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24D-213
BP-2024-0361 6 PROSPECT CT COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-213-001 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-2024-0361 PERMISSION IS HEREBY GRANTED TO: 2024 Project# INSULATION/WEATHERIZATION Contractor: License: DIPIETRO HOME ENERGY Est. Cost: 2872.62 SOLUTIONS DBA REVISE 104464 Const.Class: Exp.Date:03/06/2026 Use Group: Owner: BREWER BREWER SARA A& DIANA J Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: URC Applicant: REVISEBREWER BREWER SARA A&DIANA J Applicant Address Phone: Insurance: 32 MIDDLESEX ST 351-588-0362 WC100142002 HAVERHILL,MA 01835 6 PROSPECT CT NORTHAMPTON, MA 01060 ISSUED ON: 04/01/2024 TO PERFORM THE FOLLOWING WORK: INSTALL ROOF MOUNT TURBINE VENT, ATTIC INSULATION/WEATHERIZATION/AIR SEALING 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 Massachu tts W Board of Building Regulations and St:ndar t MAR 2 9 2O2e, ' ICI O ALITY Massachusetts State Building Code, 7:0 C ' U E Building Permit Application To Construct,Repair, l eno9itl�.a...... Re ised ar 2011 One-or Two-FamilyDwelling' ------ N°8ThAMPr0N INSPEcrloNs S MA()7l�^,q This Section For Official Use Only _ Building Permit Number0F 20Zy—O3 Co I Date Applied: 03/25/2024 /4,a 7Z-) /. /' Z _ 3-2q zozy Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 6 Prospect Ct Northampton,MA 01060 2.Q i)-2-13—0 0 l l.la Is this an accepted street?yes V no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: (AI e . 16 acres 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 la On site disposal system ❑ Check if yes0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Diana Brewer Northampton,MA 01060 Name(Print) City,State,ZIP 6 Prospect Ct 617-869-3819 dianabrewer74@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ 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 $2872.62 1. Building Permit Fee:$ 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�:� 2872.62 Check No. (Z, ,j�heck Amount: 6 Cash Amount: 6.Total Project Cost: $ ❑Paid in ull 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-104464 03/06/2026 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 M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 351-588-0362 wx-permitting@callrevise.com t Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC 185083 04/24/2026 Dipietro Home Energy Solutions dba Revise HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 32 Middlesex St wx-permitting@calirevise.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 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. �—�' 03/25/2024 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 Department of Industrial Accidents ~�:�1.— ' Office of Investigations ',W. _ Lafayette City Center MI 2Avenue de Lafayette, Boston,MA 02111-1750 J `'".., 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 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 3. 0 Demolition workingfor me in anycapacity. employees and have workers' p 9. ❑Building addition [No workers' comp.insurance comp.insurance.: required.] 5. 0 We are a corporation and its 10.❑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 12.0 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.#:WC100142002 Expiration Date:04/20/2024 Job Site Address: 6 Prospect Ct 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 nalties of perjury that the information provided above is true and correct. Signature: - Date: 03/25/2024 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): 10Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0 Other Contact Person: Phone#: ACL RL® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/14/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Emily Costello NAME: Costello Insurance Group (A/C,No,Extl: (978)374-6352 jn/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 TO RENTE CLAIMS-MADE X OCCUR PREMISES(Ea occur ence) $ 50,000 MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2023 04/25/2024 PERSONAL BADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO n LOC PRODUCTS-COMP/OPAGG $ 2,000,000 MT OTHER: pollution $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED -SCHEDULED HS6326 05/09/2023 05/09/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) Medical payments $ 10,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE EXC4245322 04/25/2023 04/25/2024 AGGREGATE $ 3,000,000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Town of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 210 Main Street THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Northampton, MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,nn,'1 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 ,4C-4SPRO CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) 4/19/219/2023 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 CO ME:NTACT Anya Toteanu NA HUB International New England PHONE FAX 300 Ballardvale Street (A/C,No,Eat): (NC,No): Wilmington,MA 01887 ADDRESS:anya.toteanu©hubinternatlonal.