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17 PLYMOUTH ST - BUILDING INSPECTION (2) RECEIVED The Commonwealth of Massachusetts Board of Building Regulations and Standard CITY OF Massachusetts State Building Code, 780 CMh1b JAN 2b A � CALENI ,,Ys d ildar 2011 r Building Permit Application To Construct, Repair, Renovate Or Demolish a One- or Two-Family Dwelling This Section For Official se Only n Building Permit Number: Date plied: nA . 1 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address•7U 5+. 1.2 Assessors Map& Parcel Numbers pl A d 1.l a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq fin Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (MG.L c.40,§54) 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' 2.1 Owner'of Record: . la✓�rEi� eQn MAC-4Ef-L)M 5alef�-t M/� 019 -70 Name(Print) City,State,ZIP I'1 Pl�l� No.and treet Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': vt (( D n,2_ 1 /1,2.C�) a55 Cs-1 -f-r,l �-0 6 e SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and Nlaterials) Official Use Only L Building S g 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (IiVAC) $ List: - 5. Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ t�s° ❑Paid in Full ❑ Outstanding Balance Due: m12�A lip 1/2Fs ra lsed� /� K SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) �7 0S-r-114� to,zl rt s Gc�✓C�1 License Number Expiration Date Name of CSL Holder ' /,5- /Vo/th 54 List CSL Type(see below) U No. and Street Type Description � -� U Unrestricted(Buildings R Restricted 1&2 Family Dwelling City/Town, State, ZIP M Mason ry RC Routine Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) LD( 6O C( ?_ A +- 4 t �trv) r /n G - HIC Registration Number Expires V iation Datte HIC Compan�Name or HIC Registrant Name �F i\la f L No nd Street �a C`vy ' nn �.. C) lei_J U Email address City/Town, State,ZIP�I Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.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 .......... 19/ No ... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property, hereby authorize (��t y S Zo✓2- to act on my behalf, in all matters relative to work authorized by this building per it application. JNN Print Owner's Name(Electronic Signature) 20204 SECTION 7b: OWNERS OR AUTHORIZED AGENT DECLARATION Bye ring my name below, I hereby attest under the pains and penalties of perjury that all of the information tort ' d this application is true and accurate to the best of my knowledge and understanding. r� Print Owner's or Authorized gent's Name(Electronic Signature) J e NOTES: I. 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.eov/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" Uv e.'. A & A SERVICES, INC. A&A SER 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 ENTRY DOOR SPECIFICATION SHEET Buyer(s)Name Date of Contract i6t WAf-A �1`I�ziv �l fl Y 21 1 w1 Buyer(s)Street Address,City,State and Zip Code i R- s r o 7a Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address q 7�- Y— The Buyers)listed above hereby jointly and severatly 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. ENTRY DOOR 4-Re/mov nd dispose of# Ci�/� _ existinq entry door u-nits.. I, nsEYf tall new entry doors# OlVe— Manufacturer /series Location -40yrIy. 'fl7 84 ?A1+ 4/ Type: ❑Steel UtIrperglass ❑Sliding Patio Door ❑French Hinged Patio Door s Model# /rv�� . Sidelighl(s)# Sidelight(s)type/model# OPTIONS: /Nlilf'i Nish Adjustable threshold for door. ❑ Grids for patio doors: Style: Prefinished ❑yes ufio color: interior exterior_ ❑ Expand or shrink the size of the opening Details ❑ Cover exterior trim with aluminum cyil stock: Style Color Hardware: Wtockset U eadbolt ❑ Footbolt ❑Mail Slot ❑Peepsite Detail l h 2 M um 6/1',eBr z: p_ Re lace interior trim ae-Reedl Details e Replace exterior trim a:aseedeel- Details :7VG X nPyIf —, $efl 6-1 r ❑ Install oak strip at floor as needed. fa—Cau/lk interior and exterior edges. InB� sul d new door unit where possible. _ In�Painti 'e-not included. Details in this proposal are set up and clean up. 2fNtri t' i nc%uded STORM DOOR ❑ Remove and dispose of# existing storm door(s). ❑ Install new storm doors# Manufacturer /series Style Color Type: ❑Aluminum ❑Solid Core ❑ Location: ❑ Hardware style Color SPECIAL INSTRUCTIONS: m Win/ lvouSc creW o U U4 z7 stir Lj�r�t/fc� P yi17 if/ C 14 life Tit/.1P-3 . It Is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,consti- tutes the entire understanding between the partles,and there are no verbal understandings changing or modifying any of the terms. This contract may not be chr.,dd ranchland its termsranchland or varied in any way unless such changes are in writing and signed by both the Buyers)and the Contractor. Buyers)hereby acknowledge that Buyer(a)has read this epaellfleetlan She.. Contractor Initials: _SL— Date: L l0 Buyer's Initials:j/ L Yv, Date: I I I(9 /{.