28 RAYMOND RD - BUILDING INSPECTION (2) ' 0 u.) a �d
The Commomvealth a�s�aFVtb]a¢t( 'giRVIC
G$ CITY OF
Board of.Building Regulations and Standards ,
i%�J Nlassaehusetts State Buildi 7 CN R SALENI
Revised Mar 7
° . �°l d �: 49 o/l
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One- or Two-Family Develling
(� This Section For Offigial Use Only
l " Building Permit Number: D e A lied:
Building Official(Print Name) Signature Date
4�J l SECTION 1: SITE INFORtNIATION
1.( roperty Addres : 1.2 Assessors flap& Parcel Numbers
�
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
P Y
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required ProvidedP1.7Flood
uired Provided Rzquired Provided
L6 Water Supply: (NLG.L c.40, §54 Zone Information: 1.8 Sewage Disposal System:
Public❑ Private ❑ Outside Flood Zone?
Check if yes❑ iblunicipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2KOwnetrt cord:
alev.-, MIN- 01q-70
Name(Print) City,State,ZIP
a � Y�A.tMo✓v� ILL— —
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteratton(s) Addition ❑
Demolition ❑ I Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Propos Work': f tt C i a P S
0-5✓1_5�j— Irn0 ra
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
L Building $ 30 i I. Buildin; Permit Fee:$ Indicate how fee is determined:
�. Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost' (Item 6)x multiplier x
IPlumbino S
2. Other Fe
es: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ --
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ 3o- ❑Paid in Full ❑ Outstanding Balance Due:
I
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
r.la p S Gc9�2�{ License Number Expiration Date
Name of CSL Holder 1
J�S Alo/ 5 I List CSL Type(see below) u
No. and Street Type Description
Y-76 U Unrestricted(Buildings up to 35,000 cu. R.)
Ctty/Town,State,ZIP R Restricted 1&2 Family Dwelling
M I Masonry
RC Roofing Coverinc
Ps Window and Siding
Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
� S2ir� �sDI (o09
� IncInc -
HIC Registration Number Expiration Dale
HIC Company Name or HIC Registrant Name
/L S m a ✓fi(2 S�-°
No. nd Street
�LL n \ 11n /]_. O Email address
City/Town, State,ZIPS l R 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 .......... No........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject property,hereby authorize �I y -S 20./2
to act on my behalf, in all matters relative to work authorized by this building per it application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
Bye ring my name below, I hereby attest under the pains and penalties of perjury that all of the information
cont ' d this ap lication is true and accurate to the best of my knowledge and understanding.
� r� q _?�6.,t
Print Owner's or Authorized gent's Name(Electronic Signature) 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.masaQov/oca Information on the Construction Supervisor License can be found at www.mass.gov/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"
r —
t ji: — The Commonwealth of Massachusetts
a F Department of Industrial Accidents
}E
r i office oflnuestigations
E ! .
600 Washington Street, Tl' Floor
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors
Annlicant information: Please PRINT leeibly
name:
address:: //J l VO✓ttt SfY-etLT
city JCnl2 kt,\ state M14zio, 6/770phone# 97?--7"1i-oVay
work site location(full address): 92! „Q s/M 0✓y-CL ^cu.�,,/ "::�'' l.�lr\� 1 s'O �,t A-- 6-1-9 7 U
❑ 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
21 I am an employer providing workers' compensationg for my employees working on thisjob.
Af ?T company name: -'s—Za—V
address: f 1 .S A/0 ✓1-11 S�1
city: i tm, M phone 0: O — / I Y
insurance co. _- 01 'Q b� '.S policy V AA CI Is
❑ 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:
city: phone#.
insurance co. policy#
company name:
address:
city: phone#:
insurance co. policy#
Attach additional sheet ifnecessary
Failure to secure coverage as required under Section 25A of MGL lit can lead to the imposition ofcriminal penalties of a fine up to S1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and it fine of S100.00 it day against me. 1 understand that it
copy of this statement maybe forn/tothefee of Investigations ofthe DL\for coverage verification.
t(to hereby/certify un( th pais of perjury that the information provider/above is ttrite and correct.
signaturA/ �7 Date
Print name Phone#77 .
- " official use only do not write in this area to be completed by city or town official
city or town: permit/license# ❑Building Department
[]Licensing Board
❑check irimmedi:ue response is required ❑Selectmen's Office
❑Health Department
contact person: phone#; ❑Other
eovised Sep,.2003)
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Certificate No: A043066
r THE COMMONWEALTH OF MASSACHUSETT,S
sir` EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT
�i DEPARTMENT OF LABOR STANDARDS
` 19 STANIFORD STREET,BOSTON,MASSACHUSETTS 02114
DELEADER CONTRACTOR LICENSE
A & A SERVICES, INC.
115 NORTH STREET
SALEM MA 01970
I
LICENSE: DC000440 EXPIRES: Sunday,June 07,2015
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 1 I § 197B(b)(2)AND 454 CMR 22.03.
HEATHER E. ROWE,DIRECT-0R:,
1
1 T
3Dard of 9,11Jing Office Of Consumer Affairs&Business Regw:w,bn
( mtruemn Su pe n i.„r > 5C—�_. HOME IMPROVEMENT CONTRACTOR
_scans- CS-057733 ,�- Registration: 101609 Ty6e:
'Expiration: &25/2C16 Private C a ooratio
CHRISTOPHER ZORZY "
115 NORTH ST A&A SERVICES, INC
Salem NIA 01970i s'
Christopher Zo¢y
115 North Street
f
Salem, MA 01970 -----_�
��mmriicm 05/26/2015 Uadersecretan
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+ Phone: 978-741-0424
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A e Fax: 978-741-2012
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Since1982 www.a-aservices.com
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f"►&A SERVICES 115 North Street
Salem, MA 01970
Date:
Work Specifications for Roofing Projects
Name: , O L (_i
Address: (, -�e y AAcO(� RDL_
City: State: IN Zip Code:
Areas to Be Re-Roofed: fD d IV 1,r1da1v
Roof Areas Excluded from Re-Roofing: r
P2Waste
ullPermit with Community as Required.
disposal is included u ing eithe dump truck r dumpster. If dumpster is utilized
(site location: PC_ as agreed to by the home owner), it will have plank
stock put under dumpster as property protection.
Tarp house from fascia board to ground and beyond to protect house from falling roof
shingles. A&A Services makes every attempt to protect home, decks, driveways,
landscaping, and shrubs. Due to the heavy weight of roofing shingles coming off the
home we cannot be responsible for damage to landscaping and shrubs.
0Strip roof of G NG- layers of roofing shingles.
5. Inspect roof deck after removal of shingles for any rotted wood. If any replacement is
needed, the first 32 sq.ft. is included. For any o% pairs: 4x8 sheets of plywood
removal and replacement will be billed at $ LO per sheet. The charge for re�shhe thing
deck with 1/2" of plywood (go over exisiting roof, k), if needed will be $ per
she t. n-king replacement is billed at $�per linear ft., and carpentry repairs at
�jP
$ per hour.
Install GAF storm guard leak barrier 6' up roof from edge of fascia board (code calls for
3'). A&A Services is dedicated to using extra ice dam protection in our unpredictable
New England weather. GAF storm guard leak barrier/ice dam protection material is a
flexible membrane that sticks to the roof deck to prevent it from moving when shingles
are installed over it. This membrane self-seals when nails are driven through so water
cannot leak through it. t
stall GAF storm guard leak barrier 18" in from edge of rake (eave areas of the home).
This prevents wind-driven rain from penetrating the edge of your roof and causing leaks.
Buyer Initials: Date:
PFD
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Phone: 978-741-0424
a ernee W t OaO.J'J dO f/� Fax: 978-741-2012
since 1982 www.a-aservices.com
A&A SERVICES �'t W t r 115 North Street
a . . s FIAS�i V� -�- f C2'Ft�!!t3+4C Salem, MA 01970
,�nstall GAF storm guard leak barrier 36" in valleys of home and at any roof penetration
( / such as chimneys, exhaust vents, vent pipes and skyli V,'is for dded protection against
leaks. Cf�<<et K� ok tibf 5
a))Install
F-8" drip edge to perimeter of the roof deck. Drip edge helps support the roofing
shingle at all edges of the roof, manages water flow off roof and into gutters, and also
protects against wind-driven rain penetrating the edge of the roof. Available in 3 colors:
Mill (Aluminum), Brown, a White
10. stall GAF deck armor to remaining area of the roof that is not covered with GAF storm
guard. GAF deck armor adds another layer of protection against leaks from wind-driven
rain. It being extremely breathable, lets moisture escape from attic space and helps
preserve your roof deck.