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Independence Casualty Insurance Company 11984 INSURED INSURER B: Dipietro Home Energy Solutions,Inc.,Joseph A.Dipietro INSURER C: Heating&Cooling,Inc _ 32 Middlesex Street INSURER D: Haverhill,MA 01835 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMMIDD/YYYYI IMMIDD/YYWI COMMERCIAL GENERAL UABILITY 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 LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $__ OWNED SCHEDULED AUTEO�S ONLY AUUTNOpSWryEp BODILY INJURY(Per accident) $ HAUTOS ONLY AUTOS ONLY (Perr accident)p AMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N WCI00142002 4/20/2023 4/20/2024 X STATUTE ER 1,000,000 ANY OFFICER/MEMBPROPRIETOEREXCLUDEED ECUTIVE CI N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 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 AUTHORZED REPRESENTATIVE 9'09- ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD --- Commonwealth of Massachusetts . . Division of Occupational Licensure Board of Building Re ulations and Standards ConstF , SApervisor +lc. * .. . . . i res . 0310612026 CS-104464 .4,...c,r ,t,,,,,,,,..„„.,,,,,„::r ,. ... , _ � � p • 440 .... , , JAMES G DI r POULOS; ' . ' , 25 SEVENS TER RD HAVERHILL itA 01830 ,,,,„: , . ''''' .1V ')*-7 .. . OLIVACt° ,''..' 'kJ", 4 er-tr* - ' (N.° -i', l' " . Commissioner . Construction Supervisor Unrestricted - Buildings of any use group which contain less than 35,000 cubic feet (991 cubic meters) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call (617) 727-3200 or visit www.mass.gov/dpl THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Aff Business Regulation 1000 Washing -Suite 710 Bosto . _ - : 118 Home Irmo = `ra .•rzIs,-; =- iistration 1. 0 `— „'Type: Corporation DIPIETRO HOME ENERGY SOLUTIONS INC i ce"- 111=" Lion: 185083 ,.. D/B/A REVISE I #ation: 04/24/2026 32 MIDDLESEX ST. . HAVERHILL,MA 01835 s*Mty, _, S't♦ Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affh.. &Business Regulation Registration valid for individual use only before the HOME IMPROVE'1,, ONTRACTOR expiration date. If found return to: ,.;_iT.r::r i, Office of Consumer Affairs and Business Regulation .„,, , , 1000 Washington Street -Suite 710 is ,-.y,4:411r, Boston,MA 02118 DIPIETRO HOME EN--, • 9 O/B/A REVISE JOSEPH DIPIETRO Sbir 32 MIDDLESEX ST. .r' HAVERHILL,MA 01835 ' ' Undersecretary tia.V.I lulAvithout-sigrtature Revise Energy Planview Diagram Customer: e r Advisor Name: Ji t Litio Address: C..} Any limitations to aces by truck? Y N Town: Site ID: , 'Use the greater of the two BAS It's when calculating for MVR IiOriii6i4Al3c1 of stories 1.5 2 2.5 3 BAS 1: 15 cfm X#occupants X n-factor = 5 IBAS 2: .00583 X area X height X n-factor = Mechanical Ventilation Recommended:BAS>final M50) (0.7 X BAS) echanical Ventilation Required:(0.7 X BAS)>final CFM50 : this part of a multi-unit workscope?Y M,ArS Multiplier?W >6*Loose Insulation Cross-Batt >6'Mix Loose/x-batt Truss Norkscope: — Ilb't o 1 cur 7 3 63XICO) 5OFF1 f� • Upc. i c.. -c(.c r 7Z:` 5 i-t-S,/sweep L-1 t Sklecd—rn Qtc 1,105e- scow p i 011 Darn 0 C Turbrie ) Any work scoped outside of best by? st G- �, 26 vl 1 1 8 :a Built at Yr W Yr ltialtion SOFT FT/300 Yo Low/High sting High sting Low Vents,# ©� sting Propervents guired Propervents — Tit vent? Y N -STREET- AP vent? Y N 40ft WEATHERIZATION mass save BARRIER INCENTIVES t;.r+i.a.hNrexr�N»rw e+no.ti�, Based on your Energy Specialists recommendations, your home can benefit from program-efrg,ble irsulatror+and/or err seiMeq improvements Before moving forward.prase follow all the instructions below to remedies your weatherization berriwl. CUSTOMER INSTRUCTIONS 1. Hire a oualified.licensed contractor to evaluate and/or rernediate the wsathenzetion beerier(%) 1 Submit signed and completed copies of this form and o copy of the paid contractor invoices)within 60 dales of your Horne Erwpy Assessment to. Submit iugnsd end completed copies of this Contractor Evaluation Deport end•copy of tin.embed end ttendillell Contractor lrtyoice to the Participating Home Performance Contractor that curnesetrrd your Nome lwerpy AaaaeeevalWL 3.The weatherization incentrve will be deducted from the customer co-payment amount of the weather,zation work A rebels 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: Diana Brewer Client a or Site ID.. 817051 Site Address 6 Prospect Ct cpty Northampton Star MA ZIP 01060 Pnore Ntrrnber 61 me Email. dianabrewer74@gmail.com Cs toriter/Horrherserner Signe:um: Debt KNOB AND TUBE WIRING To determine if there is an betray knob end tuber/aim the contractor will evaluate the following arras where Noble Mersa Saw' weatherization recorr mendetions have been mode: ■Attic Floor !Attic Waft ■Attic Stops 0 Exterior Wall ■Basement O Other U Other dI have performed/TV nspeetlarh delermssed there is no MTV and tube np rh the ere=MMelad belovr Ei Attic Floor fT Attic Well ®Ault Slope f'E.irtenor Wall (If B.swnent OOther OOther { I have readand agree to the Arms and C((o'ndroons on the back of this form. �rn— -Cork Contractor Namee(: 1rrs,,��K� e 1 Address Z 7 YAt t"�i C`•� A4 L CRY k-"j�[ J . 1�e startk k =jP D‘03 CI Company Name:i .. a 4t *JAL-u u-4 LLC� License Number (' ) 3 / / Contractor signature: Oates 3` 7! 2t`1 MECHANICAL SYSTEM BARRIERS DIP f<:• High Carbon Monoxide:Contractor is to service and re-evaluate the selected mechanical system(s)and reds the carbon rnonoxtde level. as measured in the undiluted flue gas,to below 100 parts per million(ppm) Draft Felker Contractor is to correct the draft in the sele‘tel flue(s) Refer to table on reverse for acceptable ora!'t ranges High Carbon Monoxide Draft Failure Existing CO ppm Revised CO ppti. Existing Draft Pa: Revised Welt Pic Heating System Hot Water Heater Other Spillage:Contractor Is to correct the spillage of flue gases in the selected mechanical systems) Must not spS after 60 seconds of CperathOn O Iteatng System 0 Hot Water Heater 0 Other O I have Performed my inspection and have corrected the Morris noted in the antes selected elborn D I have read and agree to the Terms and Conditions on the back of this form. Contractor Name Address C►ef Suer ZIP Company Name License Number Contractor tlgnet nn Uri Continued on bed' (page t d 7) DocuSign Envelope ID:2E1EF957-1AEA-4D41-BAD3-B5356179B0CD Revise EVERS=URCE Home Performance Contractor 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CLIENT H WORK ORDER Sara Brewer (617) 869-3819 02/29/2024 817051 76201 SERVICE STREET BILLING STREET PROPOSED BY: 6 Prospect Court 6 Prospect Ct Revise 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 4 $145.28 $145.28 Provide labor and materials to install Q-lon weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 4 $118.64 $118.64 Provide labor and materials to install a doorsweep to restrict air leakage. DAMMING 6 $16.68 $12.51 $4.17 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLOOR ENCLOSED CELLULOSE 6" DENSE PACK 728 $2,074.80 $1,556.10 $518.70 Provide labor and materials to install a 6"layer of R-19 Class I Cellulose to floored attic space. SHEATHING ACCESS 1 $46.24 $34.68 $11.56 Provide labor and materials to make an access opening from one attic area to another by cutting a passage through sheathing. This access will be left open as it is between two common unheated non firewalled attic areas. PROPAVENT 2'OR 4' 3 $14.04 $10.53 $3.51 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. REPLACE BATH FAN HOSE 1 $32.23 $24.17 $8.06 Provide labor and materials to install an insulated 4"exhaust hose to existing bathroom fan(s). INSTALLTURBINE ROOF VENT 1 $198.21 $148.66 $49.55 Provide labor and materials to install a roof mounted turbine vent. DocuSign Envelope ID:2E1EF957-1AEA-4D41-BAD3-B5356179B0CD Revise EVERS-URCE Home Performance Contractor 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CLIENT# WORK ORDER Sara Brewer (617) 869-3819 02/29/2024 817051 76201 SERVICE STREET BILLING STREET PROPOSED BY: 6 Prospect Court 6 Prospect Ct Revise SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton,MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL INSTALL ALUMINUM SOFFIT VENT 3 $119.91 $89.93 $29.98 Provide labor and materials to install 4"X 16"rectangular aluminum soffit vents to increase ventilation in attic areas. Specify color: White or Gray. Total: $2,872.62 Program Incentive: $2,247.09 Deposit: $0.00 Final Total: $625.53 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Six Hundred Twenty-Five& 53/100 Dollars $625.53 �Docu Signed by: �Docu Signed by: ki/tA f SL 2/29/2024 Pttu 4. brut/ " —887A148891 AD4FA.._ �DFAC44A385DA477.. CUSTOMER SIGNATURE 2/29/2024 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. DocuSign ERnvelope ID.2E1EF957-1AEA-4D41-BAD3-B5356179B0CD the way save f . 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 Diana Brewer 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. Signed under the pains and penalties of perjury. ,-DocuSigned by. Owner Signature: Pig emu,, DFAC44A385DA477_. Date: 2/29/2024