55 RAYMOND RD - BUILDING INSPECTION (2) DATE:
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building i6&_ p n-xY Y A)a
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install Sidiu&9e eck, Shed,Pool
Addition, Alteration, epair/Replace, F ndation Only, Wrecking
Other: F
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inspector of Buildings:
The undersigned hereby applies for a permit to build according to the following specifications:
Owners Name:: M h A I`fA a Contractor: Christopher 2 n r Y
Street hIJn1"Y1 CitYSJIom Street 115 North Straat City_ Ga1am
State.MA Phone (q1g) -7,HJ4-SHLr., State MA Phone(97g) 741-0424
Architect: City of Salem LicA 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, Multi Family# Other
Estimated Cost of job$ �
Will building confirm tglaw? yes no
Asbestos?_yes ✓ no
Description of work to be done: sf--t I . one 6) reQ LQ D/)pn/ bba ) a)in oo)
D/)P ll� /oplQ 1142�Oi 1 l'YI p O /t)IYZ�O(A� i tJY Q(OU-Mtah�
Drawing b fitted:_yes no Mail Permit to: 115 NORTHTREET
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Signature of Applicati ,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:
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�\ The Commonwealth of Massachusetts
Department of Industrial Accidents
O///CO 0//OYOSU08//0®S
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
name:
location:
city Phone#
❑ I am a homeowner performing all work myself.
❑ 1 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.
compallyname: A & , A'^'Services , Inc . ie. St•ktr.:, atiy,,, ,
address: 115 North Street 7
city: Saleiii, I$A 01970w'«tr"' 0
PhoneN• 978-741-0424
insuranceco. The Tradelers policy# 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
it
address:
ct ,':", - hone#:
i f y+t,•lyn � �i
insurance co: olic N `F l�i'B. S
.•,. Ott 2..r, .
Company name `'',� � •
address
cif �.c
honep.,
insurance co. �;•� olle N,
Failure to secure coverage as required under Section 25A of MGL 152 caa lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or
one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER mad a fine of$10040 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
l do hereby cerafy n r he ins and penalties of perjury that the Information provided above Is true and correct.
Signature Date //—/ 7-0
Printname Christopher Zorzv, President Phone# 978-741-0424
official use only do not write in this area to be completed by city or town official
city or town: permitAlcense N nBuilding Department
❑Licensing Board
❑check if immediate response is required QSeleetmea4 Office.
QHealtb Department
contact person: phone it; flOther
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DIS?OSAL 0: D=B3T_5 AF:IDAVIT
in accordance with The provisions oI FGL c 40 , 554 , S ackno::ledge that as a
condition of 3uilding 9erm= t all debris resulting from the
consLructian 2CLiv1Ly gOVerned by this Building ?e -t shall b d-sDOsed aI i.
a properly licensed solid vasre disposal facility, as defined by MCL c III,
S 150A. Salem Transfer Station owned by:
The d=_Arll)el be disposed of at : Northside Carting
laczt-on of facility
Sig tu:= of =t Az)piicant Date
ully co_plete the follo::ing information:
(?lease print clearly)
Chri§t6pheicZo;iyc .
Name of Permit Applicant
A & A Services , Inc .
Firm Na_e, if any
115 North Street , Salem, MA 01970
Address . City 6 State
The above stature --quire` that debris from the demolition, renovation. reha'
or other alteration of building or structure be disposed of in a properly
licensed solid _aste disposal I2cility as defined by t:GL cIII. 5150A and T,`la
building permits Or 1-ceases are to indicate the, location of the 22Cility at
liu:I'll of Building Regulations and Standards
tiL HOME IMPROVEMENT CONTRACTOR
Registration: 101609
Expiration: 6/26/2006
Type: Private Corporation
A&A SERVICES, INC
Christopher Zorzy
115 North Street !L—�.� �r�✓
Salem,MA 01970
' Admill islrahrc
Commonwealth of Massachusetts
Division of Occupational Safety
Robert J Prezioso,Deputy Di..1, Q
Deleader-Contractor II�p
CHRISTOPHER ZORZY
Eff.Date 1,2/19/03 '
Date 1220/04
OC
' DC0004404
Member d CO.N.E.S.T.
80 .
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' ./�te L/dnM)CO'KU/va[t/L o�✓�.ad1aC�UGC�t'd C.
?; BOARD OF BUILDING REGULATIONS
.. License: CONSTRUCTION SUPERVISOR t
Number: CS 057733
Birthdate: 05/26/1958 i.
Expires: 05/26/2005 Tr.no: 12224
Restricted: 00
CHRISTOPHER ZORZY
115 NORTH STa.b
SALEM, MA 01970 Administrator
` OR U-VALUES AND R-VALUES
' ENERGV STAR
M/�RVFv/NOUSTRIES Harvey Manufactured PARTNER
= 0. Windows and Doors
t` E
WHOLESALE PRICING
�y' • 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
Low-E/Krypton quality for the ENERGY STAR® program throughout the U.S.* isosom
a
Clear Insulated Low-E* Low-ElArgon*
U-Value R-Value U-Value R-Value U-Value R-Value
VINYL WINDOWS
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 0.34 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(p9190-231) 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
Vicon Classic Double Hung (N/elded Sash&Frame) 0.49 2.04 0.36 2.78 0.33 3.03
Vicon CasemeRt/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 (pg 261-270) 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.
ffective 3/t7/03 For current pricing, call your local branch or visit www.harveyind.coin.
E
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