82 OCEAN AVE - BUILDING INSPECTION The Comntunweallh of 1l assac hu set is
Board of 131tllding Regul:uions and Standards ' \Il Vil"LI' \I.fll
MaSUChuSells State 1uilding Code. 780 ('MR. 7'�' edition tit(
Krner,/huw,rn
[iuilding Permit Application To Construct. Repair. Renos ate Or Demolish a
( One- ns Section or DtrellUse — —
\\`f1J
'This Section For Official Use Only
Building Permit Number
Date :applied:
Signature:
Buildin, Conun no,snniar/ Impcetor of Buildings Date
SECTION 1: SITE INFORMATION
LI Properly Address: 1.2 :\ssessurs Map & Parcel 'Numbers
Airenae
Ma Number Parcel Numher
I.la is this an accepted street? yes no_ p
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sy fU Frontage(li)
1.5 Building Setback's (ft)
Front Yard Side Yards Rear Yard
i Required Provided - Required Provided Required Pnre iJed
i
1.6 Water Supply: IM.G.L c. 40. §51) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone' Municipal ❑ On site disposal system ❑
Public❑ Pro vale❑ Check if yesC
SECTION 2: PROPERTY OWNERSHIP'Lsl pp..,
2.1 Owner'of Record:1)1000 �� D( D r117 t ll
Name rmt) _ Address for Service:
(-31 7M�4 - 7 19 a
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building ❑ Owner-Occupied Repairsls) ❑ Alteration(s) Addilirut ❑
Demolition - ❑ Accessory Bldg. ❑ Number of Units __" Other .❑ Specify:
Brier DescriptionurPropusedWork': `
I 2X1 i r
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimmed Costs: OPlicial Use Only
Item (Labor and Materials) -
I. Building $ �. I. Building Permit Fee: $ Indicate haw tee is dctarnuned:
❑ Standard City/Town.:\pplieation Fee
2. Electrical $ ❑Total Project Cost (Item 6) x multiplier
3, Plumbing $ 2. Other Fees: $
-1. ,Mechanical IFIVAC) $ List: - --
5. Mechanical (Fire S -- —
Tonal All Fens: $
Suppression) -
Check No. Check Amount: ('u,h :\nnwnL
b Tota1 Project Cust
J ' �3� ID�D�.� ❑ Paid In Full ❑ OIIIbt" riding Balance Due:__ _-
T
I
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor (CS1.)
( I �
� hry1 Jnploex �nYZU Laren c Numbeir liNpir:won Uola
Name of C'SL- Ilolder —� —
I_ul C'SL'I'cpc (zee helowl U—
, I'v e\d Drscri rimn
L Lnresun'led+u rat ±;.11U0 Cu. Ft.
R RestrielCd 1&,2 F:unih Dvellin_
S( naut 11 LI 11 N1: onn )nhgr rne
l elrphanc A1'S Reenlrnu,J AA'indu�s .wd Sailing '
SF Residainial Solid Fuel liiunmLP \ >>liunce bn(.�I l.woii�
D Residenlml Demolition
5.2 Re ist•red Ieiylome Improcenj nt Contractor (HIC)
SICQS -Ln0 10 I_fz.0(61 --
IiIC Company Numiar HIC Registrm t Nm Regtstruuan Number
IR (o�a(o�l(7
Address —
Expiation Dane
Siiut r Telephone
SECTION : WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152. § 2506))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to prucide
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 COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject propertyjherebvv,,,,,authorize to act tin my behalf, inrelative t wu k :iuthurized by this building ple�- . OSgnatureofOwner Date
�,,� SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
I, ��✓(.�jl(��y)Q{� 1 7� as Owner or Authorized Agent hereby declare
that the statements and information on thd foregoing application are true and accurate, to the best of my knowledge and -
behalf. n
Print Name
Signature of Owner a Authonud Agent Date
(Signed under the pains and penalties of er'ur )
NOTES:
1. An Owner �aho obtains a building permit to do his/her own work ur an owner who hires an unregistel ed contractor
(not registered in the Home Improvement Contractor (HIC) Program), will riot have access to the arbitration
program or guaranty Fund under M.G.L. c. 142A. Other important information on the HIC Program and
Construction Supervisor Licensing (CSL) can be bond in 780 CMR Regulations 110.R6 and 110.10. respecti%ely,
'. When substantial work is planned, provide the information below:
-anal flours area (Sq. Ft.I (including garage, finished hasement/attic, Jerks or purdv
Gnus livmL, mea (Sq. Ft.J Habitable room grunt
Number of fireplaces Number of hedrooms _
Number of hulhrooms Number of halt/huths ---- _-- .
I'vpe of heating system _. _ Number of deck,/ p�uchcs _ __------_---_
1),pc of cooling system f_nclnsed
3. 'Total Project Square Footage' may be Substituted tuf'Tutal Project Cost'
J
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
7r1,n,�
\(.\` IR 12: 0S\l:\I,
4;.•)yF ♦ F\s:
Workers' Compensation Insurance Afftda-,it: Builders/Contractors/ElectriciansiPlumbers
> )In ant Information
Please Print Legibly
`attic 1 Bu.ula 1 k_dnlzauon InJI\Lluall: A !2 A S eYV� l�5 SI C
Address: ' Nor+h SiYP e.
City',Sctte.'Zip: IPm Mn blG-7t� Phone #: C 17 7� - ®�
.\re you an employer:' Check the appropriate box: Type of project (required):
I. 1 am a employer with—624!5— 4. ❑ 1 ant a general contractor and 1 6 ❑ New construction
employees(full and/or part-time).' liana hired the sub-contractors 7. ❑ Remodeling
a sole proprietor or partner- listed on the attached sheet.
_.❑ I ip e P P p -contractors have 8. ❑ Demolition
,hip and bona no employees These sub .
working for me in any capacity.
workers' comp insurance. q, ❑ Building addition
(No workers' comp. insurance 5. ❑ We are a corporation and its I0.❑ Electrical repairs or additions
officers have exercised their
reyuired.l 11. Plumbingairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL ❑ repairs
myself. (No workers' comp. C. 152, $1(4),and we have no 12.0 Roof repairs
��,,��
insurance required.] 1 employees. nc workers 13.9Other- 111L—'�
comp. insurance required.] J
•;\py,Ipphl'Jnt Ihar checks box 01 must also till Out the section below showing their workers'compensation policy information.
I hnncowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
�conlractors that cheek this hus mast attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
infornation.
Insurance Company Name: I ve
I Expiration Date: �i F Dq
Policy #or Self-ins. Lic. #: D �� � �'.}�. u� `
SA D O)Qh NMnite City/State/Zip: SX,t P� M �]9�U
Job Site Address:_ —_ —
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 ofcriminal penalties of
fine up to S 1.500.00 and/or one-year imprisonment, as well as civil penalties in the firm of a STOP WORK ORDER and a fine
of op to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
111\csticatiolts of the MA tar insurance coverage verification.
/do hereby certi/j' uu er the pu i and jtenalties of perjury that the information provided above is tore and correct.
Date:
11"n,l l l l l'd:
Phone =
tl(ficial use only. Do not is-rite in this area, to he completed by city or town offTciaL
City or lben: Permitil icense #_.____..--------------
lisning Aulhority (circle one):
1. Board of Ilcalth 2. Building Department 3. city/rnwn Clerk �. Electrical Inspector 5. Plumbing Inspector
6. Other ---- —
Contact Person:----___---- — Phone
Information and Instructions
\I.is,.iChuseus (kneraI I_aevs Chapter I" requtresall n TIP lo%et:, to pro%idc porkers' Compensation for t lie irentplo)-ecs.
P olsu.uu a) this salute, all eueplgrre is Joined as ci ery person in the sery iCe of anothCr under env Contract of hire.
.•gyp:C,s or implied, oral or pri it en."
.\n enrplut'er IS defined as ",in indis dual, pannCrship. .ISsoCtation. corporation or other le�:al entire. or an) nvo or more
,.tthC foregoing engaged in ajoint enterprise, and including the legal rcpresentati.es of a deceased emploter. or the
r Ccei%er or 1nb1Ce otan individual, partnership, as;ociatimt or other Icwl entity, employing employees. However the
-•,e ncr of a dwelling house having not More than three aparnncnts and %ho resides therein, or die occupant of the
,Melling Roux of:mother who cuiplovs persons to do maintenance, Conaruetion or repair work on Such dwelling house
or nn the Grounds or building appurtenant ihCreto shall not because of Suds eniplo)ment be deemed to be an employer."
\I(iL Chapter I i?, �s2SC(6) also States that "every state or local licensing agency shalt withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152, s_2S07)states "Neither tite Commonwealth nor any of its political subdivisions shall
enter into any contract for the perfixmauCe of public pork until acceptable evidence of compliance with the insurance
rcyuirenients of this chapter liave been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' -
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to till out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permiulicense applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under"Job Site Address"the applicant should write "all locations in (city or
town)." A copy of the at that has been officially stamped or marked by (he city or town may be provided to the
applicant as proof that a valid atfidavit is on file for future permits or licenses. A new affidavit must be filled out each
y car. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit
The u(fice of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate ai give us a Call.
Hie I)epaitnieut'S address, telephone and tax number.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
www.mass.gov/dia
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 properly licensed facility as defined.by M. G. L c. 111, Seca
150a.
The debris will be disposed at: Salem Transfer Station
owned by Northside Carting
Signature of Perm pplicant
Date
Christopher Zorzy
Name of Permit Applicant
A & A Services, Inc.
Firm Name
115 North Street Salem, MA 01970
Address, City, State, Zip Code
- Board of Building Regulations and Standards
Construction Supervisor License
License: CS 57733 ,
Bi rthdate': 5/26/1958
Exprratron 6126/2009 Tr1F 13739 {
r!-r l
CHRISTOPHER ZORZY
- 115 NORTH ST -
SALEM, MA 01970.�, Commissioner
. _,-vAu�,._.� . ..__.:_. ._. - ___ .._.-✓�ze �nomviixareu�eall�e o�,/�9 ae2c>!iu4e�Ia---- _.•....
Board of Building Regulations and Standards
lug HOME IMPROVEMENT CONTRACTOR
Registration: 101609
Expiration: 6/26/2010 Tr# 267870
-:-TY"P e: Private Corporation
_
A&A SERVICES, INC
Christopher Zorzy 1-'
115 North Street
Salem,MA 01970 - Administrator
Commonwealth of Massachusetts
Division of Occupational Safety
Laura M.Marlin,Commissioner sy�
Deleader-Contractor y�fV
CHRISTOPHER ZORZY
Eff. Date 04/0 /0 .O
Exp. Date OMO8/09
x'
DC000440 .:
Member of CONES T. � e
30
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIII [BOSTON-RENFW
�®�/y � A & A SERVICES, INC.
7Y ACES Telephone:5NORTH STREET, LE,MA 1 20012
Contractor Registration No. 101609
Federal EIN:04-3090162 Construction Supervisor No.CS057733
ROOFING SPECIFICATION SHEET
Buyers)Name Date of Contract
D/,qjviq Ailig v/s I 4—.)-9 -C r
Suyerys)Street Address,City,State and Zip Code
8 OcF vt S c //1 0076
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
778-7`ly-`7/9 z
The Buyers)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 Speaflcafion sheet and the front and to reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification
Sheet is a part.
ROOFING SPECIFICATION
Strip Roof of# /.TL L- layers of shingles
Install 6'of ice and water shield at base of roof where 1 'stall 15.b felt paper to roof.
possible. Install 18-24"of ice and water shield in valleys.
Flash chimney as needed(no repointing included). Z stall 8"perimeter drip edge to rakes and fascia areas.
Er tall vent pipe boots and seal as needed. a' ash valleys as needed
93'Tnstall rollout type ridge vent. 21'151anks/plywood replacement under 32 SO FT included,
'If more is needed there will be an extra charge of$
per hour for labor plus the cost of materials.
