The URL can be used to link to this page

20-007 (3) BP-2024-0191 494 SYLVESTER RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 20-007-001 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-2024-0191 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 4139 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date: 03/06/2026 LANGER DANIEL L MAIL TO: EDWARD BRYANT Use Group: Owner: JR Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA. Zoning: RR/WSP Applicant: REVISE Applicant Address Phone: Insurance: 32 MIDDLESEX ST (978)203-6736 WC100142002 HAVERHILL,MA 01835 ISSUED ON: 03/13/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERZATI 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: / // �/�_' Fees Paid: $65.00 • 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts Board of Building Regulations and Standards 'C® 2 FOR. 20 2 Massachusetts State Building Code,780 CMR 24 IC A LITYiE Building Permit Application To Construct,Repaii,Renovate; lish a evisec(Mar 2011 One-or Two-Family Dwelling1espFrTi lt This Section For Official Use Only "�'��o s Building Permit Number: grA a, '-{" '/ Date Applied: 02/20/2024 Keu ia�5s /// G 3-13-2ozy Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 494 Sylvester Rd Florence,MA 01062 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 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yea SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Hartley Grant Florence,MA 01062 Name(Print) City,State,ZIP 494 Sylvester Rd 413-275-2230 dianeipt@comcast.net 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 ❑ 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 $4139.60 1. Building Permit Fee:$ 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 Fee :, Check No.111 Check Amount: V Cash Amount: 6.Total Project Cost: $4139.60 ❑Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-loaasa !f James Dimopoulos License Number E4Hrahon 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 Masonry RC Roofing Covering 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 185083 04/24/2024 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 0 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 is true and accurate to the best of my knowledge and understanding. 02/20/2024 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 �f Y Department of Industrial Accidents Office of Investigations ' s. I�1.i 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. 0 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 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.1=I 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: 494 Sylvester 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 pa' and p nalties of perjury that the information provided above is true and correct. Signature: L Date: 02/20/2024 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): 1❑Board of Health 2❑Building Department 3lJCity/Town Clerk 4.❑Electrical Inspector 511lumbing Inspector 6.0Other Contact Person: Phone#: AC RCP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD YYYY) 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 (978)374-6352 FAX (978)521-5127 (A/C,No,Ext): (A/C,No): _ 2 S.Kimball St. E-MAIL ecostello@costelloinsurance.com ADDRESS: PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIL# 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 (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 50,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2023 04/25/2024 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY X PRO LOC PRODUCTS-COMP/OPAGG $ 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 /N. 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 `,/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 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 ) r' a I ' 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 ,a►coszo CERTIFICATE OF LIABILITY INSURANCE DATE,MM/°°"""' 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 CONCT Anya Toteanu NAME:TA HUB International New England PHONE FAX 300 Ballardvale Street (AIC,No,Ext): (A/C,No): Wilmington,MA 01887 E-MAIL anya.toteanu@hubinternational.com INSURERS)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 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 IMMIDDIYYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 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 78f LOC PRODUCTS-COMP/OP AGG $ OTHER $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ _ ANY AUTO BODILY INJURY(Per person) $ OVVNED SCHEDULED AUTOSRE� ONLY AUTOS BODILY BODILY INJURYp (Per accident) $ AUTOS ONLY AUTOS ONLY ((Perr accident)AMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE ER WCI00142002 4/20/2023 4/20/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMB NH)ER EXCLUDED? N N/A 1,000,000E.L.DISEASE-EA EMPLOYEE $ 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 Northampton, MA 01060 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 ~,..,_. Commonwealth of Massach sir f .v 7 Division of uSetts Occupational Board of BuildingLi censure censure Re ulations and Standards Cons % Cpoi ...,--, CS-104464 -,.. , pires • 03/0612026.JAMES G DI ,''1 • PpULOS ° ,,-4.x25 SEVEN SISTER RD HAVERHILL 01830w 0, }}ll ' t O °IkAt-V-C1H:1131° - , Commissioner ____S,,,,,L,e. veliati:ti, THE COMMONWEALTH OF MASSACHUSETTS ,rtOffice of Consumer Aff i Sa $ ri Business Regulation 1000 Washing �t# r ,1t-Suite 710 Bosto : , <«f +. $ 118 Home Imaro }+t :"1'' e•istration rM w '� Type: Corporation DIPIETRO HOME ENERGY SOLUTIONS r==. ,,.., flan: 185083 32 MIDDLESEX ST. ;^.. •tbn: 04/24/2024 HAVERHI MA 01835 �� - � 0/ NB Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Aff�esB Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: E_ q "04igl Office of Consumer Affairs and Business Regulation "' 1000 Washington Street•Sults 710 I ` , i _ 2q Boston,MA 02118 DIPIETRO HOME ENf~`R3Y U S`+ .. JOSEPH DIPIETRO ,+ ;% 32 MIDOLESEX ST. f ,,+/a�.�lwrf• '` y HAVERHILL,MA 01835'�y--°t'� Undersecr� -'" Not vaNd without signature HOMEOWNER ENERGY AUDIT AGREEMENT The ABCD Inc, Homeowner Energy Program provides substantial conservation work to eligible homeowners and tenants,at NO COST, Funding is provided by the Department of Energy, Eversource and National Grid. The work performed may Include: • Energy Audit • Weatherization (walls insulation, air sealing,weather-strips) • NCAP Audit (Light Bulbs, Refrigerator, and AC and Washing Machine Replacement) Heating System, repair or replacement All homes are inspected before and after the work Is completed by ABCD employees and overseen by State Auditors. All weatherizatlon works is done by licensed and fully Insured contractors and overseen by ABCD, Inc, Homeowners who have their homes treated can realize savings of 25%or more per year.An efficient home and heating system provides for significant energy cost savings, comfort and reliability. In order to receive the benefits of the Weatherization Program and/or Heating System work,you should be on the ABCD Fuel Assistance Program or Utility Discount Rate. Please contact the fuel assistance department at(617)357-6012 for more information about Fuel Assistance If you need to apply • If you're not interested, please return the attached Home Owner Energy Audit Authorization Form expressing no Interest. Please send the signed Homeowner Energy Audit Authorization form to: ABCD Weatherization Program Attn: Erin Mahoney Weatherization Coordinator 178 Tremont St,4th Floor Boston, MA 02111 If you have any questions, please call (617) 348-6419 Fax: (617) 338-0931 ABCD Weatherization Program Homeowner Energy Audit Agreement Fuel Application # l Hartey Grant I� (authorized agent)for the (PRINT NAME) property, which is located at: 494 Sylvester rd Florence 01062 (PRINT ADDRESS) Hereby authorize Action for Boston Community Development, Inc and its subcontractors to perform the following Inspections/work on the above named property,consistent with all applicable Federal,State and local regulations. (Please Note:It is the responsibility of the condo owners to inform their Association/Management Company of work to be completed) Check ALL that apply: C9.Perform Inspections and diagnostic testing within dwelling unit. SkWeatherization of dwelling unit. May include insulation of attic and walls,weather- stripping and air sealing. ❑NCAP Audit(Light Bulbs, Refrigerator,AC and Washing Machine Replacement) RHeating system inspection and diagnostic testing. Perform cleaning,tuning and repairs, or Replacement. (System/burner/oil tank, Including removal of old parts.) ❑Not Interested • Signed 1 1 Vk1 t? V1tk `-t Date: 12/15/23 Home Telephone: 413 275 2230 Other Tel: Email: dianeipt@comcast.net • Best way to contact: Home Phone 0 Email Other „ , OREVISE° 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 I, 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. Owner Signature: Ql,i{ �” (l &1X\{ Date: 12/15./23 REVISE the way you save This agreement is made by and among Revise LVI Program 32 Middlesex St 494 Sylvester rd Haverhill,MA,01835 Florence 01062 Phone:(800)885-SAVE Monday,December 18,2023 1.DESCRIPTION OF WORK TO BE PERFORMED "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. Part Quantity price unit Total Attic/basement blower door guided sealing with two-part foam 1 $125.00 man/hr $125.00 $0.00 $0.00 Sill/mudsill seal&insulate to R-19(UNFACED FIBERGLASS) 20 $3.90 In ft $78.00 Fixed Sweep triple flange 2 $27.00 ea $54.00 Weatherstrip w/Q-Ion or equivalent 2 $76.00 ea $152.00 Blower Door Testing with Zonal Pressure-Pre&Post 1 $71.00 ea $71.00 $0.00 $0.00 CAZ Testing 1 $85.00 per day $85.00 $0.00 $0.00 $0.00 $0.00 1"or 2"THERMAX or equivalent on door t $91.00 ea $91.00 $0.00 $0.00 $0.00 $0.00 Wood clapboard/shakes/shingles or vinyl(dense pack)cellulose or equivalent 680 $3.52 sq ft $2,393.60 $0.00 $0.00 Continuous variable speed fan w/controls(whole house replace existing) 1 $1,090.00 ea $1,090.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Initial Investment: $4,139.60 Additional Discount/Incentive: Total Net Investment: $4,139.60 Monday,December 18,2023 Customer Signature Date Monday, December 18,2023 Michael Madden Revise Energy Signature Date Name of Revise Energy 2.PAYMENT:CUSTOMER agrees to pay Revise Energy for the work as follows: Payment#1: $0.00 Credit card or check deposit is due at the time the Work is scheduled. Required payment information will be collected by the advisor or over the phone by a customer service representative at the time of scheduling.(Note: Mastercard,Visa,and Discover accepted). Additional Payments and Final Invoice: $4,139.60 If the final invoice is being paid by check,credit card information will still be required at the time of scheduling.Notify the customer service representative that you are paying by check and your card will not be charged unless we fail to receive payment within 5 days of invoice. The Terms of this Agreement are contained on this page Revise Energy°5 South Summer St°Haverhill,MA 01835°(800)885-SAVE hello@ReviseEnergy.com°www.ReviseEnergy.com Virtual Circle One In-Home Revise Energy Planview Diagram Customer: 44-k---(1-Sx_el OtA Advisor Name: ly‘ Arc- . Address: Any limitations to access by truck? Y 41.) Town: Site ID: •Use the greater of the two BAS tr's when calculating for MVP #of stories 1 1.5 2 2.5 3 I BAS 1: 15 cfm X If occupants X n-factor = n-factor 19 16 , 15 14.4 13.7 BAS 2; .00583 X area X height X n-factor = Mechanical Ventilation Recommended:BAS>final CFm50> (0.7 X BAS) Mechanical Ventilation Require&(0 7 X BAS) final CF M50 Is this part of a multi-unit workscope? Y or N AIS Multiplier? NM >6"Loose Insulation Cross-Batt >6"Mix Loose/x-bart Truss Worksooper C9 $tt1:1-(iCe 41"fr.k (c7 T-FC'rcO r c_ 6 te PcX7 \ 1 -r5 CD ..i;•A "Cy-- (-1,--( Any work scoped outside of best practices/approved by? ° G2) 0 ) "r• C9 411111 Area Yr Built Heat Yr OHW Yr Ventialtion SOFT SOFT/300 40%Low/High Fxisting High Existing Low Red Vents,It Existing Propervents Required Propervents THE IZATION mass say 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 1 FORM F � 7 1416011111111MtanSOLV61c. Customer Name: Harley Grant Client# or Site ID: Site Address: 494 Sylvester Road Florence City: State: MA ZIP: 01062 Phone Number: 4132752230 Email: Customer/Homeowner Signature: Date: KNOB 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: III Attic Floor al Attic Wall I Attic Slope CI Exterior W II III Basement ®Other:Whole House ❑Other: ■ I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below. ®Attic Floor ❑a Attic Wall i]Attic Slope ®Exterior Wall I Basement ®Other:Whole House ❑Other: NI I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: Fernando Blanco Address: 148 Carmelinas Circle Ludlow MA 01056 --._ City: State: ZIP.— Company Name: Blanco Electric License Number: 22452A Contractor Signature: L G Date: 03/11/23 "=F -- --� Zuq e7k nn4 U, ¢ 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. oxide Draft Fail Existing CO ppm: Revised CO ppm: • Existing Draft Pa_ Revised Draft Pa: Heating System Hot Water Heater Other: 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 tems 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. ❑ 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$250 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 Pre, re(Pa) <10 -2.5 Table 1-Acceptable 10-90 (outside Temp/40)-2.75 Draft Test Ranges >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: BLACKSTONE CoLight Columbia Gas' BERKSHIRE GAS COMPANY .- _ of Massachusetts GAS A NiSource Company EVERS URCE Liberty Utilities' nationalgrid Unitll HERE WITH YOU.HERE FOR YOU.FOR ADDITIONAL INFORMATION, PLEASE CALL YOUR ENERGY SPECIALIST. (page 2 of 2)