� /� Q�p`, /►*)e A & A SERVICES, INC. AAA� ERVICES 115 NORTH STREET, SALEM, MA 01970 •1 LTA I=1 LTA 1:11:14111VA a LyArdNm Telephone:(979) 741-0424 Fax: (979) 741-2012 Contractor Registration No. 101609 Construction Supervisor No.CS057733 Federal EN: 04-3090162 CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Bu eels Name Date of Contract wnwfd r r P Buy gal Street Address,City,State and Ze Code c a S'f- .erti O/ Da Iona Telephone Number Evening Telephone Number Mobile Tale hone Number E-Mail Address 3 The Buyerls)fisted 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 described on the front and the reverse of this agreement and any specification sheets(this'Agreement"),and Buyerls)have requested that such goods or services be installed or provided at Buyer's address listed above.ABA Services,Inc.('Contractor'),hereby agrees to install or Cause to be installed the products or services listed in this Agreement at the Buyerls)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 services purchased as described herein,regardless of timing or approval of any financing Buyerls)may seek for their purchase. p -grail Purchase Price 07J --- Est.Starting Date 7— /- Down Payment:�,�_ L.((�7e �7�p!7,,/ Est.Completion Date: GfllTtlaf !7`c�Jy Amount Due an Stan of Job: Check D.._L "'t �O� Amount Due on li of Completion: S�"�T �rJ. 91,Credit CardNo Amount Due on_of Completion:----------;77— Expiration Date: Balance Due on Upon Completion: 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.Buyerls) hereby acknowledge that guitarist has read the front and the reverse of this agreement and has received a conlpleaud,signed and dated copy of this Agreement.including the two attached Notice of Cancellation forms,on the date Post written above.Buyerls)also(1)acknowledge that they were orally informed of their right to cancel this transaction;and(11)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. 00 NOT SIGN THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES. A&A Servic s,Inc. Buyer(s)By, Sign lure Signature �— x CILttT1 Mh2GcRUM 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 dale of this transaction. See the following Notice of Cancellation form for an explanation of this right. ARBITRATION:The contractor and the homeowner hereby mutually same In advance that in Me event come paM he.a ming.mnceming Iris ennead,eitM1er party rosy wbrrit surA Elspwe to a a-,.manages se in s,G Lc as been apyowtl Ey Me scra aryot Me Eaeculiva OH¢et Consumer Maim and Business Regulations and 1M other peTy shall be re0ulred to sunrrvt to sucM1 ar Canlmarb,milyng� Bays.Inik Ir — Date: Oahe: f f a 1 b ��) NOTICE OF CANCELLATION NOT/ICE nE CANCELLATION Otte of Tombec4on_r�c,/!la YW may cancel this tienYNon.without any—.try or Dale o1 Transaction tl You—'cancel Inis Iransallon whirne any hationY or onggation,ems lnraeF✓us'ne¢(Eerslmm the move dust ll you darval.any p,olenylrWcd in, obhuiuon,WMln Mree vWnun inr ,mlM1aeEovne.m.lfywcancel,anymermytraemeln, any payments made by You under In,contract or sale,and any nomot a instrument execded any payments made by y don the Carmel or Sale,and any negotiable instrument eamemed by You erg be retuned Metier 10 days frbamit receipt by Me seat of your raocolumon notice. by you Cam be formed crown 10 days Havana modtr by In.seller o1 your car ourar-rwnme, and any security named eosins out o1 Me uensadion sell be ceoccons if you cancel you must and any ssmmly intense rupee out of me sansecron Cam M eanceriad.it you cancel.you muss make avar at e m the Seger at Your residence.and subscribers in as gone condition as when (rake available to the Seller at year re adence,and subs nbally in as good common us when rvad.dry goods degvarea to you under Mh contract or sale:or You may.if you ssb.oealr ceived,any goods eaweres to You under Has Contact or sere',crywoury n Yrusrncornply win Me mammoed of Me seller regarding Me form samem of no Cares at to sellers son the instructions of the seller regarding the room chanter r no goods at the savers e:penm and risk.If you do make Ire goods evante.an Me saner end Me Seller does non pick Anence and ask It you do make the goods available to me setter and Me Eager does nor pick come up slnM 20 data&Me date ofyour Notice of anscience Youmayrdoinordeposeaf Me them up Adman 20 days d Me data a Your Notice d eandelmon,you may,Can or disposer 9oMswnumilanyrunnerodinigon.If yuu tail r makelmessus—flabiatotM seller.wXyw b-ammuse Moa enyrrtia—b Motion.Herself to make Magwds syelieoio home Seller.nett agree in return Me goods to theSawn and lal to do so then rain remain fraud he pedbrmane<o1 you egret,to return the goods to the Sells,and fail to do an.Men past remain lraise for penrrmanm of odiganons under Me Contract.To tercel this uensec9m,mail m dNHer a signed and dated of m cdigagons under the Contract.Trained arm estimation,nail ordebu era sgned end dated mpY of am canMlabon notes or any other wnllen noere,n¢eM a leIeg,m. Afl copy o1 Is canden ors-am or any Orson vrtMan notice,or sand a telegeem h ABA 5 Its North street Seem M 01970,NOT IATER TIUW MIONIGXT OF n �rcee, 115 NOM Stress,Set..MA 01970.NOT LATER THAN MIONIGXTOE 7, 9 I HEREBY CANCFLTHIS TRANSACTION IXEREOy CANCEL THIS TRANSACTION Conwrrer'a Signs Oat.: consumer's Signature Dale: 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 Buyer'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 or other 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 constitute 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 pricing,unforeseen structural defects or pre-existing conditions to the Buyer's property,the Contractor may cancel this Agreement within30 days of its execution,notify the Buyer of such a cancellation in writing and return 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. 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 form,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)thc-Contractor's costs for any specially orders or any custom manufactured items.BuyWagrees to pay 1 %%per month on all amounts due and owing from the buyerto the Contractor accruing from the dale 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.Buyer grants 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 an inspection of the premises and perform any remedial work to the extent the Buyer is entitled thereto under this Agreement or the Contractors 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 anAgreement 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 inquiries can be directed to the Contractor,who may be reached at the telephone number on 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 Slate 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 to this 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 Mass Department ofIndustrfal Accidents Office Of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Amilicaut Information Please Print Le ibl Name(Business/Organization/individual): ( ' n� c . Address: S i v 0.,t— S f p City/State/Zip: �C~ C w1 MU(9'U Phone#: (-7 Are you an employer?Check the appropriate boa: 1.[a'I am a employer with�_ 4. ❑ I am a general contractor and I Type of project(required): 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. 2'Renwdeling ship and have no employees These sub-contractors have working for me in any capacity. workers'comp.insurance, g' ❑Demolition [No workers'comp.insurance 5. ❑ We are a corporation and its 9. ❑an addition 3.❑ required] officers have exercised their 10.❑Electrical repairs or additions I 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 insurance required.]t employees.[No workers' 12.❑Roof repairs comp.insurance required.] 13.0 Other - "Any applicant nut checks box#I must also fill out the section below showin their work t OMMIO.eth who submit this affidavit indicating they nm doing all work am then hire outside contract.,mascy t submit aaam atfidavit indicating such. tCon[ractms that check this box must attached an additional sheet showing the name oFthe subcontracrors and(heir workers'comp.polity inf.rmaduch I am an employer that is providing workers'compensation information. — insurance for my employees. Below is the poliry and job site y— Insurance Company Name; ` �fl�U �� f S' Policy#or Self-ins,Lic. #: r�}- 3 ('Vlg Expiration Date: (02 Job Site Address: 17 P�ufyt 0 u I I/I �Attach a copy of the workers' � City/State/Zip:_t;:a[e- Vt /Y�i'�619'7b 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 fomr 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. I do hereby certify n er he pains and penalties ofperjuy that the information provided above is true and correct Signature, Date: Phone# -1-(��-�/- 0�{'a-�/ [6.Other cial use only. Do not write in this area,to be completed by city or town official or Town: PermttlLlcense# ng Authority(circle one): ard of Health 2.Building Department 3.Cily/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector act Person: Phone#: ON, Phone: 978-741-0424 "12-2012 Fax: 978-741-2012 A&A SERVICE 115 North Street com 115 North Street • . 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 Signature of rmit Applicant Christopher Zorzv, President Name of Permit Applicant JAN202016 Date Phone: 978-741-0424 1!159x2_,oi z Fax: 978-741-2012 fA�111 Ilk®Y rC// 1,1I 9_IL�� ies.com 115 North Street• . . Salem, MA 01970 January 20, 2016 City of Salem Building Dept. 120 Washington Street Salem, MA 01970 To Whom It May Concern: Enclosed please find the permit application for Ed and Eileen Margerum, 17 Plymouth St., Salem, MA. I have enclosed a check for $25.00 based on your fee schedule of $7.00 per $1,000.00 and a minimum of $25.00. The job was $2,850.00. Please send the completed permit 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 U 0 Office Manager A S A SERVICES,INC. 301 City of Salem 1/20/2016 Margerum Entry Door Permit 25.00 A&A Beverly Coop 6 Margerum Entry Door 25.00