2024 Ground Source Heat Pump Install QA

If you have questions about this form, contact CMLP Energy Efficiency & Electrification Coordinator Jan Aceti, at jaceti@concordma.gov or 978-318-3151.

Was natural gas the building's primary heating fuel before the heat pump installation?*

YesNoNo - the building had gas as a supplemental heating fuel but not as the primary heating fuel

Customers of CMLP who heated their home primarily with natural gas before the heat pump installation are eligible for Mass Save's ground-source heat pump rebates. CMLP does not offer rebates to these customers. Please refer to the Mass Save heat pump rebate webpage here, and assist your customer with applying for the applicable Mass Save rebate. The Mass Save program does not require a pre-install or post-install approval.

Installation Address*

Was this project pre-approved by CMLP?*

YesNoNot sure

Were any changes made to the project after it was pre-approved? (For example: changes to number or models of equipment installed. )*

YesNo

Customer Name*

First NameLast Name

Customer E-mail*

Used for rebate milestone updates. If your customer does not have one, please use your own.

Customer Phone*

Installer Company Name*

Installer Email*

example@example.com

Installer Phone Number*

Please provide a number where we can reach you directly to ask any questions necessary to process this Install QA.

Number of Living Units on Property*

Note: Individual living units in residential 5+ unit complexes on common property, including 1-4 unit buildings that are part of larger complexes on common property, are not eligible for whole-home rebates but are eligible for partial-home rebates.

Is this project a whole-home solution or a partial-home solution? (i.e. is your customer applying for CMLP's whole-home rebate or partial-home rebate?)*

Whole home (Heat Pump Only)Partial home (Dual-Fuel/Hybrid)

Are there existing heat pumps in the home that are being used to meet 10% or more of the whole-home heat load, with the addition of new equipment meeting the remaining heat load?*

YesNo

Please Note:

The project electrician must obtain an electrical permit online prior to installation, and schedule an inspection by the Town's electrical inspector after the work is complete. If the project requires sheet metal ducting work that goes beyond minor repairs, a sheet metal permit must have been obtained, and an inspection scheduled.The project must pass all relevant inspections before this Install QA form can be submitted. Enter the relevant inspection approval dates below. More information about Town of Concord Building Department permits and inspections can be found in the Quality Assurance Section of CMLP's Heat Pump Rebates for Your Home page.

Date of Electrical Inspection Approval*

Subject to verification by CMLP

Did this project have sheet metal duct work beyond minor repairs? Examples are installing new ducting, or replacing, changing, or significantly repairing existing ducting.*

Date of Sheet Metal Inspection Approval*

Subject to verification by CMLP

A drilling permit must have been obtained from the Concord Board of Health. Enter the permit issue date below.

Concord Board of Health Drilling Permit Issue Date

Subject to verification by CMLP

Existing Systems*

	Existing heating fuel	Existing heating system type
Existing primary system
Existing secondary system, if present. Otherwise, leave blank.
Other existing system, if present. Otherwise, leave blank

A Manual J is required for whole home systems. Please upload it here.*

Must include input summary page

Did you complete a Manual J to estimate the heating load?*

Upload of Manual J report and software design report showing system's heating capacity. (Multiple files can be uploaded in this field.)*

Include input summary page of Manual J report.

A software design report showing the system's heating capacity at the incoming water temperature is required for whole home systems. Please upload it here.*

How many heat pumps are being installed?*

Distribution Type*

System 1 (S1)*

	Manufacturer	Model number	Distribution type	AHRI #
System

System 2 (S2)*

	Manufacturer	Model number	Distribution type	AHRI #
System

System 3 (S3)*

	Manufacturer	Model number	Distribution type	AHRI #
System

System 4 (S4)*

	Manufacturer	Model number	Distribution type	AHRI #
System

Please upload a copy of the final invoice showing the model numbers of all installed equipment. A clear photo or PDF file of the invoice will suffice. The document uploaded must be an invoice, not an estimate, and include all equipment model numbers and the project cost. If your final invoice does not include model numbers, please take photos of all equipment plates clearly showing the model number for final verification IN ADDITION to the invoice. Upload the photos using this same upload field. *

Installation Questions*

	Yes	No	N/A
If you decommissioned an existing system containing refrigerant, was the refrigerant safely recovered per EPA guidelines?
Were the line set(s) pressure tested using dry nitrogen and evacuated with vacuum pump per manufacturer’s instructions?
Is the condensate line sloped downhill and away from crawlspaces, walkways, and other outdoor equipment?
Is all new ductwork sealed and insulated to a minimum of R-8?
Are all applicable breakers clearly labeled on the electrical panel?
If thermostats are used, are they on interior walls, away from direct sunlight, appliances, or drafts?
Has the customer been shown how to correctly use the thermostat/remote control?

Optional notes

Any specific design or sizing details that seem relevant or general feedback on the form and information requested.

Click "Save" if you wish to continue working on the form later.

Click "Submit" if you have finished filling out the form and wish to submit it to the Concord Municipal Light Plant for review.

2024 Ground Source Heat Pump Install QA Form

Program Requirements

Project Details

GSHP System Design

Invoice: