29-386 (7) BP-2023-0480
36 BROOKWOOD DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-386-001 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-2023-0480 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
DIPIETRO HOME ENIRGY
Est. Cost: 1024 SOLUTIONS DBA RE SE 104464
Const.Class: Exp.Date: 03/06/2024
Use Group: Owner: E LOBDELL ROGER G&JOANNE
Lot Size (sq.ft.)
DIPIETRO HOME ENERGY SOLUTIONS DBA
Zoning: WSP Applicant: REVISE
Applicant Address Phon : Insurance:
32 MIDDLESEX ST (978)203-6736 WCA00573401
HAVERHILL,MA 01835
ISSUED ON: 04/19/2023
TO PERFORM THE FOLLOWING WORK:
INSULATION/WEATHERIZATION
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: I
• a' • 2Till •
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissio ner
t.. ;,1\
l's\
`i ulc r I g7Z
The Commonwealth of Massachusetts qP
• ' e Board of Building Regulations and Standards 9 / FOR
r /: Massachusetts State Building Code, 78aCMR. n <90 MUSE CIPALITY
Building Permit Application To Construct,Repair,Renovat&'OrDeiRolish a Revised Mar 2011
One-or Two-Family DwellingAs.,,,,---74 ,.
A �T 's Section For Official Use Only "'�o�oNSs
Building Permit Number:t fr�'a?.�" /[ 5 0 Date Applied: 04/13/2023
Yeuu—) 41 )/ — if iq Z623
Building Official(Print Name) Signature Date
SECTION I: SITE INFORMATIQN
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
36 Brookwood Dr 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 CI Municipal_ Outside Flood Zone? Municipal 0 On site disposal syst m 0
Check if yes0 f
SECTION 2: PROPERTY OWNERSHIP' F
2.1 Owner'of Record:
Roger Lobdell Florence, Ma 01062
Name(Print) City,State,ZIP
36 Brookwood Dr 413-320-9154 rlobdell@crocker.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORKi2(check all that apply)
New Construction 0 Existing Building❑ 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 i
(Labor and Materials)
1.Building $1024.31 1. Building Permit Fee: $ Indicate how fee is det rmined:
❑Standard City/Town Application Fee
2.Electrical $0 ❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $0 2. Other Fees: $
4.Mechanical (HVAC) $0 List:
5.Mechanical (Fire —
Suppression) $0 Total All Fte
Check No.Ur I Check Amount: Cash Amount:
6.Total Project Cost: $1024.31 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-104454 03/06/24
James Dimopoulos License N{imber Expiration Date
Name of CSL Holder
List CSL Type(see below) U
32 Middlesex St
No.and Street Type Description
Haverhill,MA 01835 U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
-'mom— WS Window and Siding
SF Solid Fuel Burning Appliances
978-203-6736 melissat@callrevise.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC
03/11/24
James Dimopoulos Dipietro Home Energy Solutions dba Revise
IC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
32 Middlesex St melissat@callrevise.com
No.and Street Email address
Haverhill,MA 01835 978-203-6736 I
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 submitte with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes 0 No 0
SECTION 7a:OWNER AUTHORIZATION TO BE OMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I
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.
� 04/13/2023
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 c¢ntractor
(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/di1s
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or parch)
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 ofMassachtlsetts
Department of Industrial Accidents
Office of Investigations
' Mill� Lafayette City Center
A 2 Avenue de Lafayette, Boston,MA 0 111-1750
www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Cori tractors/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#:(971 203-6736
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 g. ❑Demolition
workingfor me in anycapacity. employees and have workers'
P ty 9. ❑Building addition
[No workers' comp.insurance comp.insurance.:
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.12Roof repairs
insurance required.] t c. 152,§1(4),and we have no Weatherization
employees. [No workers' an 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.
tContractors 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.#:WCA00573401 3xpiration Date:04/20/2023
Job Site Address: 36 Brookwood Dr City/State/Zip:Florence, Ma 01062
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pa' and p nalties of perjury that the information provided above is true and correct.
Signature: Date: 04/13/2023
Phone#: (978) 203-6736
Official use only. Do not write in this area,to be completed by city or town t ficial.
City or Town: Permit/License
Issuing Authority(check one):
10Board of Health 20 Building Department 3.DCity/Town Clerk 4.I■Electrical Inspector 59Pluntbin�g
Inspector 6.0Other
Contact Person: Phone •:
- " DIPIEHO-01 _C1 OSNIali1_Ia
ACC7RO CERTIFICATE OF LIABILITY INSURANCE DATE tMH:DO/YYYY) .
46.... 4/4/2022
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 1s 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 C TACT Anya Toteanu
E ---- ---- —- - - - -
HUB International New England PHONE FAX
300 Ballardvale Street (AIL,No,EV) (At.No).
Wilmington,MA 01887 kDOREss:anya.toteanuaihubinternational.com
INSURER S)AFFORDING COVERAGE — MC_I__.—
INSURER A:Atfan c Charter Insurance Com_pany _44326
i
INSURED k INSURER e
Joseph A.Dipietro Heating&Cooling,Inc.,Dipletro Horne !NsuREnc: — �f
Energy Solutions,Inc.,Revise.Inc. i `
32 Middlesex Street _Msime0��
Haverhill,MA 01835 I INSURER E. .. . i
INSURER F: _._
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT T THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONT CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL ,IES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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Y73R TYPE OF INSURANCE IADDLiSUBR, POLICY NUMBER I POLICY EFF POLICY EXP _—__--- --'�T ___. _Imo .1k!IkD9nYT1.11144ztP.71Y1} _ UMRS
'COMMERCIAL GENERAL LIABILITY I � EACH OCr,;RicNc.E
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Pr�LrGY To, I I LOC i PNGKA,CT - I.IAIP,Cs'AUG $ _____._--I
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EXCESS UAB I j CLAIMS-MADE I ; I Ai,GR GATE S •
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AA EMPLOYERS'LIABILITY rN I WCAO0573401 412012022 412012023 ATV ER.
AV'r R:CFH1ETCR PA2`kFRFkECUTIY' r 1,000,000
j N igt;c4EXCLJOEL' , N E-NrA L sn�Ha, r $ , 1,000,000
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CESCRiPTtON OF OPERATIONS'LOCATIONS,VEHICLES(ACORD 101,Add4ronal Remmes Sche ule may be Alachad$more syace,e'eq..edi
CERTIFICATE HOLDER CANCELLATION
Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
212 Main St THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Northampton, MA 01060
AUTHORIZED REPRESENTATIVE
i
Ill /.1.
l'
ACORD 25(2016/03) (01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AC Df C4:14.'t20zz
CERTIFICATE OF LIABILITY INSURANCE OA?EIMi2022YY)
1..•---
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 Costelip
Cost&to Insurance Group. PHONE (978)374.6352 (OM 52 I-S 127
o..c No.Es0; A/C.►W
2 S.Kimball SI. E-liI A RLESS: ecosteilopceslelloin,Lrance.corn
L7 BOX 5248 I INSURER{Si AFFORDING COVERAGE RAC rl
Br.T/1fOr4 MA 01835 INSURER A. Colony A.go Insurance
INSURED INSURER s: Commerce insurance Co_ 34754
Cip,etro Home Energy SotuboI`5,Inc. INSURER C:
DBA Revise i INSURER D.
32 Middlesex Street I INSURER E I
BradtJrd MA 01835 1 INSURER F:
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COVERAGES CERTIFICATE NUMBER: CL224 1802385 REVISION NUMBER:
THIS is TO CERTIFY THAT THE POLICIES CF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLH:Y PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY f)L ISSUED OR IJAY PLR TAM THI.INSl1.ZANCC.AFFOROLD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
EXCLUSIONSAND CONDITIONS OF SJCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
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CERTIFICATE HOLDER CANCELLATION
Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
212 Main St THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN
Northampton, MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
I .
1988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington-Straet- Suite 710
Bostorh Massachusetts 02118
Home lmprovemerjfeonfractorRegistration
Type: Individual
Regt rition: 167375
JAMES G.DIMOUOULOS ERpitation: 03/11/2024
25 SEVEN SISTER RD
HAVERHILL,MA 01830 1 .ti.'1
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
R_ogiettstiOn Expiratigp 1000 Washington Street -Suite 710
167$75 03/11/2024 Boston,MA 02118
JAMES G.DIMOUOULOS.
