141 REAR NORTH ST - BUILDING INSPECTION C-K 30"7
The Commonwealth of Massachusetts
Department of Public Safety
1 Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
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,e4✓(/o/tKS4-, U.t,fi a <S lLevr MA bt`t-70
No.and Street City/Town 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❑ 1 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/rp quire&? \ Yes ❑ No I9�
Brief Descri lion of Proposed Work: 1yN S4--0.t/ Ta ✓ Cq ) V r"I Y'r0 l0.c-e—".e ✓cf
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.)
Total Area(sq. ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional I-1 ❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑
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 ❑ I1I13 ❑ 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❑
Private❑ or indentify Zone: or on site system❑
required ❑ or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: NIA Historic Commission Review Process:
Not Applicable❑ Is Structure 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:
Mt�tL-11=-D 1 �Cz3 hr .
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
rctL.� l L Eo . lq luo/- h Sit-V,% f,a- 50s k1 6191 70
Name(P No.and Street City/Town Zip
Property Owner Contact Information:
Ow l -2()- I9Z2- _
Title Telephone No. (business) Telephone No. (cell) e-mail address
If applicable, the property owner hereby authorizes
C tltr( 5 2or 2�/ (l 1'�_VVd✓tll St- Scklt-_w _0l 4- 0 t`i-76
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 permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0 and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor 11
Company Name
r,kr,s- -733
Name of Person Responsible for Construction License No. and Type if Applicable
)/S /Uo✓tit Si= '5 0.& Vk 0 l c�-7G
Street Address City/Town State Zip
7q--741_ 0q2-
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 issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes 0 No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs: (Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ �� Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)_$
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.-Mechanical Other $ Enclose check payable to
6.Total Cost I $ 0 C) (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of my l �wledge and understanding. ��ee �j ��
�r-e.S c
Please print and sign name Title Telephone No. D e6 2116
It S 0'1-n1 S 4 �_,r
Street Address City/Town / State Zip a
Municipal Inspector to fill out this section upon application approval: J�a
Name ate
v (�(�_°°°9M A & A SERVICES, INC.115 V
A&A S� ICES TelephoNORTH)T�0 24 Fax: 978M741 20012
• ••
Contractor Registration No. 101609
Federal EIN:04-3090162 Construction Supervisor No.CS057733
WINDOWS AND STORM PRODUCT SPECIFICATION SHEET
Buyerts)Name Date of Contract
), G i!�fdN l/
Buyerts)Street Address, by,State and Zip Code^,_ /��
L /v�� f r�r Z S( f'I b t I q
, U
' � �
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
�2�- 7 Z
The Buyerts)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 part.
WINDOW REPLACEMENT
Remove and dispose of# existing wind/ows. fifA�� SL1,0I tS�J�`-`"�
IT Install # 1ouf view ` Nnn5 L-./ 5C17'�"I S windows(ami (Wood
(Manufa urer) -sue
Options: Style Drylble ff\001 Grid pattern
Color Interior Color Exterior W �e� Glass Type
If Wrap exterior trim with aluminum: Style Color
® All windows will be installed according to the installation procedures in the portfolio. 4
^ �k7s
Caulk all interior and exterior edges. --'rr/ w 1
4 nsulate where possible around new units. w)V S'l
If Insulate window weight pockets if exist,and around new window units where possible. d'F j Gc`
n Pepe varupm and cleaning _C.vs L^.Side and.out
t Inrlutled in this;xoposzl are se•up,clean���, .._�_ _, ._.._c=_n g Ivi.^.�' - —— -
Building permit included.
BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS
I- Create new window opening by cutting through existing home and framing in opening.
t Remove and dispose of existing unit(s)in its entirety.
Note:Electric and plumbing may exist in wall and will require additional costs to customer if need to be dealt with.
t 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.
If Bay t Bow t Casement If Other window(s)to include new interior style trim and new exterior style trim and head
flashing as needed.
O'Note: Painting and staining not included.
STORM PRODUCTS
If Remove and dispose of if existing storm window(s).
If Install new storm windows# Manufacturer
Style Color Option
If Remove and dispose of# existing storm door(s).
4 Install new storm doors# Manufacturer
Style Color Type: t Aluminum If Solid Core
SPECIAL INSTRUCTIONS:
Sir scc RAO C*E_2 I KC'I _ w� 1 �5
se
4 y�-,,v_-=. e_-AAdki na nF erector sills 41clucle
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 games,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 bath the Buyerts)and the Contractor. Buyers)hereby acknowledge that Buyers)
has mad this Specification Shret.
x Contractor Initials: -5 L_ Date: iCJ Buyer's Initials: Dat�L
^ A `,AR
A & A SERVICES, INC.
A�W��Y 115 NORTH STREET, SALEM, MA 01970
REM. Telephone:(978) 741-0424 Fax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EN: 04-3090162
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
Bu e s Name Date of Contract
'eu er s' Street A(ress, City,State and Zi Code
Da 'ma Tele hone Number Evenin Tele hone Number Mobile Tele hone Number E-Mail Atltlress
The Buyers)listed above hereby jointly and severally agree to purchase the goods andlor services fisted on the accompanying specification sheets,in accordance
with the prices and terms described on the front and the reverse of this agreement and any specification sheets(this'Agreement'),and Buyer(s)have requested
that such goods or services be installed or provided at Buyer's address listed above.ASA Services,Inc.('Contractor'),hereby agrees to install or cause to be installed
the products or services listed in this Agreement at the Buyeds)address written above.This Agreement represents a cash sale of goods and services.The Buyerls)
agree to pay in cash the cost of the goods and servic s purchased as described herein,regardless of timing or approval of any financing Buyerls)may seek for their
purchase. Je —
Purchase Pro J Q+ Est.Stating Date:
Down Payment/ E .Completion Dale:
ElliCash
Amount Due b Jot}: Xiii Check
31
Ot Credit Card
Amount Due on_of Completion; No.
Amount Due on_of Completionq Expiration Date:
Balance Due on Upon Completi S CVC Code:
It is agreed and understood by and between the parties that this Agreement, front andlback 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.Buyerls)
hereby acknowledge that adverts)has read the front and the reverse of this agreement-and Chas received a completed,signed and dated copy of this
Agreement,including the two attached Notice of Cancellation forms.en the date first written above.Buyer(s)also(1)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 Buyer(s)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 Serv' es,Inc. Buyer(s) --
By: rr�
Signature Signatu e 1�
Print Name rint Na e
Signature
Print Name
You,the Buyer(s), may cancel this transaction at any time prior to midnight of the third business day after the dale of this
transaction. See the following Notice of Cancellation form for an explanation of this right.
ARBITRATION:The wmracher aral Ibe i me caner hereby muwally agree m aevanre halm me event abler part has a drumbe mnwming this come s elumb part may submit such dispute w a
,Mate himention-.do aniM has been elands 0 by lee SboveryOMe Executive Othm of CishourearAffirriand Guam,.Regula6one and to other pan,shall terminated to su first ro such
marptim as proved m M.G.L c 14M,
card—rinirinls: Buycrs
arse.
L IL ``11��II NOTICE OF CANCELLATION
Date al Transaction L You may cancel this tr onsac4on,cit .any ImpM or Date of Ter sacco iV You may mn-I Mrs Irene on.wl out any pmalb or
OCIigeOon.within lM Yne adaya M1Omine abovedate.ll you Carrel.any propenY traded in, oGigetion,rwrom three days troth Me aMve dale.Ilyw rental,any propeM traded ln,
any pe fronts node by You under the Contract a Sale,and any railroads inWmrent exerted any payrrems made by you under the Con ra0.or Sale,and any negotiable inswnent e�au,ted
by You wi be retumed within 10 days beloxing recspt by Me Seller Ot your pncellation rntica, by you will be reNmee Hlhm 19 days tollonrg—at N the Soler of your dencelaem-a-.
and any secunty usese arising out N the transaction will be comp any If you aan J.You mrml and any army inte be adsirg out of Me possession art,be cancelled.If yeu cancel,you rust
mske available to Me Sake at year residence,and substantially in as good..dean as when make availede to the seller at your residence,and substantially in as good condition as when
redeload.any goods delivered b You under this Contract or yak;or you may,11 yen War.¢npty nourmad any,..] deuce d.y under Mis Cmtmdor Seb;oryruMy,ilyou wish.comply
WM the InsWcdrn,of Me Seller meaning Me return Mutant of me areas at the Sellers win Me instructions of the Seller marks,the return shipment of the goods at the Sellers
expense and lick.II you do make Me goods available to the Soler and the Sells,does nor pick expense and risk,If you do make Me gwds evatiable to the seller and to stller does set pick
Main up vice,20 days aline data of Your Notice at Conrelladrn,you may mon or dispose Of the them up MMin 20 days OI Me dare of Your Notice of Canwlladon,you ivy retain or dispose of
gx]s vnMoul any NMer obligation.If you for to make the pares evailaire to Me Seller,by T you thegOOdswilhoadanyNMerideaption.Ifywlaillormke MegwdsavalladetDthesller,o,d
agree to return the Posts b Me Soler and fail to do so.Men yen remain liable for pedomance of you agree to return the goods to the salerand fail 0 do As then You remaM liable for peMmunce
all obligations under the demand.To vncel Mis tran88Non,roil or tleMer a signed and dated of as obligations under Me Comma,To dent this treneectim,mail or d dh ar a signed no aated
copy of the canmlbeon noted Or any ether 7mr nrdre,w sale a telegram, t copy of Me dart Jladon notice 9r any Other vxitlen nester or send a teleg,am�.tl s.
115 North 5treel.5alem rod 01970,NOT LA TER TH4N MIDNIGHT OF ratio 115 NOnh greet Salem MA 019]D,NOT LATER THAN MIDNIGHT OF
I HEREBY CANCEL THIS TRANSACTION J� I HEREBY CANCEL THIS TRANSACTION
COnsurrer'ssignature Dale', comma m'S Signawm Date.
ADDITIONAL TERMS AND CONDITIONS
Contractor Responsibility.The Contractor will issue its formal warranty upon full payment,which shall constitute the
Contractor's warranty for the labor and materials provided to the Buyer.Contractor agrees that all work done pursuant
to this contract shall be of a workmanlike manner using professional quality materials and supplies.Warranties are
available for inspection at the time of signing of the contract.Contractor accepts no responsibility for any damage
resulting from structural or other defects in the property at which the installation is carried out.Buyer acknowledges
Contractor's products do not correct or cure structural problems.Contractor shall not be responsible for(a)any
damages arising in whole or in part from strikes,fires,accidents,floods,governmental actions or any other causes
beyond control of Contractor or(b)any damages including without limitation,lost profits or reduction in value of Buver's
property,arising from Contractor's delay in performing under this Agreement or due to its breach.of this Agreement.
Condensation/Mold;The contractor is not responsible for conditions beyond its control,such as condensation which
may form on or within a window or between windows resulting from pre-existing conditions in the Buyer's home and.
external temperatures.Some condensation may also form on the frame or portions of the roof.Reducing the humidity in
your home will often remedy any condensation problems.The Contractor is also not responsible for existing or -
developing spore or mold growth.Mold may be due to condensation which may form on or within walls or other surfaces
resulting from[pre-existing conditions in the Buyer's home and internal or external temperatures.Buyer indemnifies and
holds Contractor and its employees,authorized contractors and their subcontractors from any claims as to the
identification,detection,abatement,encapsulation or removal of mold,asbestos,lead based products orother ,
hazardous substances inside or outside of the structure being improved. - - -
Permits: In Massachusetts,the Contractor is responsible for applying for and obtaining any and all necessary
permitting.Homeowners who secure their own permits will be excluded from the guaranty fund.provisions of .,
Massachusetts law:
Delay/Unknown Conditions: Events beyond the control of the Contractor,such as Acts of God,labor strikes, - - - - -
inclement weather,material shortages,Buyer's:inability to qualify or obtain financing,delays by local government
authorities in issuing or otherwise approving inspections,permitting or other required authorizations for the job,or other
events resulting in delays in performance of this agreement do not constitd[e.abandonment and are not included in -
calculating time frames for performance by Contractor.In the event the Contractor determines that this Agreement
cannot be performed as intended by the parties due„for example,to incorrect pncing,'unforeseen structural defects or
pre-existing conditions to the Buyers property;.the Contractor may cancel this Agreement within 80 Hays of its - -
execution,notify the Buyer of such a cancellation'in'writing and.retum all monies paid by the Buyer.-The Contractor and
the Buyer(s)have determined that a definite completion date is'not of the essence to this Agreement.Contractor will not
be responsible for any work not specifically listed in this Agreement or the Addendum.
s
Late Cancellation,Late Payment/Default: If Buyer attempts to cancel this Agreement at any"time subsequent to
midnight of the third business day after the date of the Agreement,as more fully described on the Notice of Right to
Cancel forth,and Contractor accepts such late cancellation,then Buyer agrees to pay Contractor a,cancellation,fee _
equal to(i)_15%of the Agreement's purchase price to offset Contractor's incurred labor,administrative fees and-
material costs;plus(ii)the Contractor's costs for any_specialty orders or any custom manufactured-items.Buyeragrees --- -
to pay-1 %%per month on all amounts due and owing from the buyer to the Contractor accruing from the date due and -
running to the date the payment is made.'If Buyer is in default of this Agreement,Buyer agrees to pay,Contractors "
attorney fees equal to 15%of the defaulted amount or as otherwise allowed by applicable law.Buyer also.agrees to pay
any other costs or expenses of repossession,collection,or realization on any security including court costs,to the
extent not prohibited by law. -
Security Interest:This contract may result in a lien on or security interest on your residence`Buyergrants Contractor a
security interest under the Uniform Commercial Code and other applicable law governing security interests in the
property purchased pursuant to this Agreement,including a security interest in any proceeds from the sale of such
property.Buyer agrees that the property purchased under this Agreement is,and will remain,'personal property,
regardless of the fact that said personal property may become attached to Buyer's real property.
No Set-Offs or Retentions.Upon substantial completion of the Contractor's performance,Buyer shall pay all amounts
due under this Agreement in accordance with its terms without any right of set-off or retention.Substantial completion is
defined as the job being materially completed,functional as intended,and a final inspection,permit or occupancy
certificate,as the case may be, having been obtained.If after making full payment,the Buyer alleges that the work is
defective in any respect,the Contractor,without waiving any of its rights,shall cause aninspection of the premises and
perform any remedial work to the extent the Buyer is entitled thereto under this Agreement or the Contractor's Warranty
at no cost to the Buyer.
Buyer's Representations:Buyer represents and warrants that(a)any credit information furnished by Buyer in
connection with this transaction is true and complete;(b)no person has promised or offered to pay,credit,or allow to
Buyer any compensation or reward for the procurement of an Agreement with others as an inducement to enter into this
Agreement;(c)no person has offered,delivered paid;credited,or allowed to Buyer any gift,bonus,award,money,
merchandise,trading stamps,or cash loan as an inducement to entering into this Agreement;(d)Buyer is the owner of
the property where the goods and services are being provided.
Miscellaneous:Problems and ingmneszcan be directed to the:Contractor;who may be reached at the telephone
_ gumbecon-the front of this'Agreement.In construing this Agreement,the gender and number of words used may be
changed to meet the context.Any part of this Agreement contrary to law of this State shall not invalidate other parts of
this Agreement.This Agreement is to be governed by the laws of the State in which it is performed.All contractors
and subcontractors must be registered by the administrator of the Massachusetts Board of Building
Regulations and Standards and any inquiries about a contractor or subcontractor relating to a registration
should be directed to the Director,Home Improvement Contractor Registration One Ashburton Place Room
1301,Boston,MA'02108 Tel: (617)727-8598.This Agreement and any accompanying documents represent the
entire agreement between the parties and there are no,prior or contemporaneous oral or written agreements or
representations on which either party is relying.Any modifications tothis Agreement shall not be effective unless in
writing,signed by the Buyer(s)and a President or Vice President of Contractor.The section headings contained in this
Agreement are inserted for convenience only and shall not affect in any way the meaning or interpretation of this
Agreement.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,M,4 02111
whew.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information / Please Print Legibly
Name(Business/Organization/Individual): pT 4--irl �y's/ j�lLS I/2 C-
Address: I (5- fG f(' S:+ p
City/State/Zip:_ SC��yv� M ft-09-10 Phone --7 Lf/— r
Prequired.)
you an employer?Check the appropriate box: - Type of project(required):
I am a employer with � 4. ❑ 1 am a general contractor and I 6. ❑New construction
employees(full and/or part-time).' have hired the sub-contractors
I am a sole proprietor or partner- listed on the attached sheet.t ?. ['Reirmdelingship and have no employees These sub-contractors have 8. ❑Demolitionworking for me in any capacity. workers'comp. insurance. 9. ❑Building addition[No workers'comp.insurance 5. ❑ We are a corporation and its
officers have exercised their 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself.[No workers'comp. C. 152,§1(4),and we have no
12.❑Roof repairs
insurance required.]t employees.[No workers'
comp.insurance required.] 13.0 Other
Any applicant that checks box a I must also fill m[the section blow showing their workers compensation policy information.t Homeowners who submit this affidavit indicating they am doing all work and then hire outsideconuactors must submit a am affidavit indicating such.
'COmraelOq that check this box most attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy inimma5on.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site
information.
Insurance Company Name:��(A V �l f S
Policy#or Self-ins.Lic.#: tto, q-q-3 ( � Expiration Date: !_ -t 3—)
Job Site Address: I__R/yCJ' "( )'f"t,( y1L-f City/State/Zip:-SC evvt #1411-0 19 70
Attach a copy of the workers'compensation policy 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. .
/do hereby certify n er a pains and penahies of perjury that the information provided above is true and correct.
$IQmamre: Date FEB 1 6 2016
Phone#: `"I
FFuse only. Do not write in this area,to be completed by city or town ofcial
n: Permit/License#
hority(circle one):
Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
son: Phone#:
. Phone: 978-741-0424
M2 Fax: 978-741-20 12
.a -comp &A \ERVIV'`g 115 North Street IN • U - . Salem, MA 01970
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of M.G.L.c.40, Sec. 54, a condition of Building
Permit Number is that the debris resulting from this work shall be
disposed of in a property licensed facility as defined by M.G.L.c. 111, Sec. 150a.
The debris will be disposed at: Waste Management 877-515-2845
c/o Melrose Transfer Station
740 Broadway
Melrose, MA 02176
or
Waste Management, Dumpster Service
at
115 North Street
Salem, MA 01970
H. ) '
Signature of Permit Applicant
Christopher Zorzv, President
Name of Permit Applicant
FEB 16 2016
Date
Certificate No: A044298
�. THE COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT
t
., r DEPARTMENT OF LABOR STANDARDS
C•,, .i 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.
i
THIS LICENSE IS VALID FOR A PERIOD OF ONE YEAR.
I !
THIS LICENSE MUST BE MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN DELEADING
WORK IN ACCORDANCE WITH M.G.L. CH. I I I § 197B(b)(2)AND 454 CMR 22.03.
I
i
ILLIAM D.McKMEY,DIRECTOR
�. �i� j^/� .. ,� ,�i Massachusetts - Department of Public Safety -
Ofnee of Consumer Affairs&Business Regulation Board of Building Regulations and Standards
IOME IMPROVEMENT CONTRACTOR """"'��' �'�'•�'r —`��
iA ,Registration: 101609 Type: ^License: CS-057733
x .6�-%
,,Expiration: 6/26/2016 Private Corporal n!
CHRISTOPHER 4b
P/e A&A SERVICES, INC Y/f 115NORTHST ; AM- 0 _
fa Salem 11tA 01970%Christopher Zorzy ,
115 North Street
.�L r
Salem, MA 01970 Undersecretary ^' —� �� iu Expiration
Commissioner 0 5/2 612 01 7
A&A SERVICES, INC.
115 NORTH STREET
SALEM,MA 01970