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2B NIMITZ WAY - BUILDING INSPECTION (2) KK The Commonwealth of NYassac'husetEs iF Department of Public Saf env Massachusetts State Building Code 44t9 60&)3O A fl 5b Building Permit Application for any Building other tliin a One-or Two-Family Dwelling (This Section For Official Use Only) C(, Building Permit Number: Date Applied: Building Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) .9 No.and Street City/ own J Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ Alteration Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No Is an Independent Structural Engineering Peer Review required? Yes ❑ No 0�- Brief Description of Pro se Work: Kep ng e.,6 vik r1i X Lq dPr!L W A-tA, Y1` VI2 CT_ lly (Spas 6" TLA7-, AliQcl�ecl� - SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories (include basement levels)&Area Per Floor(sq.ft.) 0 Total Areas .ft. and Total Height ft. ( q ) o ( ) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional 1-1❑ I-2❑ I-3❑ 1-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4A S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ VA VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑ required Clor trench or specify: Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ r S\l Railroad right-of-way: Hazards to Air Navigation: b1A Historic Commission Review Process: Not Applicable❑ F tructure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: 12` 5 i Y1 rAA L_vi,� v0 C7 C SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner, Na (Print) No.and Street City/Town �— Zip Property Owner Contact Information: VL_Jl -©j (calf= Title Telephone No. ( m Ss) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes �; 1 /S Q ()a �Zc� Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building ermit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) Tf building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 17 and skip Section 10.1) 10.1 Registered Professional Responsible for Construction Control jo l(,,n°7 ��J (RgE} trant) �� Tele o¢�ifV^o^. e-mail ad, _d;ess �„i.,�(.t Regi anon Number / J L1121 p W1� LZ�LV i Street Address City/Town State Zip Discipline Exlfirat4 Date 10.2 General Contractor Company Name nr 5�DtO�'1P(/ 122� C - 0.Cr/933 G( -ta _ P o iC e for Constru lion c S Jnicense No. and Type if Applicable Street Address t��T— City/Town' �Istthat`7ee ZZi_►p—t�J_-_��S/J� sue- 1- ya Telephone No. (business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the is ante of the building permit. Is a signed Affidavit submitted with this application? Yes V No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs: (Labor and Materials) Total Construction Cost(from Item 6) 1.Budding $ U V t V v Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate munici ctor)=$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee $—LQcontact municipality) 5. Mechanical (Other) $ Enclose check payable to 6.Total Cost $ aM (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby a est under(the pains and penalties of perjury that all of the information contained in this application is true and accurate to the t of my owledge and understanding. Y r e; ex =a-� j 9116 Please prmk a{t^ � si�name eleph Date �4 �l�P TZ o Street Address City/Town State Zip / Municipal Inspector to fill out this section upon application approval: �' lOA Name Date American Properties Team, Inc. TO: 2B Nimtiz Way FROM: Jennifer Pappas, Property Manager RE: Deck Replacement DATE: November 28, 2016 Please be advised that the Board of Trustees for Pickman Park has approved the replacement of the deck at the above referenced unit. This approval is contingent upon it matching the existing deck (composite materials can be used) and following the Engineering Alliance Deck Specifications. The Board will not allow any design alterations. We also require that permits be pulled in advance(regardless of what your contractor may tell you), and then a copy of the final approved permit once completed must be sent to APT for the unit file as well. You will need to bring a copy of this letter to the Salem Building Department in order to receive your permit. Should you have any questions or require additional information, please feel free to call the APT Service Team at(781)932-9229. cc: Unit File 500 WEST CUMMINGS PARK•SUITE 6050. WOBURN -MA 01801.781-932-9229 FAX 781-935-4289 Appendix 1 For the demolition of structures the building permit applicant shall attest that utility and other service connections are properly addressed to ensure for public safety. Please fill in the information below and submit this appendix with the building permit application. The building permit applicant attests under the pains and penalties of perjury that the following is true and accurate. Property Location (Please indicate Block # and Lot # for locations for which a street address is not available) nn W4 ��,m4m V1 -l 0 ��7�� No. and Street T City /Town Zip Name of Building(if applicable) For the above described property the following action was taken: Water Shut Off? Yes ❑ No D-' Provider notified and Release obtained? Yes ❑ No ❑ Gas Shut Off? Yes ❑ No IQ,'� Provider notified and Release obtained? Yes ❑ No ❑ Electricity Shut Off? Yes ❑ No Provider notified and Release obtained? Yes ❑ No ❑ Yes ❑ No Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Yes ❑ No C➢i Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) �A//� �+�p�/��/p1�°c A & A SERVICES, INC. Ae1A SMV,VGJ 115 NORTH STREET, SALEM, MA 01970 • •'• Telephone:(978) 741-0424 Fax: (978) 741-2012 Contractor Registration No. 101609 Construction Supervisor No.CS057733 Federal EIN: 04-3090162 CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Bu er s ante Date of Contract �a Buyers) Street Address, Ci ,State and Zip Code r fz34 1¢w /kiiii- O( d Oa 'me Tele hone Number —EveningInd¢ hone Number Mobile Telephone Number E-Mail Address / The Buyers)listed above hereby jointly and severally agree to purchase the goods andlor services listed on the accompanying specification sheets,in accordance with the prices and lens described on the front and the reverse of this agreement and any specification sheets(this'Agreement),and Buyers)have requested that such goods or services be installed or provided atat Buyer's address listed above.A&A Services.Inc.("Contractor),hereby agrees to install or Cause to be installed the products or services listed in this Agreement at the Buyerls)address widen above.This Agreement represents a cash sale of goods and services.The Buyers) agree to pay in Cash the cost of the goods and services purchases as described herein,regardless of timing or approval of any financing Buyerls)may seek for their purchase. p f���41f*/ ? �J Ajrr^'— Purchase Pr ,l n �y Est.Staling Date: Down Payment f /©De CCJ �Y Est Completion Date: `�a�JOO /n�V'�'iV� O�Cash ue on tart of Job: MA/.fie+�H� U, Check r 9�f oi•Vp/I E �'Credit Card Amount Due on_of Completion: No. 2loa° clrre�+ /a9Hz Amount Due on T�s Completion:��/J/� p Expiration Date' {I Sislre Due on Upon Completion: zS00 _ �� �/Z p�Q� CVC Code: Cr 1—i agreed and e�ate,ce�yrh-vie 1J c+n.e l It Is agretl and u tl by and HE Beat the parries that this Agreement, front and back and any addendum, constitute the entire understanding between the parties, antl there are no verbal understandings changing or modifying any of the terms of this Agreement.Buyer(sl hereby acknowledge that Buyerls)has react the front and the reverse of this agreement and has received a completed,signed and dated copy of this Agreement,including the two attached Notice of Cancellation forms,on the date first waned above.Buyerls)also(i)acknowledge that they were orally informed of their right to cancel this transaction;and(if)request that they be contacted via their telephone numbers or email,as listed above,In the event Contractor believes Buyerls)would be interested in any additional quality products or services of Contractor.DO NOT SIGN THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES. A&A Service lac, guy (, By: Signature Sienant Name /N' I, / e9✓f rSSf✓L Print NaN Signature Print Name You,the Buyerls), may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the following Notice of Cancellation form for an explanation of this night. ARBITRATION:The matracbr and me a meowner M1ereOy mrs-ly agree in ad-roa rnat Ia me event eitllerpaM leas a dispute ddrwmMg this contract,retherpgrty roy subo l¢uch dispute to a pnvare strum lion service Arrot has been approved by the Serelaryolthe Enemrie,Otfire of Consurre-Afraide end Broades Regulations and hood ar peM shall be reauiree b submr W sort, arbitration as proved rat MI s.t@A, runo ormaml, B„yertm'lm Dad: care: [ /ZfIn veel(s NOTICE OF CANCELLATION NOTIL F L LLATIO Data m nanzanion va 9'/ You me,adwl this tanaaaaan,wthout any We,ar Date or Talesman O� /�a You may anal tat uantaation,wmow any penalty or omigation,wiNinmree dystrommeaboveeab.tramped anywomdyeaeedin, oblearanmainture. apes days nomme above care.Hym anaN,any pmmnyvaaea m. any payments omee by y lea eonuam nt sale,one any negosama Inammam-.enured any payment made by you has.,In.Cono-am or Sala,and any revenues instrument e.ewred by you All be returned vued to days muoWang rermpt by due seler of your emouamn house. by you All be remmee worm w days indeed rerapt by the seller of your ante lawn anewn and any security interest anang on of the transaction Will be correct II you deproso,me must and any se amor interest adsing out the t ansactim Al be damaged If yen monal,you must make avanable to the Seller at your resident .and substantially in as gmtl dendused es Men make available he the Seller at your residence,and substantially In as gone wndi4on as Avon ivea,any goods slow to you under Nis Comand or sale.or you may,a you Msh,comply acemed,any goods deverearo you under Ois Contram an Sale;or vnn me parameters of the Sena,re regarding the ream anti of may,Hyou Wish,Songs gsr a pmant M ms gag at me Sellers silo the Ind awns of the Senor regarding me rebm th Seller at me emus at deep et pink Meedo,ame.era nsk.a you lh make me goods available m me serer one me sever doer not pirA fromsposerse up and n 20 a you do make ma yours available b the saner and Ire seller aces net pick Nero sathoun n auman me Bare nlvour fatice ma a the good rou lathe the Seltpose of too from goods AL z0 days m the data or your Nohre of cake[he oo You may leh pro ekpnse of g,,beto man any further obligation.If red fail b make the BOMsaysenliabrhe Seller,ortle You in to amtlso moon any flusper gesai the Spn.11y*d(all toose,thengmtlsrom available Ne Seller or it .11 detoreWmthe goods to theSeller aence,mile turnaround. ao,r her yarem or delverbrpedandbaed you agree bons undrt the goconfir eaocanAi ne batbeosq roan you or serer asigedandanw dopy if mecoas unaerme Conran any rsner eomdr :b ction,maile.hod er .signetl see... chit obligations ationtam.y hT1a ltMs oanwc0an,mailordelrvera signed and dared ropy W me anreualron noose w any omar xrmen nonce,w sane a Ia rAces, ropy or me mmenaeon dour¢in any aver wnMn douse,or sane a relegam,le Ns �ervi 115 North Street,Salem MA 019Tq NOT LATER THAN A11ONIGHT OF 115 NOM¢treat¢diem MA 019]o.NOT LATER THA'Ncne0 GHT OF no, t HEREBY CANCEL THIS TRANSACTION I HEREBY CANCEL THIS TRANSACTION Consumer%SEmm Date: Oonsmer s Signature Oa.: �X�� �+ A & A SERVICES, INC. 115 A&A SERVICES TelephOR:f(9 STREET, fax:978 41-Z070 12 Contractor Registration No.101609 Federal EIN: 04-3090162 Construction Supervisor No.CS057733 MISCELLANEOITS SPECIFICATION SHEET Buyer(S)Name Date of Can ,e IQ An55 �a oZ 16 Buyers)Street Acess,City,State antl Zip Cotle i a4 t{7 W Ic?77d Daytime Telephone EveningTelephone Mobile Telephone Number E-Mail Address [! The Buyer(s)listed above hereby jointly and severly agree to purchase the goods and/or services listed below,in accordance with the prices antl terms de- scribed on this specification sheet and the front and the reverse of the acoompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which the Specification sheet is a part. t''', ^ SPECIAL INSTRUCTIONS RMPe 16 vvty_AYr 6prai�-�-- �Y66b e- Q_9AAa1.tZ=l7lc� �_�S LYTZt7 en i fr eX1 5Tl Y1c C4_kC A'0,_K L441 RptO� 1Z7>< (o7 tl i4 `iSr-eP_s ir, o z' 54ua lesion/ �^A,,�s11`` exis-h na Y OWW—kQ Av1A Q,660 PA!k+— f565'1--,PLc) 1llGs i u6 3 New CooCmJy_-T rA-,✓I&C wi` i ';�fArcA2Q_AS Ann NQ1,43 6�»GIy4e_ p!EL Pk>cbo{{av o�s(�S oj�, amok_ 4-o be_P z,�_6 w;At,1 AoLj,3�� nec-ori PiA4-e 2a5�.+ 17-7IAslaA 4r) Cody LAVA-ou-I + 16'1 O N Gl 1 J,'t(n )3AAn3!- S 6+A- C 40 raer,s 40 be- PT I Z A,) c0,1e- v a s g ll P� �� T�eck v u f r, 1 X'� flock A5 �rn,I�sfac� �OtAeL-k1 Y C4 1 , f?-7I IE_Q/f1�. IN�In HdCJ R55 �V� E r-l-X steps �5 Fi} ;1;K Susie -Fo �wt�cG� �x i n� PT'Z XG �P R i IS wi 'Vy r�—_, 27C unde-rii k A5 bcw t rA l !%r 1/y P7- e s S'a c ,w e> f ioc -0 3 S It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEM NT, constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying and of the terms.This contract may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyers)and the Contractor. Buyer(s)hereby acknowledge that Buyeds))hhas read the Specification Sheet. Contractor Initials: 5 L- Date:i416 Buyer's Initials:l Dat (c A & A SERVICES, INC. A&A SERVICES T115 elephone:ORTH STREET, fa E 9 MA 1-2 i0 Contractor Registration No.101609 Federal EIN: 04-3090162 Construction Supervisor No.CS057733 MISCELLANEOUS P IFI ATION SHEET BuyegS)Name Date of Contr 1 r7 /e Buyers)Street A dress,City,State and Zip Code 4i YLPJ Daytime Telephone Evening Telephone Mobile Telephone Number E-Mail Address ZW The Buyerts)listed above hereby jointly and severly agree to purchase the goods and/or services listed below,in accordance with the prices and terms de- scribed on this specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which the Specification sheet is a part. SPECIAL INSTRUCTIONS \ � nf�cewudf .Sc�� �ccnfin�) 6 /R� G/A�pbatal2�.S u,i 4l nri w.a� cecla.- �/,wnbor<t!d5 p nd ktckbct4fd-n4 Sher wty-L wC-! x rSter—< A5 lyendcd �. �0 in S . Fni GfU N��'�l-l-� n �-raNt NAG h h�rs +n` ,access ��d. ro�rd 11 ni-I— Gn✓1/l[�l� Std25 f�GU(f�d. � n It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT, constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying and of the terms.This contract may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyerts)and the Contractor. Buyers)hereby acknowledge that Bui has read the Specification Sheet, Contractor Initials: 5L Date: Io a 1k Buyer's Initials: + Date: w, L L-r t• S+�pf���Y1 Dec, u n i f Z (V iwtii�2 f(1 p o ect- Ap ern. 5 +c oe hew P� LA3 P Aiz �o o d 5 L�Rstfe►� '� C-C, , n < .��� Dec►:��� �-re�s � � ►x -�;s�rs t 7 0 vts�i-�� dri yzwan� �LlA ,, a� A- -B. 33 _ l X� }o (110 h}efd_Lw_'�i -_ - �i J �� T � I Y1 w � Y � ppyy y +. 1-71 AW � AL It , w +X + f r` r ■■ " w Alhow .___ Massachusetts Department of Public Safety Board of Building Regulations and Standards A&A SERVICES, INC Christopher Zorzy 115 North Street License: CS-057733 t� Salem, MA 01970 CHRISTOPHER 7y0 ¢ ` t IS NORTH ST I _m Salem MIA 0197W: i S�,n i .. eum-usni ter. r '��r Trr,�unu.n uru rn�/�r� ��rntinn�runL/-i J -'� EX2n - 05/2612r>r201017 Oflice of(ansnmer Affairs&Business Kegnlalinn Commissioner i l� ' lF Fy,I16 HOME IMPROVEMENT CONTRACTOR I }I Registration. ' t01609 Type: Expiration: _6126/2018 Private Corporation A&A SERVICES, INCi Christopher Zorzy 115 North Street - Salem, MA 01970 Undersecreta'Y aCITY OF S<U.EM, NL-kSSACHUSETTS BUILDING DEPART%M.NT 120 WASHINGTON STREET, 3' FLOOR TEL (978) 745-9595 FAX(978) 740-9846 KI�>BERLEY DRISCOII. MAYOR THoaus ST.PtERRE DIRECTOR OF PUBLIC PROPERTY/BUI DLNG CO%LNIISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 Cb1R section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will betransported by: (name of h er) The debris will be disposed of in Oki (name of facility) 21 i I , p (address of faci(it ) signature of permit applicant 1 � dat Je6risulTduc r, CITY OF SM-E:N11 NLNSSACHUSETTS BUILDING DEPART\(ED T 120 WASHINGTON STREET, 3-FLOOR. T EL (979) 745-9595 FAX(978) 740-98•i6 KImBF_RLEY DRISCOIl. Alt T HOs1As ST.PD:M DIRECTOR OF PCBLIC PR0PERTY/3L'ILD0IG CONLNIISSICINFR Workers' Compensation Insurance Affidavit: Builders/Contractors/El 11 ectricians/Plumbers Applicant Information /� / C Please Print Le ibl Name(Business:OrganizatioNlndividual): A Address: I City/State/Zip: Phone k: / — �' —® LN Are an re y employer?Check Lthe appropriate box: 1. I am a 4.employer with , Type of project(required): T ❑ !am a general connector and[employees(full and/or part-time).• have hired the sub-contractors 6. ❑New construction 2_❑ I am a sole proprietor or partner. listed on the attached sheet, t 7. []Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity, workers'comp.insurance. [No workers'comp, insurance 5. ElWe are a corporation and its 9. ❑Building addition required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ l am a homeowner doing all work right of exemption per MGL I I.❑Plumbing repairs or additions myself.(No workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees. (No workers' COMP. insurance required.] 13.❑Other 'Any applicant that checks box 4 1 must else Fill out the seclien below showing their wmkets'compensation policy infutmmiom'tfnttmuemerx who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicting such �Cumracwrs than check this box must attached an additional sheet showing the name of d w mb•ty ntrnctory and thew workers,wmp,policy information. l am err employer iliac is providing tvorkers'compensation Maturance for my employees. Below is the poilty and job site information. Insurance Company Name: l ' 1J /�� V C I D rS Policy 4 or Self-ins. Lie,tf:_ 0�f 7r 7/� S( I Expiration Date: 1 Job Site Address: 44, S J City/State/Zip. Attach a copy of the workers'cowl 7 ation poll 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. l do hereby certify under the pp�ains and penalties ofperjury that the tuformarion provided aba a is fr a and correct. Date 11, Phone#: — OJrcial use wtly. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/rown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: -- Phone It: