7 RANDALL ST - BUILDING INSPECTION (2) A�pLIC�ITION FOR
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LOCTIG�A/�/ OON {A
PEqMIT GRANTED
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nppRo�r�D
INSPECTOP OF BUILDINGS - --
CERTIFICATE OF OCCUPANCY ~_
YES _.
NO
DATE: 7 22 - QH
(Eizp of �arpm, a gat ju Q�z
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building 7 &ndol 19yn2 J
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install Si ' truct Deck, Shed, Pool
Addition Alteration, epair/Re la , Foundation Only, Wrecking
Other: F
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PECOCESSING
To the Inspector of Buildings:
The undersigned hereby applies for a permit to build according to the following specifications:
Owners NameiL- a ja Contractor: C n r; s t n ph a r 9.n r z; _
StreetinYY (ll �( , Citys(a- Street 115 North Straat City Ral am
State,(_ Phone (a-7$)7L45-0,�N5 State MA Phone(97g)-JA1-0424 _
Architect:_ City of Salem Lie# 14 0 5
Street City State Lic#0 5 7 7 3 3 HIP# 101609
State Phone ( ) Homeowners Exempt Form_yes�no
Structure: (please circle) Single Family, ulti Famil Other
Estimated Cost of job $2nt N(o, nh
Will building confirm t law?, yes no
Asbestos?_yes7no
Description of work to be done: P)nf to P X I 1/Y) a)n- -:�nn a re('a r opcch
Wilh 0 new tLr'r( h of -I hP 4 ame dime iDhS-
� t� lac� Pb�s�lr,� l�iliV, hv�n, i, �i�-h np� Ir�UIV_�i��nC�
SERVICES
Drawin Sub itted: yes no Mail Permit to: II6 NORTH STREET
X
�Q X�cAT FAI�MIA 91 7^
Signature of AplAicition,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX (6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# Zoning Map/Lot
Permit fee$
COMMENTS:
.. ��
The Commonwealth of Massachusetts
Department of Industrial Accidents
0fice0//6IrOSd080005
600 Washington Street
Boston,Mass. 02111
Workers' Compensation Insurance Affidavit
name:
location:
city phone#
❑ 1 am a homeowner performing all work myself.
❑ I am a sole proprietor and have no one working in any capacity
❑ 1 am an employer providing workers' compensation for my employees working on this job.
comoanynam: A &, A .Services , Inc . fie, r .� ,: Stilr
address: 115 North Street ^;kc �srrAyr,
city: Salem', MA 01970 ohone# 978-741 0424
insurance co. The 'Travelers oolicv# WC939XI256
❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
have
the following workers'compensation polices:
company name'
address: ;�` op�fR` t
city* hone d: 1-.,
r
insurance co:
Company name.. -
cif
N hone#:- x
insurance co.
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to sI w.00 and/or
one years'Imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a
copy of this statement m be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do hereby carij r th ah a(nl�d/penglges ojp ury that the Information provided above is true and correct.
Signature ` 10 /L/ Date
Printname_Christooher Zorzv, President Phoned 978-741-0424
official use only do not write in this area to be completed by city or town official
city or town: permit/Ilcense# PlBullding Department
check if immtdlate response Is required QSelectmt QUee la t 9oaffi
o a office
QHealth Department
contact person: phone#; flOther
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. 11J, Sec.
150a.
The debris will be disposed at: Salem Transfer Station
owned by Northside Carona -
Signature of Pe d Appl' icant
Date
I
Christopher Zorzv
Name of Permit Applicant
A &A Services, Inc.
Firm Name
115 North Street. Salem, MA 01970
Address, City, State, Zip Code
U-VALUES AND R-VALUES ENERGSTAR
�RV INOVSTRIES Harvey Manufactured PARrrteR
• Windows and Doors
WHOLESALE PRICING
• U-Values in accordance with NFRC-100 • Based on residential sizes
• U- and R-Values are subject to change without notice • Whole window values �=
All Harvey vinyl windows with Low-E/Argon and all Majesty double hung windows with a®
Low-E/Krypton quality for the ENERGY STAR® program throughout the U.S.' rsosom
Clear Insulated Low-E* Low-FJArgon*
VINYL WINDOWS U-Value R-Value U-Value R-Value U-Value R-Value
Classic Double Hung (Mechanical) 0.50 2.00 0.37 2.70 0.34 2.94
Classic Double Hung (Welded Sash) 0.50 2.00 0.36 2.78 0.33 3.03
Classic Double Hung (Welded Sash & Frame) 0.49 2.04 ! 0.36 2.78 0.33 3.03
Classic Acoustical Double Hung STC40 0.23 4.35 0.18 5.56 0.17 5.88
Signature Double Hung (Mechanical) 0.50 2.00 0.37 2.70 00.34 2.94
Signature Double Hung (Welded Sash) 0.50 2.00 0.37• 2.70 0.34 2.94
Slimline Double Hung (Welded Sash) 0.51 1.96 0.38 2.63 0.34 2.94
Slimline Double Hung (Welded Sash & Frame) 0.50 2.00 0.38 2.63 0.35 2.86
Slimline Single Hung (Welded Sash & Frame) 0.50 2.00 0.38 2.63 0.35 2.86
Vinyl Casement/Awning 0.47 2.13 0.34 2.94 0.31 3.23
Vinyl Casement/Awning and Thermal Panel 0.31 3.23 0.25 4.00 0.24' 4.17
Vinyl Designer Shapes 0.49 2.04 0.34 2.94 0.30 3.33
Vinyl Hopper 0.47 2.13 0.35 2.86 0.32 3.13
Vinyl Picture Window 0.46 2.17 0.31 3.23 0.28 3.57
Vinyl Welded Deadlite 0.50 2.00 0.34 2.94 0.31 3.23
Vinyl Roller - 2 Lite and 3 Lite 0.50 2.00 0.36 2.78 0.33 3.03
Clear Insulated Low-E* Low-E/Argon*
VINYL NEW CONSTRUCTION WINDOWS(pg190.231) U-Value R-Value U-value R-value U-Value R-value
Vicon Double Hung (Welded Sash & Frame) 0.50 2.00 0.37 2.70 0.34 2.94
Vicon Single Hung (Welded Sash & Frame) 0.50 2.00 0.37 2.70 0.34 2.94
Voon Classic Double Hung(Welded Sash&Frame) 0.49 2.04 0.36 2.78 0.33 3.03
Vicon Casemept/Awning 0.47 2.13 0.34 2.94 0.31 3.23
Vicon Picture Window 0.47 2.13 0.32 3.13 0.28 3.57
Vicon Designer Shapes 0.48 2.08 0.32 3.13 0.29 3.45
Temp.Clear Temp Low-E Temp.Argon
PATIO DOOR (pg 257-260) U-Value R-Value U-Value R-Value U-Value R-Value
Harvey Solid Vinyl Patio Door 0.49 2.04 0.40 2.50 0.37 2.70
Low-E/Argon* Low-E/Krypton*
WOOD WINDOWS (pg261.270) U-Value R-Value U-Value R-Value
Majesty Double Hung N/A N/A 0.35 2.90
Majesty Fixed Casement (PW) 0.37 2.70 N/A N/A
Majesty Casement/Awning 0.42 2.38 N/A N/A
Majesty Picture Window (DH) 0.34 2.94 N/A N/A
'The use of tempered Low-E glass may effect ENERGY STAR*qualification in your region.
U- and R-Values are subject to change without notice.
Not all products stocked at all locations. Call your local branch for availability.
Pricing and information are subject to change without notice&may vary from region to region.
ve 3/17103
For current pricing, call your local branch or visit www.harveyind.com.
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