Dumpster/Disposal Included: ❑Other:
Location: vE(^-'�7 '
Install new roof: Manufacturer�f�R-'T14/�7T='�� yr Stylettype Z3
Included in this proposal are thorough cleanup,building permit,and company/manufacturer warranties. -
RUBBER ROOFING SPECIFICATION
❑Strip Roof ❑ Not Strip Roof - -
❑ Install 1/2"High Density Fiberboard to existing roof using ❑Flash obstacles as needed.
screws and plates.
❑ Install.060 membrane EPDM(Black)rubber roofing to ❑ Install 3x3 aluminum drip edge to perimeter of roof with
fiberboard.s seam tape.
❑ Flash up sidewall as needed.
Included in this proposal are thorough cleanup,building permit,and company/manufacturer warranties.
SPECIAL INSTRUCTIONS:
��7vtCrv� d-lll L 4Lff72.S eF F=X rS77,ZZ /Zo'e)C aN /ZfJ'-J"(ilJ ,FfaUS(- /'C-c LG /.tom .
�liRe%1 RaoLs ,0,r.� f-2c.vr spot— cF C-f/R.Ft�E- /'�o�. IZrY'A/2
AI 1-4 ra 3� s� 2fFcns/f r/f/� tEcr Pi�fS
4S /LEjt ckM, 4.k S7711( f/'� L.-d4-3�7� Sh//EL c /2rlKt-� AX.J)
4S!3:Vt7S- . e ti OI_/�Y?? PEA 9 [ lti/Ja� 4f2C A
-5 221:1 t_ 3-774B SH 1-G75 c'
It Is agreed and understand by and balwron Me padfas that this Specification Sheet,along War CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
Me entire understanding between has parties,and there are no verbal understandings changing or modifying any of Me terms. This cornmet may not be changed or Me
forma modified or varied In any wry unless such changes are In writing and signed by both Me Baryons)and the Contrector. actions)hereby acknowledge that Buysrial
has read are Spechurdi n Sheet q �+
Contractor Initials: L� Date: ! �Zl'¢� Buyer's Initials: Date:
IDArmy
� . A & A SERVICES, INC.
A&A S '�'1f' ES 115 NORTH STREET,SALEM,MA 01970 -
f Telephone:(978)741-0424 Fax:(978)741-2012
Contractor Registration No. 101609
Federal EIN:04-3 0901 6 2 Construction Supervisor No.CS057733 -
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT -
Buyer(s)Name Date of Contract
DlA /i1 M-p-sods
Buyers)Street Address,City,State and
ddl1Zip Code
cP� QC7gN Irk fK I M14 019-76
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address:
The Buyerpu listed above hereby jointly and severally agree to purchase the goods and/or services listed on the accompanying specification sheets,in accordance with
the prices and terms descnbed on the front aid the reverse of No agreement and any specification stream phis'Agreemenn,and Buyarpe have rauguasted that such
goods or services be Installed or provided at Buyer's address listed above.AIIA Services,Inc.('C.olxredol),hereby areas N install or cause to be installed Ne products
or services listed in this Agreement at the Buyers)address written above. This Agreement represents a cash sale of goods and services. The Buyer(s)agree to pay in
cash the war of me goods and services purchased as described herein,regardless of timing or approval of any financing Buyer(s)may seek for their purchase.
Purchase Pnce:ri'J 66 F7_A11- fir Q 7B Esl.Starting Date:
Down Payment: T/ Est.Completion Date:
❑Cash
Amount Due on Start of Job: ❑Check
❑Credit Card
Amount due on_of Completion: _ No. -
Amount Due on of Completion: Expiration Date:
Balance Due on Upon Completion: 9 y 6 CVC Code:
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(s)hereby acknowledge that Buyer(s)has mad 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 data first written above. Buyer(s)also
(q acknowledge that they were orally informed of their right to cancel this transaction;and(II)request that they be contacted via their
telephone numbers or a-mail,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 IP IT CONTAINS ANY BLANK SPACES.
S rvices `c. _ Buy s)By:
By:,, — - -
Signs33ure /7 Signature r
Print Name Print Name -
Signature -
Print Name
You,the Buyer(a),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. a
AR Ioa:Tne wntmaor and me yemayaM tn mr rew mdumy None In advance Mad Mare avoid agm m perry rim a abpum � wo-t oamine min m alma. m ga may iubmlt mih agraMbb
a pirveta wise,.dance cants rim been epprvv.d by tla swmmymme e.earcoi omu.mconaum.r An eeuslmm aegwmbm aria my dm.r vary endbrenwreamaMbmnm
aura aNlvatm re proved inMAL cl4tA. ,ten
/7S LEA'` aura.
am
.OmQF OF QANQm L.noN NOTIC OF"PNf IEI_I a
.an.d Trenmmion 9 o�u may mM'1 mu Memm9a.yonnom any M moy orenvoi m Tragroo n 9 "ZP G may mntm cam for m mote,yoiu tut any aermy or
pai(auon,agan thimebMea-e dye lmn Me move date.It you owner.any progeny arced Jr. oelgauon.wm,ln tnrea weal...sere awn me emus rime.uyouunam.arypmparyartain n.
any programme,mean to you utlu to contract or sm,and arty naeoodw argument eANVted any pamend trade by you Mom me contraat w sal,and any nep,4ede ln9dumenl eaNded
ter you MII Ce reNmea amth 10 date fdlpwirg rectum In me sager m yorr momentum mew. by Mu man Ica retuned wMm la days lrstrong once,or me See d your wrxelbtlpn npEu.
end arty mourn named amm,me of Me gavaten mall be mnwued.n you tlnwl.you mug and vy toci lamer owing am of bw hmau4on man as Canceled. Il you moral,you morn
mite msiatte to mr Sauer et your madame,in wlgmitlmty,no rand w2lbnm xTan isaivat. away avaMabk to ma s.Ib to ySa reWeM-.in wnAamlmy ae pa]corrosion as wMn removed.
am Maeda dlirned to you Motor has canned or Seed:or you may.it you asM,compy'Mh me any ewQa aalvered to ro,under tub common or me:or you my,n you xuR wmpty your ma
menceare.1 at yesrm rparaing me realm anlpmem Nmag.on me SNlan mpmw and msWmbom el me Seller regmsrp the reNm dommt o1 me goals ad Me Began mipenee end
mrk, i,dM not me gwa9 evtileblm to iM selbr and ma seven dam MI agger,mom up nt It you do Monte Me pas m evalable to me salter mq me dollar dame not pick tlbm ug
ormin so led of tun May of your Nagar of cameraman,you may Near or dkpua of the QW9 a1mN M dap d the date of you9 Nmke of Cameroon,you may nbin m dinarea al me game
..any NNw Mbit,...11 pu.to dyke theg.wellede to me saris or ll you ago xitMut any lunlrer obligation.11 you col to make de goods mandate to me Selby.or a you elm
to room me galas W any over and leg to do ro,man you rmnain India lm permanence ou cal breWm the sands to me egur end bllon,do w,man your area glade far domaenm ot ap
odlpatiw uMv me emNBCL To camel mu Monsignori met or aNrver a Stand mid mated cagy pMgentare under me Contract To work any beneeCLbn,mvl or delver a epwtl Md amen top)
of to circulation notlm a and/timer woman nonce,or send a underarm, A6A 5e 11 of me mnwregan orderor any Amer wntl.a nb w u i . nd a magam,to— t
North Strm(soury.Maegamest1.r 01970.NOT tATEa THAN MIpNIGM Of G 4 Norm seem ame, ewchusrb(lim).NOT IATFA TXAN MIDNIGXT OF
_ (Dam) ((star
INEREBYCANOELTuSTMNSACTON. conwmessgnmua Dme XEnEaYCANCELTMSTPANSACTI Coiumer egareNre Dan
TELEPHONE PURCHACE ORDER FORM A& A Services, Inc D69
A & A SERVICES, INC. Ship to: Directions:
115 North Street
Salem, MA 01970
Tel: (978) 741-0424
Fax: (978) 741-2012
Date / Time Ordered By Expected Date of Arrival Confirmation #
/0- 3 -6,s� /o -3 -OK
Job Name Spoke To Supplier/ Lumber Yard A & A Office Notes
/%f7v/5s &40,
Quantity I Description Quantity Description
e"c / -3 444c4
l o r ,"
.. oe ale
O f
i
do loc.-le- < rim rz
v
s a,,v
INFORMATION LEAD SHEET
Appointment Date: 9/29/2008 Call Taken By: ML
Appointment Time: 12:00 PM Form Entered By:WF
Salesperson: Lead Set Date:9/27/2008
Program:
Initial Project: Roofing i
Customer Name: Diana Marquis Home Phone: (979) 744-7192
Spouse: His Work Phone:
Other:
Her Work Phone:
Mailing Address: 82 Ocean Avenue
City/State/Zip: Salem, MA 01970 Fax:
Job Address: 82 Ocean Avenue Cell Phone:
Job City/State/Zip: Salem, MA 01970
Permit Required: I S" O
Asbestos: Iti-Family#:
Notes: Repeat (S �L e,
(Jvi6 tvo i'v7D lan
l*Lr�O ,'cu A??