JAMES DIMOUOULOS / --` eer 'am
25 SEVEN SISTER RD �,reeNr--.;'
I{gVERHILI,MA 01830 Undersecretary C_.. Nsttid without signature
10 Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Regulations and Standards
_1�it f
Const{fjort VORrvisor
CS-104464pires:03106l2024
JAMES G D11r1OPOULOS
25 SEVEN SlitTER RD
HAVERHILL MA 01830 >
lot it t A 11 �.
Commissioner c,1a /,' '3i»c•ta...
REVISE : . .:�� _ _ =
the way you save _ r
Customer: 0,e)& 15 Advisor Name: vl c.t,-1,179( M i
Address: i}G .C5-4Cr t 0-tC, {)tA. Any limitations to a• ess by truck? Y 0,1
Town: IGU -G u
Site ID: 7 L l6_..._..�...._-__-. Use the greater of the two BAS Ms when calculating forMVVR
n of stories 1 1.5 2 2.5 3 I BAS 1: 15 cfm X lf occupiants X n-factor =
n•factor 19 16 15 14.4 13.7 I BAS 2: .00583 X area X height X n-factor=
Mechanical Ventilation Recommended_:BAS>final >(0.7, X Be Ste)NIA
Mechanical P ntilation Required:(07 X BAS)>final CFM5O
------- --Is this part of a multi-unit worksco e?Y o N labon Cross-Ban xB Mix Loosen-ban rues
workscope
ttf ,c-k ,5
Any work scoped outside of best practices/approved by.,
36
,14
Area
Yr Built
Heat Yr
DHW Yr
Ventialtion SOFT
SOFT/300
40%Low/High
Existing High
Existing Low
Rec Vents,U
Existing Propervents
Required Propervents
Soffit vent? Y N
Ridge vent? Y N -STREET- Page_of
Gable vent? Y N --
S I-67964
Page 1 of 1
DocuSign Envelope ID:7BCB19DA-6444-4718-8F8A-C9FA36FOB8EB Page 1 of 1
0 REVISE ENERGY401-1
5 South Summer St.Haverhill,MA 01835 mass save
PARTNER
1. DESCRIPTION OF WORK TO BEPERFORMED
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:Roger Lobdell
Email:Not provided
Phone:413-320-9154
Premise Address:36 Brookwood Dr,Northampton,MA 01062
Mailing Address:36 Brookwood Dr,Northampton,MA 01062
Project ID:4810320
Date:April 12,2023
Job Description
Measure Description Location Quantity Unit Total Cost Customer Cost
Air Sealing at Estimated 62.5 CFM50 Per Hour 10 hr $943.30 $0.00
Rim Joist-6" Fiberglass Batting 10 SF $26.90 $6.72
Bath Fan Hose 1 each $28.00 $7.00
Door Sweep (with AS hrs) 1 each $26.11 $0.00
Project Total $1,024.31
Weatherization incentive ($41.18)
Air sealing incentive ($969.41)
Total Program Incentive -$1,010.59
Customer Total $13.72
2. PAYMENT:Customer agrees to pay REVISE ENERGY for the work as follows:
Payment#1(Deposit):$
-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 Feral 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
pDocuSigned by: �DocuSigned by:
4/12/2023 M� �J„- 4/12/2023
C t BEE2F9 �D4 6611,
Dale REVILD4784CBB9E1D490... �'"� Date
FMichael E Madden
Name of REVISE ENERGY Reffeseriatme
The Terms of this Agreement are contained on both sides of this page
Revise Energy 5 South Summer St Haverhill,MA 01835,800-885-SAVE hello@ReviseEnergy.com a ReviseEnergy.com
DocuSign Envelope ID:7BCB19DA-6444-4718-8F8A-C9FA36F0B8EB
REVI
1�--' 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
Roger Lobdell
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.
c—DocuSigned by.
Owner Signature: rep, (AM
FBEE2F05332D451_.
Date: 4/12/2023