011.1
stall GAF ProStart starter shingles at perimeter of roof. This is important because the
starter shingle has additional adhesive which prevents the first row of shingles from
blowing upward in heavy winds. ? 9 �u15 + C-e Sat-( e Xi S�-I� 3 G I `/�
U4/✓�
)(Re-flash chimney: remove and disp f old flashing, cut into mortar with grinder
approximately 8" up chimney, feed new lead into newly cut mortar joints, install lead in a
step-flashing manner, and run approximately 4" onto roof deck. Seal all edges with
Geocell sealant. Lead is used as a flashing material on chimneys because it is very
pliable. Lead flashing molds to uneven surfaces and stays in place for years.
Astall aluminum vent pipe boot with rubber gasket around all vent pipes and then seal
th Geocell sealant. This application prevents leaking around vent pipes.
�>Will
ntilation is a requirement for long-term roof performance and warrantee validation. It reduce energy consumption and create a healthier and more comfortable home
environment for you.
A&A Services will utilize the following type of ventilation system for your home:
Gable Vents: Add:
/ iCJtilize Existing:
l •/ Expand Existing:
Soffit to Ridge: (Soffit Vent as Intake)Add: Type:
• (Ridge Vent as Exhaust) Cut in as required and add GAF Snow Country Baffled Ridgevent to
ridge(s). Location:
Aluminum Slant Static Roof Vents: # Location:
Mechanical Ventilation (Electrician Not Included): #
• Type: Location:
Buyer Initials: ate:
-Jan,2015
Z:\A&A Common Folder\Referrals\Referral Kits\Roofing\Roofing Specifications Sheet
+ Phone: 978-741-0424
AGmce above Fax: 978-741-2012
�, `' ^
9nml%2 www.a-aservices.com
A&A SERVICES 115 North Street
. . Salem, MA 01970
tn/ re Pnssi
Onstall GAF Roof Shingles Style: I lot(IiA . )Color: 5 4-ke-WdOd. MICA- § 02-tu>44y-
A-rc1,L,;ed�QA
Nail locations vary by shingle and Uf slope. It is critical to fasten the shingle in the
proper locations in order to achieve desired performance and meet warranty
requirements.
• All nails that will be used on your roof will be barbed or rough-shanked nails and
will be resistant to corrosion.
• In most applications, shingles will receive 6 nails and all nails will be long enough
to penetrate min. 3/4" into the roofing deck. (Using 6 nails per shingle and
utilizing ProStarter shingles at rakes and soffits upgrades the wind rating of your
roof to 130 mph.
16. stall GAF Timberte "cap shingles. These shingles add the finishing
touch to the peak and/or ridges of your home. They are also designed to handle some of
the toughest areas of roof protection. '
_fJtQ have self-sealing adhesive that seals each shingle tightly and helps reduce the risk
of blow-off.
77. can off roof with blower to remove any debris. Clean out gutters of any roofing debris.
Rake clean all work areas. Leaf-Blow the perimeter of work areas. Go over grounds with
magnetic rake to pick up any loose nails. Please note: you may want to cover your attic
belongings due to roofing debris sometimes falling through the gaps in the roof deck.
That cleanup is not included.
18. is is a safety equipment project. We value our help and are concerned for your
liability.
19. upply owner with partial leftover bundle of shingles to have in the future if needed.
20. &A Services is a certified GAF installer. We follow all Massachusetts building codes
and GAF manufacturer's installation requirements. By-de{n
See warranty for more details. Massachusetts
Law requires contractors to warranty their work for 1 year against installation defects.
A&A Services offers warranties for their roofing work for 10 years against installation
defects. If any problems occur at any time, A&A Services will come out free of charge to
evaluate and help our c tourer hrr�ugh any manufact er's warraa claim.
Buyer Signature Salesm'nSignature
Date: � 1 J�P4 All /,�I�fNCl/A Date: *45
Buyer Print OY�/S ✓�G laP, Salesman Print T
Z:\A&A Common Folder\Referrals\Referral Kits\Roofing\Roofing Specifications Sheet-Jan.2015(2).docx
130 A & A SERVICES, INC.
A&A SERVICES 115 NORTH STREET, SALEM, IYtA 01970
• Telephone:(97S) 741-0424 Fax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
Bu er(s) Name Date of Contact
n �� 5 a,
Bu er(s)Street Address. City,Stale and Ze
Coda
Y,,��d. I-e-devs 11417 c�rQzc�
Da ime Tele hone Number Evenin Tele hone Number Mobile Tele M1one Number E-Mail Address
The Buyers)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 described on the from 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.A&A Services;Inc.("Contractor'),hereby agrees to install or cause to be installed
the products or services listed in this Agreement at the Buyers)address written above.This Agreement represents a cash sale of goods and services.The Buyers)
agree to pay in Cash the cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyers)may seek for their
purchase.