(� 164 /9t 14 s,y
Date Proposal Sent: Contracted Project:
Proposal Price:
Contracted Price:
MarketSharp Customer:
QuIckbooks:
COMPLETED
Production
Job Envelope:
Job Number: PAID IN FULL
I, I
V L
ty-
311
1
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i
13
Yy ,v i? x Z -- 15y
�1 p -3 -T�3 5�3� = 11, 130
3� sty 13166Y
q�p� A & A SERVICES, INC.
A&A�' 91' ICES 115 NORTH STREET,SALEM,MA 01970
Telephone:(978)741-0424 Fax:(978)741-2012
Contractor Registration No. 101609
Federal EIN:04-3090162 Construction Supervisor No.CS057733
ROOFING SPECIFICATION SHEET
Buyers)Name Date of Contract
/�INft �ff4ftQlllS `�—�9 -C1�'
Buyer(s)Street Address,City,State and Zip Code
$ O e F ALL— S L //i! 0
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
The Buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,In accordance with the those and terms described on
Mis Specification sheet and the front and the reverse of the amompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification
Sheet is a part.
ROOFING SPECIFICATION
Strip Roof of M /.YL L- layers of shingles
nstall 6'of ice and water shield at base of roof where LillInstall 15.b felt paper to roof.
possible. Install 18-24"of ice and water shield in valleys.
ash chimney as needed(no repointing included). ZKnstall 6"perimeter drip edge to rakes and fascia areas.
Er�lnstall vent pipe boots and seal as needed. Flash valleys as needed
.UrTnstall rollout type ridge vent. Uri5lanks/plywood replacement under 32 SO FT included,
*If more is needed[here will be an extra charge of$ ,
per hour for labor plus the cost of materials.
Dumpster/Disposal Included: ❑Other:
Location: lvEd'-'h
Install new roof: Manufacturer CE1L7n/171FVC> yr - Style/type
Included in this proposal are thorough cleanup,building permit,and company/manufacturer warranties.
RUBBER ROOFING SPECIFICATION
A Strip Roof O Not Strip Roof - -
❑Install 1/2"High Density Fiberboard to existing roof using ❑Flash obstacles as needed.
screws and plates.
❑ Install.060 membrane EPDM(Black)rubber roofing to ❑ Install 3x3 aluminum drip edge to perimeter of roof with
fiberboard.s seam tape.
❑ Flash up sidewall as needed.
Included in this proposal are thorough cleanup,building permit,and company/manufacturer warranties.
SPECIAL INSTRUCTIONS: �^ ,
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N le agreed end understood by and between the pelves Mat Mis Specification Sheet along wnh CUSTOM REMODELING AND IMPROVEMENTAGREEMEW,constitutes
the entire undermaro ng tlemmen the paNes,and there are no verbal understandings changing or modifying any of the terms. The contract may not he changed or Bs
terms modified or varied In any way unless such changes ere In writing and signed by boM Me Buyers)and the contractor.Buyer(a)hereby acknowledge that Buyane)
hem reed this Spec) motion greets
Contractor Initials: Li/- C Date: ! -Z!'-�� Buyer's Initials: _ Date:Z /// b