2025 GSHP Install QA Form

Customer MLP*

Does the customer heat their home with natural gas as their primary heating fuel?

YesNoNo - the home has gas as a supplemental heating fuel but not as the primary heating fuel

Customers of RMLD who heat their home with natural gas are now eligible for Mass Save's enhanced heat pump rebates for 2022-2024. RMLD will no longer be offering 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. Please also be aware of the following differences in the Mass Save rebate program's requirements compared to RMLD's rebate program.

The Mass Save program does not require a pre-install or post-install approval through Abode.
Equipment must be installed on the Mass Save Heat Pump Qualified Product List (HPQPL). Equipment that qualifies for RMLD's rebate may not qualify for Mass Save rebates, and the system being proposed for this customer may need to be adjusted.

Customers of HMLP who heat their home with natural gas are now eligible for Mass Save's enhanced heat pump rebates for 2022-2024. HMLP will no longer be offering 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. Please also be aware of the following differences in the Mass Save rebate program's requirements compared to HMLP's rebate program.

The Mass Save program does not require a pre-install or post-install approval through Abode.
Equipment must be installed on the Mass Save Heat Pump Qualified Product List (HPQPL). Equipment that qualifies for HMLP's rebate may not qualify for Mass Save rebates, and the system being proposed for this customer may need to be adjusted.

Customers of NMLD who heat their home with natural gas are now eligible for Mass Save's enhanced heat pump rebates for 2022-2024. NMLD will no longer be offering 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. Please also be aware of the following differences in the Mass Save rebate program's requirements compared to NMLD's rebate program.

The Mass Save program does not require a pre-install or post-install approval through Abode.
Equipment must be installed on the Mass Save Heat Pump Qualified Product List (HPQPL). Equipment that qualifies for NMLD's rebate may not qualify for Mass Save rebates, and the system being proposed for this customer may need to be adjusted.

Customers of WMLP who heat their home with natural gas are now eligible for Mass Save's enhanced heat pump rebates for 2022-2024. WMLP will no longer be offering 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. Please also be aware of the following differences in the Mass Save rebate program's requirements compared to WMLP's rebate program.

The Mass Save program does not require a pre-install or post-install approval through Abode.
Equipment must be installed on the Mass Save Heat Pump Qualified Product List (HPQPL). Equipment that qualifies for WMLP's rebate may not qualify for Mass Save rebates, and the system being proposed for this customer may need to be adjusted.

Is this ground source heat pump system being installed as part of a new construction project?

NoYes - in a newly-constructed additionYes - in a newly-constructed home or outbuilding

Pre-Approval Override

The customer is opting to apply for a rebate through RMLD even though they are a customer of the Mass Save program. In this case, the customer and contractor must agree not to apply for a Mass Save rebate.N/A

Please upload a letter signed by the customer attesting that they will not be applying for a Mass Save rebate.

Contractor Name*

Contractor Phone

Please enter a valid phone number.

Contractor Email*

example@example.com

Customer Name

First NameLast Name

Customer Email*

Used for rebate milestone updates & customer survey at end of rebate process. If your customer does not have one, please use your own.

Customer Phone*

Please enter a valid phone number.

Project address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Contract total*

Utility Authorization Number (UAN)*

Please contact RMLD to obtain the UAN. You will need the Electrician License number to complete this. Call 781-942-6598

RMLD requires that all projects complete a Town Wiring Inspection upon completion. Please confirm that you understand this requirement.*

WMGLD requires that all residents complete a home energy assessment through the MMWEC Next Zero program. In order to be eligible for a WMGLD rebate, your customer will need to have received an assessment within the last three years OR receive an assessment within one year of ASHP install, and will not receive their rebate until the assessment has been completed. See https://nextzero.org/ to schedule an assessment. Please confirm that you understand this requirement.*

MGED requires that all residents complete a virtual home energy assessment through Energy New England (ENE) within within the previous two years prior to filing for the heat pump rebate. If an energy assessment has not been completed prior to the heat pump system being installed, it can also be completed afterward by scheduling at https://www.energynewengland.com/CMS_Intake.aspx or by calling 888-772-4242. PLEASE CONFIRM THAT YOU UNDERSTAND THIS REQUIREMENT. *

HMLP requires that all projects complete a Town Wiring Inspection upon completion. Please confirm that you understand this requirement. The electrical permit and wiring inspection can be arranged through Hingham's Town Building Department by calling (781) 741-1420.

CMLP requires that all projects obtain an electrical permit and that the Town of Concord’s electrical inspector inspect and approve the installation. Please confirm that you understand this requirement.

CMLP requires that all projects involving sheet metal ducting work that goes beyond minor repairs obtain a sheet metal permit and that the Town of Concord’s inspector inspect and approve the installation. Please confirm that you understand this requirement.

An energy assessment within the last three years or scheduled within six months after project completion is required by CMLP for projects involving homes built before 2008. Outbuildings are exempted. Please confirm that you and your customer understand this requirement.

WMLP requires that all projects complete a Town Wiring Inspection upon completion. Please confirm that you understand this requirement. The electrical permit and wiring inspection can be arranged through Wellesley's Town Building Department by calling (781) 431-1019.*

If installing a new outdoor unit (not replacing an existing) the town of Wellesley Building Department requires a plot plan to prove the new outdoor unit will not be installed in a setback area. For details please call Wellesley's Town Building Department by calling (781) 431-1019. Please confirm that you understand this requirement.*

Customer's primary use for GSHPs*

Replacing or adding systems*

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

Whole homePartial home

System size*

	Est. design heating load for whole building	Total nominal heating BTUs of GSHPs being added	Total square footage of home	% of home square footage to be conditioned by GSHPs
Sizing

Copy of total nominal BTUs added

Copy of whole building design load

~% of design load covered by GSHPs

Supplemental 0-49%
Majority Replacement 50-75%
Full Replacement 76-100%

What type of Manual J did you complete to estimate the heating load? *

Upload of Manual J report**

*MUST INCLUDE INPUT SUMMARY PAGE

Loop Configuration

Total number of bore holes

Total bore hole depth (ft)

Total length of pipe for horizontal system (ft)

Total length of water column (ft)

Approximate year built*

Existing systems*

	Heating fuel	Heating system type	DHW fuel	DHW type
Existing systems

How many heat pumps are being installed*

Distribution type*

Type of floor plan being conditioned by GSHPs

Is the existing heating system being left operational?*

What is the overall heating strategy for the existing system and GSHPs?*

Does the system being installed include any auxiliary electric resistance heat?*

Approximately what outdoor temperature will the auxiliary electric heat need to turn on?

Distribution type (S1)*

Heat Pump (S1)*

	Manufacturer	Model number	# of distribution systems	AHRI #
Heat Pump

Distribution type (S2)

Heat Pump (S2)*

	Manufacturer	Model number	# of distribution systems	AHRI #
Outdoor unit

Distribution type (S3)

Heat Pump (S3)*

	Manufacturer	Model number	# of distribution systems	AHRI #
Outdoor unit

Distribution type (S4)

Heat Pump (S4)*

	Manufacturer	Model number	# of distribution systems	AHRI #
Outdoor unit

Distribution type (S5)

Heat Pump (S5)*

	Manufacturer	Model number	# of distribution systems	AHRI #
Outdoor unit

Distribution type (S6)

Heat Pump (S6)*

	Manufacturer	Model number	# of distribution systems	AHRI #
Outdoor unit

Paid Invoice: Please upload a copy of the final PAID invoice or contract showing the model numbers of all installed equipment and a $0 remaining balance. A clear photo of the invoice or contract will suffice. In order for your customer to receive a rebate, the final paid invoice is required. If your final invoice or contract 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.

Please upload all spec sheets and AHRI certificates for selected heat pump equipment*

Specification sheets, "cut" sheets, or submittals are all acceptable provided they include power input data for the utility's engineers.

Please upload all AHRI certificates for selected heat pump equipment*

How many indoor ductless or ducted air handlers units were installed as part of this project?

Upload photos of each indoor ductless and/or ducted air handler.

Did you complete a manufacturer startup sheet(s) for the installed equipment?*

YesNo

Reason for not completing manufacturer startup sheet.*

Calculated COP

Calculated EER

Installation Questions

	Yes	No	N/A
If you decommissioned an existing system containing refrigerant, was the refrigerant safely recovered per EPA guidelines?
Line set(s) were 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?
Are any ducts/air handlers in unconditioned spaces?
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

Ready to submit?*

Yes

Ground Source Install-QA Form

Project Details

Customer Interest

GSHP System Size

Home Details

GSHP System Design

System 1

System 2

System 3

System 4

System 5

System 6

Documents and Photos

Attestation Questions