Loading...
141 R NORTH ST - BUILDING INSPECTION l The Commonwealth of MCss husettk EIVED � Board of Building Regulations adq{@ S,c ^ 4• , u NAL cr.VICES ` Massachusetts State Building o 8 '�• Building Permit Application To Construct, Repa r, p Ae�SDeQyoltt�9 Rev. Sept 20l4 One- or Two-Family Dsvelli . This Section For Official Use Only Building Pennit Number: Date Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers � LFI (� Alor�hSi a tSG(ern 1.1 a Is this an accepted street?yes no blap 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: (ivLG.L c.40,454) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone?Check if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2t1—Owner'of Record• i Iz c u u cz°1fic,� Salem , MA 019 70 Name(Print) City,State,ZIP ► y � DJ IT 78 ��fo-lS7z t h"'! Q1�>�sSbbo.orcl No.and Street i'elephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg.❑ 1 Number of Units Other ❑ Specify: Brief Description of Proposed Work': Ins-[-a re, I �cen on+ Ifl -W S SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building $ O 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees: $ - Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ !.� 30 0 Paid in Full ❑ Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) GYl (- 4-y phe(- Z� License Number Expiration Date Name of CSL Holder I (� �'Or ( „fir )�, List CSL Type(see below) No.and Street lY Type Description <:�/A leYY) ytn q O+q 7 0 U Unrestricted(Buildings u to 35,000 cu. ft.) City/Town,State,ZIP/' R Restricted 1&2 Familv Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances q1a 7q 6OLt (,Zo{zy p q-s}�otces.Com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) t-A 7t"( )`(S S,nL l�n© io JDateHIC Registration Number ExpiratioHI Company Nam�r -[IC 2cefis[ran[Hama II eet rt C(ze1 �Q -C"!gmiCc ✓n* and Street' IrnA o(q 70 LI Email address City/Town, State,ZIP - Telephone SECTION 6:WORKERS' CONIPENSATION INSURANCE AFFIDAVIT(NI.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 ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE CONIPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property, hereby authorize L._.I/S.f I S 2or2� to act on my behalf, in all matters relative to work authorized by this building permit app ication. 4� CO3-) +V-0, C- — 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 contain ' thi application ' true and accurate to the best of my knowledge and understanding. 7— 1Pnnt-Owner's r Autho `ed Agent's Name-(Electroric"S7gnatu ee)I 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.uov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dos 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" ACKNOWLEDGEMENT and CONSENT I, Georgialee Simko, the undersign, hereby acknowledge and consent to the window replacement of the second floor windows owned by Tracy Hutton, trustee and owner of 141 R. North Street, Unit#2 in Salem, MA. Dated: l h Georgialee Si o Trustee/Own 141R. North Street, Unit#3 ACKNOWLEDGEMENT and CONSENT I, Pam Rehal, the undersign, hereby acknowledge and consent to the window replacement of the second floor windows owned by Tracy Hutton, trustee and owner of 141 R. North Street, Unit#2 in Salem, MA. Dated: j ww 5 Pam Rehal Trustee/Owner 141R. North Street, Unit#1 FN it.Ar�, � cep A & A SERVICES, INC. P1QWSERVS 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 s Name 7^Z3-/T— Date of Contract %itq c uTToA/ Bu s Street Address,City,State and Zip Code Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address 6�78-7Yo_l8 'L htL 0i(0 The Buyers)listed above hereby jointly and Severely agree to purchase the goods author services listed on the accompanying specification sheets,in aworiV with the prices and terns described on the front and the reverse of this agreement and any specification sheets(this'Agreement"),antl Buyers)have requestea that such goods or services be installed or provided at Buyer's address listed above,A&A Services,Inc ('Cont..t.0 hereb agrees to install Or cause to be installed the products or services listed in his Agreement at the Buyers)address wriflen above.This A reement re _ agree to pay in cash the cost of the goods and services purchased as described herein,r purchase. Purchase Price 1030 GGG Down Payment / �il/O III! I Amount Due On Start of Job: Amount Due on of Completion: Amount Due on of Completion: I I Balance Due on Upon Completion O' It is agreed and understood by and between the parties that this Agreement, front and back and any addendum, constitute the entire understanding between the parties, and there are no verbal understandings changing or modifying any of the terms of this Agreement.Buyer(.) hereby acknowledge that Buyer(s)has read the front and the reverse of this agreement and has received a completed,signed and dated copy of this Agreement including use two attached Notice of Cancellation forms,on the date first written above.Buyers)also fit acknowledge that they were orally informed of their right to cancel this"reaction;and Ili)request that they ber contacted via their telephone numbers or email,as listed above,in the event Contractor believes Buyerfal would be Interested in any additional quality products or services of Contractor.00 NOT SIGN THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES. A&A Se r ' 1c Buyer(. By: x Signature /��Yv� Signature! Print Name ` Print Name Signature Print Name You,the Buyer(s), 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 right. ARBITRATION:The mrthaveantl Ne Mmdayear foods nuWallyagreein askance Palm me minor ortmeread"has a eiywhodsngming this wntratl,aNerpeM msY subrNl wUieisputema piked'N-eon seMce !.'.a been approves by me seo issov'me Emwtive Ofiwal CommoserAffiampard Business Reguleeom are me omer party shall Ee reguiree to suaml to cam im ibeem as proved in M G.L c.1121. Canimnt s T✓� / Sri milIs'� Dog: De,: yy NOTICEOFCANCELLATMN �/ q HOTCE OF CANCELLATION Date m Trensai �y;� Ywr may cancel mis hacksaw,WmoW any penalty or Dele o1 Tnnaectord�`3-75You may canal this tra empann knout any penalty or powder.vMnn does business days ham me above dam.it you carol.any gralsaM heart in. obligatlon,viWnMree busirreas pays M1wn me eWre Ogre.Ilywunre,.anypmpeMmuddium, any paywards mods by You unit me contract or Sale,and any neatr abd immmmom e.ewbd any payments matla by your under me Co.,or sale M,one a opeotiabm ins nl Orstrwre . b/you WII be rervmed Wmin 10 days Warsaw meeipt by me Sei of ymr carsommoon nodes, by you WII be comment WNIn 10 days folloying retch by me seller m your cons elikimn nice. and any security intere&anew WI of Me mamaclmn will his grcell int If you cancel,you trust and any recuety inleregl among cut W me formation WII be canceled.It ycu Canon,you MY rust rr¢keed.inyane bmefi at youour ofounder this and substantiallyar SAW; Inas guadmay youAnas¢Ten make avacrygame tome Seller etyour houundeenw,and actwSalk, it as Rand my,fyouasseswhen ressoAM Me anygacda delivered Bulk, one skiing eorbaR moment t a me g,llywwiat ovinglySaid, eM to any goods dof Me me,maturing Me a mart Shipment t a my, Wm me inmuvgdas of me seller y u you avian,wrrgly regaNmg da realm Me Seim M a.1 at me Sellers Wm me andNmrnm nl de Sane,reg ooiay me rawm Me Sal a me gads al es Seneca uyeme andtax.Nreof Mcrepe ma totemmes of Grble dime sendand w.tutu doesrat Me main up over 20ay.It you ttna4arde yourandsofmNe Sauer and me Baron aces none of Main up Wmm an mate of ma maps of spurYou o ofeanMgovas a,yovmryrelaiasn or efor or I You main up Wmmzoegysmmophim Wyour Hands of eaothetien.sau laletu passive of agree WmwlaM Me appSumer to oawfow m.n you fail maMeMe n ot,huanmetr to.tutoroc yr, yo gads vnmeNaon he. ar1.ti.sur.dye tail do A.thngeldm—tohark.fine.Mler.rce at eebfory wassundrme mdse,To shand milmaoao.denymmrvmlivera signed of of al Commodore mal aeMsmma smeared lrBmeoa0.Pan you amainnaaalrrcermd api all myatima roger da emo-aa.To mnml Pion o-anmaturr.manor eelmara.Maned and dates mall rolleati.narede.mee.nfaa.To vn�l mis vana.w.n.mail..aturera mi9red and aadd mpy Mthe dowee on Mi or any Omer wormno yor geed alel = �5 e, copy of me unmlersum notice or any rev cancer notice...age a lelryam A-Reveal IIS NoM street syem M501.0,NOT LITER TXAN MIDNIGHT OF al 115 NO-Be-'Salem Me 01910.NOT LATER THAN MIDNIGHT Or;i=7 ,S 11M, I HEREBY CANCELTHIS TRANSACTION 1 HEREBY CANCEL THIS TRANSACTION T�'- �/ consumer s&,calm aele: Casurrers slgnalum Dam: + nc a 1 (�_ ��` A & A SERVICES, INC. A�S�D ICES Telephone:: (97)74115 NORTH �1-0424 Fax: (978)741-2012 Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET Buyerls)Name Date of Contract All V 111V77-0 A/ 7 -7- S' Buyerls)Street Address,City,State and Zip Code /L// R NM, sT tf z 54Z-'Zm Mel- 8 c9-)O Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address The Buyerls)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on this Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification Sheet is a pan. `J WINDOW REPLACEMENT t Remove and dispose of# ! existing yy�'indows. Install # new S'(/rV/L/5�/R50W-n✓{LS windows:&Vinyl If Wood (M nufacturer) Options: Style E) H' Grid pattern / ig- n� � Color Interior "/-fv- Color Exterior bV Aitt Glass Type Vo'✓nu�•T✓IS— ' Wrap exterior trim with aluminum: Style Color All windows will be installed according to the installation procedures in the portfolio. 9 'InsCaulk all interior and exterior edges. t ulate where possible around new units. 9IfInsulate window weight pockets if exist,and around new window units where possible. Included in this proposal are set up,clean up,Helps vacuum and cleaning windows inside and out. Building permit included. BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS If Create new window opening by cutting through existing home and framing in opening. t Remove and dispose of existing units)in its entirety. Note:Electric and plumbing may exist in wall and will require additional costs to customer if need to be dealt with.If Install window(s)into opening(s). Note: If Bay or Bow installation to include cable support system,new roof system(matching color as close as possible) or tie into existing soffit system. t Bay If Bow t Casement t Other windows)to include new interior style trim and new exterior style trim and Heed flashing as needed. '- Note: Painting and staining not included. STORM PRODUCTS If Remove and dispose of# existing storm window(s). l t Install new storm windows# Manufacturer Style Color Option t Remove and dispose of# existing storm door(s). t Install new storm doors# Manufacturer Style Color Type: t Aluminum t Solid Core SPECIAL INSTRUCTIONS: nn IIY,5 72h � A/9X/ Pvc ,St CA (7[ 1hii /-V L �G773K !v/Z_ S 7$15!S 7b AvL- y Wit Ma IF Mt 'S 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 any 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 Buyerls)and the Contractor. Buyerls)hereby acknowledge that Buyerls) has mad this Specification Sheet �r�r '` Contractor Initials:� Date: —Z7J—)� Buyer's InitialsVDate:�Q�s a - The Commonwealth of Massachusetts 4, =�. Department of htdustriol Accidents L l s{ Office offgflesfigatims 600 66'nshinoton Street, 7"Floor =_' Boston, Mass'. 02111 �� Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors Applicant information_:, Please PRINT leaibly name: ch. K address NOr t sti-2P7 city f5c, FFstn/tce ziv 1)1971) phone N [ 75 —71// QV,�11 work site location(fill address): I41 / a �(Ean /n)+ q (ne —Jo❑ I am a homeowner performing all work myself. Project Type: ❑New Construction ❑Remodel ❑ I am a sole proprietor and have no one working in any capacity. ❑ Building Addition [� I am an employer providing workers' compensation for my employees working on this job. company name: A •f t': Sz—V 1 2> f, address: C ( .� A'lI0 ✓ f�iy 5�r (� p `` /�` / city: -7, i—��l(�^'. /lq phone N: —( 2 — 7 7y (��'—fQL Q insurance co. l ✓auet-e ,Y ',T policy C)gut� f�fp b f 5- �Q /—f,7'�� ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the co tin actors listed below who have the Following workers' compensation polices: company name: address: city: phone N: insurance co. policy N company name: address: city: phone N' insurance co. policy N Attach additional sheet if necessin'y Failure to secure coverage as required under Section 25A of IGL. IS_can lead to the imposition of criminal penalties ora fine up to S1,500,00 anal/or one years'imprisonment as,yell as civil penalties in the form ora STOP vi oRK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarde(the fice ofInvestigations ofthe DIA for coverage verification. l do herebycertify uur a to•pains ans of perjury that tie information provider/above is true and correct. signamrc'✓ DatePrint name Lys✓ l ..C :0O✓: .x Phone N L� official use only do not write in this area to be completed by city or town official city or torn: permit/license tl ❑Building Dep:p'hnent ❑Licensing Board ❑check if immediate response is required ❑Selectmen's office ❑llealth Department contact person: phone H; ❑Other (—iwd Sept Eool, Certificate NO: A044298 THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT DEPARTMENT OF LABOR STANDARDS 19 STANIFORD STREET,BOSTON,MASSACHUSETTS 02114 DELEADER CONTRACTOR LICENSE A&A SERVICES, INC. 115 NORTH STREET SALEM MA 01970 LICENSE: DC000440 EXPIRES: Saturday,June 25,2016 IN ACCORDANCE WITH M.G.L.CH. 111, § 197B(b)AND 454 CMR 22.03,THIS LICENSE IS ISSUED BY THE DEPARTMENT OF LABOR STANDARDS TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF ENTERING INTO OR ENGAGING IN DELEADING WORK. THIS LICENSE IS VALID FOR A PERIOD OF ONE YEAR. THIS LICENSE MUST BE MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN DELEADING WORK IN ACCORDANCE WITH M.G.L.CH. I I I § I9713(b)(2)AND 454 CMR 22.03. i WILLIAM D.McKINNEY,DIRECTOR cT / �' j/ruJur•/u.r�/G i Massachusetts -Department of Public Safety ro wanearemen!�C Pi vs Orlice or Consumer Affairs&Business Regulation ( Board of Building Regulations and Standards IMMIM ( OME IMPROVEMENT CONTRACTOR Construction Suner"isor egistradon 101609 Type: I License: CS-057733 Expiration 6/2612016 Private Corporatio I �� } c _` I CHWSTOPHERZ ',p. P/® A&A SERVICES. 115NORTHST a Salem MA 019707kv Christopher Zorzy t ®:p' 115 North Street Salem,MA 01970 Undersecretary ��'�" Expiration Commissioner 05/2612017 A&A SERVICES,INC. 115 NORTH STREET SALEM,MA 01970 n �ili�, �, , „ =y, >a „ - ='�1 _, a co:-aPi9 ] of la- rJlv�� y of y� p;�s= iY,ALpplloa .. , A ay31 bi?xP E?Se;>1 Lin MPhone: 978-741-0424 jjj Diaz zoz Fax: 978-741-2012 //25r1 R I'II 115 North Street ® : ® Salem,MA 01970 August 3, 2015 City of Salem Building Dept. 120 Washington Street Salem, MA 01970 To Whom It May Concern: Enclosed please find the permit applications for Tracy Hutton, 141 R North St., Apt. 2, Salem, MA and Michael Allen, 15 Pope Street, Salem, MA. I have enclosed a check for $25.00 based on your fee schedule of$11.00 per $1,000.00 less the $19.00 credit I have for overpayment on Munroe job. The job is $4,030.00. And I have enclosed a check for $28.00 for the second address for window replacement and the job is $3,162.00. Please send the completed permits to A & A Services, Inc. at 115 North Street, Salem, MA 01970. If you have any questions, please contact me at (978) 741-0424. Thank you for your assistance. Sincerely, Barbara Zorzy Office Manager r,