Purchase Price: /J / IC /
d "LL� Est.Starting Date: /
Down Payment `"� 7 _ /CGI�(as� Est.Completion Date: A../
ash
Amount Due on Start of Job: furl Check
Amount Due on of Completion' Elf Credit CardNo.
Amount Due on_of Completion'. •' Expiration Dale:
Balance Due on Upon Complelio = 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.Buers)
hereby acknowledge that Buyers)has read the front and the reverse of this agreement and has received a completed,signed and dated copy y this
Agreement,Including the two attached Notice of Cancellation forms,on the date first written above. ceive s)also pl 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
CONTAINS ANY BLANK SPACES.
Contractor believes Buyer(s)would be interested in any additional quality products or services of Contractor.DO NOT SIGN THIS CONTRACT IF IT
A&A Services,Inc. Buyer(s) /� P
Signature F.SK�p
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.
ARBITRATOR This wmraceirand Inc---a'beraby muwalp agree I.mound.Thal m me avem enter party,has a dispute comammg this comae.either party trey submit such oispwe to a
prate annarrom service whedl has beer eppmv.to tine Sej myth a ,eculiSO Otnae of Consumer Affairs and Business Regulations and Inc other party shall be Pound to suEm.to such
artiVationmanduedm eGL e1JPA. !G 1i
Cnnlraclnr inilos: tluyri.Inil la
oat.-
��/, NOTICE OF�CANC LLB ???��/ NOTICE OF CANCELLATION
pale of Transaction EJ�.You may cancel Inns Iransactbq vnthoul any penally or Do.of Transaction et may cancel This Vansazlion.wilnout any penalty or
obfgrood,wllNn Nreeefff bossy((( days it=Ne above date.11 you cancel,any employ traded in, oblige Tvnlhin three Caysham the above are,if you cancel,any property Tabery.
any payments made by you under Me Contract or Sale,and any nesuribtetnslmmenl is.med any Payments made by you underthe Contract or Sale.and any comfortnegomplle executed
by you WII be returned vnNin 10 days following receipt by the Sol a of your cancellation entice, by you will be returned within 10 days lollwmg receipt by the Seller of your wnaellation notice,
and any security Have ansing out or Me Transaction MII be canceled.11 you cancel.You trust and any sewdly interest drift g out o1 Me transaction Pan be cancelled.II you cans you trust
trade available to the Seller at your remence,and alubslai in as good cards on as when make available to this Seller at your resident¢,and sunslantially a as gum condition as wren
received,any goods delivered to You under this Confused or Sale:or you nay,if you wish.comply moved,any goods tle:hered to yw vntler rllis Comracl or5ale:or you rray.Il you vnsR comply
van The Insuuclims of Me Seller regarding the return Shipment o:tire goods at the Seller's with me Instructions of the Seller regarding the return shipment of the goods sl the Seller's
expense and ned,It your do make the goods available to the seller and the Seller does nor pick expense and risk,If you do Make the goods available to the Seller and Me Seller does not pick
them
mmors 20 days of the date of YourNoece ofdi Cancellation,you may retain or seos.onne them up wNnm ze days of the date of your Notice of Cancellation you may relam at dispose of
goods t utany Nnherobigicon.Ifyo fail W of the goods available lathe Seller,or ll you the goods without any further obligation.If you fail to make the goods available or Me Seller,or if
agree to return the gems to the Seller and fail to do so,Men you remain liable for performance of you agree to rends the ord, to IM1e Seller and fad to do so.Man you remainliable for peopeanca
all Mligadons under the Contract.To Cancel this transaction mail or Spider a signed wind dated of all obligations under the Contract.To cancel this Transaction,mail or deliver a signed and dated
day
115 N nn.tan¢Ilalem nun Ar 1970.NOT-ATER id THAN P or send a lelegram�lBA S rvi e 11E our cane Saturn
nodca or ages.
NOT
L TER nouce..r sand a l¢/teen/ q6 5ervmei
115 Nmlh Street,Salem MA 019]O.NOT IATEq THAN MIDNIGHT OF 115 NonM1¢Treat Salem M4 019T0.NOT LATER THAN MIDNIGHT OF ///�jj,1
I HEREBY CANCEL THIS TRANSACTION �p I HEREBY CANCEL THIS TRANSACTION
Consumer s Signature pale'. Crrodursegralure pale: