2013 masssave incentive request form

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Massachusetts Residential New Construction Program is sponsored by the following Program Administrators: Berkshire Gas, Cape Light Compact, Columbia Gas of Massachusetts, National Grid Gas & Electric, New England Gas, NSTAR Electric, NSTAR Gas, And Western Massachusetts Electric Company.

2013 Incentive Request Form* INCENTIVE RECIPIENT INFORMATION Contact: (must match application)

Company: (incentive check will be issued to)

Mailing Address: Street or PO Box, City, & Zip Code:

Phone:

Note: BUILDER, DESIGNER, or Homeowner can get the cash rebate

E-mail:

TAX ID or SS# (W-9 Form Required for Columbia Gas and New England Gas Incentives):

PROJECT INFORMATION Project Name:

Performance Path

Project Street Address, City, & Zip Code:

Choose a Heating Fuel Type:

Prescriptive Path

Natural Gas Master Metered

Electric Service Provider: Gas Service Provider:

Electric Master Metered

Natural Gas

Propane

Electric

Other

Permit Number:

Energy Code Type:(IECC 2006, IECC 2009 or MA Stretch Energy Code)

Number of Stories:

Total Number of Units Expected to Complete:

Oil

PRESCRIPTIVE PATH INCENTIVE SPECIFICATIONS Prescriptive Option I

Projects must meet the requirements of the Option I Prescriptive Measures List

Prescriptive Option II

Projects must meet the requirements of the Option II Prescriptive Measures List

REQUESTED PRESCRIPTIVE PATH PROGRAM INCENTIVES Total # Single-family Market Rate Units:

Total # Multi-family Market Rate Units:

Total # Single-family Affordable Rate Units:

Total # Multi-family Affordable Rate Units:

Total # Single-family Low Income Units:

Total # Multi-family Low Income Units:

Incentive Level

Prescriptive Option I

Prescriptive Option II

SINGLE-FAMILY Incentive Number of units

$1,250

$7,000

MULTI-FAMILY (2-99 units) Incentive Number of Units

$1,150

$4,000

MULTI-FAMILY (100-199 units) Incentive Number of Units

$850

$3,000

MULTI-FAMILY (200+) Incentive Number of Units

$550

$2,000

Total Prescriptive Path Program Incentives Requested * Incentives available to residential new construction less than three stories.

ENERGY STAR V3 (Awarded per Project) $25 Check if applicable. For 1st completion in Project

$25 Check if applicable. For 1st completion in Project

$25 Check if applicable. For 1st completion in Project

$25 Check if applicable. For 1st completion in Project

Total Dollar Amount Requested $

$

$

$ $


PERFORMANCE PATH INCENTIVE SPECIFICATIONS TIER III Multi-family projects will be reviewed for final fee structure.

TIER I

15% improvement or better over the 2012 MA baseline home and compliance with sections 3 and 5 of the TERC

TIER II

30% improvement or better over the 2012 MA baseline home and compliance with sections 3 and 5 of the TERC

TIER III

45% improvement or better over the 2012 MA UDRH and compliance with sections 3 and 5 of the TERC

ENERGY STAR Version 3

Meet requirements for ENERGY STAR Version 3.

In 2013, customers need to apply for Tier III in order to receive the Tier III incentive level. Any exceptions must be approved by the Program Administrator. Tier III units are NOT eligible for High Efficiency Water Heating, Heating and Cooling Incentives.

