22-24 ST. PETER ST - BUILDING INSPECTION The Commonwealth of Massachusetts
4 Department of Public Safety
�JII( Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-
Famil Dw in
('This Section For Official Use Only)
Building Permit Number: Date Applied: Building 'cial
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for hich a street a ess is n
2 -J4 s+_ Re4-er's MA- 2�0
No.and Street City/Town Zip Code Name of Building(if applicable) "-'
SECTION 2-PROPOSED WORK
Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Building❑ Repair❑ Alteration E� I Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No El�
Is an Independent Structural Engineering Peer Review required? 1 Yes Cl No Er
Brief Des ription of Proposed Work: I n 5+-a li 10 d0i.tlo l.0 nkV, y(v�./ PPDIci_cn M-PM'�
uj v cko.,aC
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY _
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) O
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq,ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑
1: Institutional I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-113 R-2❑ R-3❑ R-4❑
S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ Ill O IIA ❑ IIB O IIIA ❑ IIIB O I IV 13 1 VA ❑ VB O
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑
Private❑ or indentify Zone: or on site system❑ required❑or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
5+-, Pe-1- 'SFcoe I C�I.trchl�NSt Pefei's 5� Soleh,, M11- 019_76
Name(Print) No.and Street 'City/Town Zip
Property Owner Contact Information:
ru 1TFIn , r-. Ik7ozdQ✓t I�i- -M —,,49-9. i Y30 - 5-5121
Title Telephone No. (business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
41 I R_Se"iW5 1 A C NorflASi- Sa lc w. 0IR-10
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If buildin is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O and ski Section 10.1
10.1 Re istered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Fv+-1`�4✓V i cv_$ l yc C
Company Name
Lhr s 7�Or24 C 5-05-I 33
Name of Person Responsi le for Construction License No. and Type if Applicable
1ISNO✓+SAS-- 5ck_l.Cv +lit- (-) iq-7a
Street Address City/Town State Zip
Telephone No.(business) Telephone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVTT M.G.L.c.152.§25C 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes a No 13
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$ N' R/
1.Building $ ( 1 .� Building Permit Fee=Total Construction Cost x AL(Insert here
2.Electrical $ appropriate municipal factor)_$1_.
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $ Enclose check payable to y i O�— se, .c Pn
6.Total Cost $ 13, g (contact municipality)and write check number here 13 Q
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate t e b st of m' knowledge and understanding.
Chris 7or2.i 44, 1 �r�i _v� l— 9-9-7`I1- 04d
Please print andsign name Title Telephone No. Date
�ISN0/ fi:S1-- ' � M bly 10
Street Address City/Town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Date
i CITY OF SM E:TM, iN'L3,SSACHUSETTS
• BCILDING DEPART.%MNT
120 WASHINGTON STREET,3"FLOOR
TEE. (978)745-9595
FAX(978)740-9W
[CI\1BERI.EY DRISCOLL
MAYOR THO?,tAs ST.PmRRE
DIRECTOR OF PUBLIC PROPERTY/BUILDIING CO:.06DSSIONER
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Annlicant Information r1 Please Print Lealbiv
Name(Business/Organizatiorvindividmi): �� i��11 T�Yr/t (.2S INLC•
Address:_ �_l s 1�(�✓
City/State/Zip: '-�ck Le-r-n (l') A- O t�1—i O Phone
Are y u an employer?Check the appropriate box: Type of project(required):
1. 1 am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑New construction
employees(full and/or part-tithe).' have hired the sub-contractors ,_,/
2.❑ L"J 1 am a sole proprietor or partner- listed on the attached sheet.: ?• Remodeling
ship and have no employees These subcontractors have S. ❑ Demolition
working for me in any capacity. workers'comp.insurance. 9, ❑Building addition
(No workers'comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
required.) officers have exercised their
3.❑ 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 12.❑Roof repairs
insurance required.)t employees. [No workers' l3 ❑Odter
comp. insurance required.)
'Any appliemi asa checks box#1 most also rill out the section below showing rhea workers'taxnprnmion policy miurm eon
t I romcowners who submit this affidavit indicating they are doing all work and then hire outside Minnesota most submit a new,affidavit indicting such
=Contractors that check this box must attached an additional sheet showing the name of Ow sub. ntmcmn and their workers'comp.policy infommtion.
1 am an employer that is providing workers'compensation insurance for my employees. Below Is the policy and fob site
information.
Insurance Company Name:—ao t/-0—I-e✓'S CC
Policy#or Self-ins.Lic.#:�n�'� M gI S- Expiration Date:
Job Site Address: City/StatctZip: .52L—e v lMrf 0 )q7(�
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 of criminal penalties of a
fine up to S1,500M and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 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.
UNCOMMON
I do hereby cerflfy a e he pains and penalties of perjury that the information provided above is true and correct
1 r Iorl ate: - 3D
Phone q-lq�, q4(
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/Lkense#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 1.Cityrrown Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: _ Phone#:
CITY OF Smym, N'LA ss.kCHUSETTS
BU DLNG DEP.kM.(ENT
` 120 WASHNGTON STREET,3' FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KIJtBE tLEY DRISCOLL
NMAYOR T Hoalns ST.Pmm
DIRECTOR OF PUBLIC PROPERTY/BU nmNG COM\MIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit # is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
(name of hauler)
The debris will be disposed of in :
.rvl / ✓CinS+� S+uAi nn
(name of
facilittyy)'
(address of facility)
signature of rmrt applicant
36 - / �
dat
e�erisarra�:
THE COMMONWEALTH OF MASSACHUSETTS
i ,EXECITCIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT
?1 ) DEPARTMENT OF LABOR STANDARDS
19 STANIFORD STREET,BOSTON,MASSACHUSETTS 02114 '.
DELEADER CONTRACTOR LICENSE
A&A SERVICES, INC.
115 NORTH STREET
SALEM MA 01970
LICENSE: DC000440 EXPIRES: Saturday,June 07,2014
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 DELEADfNG
WORK IN ACCORDANCE WITH M.G.L.CH. 111 § 19713(b)(2)AND 454 CMR 22.03.
HEATHER E.ROWE,DIRECTOR
a�7irmronmea(l/o C%�lmreac.aruc(!i t.Zlt Massachusetts -Department of Public Safety
Office of Consumer Affairs&Busi ress Regulation Board of Building Regulations and Standards
OME IMPROVEMENT CONTRACTOR Cpustruction Supervisor
egistration 101609 Type: License: CS-057733
xprration:. 6/26/2014. Private Corporatio
CMUSTOPHER ZORZY
A&A SERVICES INC„i 115 NORTH ST "
Salem MA 01970� a
Christopher Zorzy -
115 North Street
Salem,MA 01970 - Undersecretary J,,�,,,, Expiration
commissioner 05/26/2015
� = n
P1 l :ly Iinz . I t j
Llt _pi 9 ix 0 Certainiffeed
4
jChnstopherZorzy #20120426000640
A&A Services Inc Exp 4/262017
p��pr�ii� y�ng 115 North St <._ .
SDb 1 CHRIS ZORZl Salem, MA 01970
Matthew JGibson
. ns�yei cviacmv�r�s
r asma FgA.
�6T
bro", A & A SERVICES, INC.
A&A SERVICES 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
WINDOWS AND STORM PRODUCT SPECIFICATION SHEET
Buyer(s)Name - Date of Contract
J - I k4to ii .:5,-ii i C t,u r Lr /z zd
Buyers)Street Address,City,State and Zip Code
2.'f I S+- S--, fe,L /M. 0/ d
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
Bdt,--Ai .AQ co
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 Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification
Sheet is a pan.
WINDOW REPLACEMENT
611) s S forws Wef
Remove and dispose.,of ��;;,,,At//#� existing windows. �SASGte x 1 .J�'S,
Install # -F& / new .Vu nris'e ✓din rivarj ZrIMwindowsd)inyl t Wood
(Manufacturer) /- /
Options: Style Doa6 2 Hma rPrP1 YCej Gnd pattern r n k(/ed. ds be r.(!'W 7 Ji95
1��—
Color Interior LJ I91 IC. Color Exterior 17 r�-P_ Glass Type
f Wrap exterior trim with aluminum: Style Color c}LO GU t
t All windows will be installed according to the installation procedures in the portfolio. ubj.e PA'A.G
dt_�
� aulk all interior and exterior edges.
�Ot Insulate where possible around new units.
t Insulate window weight pockets if exist,and around new window units where possible.
t Included in this proposal are set up,clean up,Helps vacuum and cleaning windows inside and out.
t uilding permit included
+ "velfL,;nsl»11 �x st;ngs�psC;n tgsror�
BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS
I Create new window opening by cutting through existing home and framing in opening.
If Remove and dispose of existing units)in its entirety.
Note:Electric and plumbing may exist in wall and will require additional costs to customer if need to be dealt with.If Install window(s)into opening(s).
Note: V Bay or Bow installation to include cable support system,new roof system(matching color as close as possible)
or tie into existing soffit system.
t Bay t Bow t Casement t Other windows)to include new interior style trim and new exterior style trim and head
flashing as needed.
If Note: Painting and staining not included.
STORM PRODUCTS
f Remove and dispose of# existing storm window(s).
t Install new storm windows# Manufacturer
Style Color Option
t Remove and dispose of# existing storm door(s).
If Install new storm doors# Manufacturer
Style Color Type: If Aluminum f Solid Core
so �e on; SoA) FronfoP at;ilinoOi� o, sI',whit �E
Io,V 6jAc cu hil OF ZNd 1 Lk ar /brA�t;rha fWM j 2o'n rV4y'sidL.15t YF
SPECIAL INSTRUCTIONS: y j1,I Fnczsfs o(7A•ee.
a ( ows f h4�e'tUp� II s ts/Zti rRn.pcs
. ' BIOCK t '7'Ac�le 139 IhioCP s/�,5�fri'I
�{� 38/ S F/EiC -� ✓
lri pie wP.0YG2r5'tr'�I'Ag
A )i- roi�d- III� Front"ZFL.
It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms.This contract may not be changed or Its
terms modified or varied in any way unless such changes are In writing and signed by both the Buyers)and the Contractor. Buyens)hereby acknowledge that Buyers)
has card this Specification Sheet. /
Contractor Initials: �� Date: y �01 13 Buyer's Initials:��� Date: ' 1 Z2(Jf
^ A �0 A & A SERVICES, INC.
UA SE R 115 NORTH STREET, SALEM, MA 01970
Telephone:(978) 741-0424 Fax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
MISCELLANEOUS SPECIFICATION SHEET
Bu r s Name Date of Contract
Ess sc C f z z d 3
Bu ers Street Atltlress, Clt .State antl Zi Cotle
..Or At4_C)l q 7o
Oa ime Tele hone Number Evening Tele hone Number Mobile Telephone Number E-Mail Address
_y
The Buyer(s)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 Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification
Sheet is a part.
SPECIAL INSTRUCTIONS
U) YliA
/ &Oi ,2 tr e 4nCl 41 C 061 r <o l'. ',I
-
t �zo11fs7/ may( C�6ACP fls,U�¢�ucl -Ttriyt-tou1- 66A« s /tIzl �
a �NSIAII dNZ SIAA1fi5� (/ Vin itv4(8 Se{iPS ( �Ui+E V�VIu 7:in+V
of 3 P t,n a w', L;t-e g rid
ki
<lrvsal.4�e grcu,ut� tr„i-1- �Cflul#� „n-1:+��-eases
(Q2Vef� 1
e G1 �h UD ,Aft ToB C�2j.41r� debf;s
a y�1 keoQu 5E e-_C�2 LU
i—u11� nsurp,A + LI3E� 1 c�"i7 Sue e da�elFs .a�a 1 Kin/
ld 04ia 'l%I.ntl rt/jed
It is agreed and understood by and between the parties Nat this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
the entire understanding between the padles,and there are no verbal understandings changing or modifying any of the terms. This contract may not be changed or its
semis modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and the Contractor.Buyers)hereby acknowledge that Buyers)
has read this Specification Sheet.
Contractor Initials: J L Date: ZO 3U Buyer's Initials:"-7`� Date: " 2 Z@t 2tleS
W Aer:de
'"` A & A SERVICES, INC.
A&A SERV'/�V ES 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
Buyers)Name Date of Contract
S 1�e�EQ s o h I Z zo 1
Buyers)Street Address,City,State and Zip Code
Z �L S+- Pe+9--s S-I--
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
iT�- q70 5V6/ 3 ua,,4-1- .
The Buyer(s)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 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
❑ Remove and dispose of# d A) existing entry door units. 7s'4,1 ndA fd P"+y
0,Wrl 31se&
❑ Install new entry doors# 61A/0 Manufacturer f2(-0✓IA /series—i/n/7-rP:;id2tlTill 6alt1�3 .
Location_ '.?IVJ FL 0q;li S i3u ns; kil � oguftg£ ynooth51420
_/ (—Pr-"�.l kn.,
Type: WSteel ❑Fiberglass ❑Sliding Patio Door ❑French Hinged Patio Door r n 15��r crii
Model# Sidelight(s)# Sidelight(s)type/model# C Aor-42
OPTIONS:
❑ Adjustable threshold for door. ❑ Grids for patio doors: Style:
Prefinished Dyes ❑no color: interior_ exterior_
❑ Expand or shrink the size of the opening Details
❑ Cover exterior trim with aluminum coil stock: Style Color
Hardware: ❑ Lockset ❑Deadbolt ❑ Footbolt ❑Mail Slot ❑Peepsite Detail
pi/'Replace interior trim as needed. Details -Z#I �'UC i X S 1o0�e
Replace exterior trim as needed. Details pj'"42ri /'t^� �31.1'E _
❑ Install oak strip at floor as needed. r PMP AnA ins+A 114'h'oh of K2 3005iti rim &.�,-I—deivwa
(sAAP- S �Ani�g14'lNoeX+, iagnile �i heri c�(liTd
�ulk interior and exterior edges. r?(pp And n,�}�9 ilA4 ip/'icF'N*C-O00 $1
Insulate around new door unit where possible. VEa96` Closet- S.{g�evt
❑Painting is not included. Details
d Included in this proposal are set up and clean up.
STORM DOOR
❑ Remove and dispose of# existing storm door(s).
❑ Install new storm doors# Manufacturer /series
Style Color Type: ❑Aluminum ❑Solid Core
❑ Location:
❑ Hardware style Color
SPECIAL INSTRUCTIONS:
�i 11 •^g£ <+oe` gyps Bat r Lng of
a1CA=r SfAgl 1-};1ncs, rein�or�� ea �5 inef-qR
/ wt c
Floiir 4 " BA ll,<ehe vg H i ope5
r �rP�crosbod �ran�+ SInR ��A;v+1 fC for @c f�5ide5 rzc�—�old�)
It Is agreed and understood by and between the parties that this Specification Share,along with the CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,consti-
tutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms.This contract may not be chango�
or Its terms modified or varied in any way unless such changes are in writing and signed by both the Sevens)and the Contractor. Bavaria)hereby acknowledge that
Buyer(a)has read this Speciificatlon Sheet.
Z 1
Contractor Initials: �/ Date: ZC7 3 Buyer's Initials: Date: X 0
41�
30'�
,, w �+��'] /1>�,c►F A & A SERVICES, INC.
A&A SER CES 115 NORTH STREET, SALEM, MA 01970
• •• Telephone:(978) 741-0424 Pax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
Bu er s Name A Date of Contr ct
- 'el"'e(i S _�rs[ofFl KrG/�1 12 2() I�
Bu rs Street Address, Cit State antl Zip Code j
{ . Q s5{ - Sf o! Zo
Oa ime Telephone Number Everning Telephone Number Mobile Telephone Number E-Mail Address
7$ N3d- 6 r ce
The Buyers)listed above hereby jointly and severally agree to pureness the goods andlor services listed on the accompanying specification sheets,in accordance
with the prices and terms described on the font and the reverse of this agreement and any specification sheets(this-Agreement'),and Buyer($)have requested
that such goods or services be installed or provadetl abet Buyer's address listed above.A&A Services,Inc.(Tontmaor-),hereby agrees to install or cause to be installed
the products or services listed in bass Agreement at the Buyers)address ended above.This Agreement represents a cash sale of goods and services.The Buyer($)
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. ni
2 p
Purchase Price: JO S �h ,J Est.Starting Date: TAP) r3i
Dawn Payment Q ro GA'U_ Est Completion Date:5V1 2.
brO /XIV! ///(/C/ U�Cas
Amount Due on Stan of Job: ° eck
Amount Due on_af Completion: �rr rl f� gyp- o Cretlit Card
Amount Due on of CompletionCAI f: ' Expiration Date'
Balance Due on Upon Completio (�—� / 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 more are no verbal understandings changing or modifying any of the terms of this Agreement.Buyer($)
hereby acknowledge that Buyer($)has read the front and the reverse of this agreement and has received a completed,signed and dated copy of this
Agreement,Including Me two attached Notice of Cancellation forms,on the date first written above.Buyers)also(i)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
Contractor believes Buyers)would be interested in any additional quality products or services of Contmetor.DO NOT SIGN THIS CONTRACT IF IT
CONTAINS ANY BLANK SPACES.
A&A Servi s,Inc. Buyer($)
By: /� l� IT_ s
Signature —
f i Signature
Print Name r
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.
ARBITRATION:The contractor and Ire nonpareil hereby herein y agree In advance Met In the event eilher par,has a dispute wn¢mmg mm mahout sinter perry may subMt such dispute to a
andure arhiustlan sari v i ich has bear apaoved by tho Saueuryd the Saudi Oafs of C nsomer Affairs and Body—Ragmabona and In.Other pan,mall te re,i 1.submtlo such
summer as prof N in M.G.L c.142A.
cammao -I St L Bayer,install,
Dora_ ,sabre s: ;O Oae'.i t JZO(S
NOTICE OF CANCELLATION NOTICE of CANCELLATION
Date al Tansaction You may wnwl Nis Vansavtion,wilhu m any penally or Data of Trade ad -Z � 3'.a my cancel this mostionon,a thwt any penalty or
Wigadoquithin tares Eu ness ayslmm Ne Grove date.If you-coal,any prop¢,traded in, obligation,MNin Nree bu tlayshom the shad dale.Ily umbel,anypmpedytreded'm,
any mrprtsmade by Un P¢ 'Conant w Sale,and any regdtiable insaumerleaecoed any payments cede by you under the rnntratl w sale,and a,negotiadeinslmnenlamcmM
by you vNl bereform acres to days Idloxing receipt by Me Seller 01 your cancellation no4w, by you will be learned amain 10 days Whose 0 receipt ev the Seller or your about notice.
and any security Interest easing om of the transaction fall[e centred.N year canded.you rust and any Semnry Interest¢ding out or to transaction vall be cancelled.It you camel,you rm¢t
cake available to the Seller at your evidence.and substanbalry in as good¢edition as Mien ,rake available to the Seller at your reducands.and substantially in as good condition as when
ived,say gooda delivered to you antler this Canbat or Sale;or you may.Il yea MsR ornery moved,any goods Salvador to you under Mis Conladrt Sale;w you not it you Msh.madly
War the reardefons or the Seller,¢gaming the return chiment 0 the goods M the Sellers wiar the insbuctiws of the after re0arding the rearm shipmnl of Me goods at me Sellers
everse and riak.It ym do ha a 0e goods available to Me Seller and Me Seller does not out aspens¢and risk.If yen do make the goods available to the Seger and Me Seller does not pick
Main up,Min 20 days M the dale of your Notice of Canmlla4on,you may resin or disease of the them up MMln 20 days of Me date or your NoSm of eardru ,you tray retain or dome 0
goods wiahom any Mercer enigma If you fail to make Me goods constable to Me SelM,or if you the goods,Mom any knew obligation.If you tail to make Me goods available to Me Seller,or it
agrea k,arum Me goods to the Sal let and fail to do W.Men yw remain Ya III e for pedomance of you agofWreturn the goods to the Eater and fail td do so,then you remain liable for pMgmance
all chligarme under Me Comes.To cancel Mrs t2n5aron,mall w deliver a signed and dated of all oblamons under as Caneart To annual this trenSeNod,nail or deliver a signed and dated
may of Me candearliker cause or
youlden
115NMh Street Salem MA01970nNOTLATER THAN MIDNIGHT OF eg2' eI A6AA�oes 115copyNOM5¢eL W be Solem MA 019T0ards reads or nNORATER THAN MIDNIGHT OFoo a;1 1ASeryices,
mar
I HEREBY CANCEL THIS TRAN$ACTON 1 HEREBY CANCEL THIS TRANSACTION
consiner's$ignNure Date:_ Consurrers Signature Dale:
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Phone: 978-741-042 4
Fax 97 012
A&A SER www.a-aservices.com
• • 115 North Street
Salem,MA 01970
December 30, 2013
City of Salem
Building Dept.
120 Washington Street
Salem, MA 01970
To Whom It May Concern:
Enclosed please find the permit application for St. Peter's Episcopal Church, 24
St. Peter's Street, Salem, MA to replace windows and an entry door.
I have enclosed a check for$159 based L your fee schedule e of$11 per$1,000.00
plus a$5 administrative fee.�The total for the job was $13,81�5.06. Jam-—�
Please send the completed permit to A'& A Servict es, Inc. at 115_North Street,
Salem, MA 01970.
If you have any question" s, please contact me at (978)741-1042.
Thank you for your assistance.
Sincerely, r
Barbara Z�y C
Office Manager
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