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16B-024 BP-2024-1499 111 FERN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 16B-024-001 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-2024-1499 PERMISSION IS HEREBY GRANTED TO: Project# insulation 20214 Contractor: License: DIPIETRO HOME ENERGY SOLUTIONS DBA REVISE DBA Est. Cost: 3958 DIPIETRO HEATING &COOLING 104464 Const.Class: Exp.Date: 03/06/2026 Use Group: Owner: GRIFFITH TAGER MIRIAM&ROBIN Lot Size (sq.ft.) DIPIETRO HOME ENERGY SOLUTIONS DBA Zoning: URB Applicant: REVISE DBA DIPIETRO HEATING&COOLING Applicant Address Phone: Insurance: 32 MIDDLESEX ST 978-270-0063 WC100142003 HAVERHILL,MA 01835 ISSUED ON: 11/08/2024 TO PERFORM THE FOLLOWING WORK: I NSULATION/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: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS.Signature: 6/2. Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner C IV o The Commonwealth of Massachusetts N Board of Building Regulations and Sta idards FC R (JDMassachusetts State Building Code,780 CMR NOV - 7 2024 MUNICIPALITY LITY Building Permit Application To Construct,Repair,Re iovabe Or Demolish a Retiised Afar 2011 One-or Two-Family Dwelling DEp7,OF GUILDIP C INSPECTIONS • ,/� This Section For Official Use ally NORTHAMPTON,MA 01060 Building Permit Number: ( �'c f 7 Date Applied: 11/06/2024 D-6 c(c1eLD //- 7.zy Building Official(Print Name) Signa Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 111 Fern St 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 2 Private 0 acme: _ Outside Flood Zone? Municipal 42 On site disposal system 0 Check if yes SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Robin Griffith Florence,MA 01062 Name(Print) City,State.ZIP 111 Fern St (917)415-6710 robing.artist@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 0 Repairs(s) 0 Alteration(s) 2 Addition ❑ 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 $3958.97 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $0 ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $0 2. Other Fees: $ 4.Mechanical (HVAC) $0 List: 5.Mechanical (Fire Suppression) $0 Total All FQ¢s• Check No. `� eck Amount: Cash Amount: 6. Total Project Cost: S 3958.97 0 Paid in Full 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 Haver U Unrestricted(Buildings up to 35,000 Cu.ft.) _ Haverhill,MA 01835 City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 351-588-0362 wx-permitting@callrevise.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(MC) HIC 185083 04/24/2026 Dipietro Home Energy Solutions dba Revise H1C 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 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 is true and accurate to the best of my knowledge and understanding. 11/06/2024 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" City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 111 Fern St Florence MA 01062 The debris will be transported by: Dipietro Home Energy Solutions dba Revise The debris will be received by: Dipietro Home Energy Solutions dba Revise Building permit number: Name of Permit Applicant James Dimopoulos 11/06/2024 9amu-d- Z7e:htea-ems Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents —- Office of Investigations fir- idly J 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'lndividual): 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 180 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors o El New construction 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 iz. (]Demolition workingfor me in anycapacity. employees and have workers' t 9. 0 Building addition [No workers' comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions ❑ 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.] r c. 152,§1(4),and we have no Weatherization employees. [No workers' I3.®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. l 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.#:WC100142003 Expiration Date:04/20/2025 Job Site Address: 111 Fern St 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 S250.00 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 penalties of perjury that the information provided above is true and correct. Signature: Date: 11/06/2024 Phone#: 351-588-0362 Official u.se only. Do not write in this area.to be completed by city or town official. City or'hogs n: Permit/License# Issuing Authority(check one): 112Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 50Plumhing Inspector 6.0Other Contact Person: Phone#: /..m..44 DIPIEHO-01 NFOWLER ACORv CERTIFICATE OF LIABILITY INSURANCE DATE(M M/DDrYYYY) `/ 4/18/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVE.Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License#1780862 CONTACT Anya Toteanu HUB International New England PHONE I FAX 300 Ballardvale Street _(AM,No,Eat): (A/C,No)._ Wilmington,MA 01887 � sanya.toteanua@hubinternationaI.com INSURERISI AFFORDING COVERAGE NAIC a INSURER A:Independence Casualty Insurance Company 11984 INSURED INSURER B: Dipietro Home Energy Solutions, Inc.,Joseph A.Dipietro INSURERC: Heating&Cooling, Inc.,Revise,Inc. — — 32 Middlesex Street INSURER 0: 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 TH'S CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE A=FORDED BY THE POLICIES DESCRIBED HEREIN IS SUB,,ECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR IADOL SUBR1 POLICY EFF POLICY EXP _m__ TYPE OF INSURANCE I INS() MD1 POLICY NUMBER IYhVDD/YYYYI,sIM/TIDITYYYi LIMITS -- COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAMS-MADE __ OCCUR PR_ttISES(Ea Oocu PeOle) $ — —_ _ MED EXP(Any one person) $ PERSONAL S ADV INJURY $ _GF,41'LAGGR7 LT APPLES PER: GENERAL AGGREGATE $ POLICYLIMITPEeT LOC PRODUCTS-COMP/OP AGG S _ OTHER $ AUTOMOBILE LIABILITY C_tEOMac�IINdEED'INGLE LIMIT 1 $ - ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOSOE ONLY _ AUTOS BODILY INJURY(Per accident) $ — AUUTOS CNLY AUTOS ONLY PROPERTY acc4enti DAMAGE S $ UMBRELLALIAB ' OCCUR EACI-OCCURRENCE EXCESS LIAR j CLAIMS-MADE AGGREGATE $ OED RETENTIONS $ A AAND EMPLSOYERS€LIABILIITr YrNX �7ATUTE T O - ANYPROPRIETORIPARTNER/EXECJTIVE WCII)0142003 �2012024 4/20/2025 E.L.EACH ACCIDENT $ 1,000,000 Q�FFICER/M1MBER EXCLUDED' N N/A (Mandatory n ) EL.DISEASE-EA EMPLOYEES 1,000,000 If yes,describe under 1,000,000 —DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 I DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD t0'.AddltIonal Remarks Schedule.may be attached it more space Is required) Part I Workers Compensation State, Massachusetts CERTIFICATE HOLDER CANCELLATION City 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 ACC. ® CERTIFICATE OF LIABILITY INSURANCE DATE(MIEODIYYYY, `,.....---- 04/13/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOTAFFP MATIVELY 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 '�o � Emily Costello NAME: Costello Insurance Group PHONE (978)374-6352 I•AX (978)521-5127 (�l1C lea Ixt1: LAIC,Nol: 2 S.Kimball St. EMAIL ecostelo@costeIoinsurance.com ADDRESS: PO BOX 5248 INSURER(S)AFFORDING COVERAGE NAIC I Bradford MA 01835 INSURERA: Colony Argo Insurance INSURED INSURERS: Arbelia Protection Ins Company 41360 Dipretro Home Energy Solutions,Inc. INSURERC: 32 Middlesex Street INSURERO INSURER E: Bradford MA 01835 INSURER F: + COVERAGES CERTIFICATE NUMBER: CL2441303422 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABG✓E 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 ADOUBR POLICY EFF POUCYFXP LTR INSO MO POLICY NUMBER thoodoorYYYY) (MMrDOIWW) LIMITS XI COMMERCIAL GENERAL LIABILITY 1.000,()Q0 S CLAIMS-MADE ❑X EACH OCCURRENCE OCCUR DAMAGE TORENTED PREMISES(Ea occurrence) S 10,000 MED EXP(Any one person) $ 10,000 A PACEP308383 04/25/2024 04/25/2025 PERSONAL dADV INJURY S 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000 X POLICY C 78iCI LOC PRODUCTS-CCMPJOPAGG S 2.000,000 OTHER: Pollution S 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LMiT ' S 1,000,000 (Ea accdent) ANYAUTO BODILY INJURY(Per Person) $ B OWNED SCHEDULED 1020128852 05/09/2024 05/09/2025 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS X HIRED NONAW PROPERTY DAMAGE S I AUTOS ONLY AUTOS()ICY) ,(Per acc denI) S X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 3,000,000 A EXCESS LIAB CLAIMS-MADE EXC4245322 04/25/2024 04/25/2025 AGGREGATE g 3,000,000 DED )41 RETENTION S 10,000 S WORKERS COMPENSATION PER OTH- ANO EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT 3 OFFICERIMEMBER EXCLUDE09 (Mandatory in NH) E.L DISEASE•EA EMPLOYEE S If yes,desalbe under DESCRIPTION OF OPERATIONS below E.L DISEASE•POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remake Schedule,may be attached if more spate is required) CERTIFICATE HOLDER CANCELLATION City 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 sr,,� , ., I 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD e. -- Commonwealth of Massachusetts 1: '�*' Division of Occupational Licensure - 1 } Board of Building Re ulations and Standards e Cons on 4eic. . tp CS-104464 t -= -- - - spires : 03/06/2026 ‘4 lido .. JAMES G DI • POULOS ' . 25 SEVEN SI$TER R I '� HAVERHILL 0180?t---,, '- 0 , .......„. 1 (4 ll. r r }' i CommissionerSoiA_Ar,Le \i‘idhisfri.____ 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 Affai Business Regulation 1000 Washings ;t-Suite 710 Bosto -, - :-•-; 11188 Home Im•ro ,-,,; :, r• T - ( 'tration ===iirms(z- "' - 1..�...�.,. �: Type: Corporation = lion: 185083 DIPIETRO HOME ENERGY SOLUTIONS INC ;I :_M :tion: 04/24/2028 D/B/A REVISE _li 32 MIDDLESEX ST. iik omA�. �� y = LtllrHAVERHILL.MA 01835 ='ta mow I ziar� \or MINI Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affa?s&Business Regulation Registration valid for Individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:CO7paation Office of Consumer Affairs and Business Regulation ReWitilitti.911 1, iiilatti141 1000 Washington Street -Suite 710 !g T 83'-•_44 04J24t2c4 Boston,MA 02118 DIPIETRO HOME ENERCsV • U • 'INC D/B1A REVISE JOSEPH DIPIETRO ,•" rir 32 MIDDLESEX ST. •(4ti. . .` e t. �ir:t� ,---' HAVERHILL,MA 01835 �t'i it • ""-t`` Undersecretary yBe ature Docusign Envelope ID:38CFB9E0-36F7-42DB-8E48-965024383582 Revise n REVISE Home Performance Contractor the way ycq.save 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CLIENT E WORK ORDER Robin Griffith (917)415-6710 10/29/2024 826152 76201 SERVICE STREET BILING STREET PROPOSED BY: 111 Fern Street 111 Fern St Revise SERVICE CITY.STATE.ZIP 8ILINO CITY.STATE.ZIP Florence, MA 01062 Florence,MA 01062 Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 12 $1,279.08 $1,279.08 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 2 $72.64 $72.64 Provide labor and materials to install Q-lon weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 2 $59.32 $59.32 Provide labor and materials to install a doorsweep to restrict air leakage. DAMMING 24 $66.72 $50.04 $16.68 Provide labor and materials to install a 12"layer of R-38 unlaced fiberglass batts for damming purposes. ATTIC FLOOR OPEN BLOW CELLULOSE 5" 1,192 $2,229.04 $1,671.78 $557.26 Provide labor and materials to install a 5"layer of R-19 Class I Cellulose to open attic space. HATCH:THERMAL BARRIER POLYISO 2 INCH(ATTIC) 1 $53.96 $40.47 $13.49 Provide labor and materials to insulate the back of an attic hatch with 2"rigid insulation board at R-10. ESigned by: Docu3pned by: fatitlit, 4rifrtk 10/29/2024 Itj(fk4tLltj4.LAuA,M1 chael Macaa9/2024 FC58C3A6CE56498... 06507198000640E Docusign Envelope ID:38CFB9E0-36F7-42DB-8E48-965024383582 Revise REVISE Home Performance Contractor Ise the way yoi.save 5 South Summer Street,Bradford,MA 01835 CONTRACT - AUDIT 1-800-885-7283 CUSTOMER PHONE DATE CLIENTS WORK ORDER Robin Griffith (917)415-6710 10/29/2024 826152 76201 SERVICE STREET BIWNO STREET PROPOSED BY: 111 Fern Street 111 Fern St Revise SERVICE CITY.STATE.ZIP BILLING CITY.STATE,MP Florence, MA 01062 Florence,MA 01062 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL INSTALLTURBINE ROOF VENT 1 S198.21 $148.66 $49.55 Provide labor and materials to install a roof mounted turbine vent. Total: $3,958.97 Program Incentive: $3,321.99 Deposit: $0.00 Final Total: $636.98 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Six Hundred Thirty-Six &98/100 Dollars $636.98 Moderate income self attest cost: S0.0( Segned by: ,-DocuSlyned by: Zfe1.114., atl& 10/29/2024 ��.I( ittAatA, Michael Madden FC58C3A6CE58496 065971980008/0F I.ub1 VINCN WWII UNC 10/29/2024 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. Docusign Envelope ID:38CFB9E0-36F7-42DB-8E48-965024383582 REVISE ��� the way 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 Robin Griffith 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. Signed by Owner Signature: ai �PCSB Ad'E5c. e Date: l0/29/2024 REVISE ENERGY DATA COLLECTION FORM Advisor Mare a I Michael_MaddeQ Stte a oat! 10/9/24 cu:ro^e► Robin Griffith Address 111 Fern Street Town Florence 01062 P T. er 9.17-41', 710 Owner Renter Years an Nome 1 II or stories I i 1.5 . 2 2.5 3 BAS 1: 15 c fm X A oc c upants X r♦f actor _ t Q rt-factor 19 16 _ 15 14.4 13.7 I 8AS 2: .00583 X area X height X tirartrw = ►O:r Pitchman( ' Recommended:BAS>final cnis0> (0.7 X BAS) Pic al Requi►e&(0 77 Fin X OAS)> ai CF 50 is this .�part of a multi-unit workscope?Y o `ArS MI #IEer? Pi, Loose Ir n�oc Cr.s B`✓ Mw L .►._oain Truss Wortscepe I &hit s�.{—� 1 a- 0 Taut csswt z Da, do K 0 3 3 kvA vt/1%YL• ArTt L Fcou ✓L .`b SC l 19a.( 7 rfA c4 i o4,vy 1 • r: l.% 10 25 6 °C) CD 28