REQUESTED PERFORMANCE PATH PROGRAM INCENTIVES Total # Single-family Market Rate Units:

Total # Multi-family Market Rate Units:

Total # Single-family Affordable Rate Units:

Total # Multi-family Affordable Rate Units:

Total # Single-family Low Income Units:

Total # Multi-family Low Income Units: Tier I

Tier II

Tier III

SINGLE-FAMILY Incentive Number of Units

$750

$1,250

$7,000

MULTI-FAMILY (2-99 units) Incentive Number of Units

$650

MULTI-FAMILY (100-199 units) Incentive Number of Units

$500

MULTI-FAMILY (200+ units) Incentive Number of Units

$350

Incentive Level

ENERGY STAR V3 (Awarded per Project) $25 Check if applicable. For 1st completion in Project

$1,150

$4,000

$100 Check if applicable. For 1st completion in Project

$850

$3,000

$100 Check if applicable. For 1st completion in Project

$550

$2,000

$100 Check if applicable. For 1st completion in Project

Total Dollar Amount Requested

$

$

$

$ $

Total Performance Path Program Incentives Requested

HIGH EFFICIENCY COOLING EQUIPMENT SF Units

# of MF Units (2-99)

# of MF Units (100-199)

# of MF Units (200+)

Total Dollar Amount Requested

Incentives

Specs

ENERGY STAR Refrigerator and Dishwasher $50 (low income units only)

Installed in all units.

$

Central A/C or Air Source Heat Pump $150

SEER >14.5 EER > 12 HSPF > 8.2 TXV or EXV required

$

Central A/C or Air Source Heat Pump $300

SEER >15 EER > 12.5 HSPF > 8.5 TXV or EXV required

$

Central A/C Air Source Heat Pump $500

SEER >16 EER > 13.0 HSPF > 8.5 TXV or EXV required

$

Ductless Mini-split Heat Pumps $150

SEER >16 EER > 12 HSPF > 8.2 TXV or EXV required

$

Massachusetts Residential New Construction Program is sponsored by Berkshire Gas, Cape Light Compact, Columbia Gas of Massachusetts, National Grid Gas & Electric, New England Gas, NSTAR Electric, NSTAR Gas, and Western Massachusetts Electric Company. 2.1.13


Ductless Mini-split Heat Pumps $300

SEER > 19 EER > 12.5 HSPF > 10 TXV or EXV required

$

Ductless Mini-split Heat Pumps $500

SEER > 20 EER > 13 HSPF > 10 TXV or EXV required

$

Heat Pump Water Heater $750

> 2.3 EF

$ $

Total Cooling Incentives Requested

HIGH EFFICIENCY HEATING EQUIPMENT SF Units

# of MF Units (5-99)

# of MF Units (100-199)

# of MF Units (200+)

Total Dollar Amount Requested

Incentives

Specs

Natural Gas Furnace $450

ECM AFUE >97%

$

Natural Gas Furnace $300

ECM AFUE > 95%

$

Natural Gas Hot Water Boilers $1,500

AFUE > 95%

$

Natural Gas Hot Water Boilers $1,000

AFUE > 90%

Natural Gas Condensing Boiler with On-Demand Domestic Hot Water $1,200

AFUE > 90%

High Efficiency Indirect Water Heater $400

Attached to natural gas boiler

These incentives are not available to propane users only natural gas customers.

Natural Gas Condensing Gas Water Heater $500

95% thermal efficiency or greater (75 to 300 MBH)

Natural Gas On-Demand, Tankless Water Heater $800

> .94 EF with Electric Ignition

Natural Gas On-Demand, Tankless Water Heater $500

> .82 EF with Electric Ignition

Natural Gas High Efficiency Storage Water Heater $100

> .67 EF and ENERGY STAR Labeled

$ $

$ $

$

$

$

$

Natural Gas Programmable Thermostat $25

7-Day Programmable

Wi-Fi Thermostat $100 Â

Wi-fi connections must be enabled

$ $

Total Heating Incentives Requested TOTAL INCENTIVES REQUESTED (Program Incentives + Equipment if Applicable)

$

$

Note: Additional incentives may be available from some of the sponsors for propane, etc. Participants should contact the sponsors directly for availability. HERS Rating Company:

Nantucket Building Science

Rater:

Thomas Barnes

Date:

Massachusetts Residential New Construction Program is sponsored by Berkshire Gas, Cape Light Compact, Columbia Gas of Massachusetts, National Grid Gas & Electric, New England Gas, NSTAR Electric, NSTAR Gas, and Western Massachusetts Electric Company. 2.1.13


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