuel Burning Appliances 413-614-0060 ext 669 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 01e35 43-614-0060 ext 669 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 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. this 11/16/2023 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 =Bit Office of Investigations Lafayette City Center 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#:413-314-0060 ext 669 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. ID 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 10.0 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.❑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: 90 Market St#2 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 do hereby certify under the pa' and p naides of perjury that the information provided above is true and correct. Signature: �- Date: 11/16/2023 Phone#: 413-314-0060 ext 669 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 21:Building Department 3ElCity/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone#: A ® DATE(MMIDDIYYYY) 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 PHONE Ext): (978)374-6352 FAX No): (978)521-5127 2 S.Kimball St. E-MAIL ecostello@costelloinsurance.com ADDRESS: PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC q 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 SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMAGE T000 RENTE _ CLAIMS-MADE X OCCUR PREMISESO(Ea occur ence) $ 50,000 MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2023 04/25/2024 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PGT LOC 0000200 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 /N AUTOS X HIRED N.,/ 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 r 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/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 V ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DIPIEHO-01 CWOODSIDE '4CoRo CERTIFICATE OF LIABILITY INSURANCE DA4/19/2023 TE ) 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 N2 ACT Anya Toteanu HUB International New England PHONE FAX 300 Ballardvale Street (A/C,No,Ext): (A/C,No): Wilmington,MA 01887 ss,anya.toteanu@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC N 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 INSURER D: 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 INSD WVD (MM/DD/YYYY1 IMM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE PREMISES Ea occurrence) 3 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY jra LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ _ OWNED SCHEDULED AUTOSRREE ONLY AUTOS BODILY BODILY INJURYp (Per accident) $ AUTOOS ONLY AUTOS ONLY (Perr ac dent)AMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N WC100142002 4/20/2023 4/20/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FICER/MEMBER EXCLUDED? N N I A andatory 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/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 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 Washingtor}Street- Suite 710 Bostorh Massachusetts 02118 Home lmprovemerit~OonfractarRegistration Type: Individual Regtltl'ation: 167375 JAMES G.DIMOUOULOS Eitpitation: 03/11/2024 25 SEVEN SISTER RD HAVERHILL,MA 01830 y ti.F., • Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affatrs&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 Roq;sststIon Exolratl.gn 1000 Washington Street -Suite 710 167$75 03/11/2024 Boston,MA 02118 JAMES G.DIMOUOULbS. JAMES DIMOUOULOS j' c 25 SEVEN SISTER RD „r0'!-,' HAVERHILL,MA 01830 UndersecretaryJ N id without signature ® Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regulations and Standards 11 Con st }iott1 Sgrvisor .z CS-104464 Expires:03/06/2024 JAMES G DIMAOPOULOS ... te 25 SEVEN SISTER RO HAVERHILL MA 01830 3 g, Commissioner :, /, t .'rxi fa. DocuSign Envelope ID:4DE7B6F5-2E27-4AA7-A0E1-B51EBBC31406 Revise Energy r= 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 Olivia Blais (413) 210-8198 09/13/2023 810566 76201 SERVICE STREET BILLING STREET PROPOSED BY: 90 Market Street 90 Market 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 6 $639.54 $639.54 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 3 $108.96 $108.96 Provide labor and materials to install Q-lon weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 3 $88.98 $88.98 Provide labor and materials to install a doorsweep to restrict air leakage. DAMMING 24 $66.72 $66.72 Provide labor and materials to install a 12" layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLOOR OPEN BLOW CELLULOSE 6" 429 $840.84 $840.84 Provide labor and materials to install a 6"layer of R-22 Class I Cellulose to open attic space. INSTALL 2"THERMAL BARRIER POLYISO ON KNEEWALL 12 $65.40 $65.40 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to a kneewall area. DOOR: THERMAL BARRIER POLYISO 2"(ATTIC) 1 $103.05 $103.05 Provide labor and materials to insulate the back of the attic door with 2"rigid insulation board. VENT BATH FAN TO ROOF OR OTHER 1 $166.53 $166.53 Install a 6"insulated exhaust hose to a flapper vent to exhaust existing bathroom fan(s). Fan will be vented through the roof or an acceptable alternative if contractor cannot vent through the roof. DocuSign Envelope ID:4DE7B6F5-2E27-4AA7-A0E1-B51EBBC31406 Revise Energy 'm, 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 Olivia Blais (413) 210-8198 09/13/2023 810566 76201 SERVICE STREET BILLING STREET PROPOSED BY: 90 Market Street 90 Market St Revise Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL 12"MUSHROOM VENT 1 $175.17 $175.17 Provide labor and materials to install a 12"diameter"mushroom"roof vent(s)to increase ventilation in attic areas. The vent can be supplied in (circle color)black, brown,gray or mill finish. Total: $2,255.19 Program Incentive: $2,255.19 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: -Docu Signed by: 04784C0B9E10490... 4100D1F64E 12408... NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. DocuSign Envelope ID:4DE7B6F5 2E27-4AA7-AOE1-B51EBBC31406 —, - �, 5 . w ,'R 1 t 1, :, - 5 �s4 z� € a ri i E , s x rw.R. '4' � a�4 '' 7 ,.. .) REVIS .. . ,. ,.. .4!-----' 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 Mary Wheeler owner of the property listed above a building hereby authorize Revise Energy or my assigned subcontractor listed above to act on my behalf and obtain permit to perform insulation and/or weatherization work on my property under the Mass Save Home Energy Services Program. DocuSigned by: Owner Signature: (ikw,y (P6Altr 41DDD1F64E 12408... Date: 9/13/2o23 I 4ittla. . ..--41 . ,,,.. , ) Virtual Circle One In-Home Revise Energy Planview Diagram Customer: Advisor Name: J V Address: �v�NAV- — - I a Any limitations to access by truck? Y/0 Town: 1)(t,.4-r _ Site ID: p �-, , 6 'Use the greater of the two BA51Ys when calculating for MVR ff of stories 1 1.5 2 2.5 3-1 MS 1: 15 cfm X S occupants X n-factor = n-factor 19 16 15 14.4 13.7 1 BAS 2: .00583 X area X height X n-factor = 7 Mechanical Ventilation Recommended:BAS>final CFMSO> (0.7 X BAS) Mechanical Ventilation Required:(0.7 X BA5)>final CFM50 Is this part of a multi-unit workscope?Y or N A/s Multiplier? N/A >6"Loose Insulation Cross-Batt >6*Mx Loose/x-batt Truss Worksco cr-+ E 4cTl L a� 6``0 C 4 a--9ii( — dlc-r GL-t-_, T v.^./�-� t a— Any work scoped outside of best practice approved by? i t r ) ) 0(----).41- t� C) A 11 ( C sw-v 3 , F )6 U 6 %t) ,cy, S ty Area YrBult MeslYW DIM Yr Ventddon SQFT r, SOFT/300 - I Eudstlng High a • Ends ng Law , Rae Vents...�. 0 1 Edging•ropone ts Required PrapMwr-s WEATHERIZATION mass save BARRIER INCENTIVES Savings through energy efficiency Based on your Energy Specialist's recommendations,your home can benefit from program-eligible insulation and/or air sealing improvements. Before moving forward,please follow all the instructions below to remediate your weatherization barriers. CUSTOMER INSTRUCTIONS 1. Hire a qualified, licensed contractor to evaluate and/or remediate the weatherization barrier(s). 2.Submit signed and completed copies of this form and a copy of the paid contractor invoice(s)within 60 days of your Home Energy Assessment to:Submit signed and completed copies of this Contractor Evaluation Report and a copy of the dated and itemized Contractor invoice to the Participating Home Performance Contractor that completed your Home Energy Assessment. 3.The weatherization incentive will be deducted from the customer co-payment amount of the weatherization work.A rebate check will be issued in the event the amount exceeds the customer's co-payment amount, 4.Complete the recommended weatherization improvements. CUSTOMER INFORMATION Customer Name: Mary Wheeler Client#or Site ID: 810566 Site Address: 90 Market st unit 2 City: Northamton State: MA ZIP: 01060 !in eresswice,i_ s_L Phone Number (413)230-6997 Email: mwheeels55@gmail.com Customer/Homeowner Signature: INA Date: 1 0/04/23 .. {f AND TUBE WIRING To determine if there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save' weatherization recommendations have been made: ®Attic Floor Ul Attic Wall II Attic Slope •Exterior Wall ❑Basement ❑Other: ❑Other. re tweo out the!iire'21 • I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below. ®Attic Floor I®Attic Wall ®Attic Slope 'Exterior Wall ❑Basement ■Other:no basment 0 Other. ro ce Miea out S the Licensed c!ectr,us^ ■ I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: OytUl1 Yilmaz Address:63 Musante Dr Apt D City: Northampton, State: ma ZIP: 01060 Company Name: Yilmaz Electric i tnl� f i License Number B9244-B Contractor Signature: G' j) G�✓X t 'V Date: 10/04/23 MECHANICAL.SYSTEM BARRIERS To be filled outbv licensed contractor) High Carbon Monoxide:Contractor is to service and re-evaluate the selected mechanical system(s)and reduce the carbon monoxide level, as measured in the undiluted flue gas,to below 100 parts per million(ppm). Draft Failure:Contractor is to correct the draft in the selected flue(s).Refer to table on reverse for acceptable draft ranges. High Carbon Monoxide Draft Failure Existing CO ppm: Revised CO ppm: Existing Draft Pa: Revised Draft Pa: Heating System • Hot Water Heater Other: I Spillage:Contractor is to correct the spillage of flue gases in the selected mechanical system(s).Must not spill after 60 seconds of operation. ❑ Heating System 0 Hot Water Heater 0 Other: ❑ I have performed my inspection and have corrected the items noted in the areas selected above. ❑ I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: Address: City: State: ZIP: Company Name: License Number: Contractor Signature: Date: Continued on back (page 1 of 2) VENTILATION Exhaust Fan for Fresh Air:Contractor to install exhaust fan to provide measured,continuous or intermittent whole building ventilation. The required rate of flow must be capable of providing CFM(measured at fan). Dryer Vent Evaluation:Contractor to ensure the dryer vent is exhausted to the exterior through hard metal ductwork. ❑ I have installed an exhaust fan to the specifications noted above. ❑ I have evaluated and/or repaired the dryer vent fan to the specifications noted above. O I have read and agree to the Terms and Conditions on this form. Contractor Name: Address: City: State: ZIP: Company Name: License Number: Contractor Signature: Date: TERMS AND CONDITIONS Eligibility Requirements:Applicant must be a residential customer of a participating Mass Save Sponsor.Customer must participate in the Mass Save Home Energy Services Program(must reside in a 1-4 family home).The qualifying barrier must be identified at the time of the Home Energy Assessment as a barrier preventing the installation of proposed weatherization improvements.Customer must complete the recommended weatherization improvements to receive the applicable incentive.Customer must submit the completed Contractor Evaluation Report including a copy of the dated and itemized invoice from the licensed contractor on company letterhead within 60 days(postmarked)of the Home Energy Assessment.If contractor invoice is not provided within 60 days,the eligible weatherization barrier incentive may be forfeited.Customer participation does not guarantee the barrier will be cleared. Contractor Responsibilities and Acknowledgement:In performing any work in connection with the Weatherization Barrier Incentive(as set forth in detail below),the contractor shall:(i)abide by all local,state and federal guidelines,applicable laws(including,but not limited to all applicable environmental laws),building codes,regulations(including,but not limited to EPA lead-safe and any and all other applicable environmental regulations)and licensing requirements;and(ii)stop work and immediately notify the customer in any case where existing or possible health and/or safety problems exist.The licensed contractor must fill in and sign off on the testing results in the appropriate place on this form.Contractor shall remain solely and fully responsible for their confirmations and notes that they provide on this form and with respect to the Contractor Responsibilities set forth above. Knob&Tube Wiring Evaluation(up to$250 incentive):The knob and tube wiring that has been noted cannot be determined inactive at the time of the Home Energy Assessment performed by the Mass Save Home Energy Service Program.Even if the observed wiring appears to be inactive,there might still be active circuits located in inaccessible areas of the home(i.e.walls,etc.).The Mass Save Home Energy Services Program requires that a licensed electrician verify the absence or inactivity of the knob and tube wiring in the areas of your home where we are proposing insulation be installed.We advise you to share this form with your electrician before hiring them to inspect your home to ensure they agree to the terms.The Home Energy Services Program will rely on the electrician's certification and will not be liable if inaccurate. Mechanical System Evaluation(up to S250 Incentive):Combustion safety testing has been conducted on all the heating and hot water systems in this home.These tests are conducted with all the exhaust equipment running simultaneously,creating a"worst-case"depressurization of the building.If a problem was identified,repairs to correct the problem must be completed by a qualified HVAC contractor.The problems and corrections are as follows: 1. Carbon monoxide levels exceed 100 ppm in the undiluted flue gases.After a clean and tune,or other applicable service,the measurement(s)of undiluted flue gas of carbon monoxide are to be recorded on the front of this Contractor Evaluation Report where program rules state the maximum allowable concentration is 100 ppm. 2. During your Home Energy Assessment it was discovered that the identified mechanical system(s)was continuously spilling exhaust gases into the home. This condition is also known as back draft and should end within 60 seconds of system operation in order to be considered acceptable.The contractor must service the system(s)to correct the spillage problem in the selected flue(s),and certify by signature on the front of this form that the spillage condition has ceased after 60 seconds of operation. 3. During your Home Energy Assessment it was discovered that the identified mechanical system(s)are not creating sufficient DRAFT.This condition is where exhaust gases are not moving through the chimney at a fast enough rate.The contractor must service the system(s)to correct the draft problem in the selected flue(s).New draft results must be provided on the front of this form and within acceptable draft ranges as described in Table 1. Outside Temp( F) Minimum Draft Pressure(Pa) <10 -2.5 Table 1-Acceptable Draft Test Ranges I 10-90 (outside Temp/40)-2.75 >90 -0.5 Exhaust Fan Installation(up to$250 incentive):The results of the completed blower door test at the time of your Home Energy Assessment or scheduled weatherization installation with a Participating Contractor,determined that your home will need an increase in fresh air flow before undertaking any program eligible weatherization work.Mass Save provides a Weatherization incentive for the installation of an exhaust fan to provide additional fresh air to the home.Your energy specialist can help determine the necessary flow rate and provide recommendations.This incentive is only available in limited situations and not all customers will receive a blower door test at the time of the Home Energy Assessment. Brought to you by: BLGICKSTONE Q tth`om; Glumofi M:a.a Gssasac husettsBERKSHIRE GAS COMPANY GAS A NiSource Company EVERS URCE Liberty Utilities' nationalgrid 0' Naile HERE WITH YOU.HERE FOR YOU. - •- FOR ADDITIONAL INFORMATION, PLEASE CALL YOUR ENERGY SPECIALIST. (page 2 of 2)