21 VARNEY ST - BUILDING INSPECTION DATE: 419/D2
�itp Dfer7YPIYi, J' � �LUEtr
tl
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building al Yarn�� ��P el'
Building Permit.Application For:
`(Circle whichever applies) oo eroof, stall Si ' ctDeck, Shed,Pool
Addition, Alteration, R air/Replace, undation Only, Wrecking
Other: t
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: n�
Owners Name: �� I 5(y)Nni r- Contractor: A 9, A ServiciS'ehn5 f-f'TT
Street Al VayneU S - City' Street( 5 Nnr4h 2, city ., m
State,M-R Phone (qq5 7JIy-0($ 9 State M A Phone- 07`90)
Architect: City of Salem Lic# I W 05
Street City State Lic f Hw k O la C)9
State Phone ( ) Homeowners Exempt Form_yes Zno
Structure: (please circle(Single Fami •, Multi Family# Other
Estimated Cost of job S 2L 85y, DD
Will building confirm to law?—/--YCS no
Asbestos?__yes—/Lno
Description of work to be done: Cn /5) j/lr?U) re0/e2Gerne/'i,
.�sfall -LO /al effhVraMDrs LL5-Aa/l 'fh/rtt� /30) �
111n1J Remok6e eYlA-hnli laWfr O)Cr-00/"s
L� of home , /l?sfall 'a' kf (8) tl
A&A SERVICES, INC.
Drawings i d: es no Mail Permit to:-- 1 SALEWIVIA o1970
1.97R d1-042d:; . -
'{
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 S
com4ms:
i
i _ J
No. �o�C O�
APPLICATION FOR
' PER TO
LOCATION
i
PEIMIT GRANTED
A ROV.fp
INSPECT , OF BUILDINGS
CMTTMCATE OF OCCUPANCY -
YES
NO t
• .. �. 1 I .—. r • • � �• a} ' t •ram•
The Commonwealth of Massachusetts
WDepartment of Industrial Accidents
Office of Investigations
600 Washin ton Street
Boston, MA 02111
www.massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information /1 /� Please Print Legibly
Name(Business/Organimtior✓Individual): K
. r1 jor yi (Q t
Address: \
City/State/Zip:_�JGLI p.M M i:1 C)l�l w Phone M / �1-N 1 241 — 0L� 9,H
[2.
re ynu an employer?Check the appropriate box: ' Type of project(required):
I am a employer with� 4. ❑ I am a general contractor and I 6. ❑ New construction
employees(full and/or part-time).• have hired the sub-contractors
❑ I am a sole proprietor or partner- listed on the attached sheet. t ?• ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers'comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
3.❑ t am a homeowner doingall work right of exemption per MGL I L Plumbing g P P ❑ g repairs or additions
myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ oofr�e�air�s/insurance required.] t employees. [No workers' 13.Ljv Other_"
comp.insurance required.] `7
•Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Ilomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such.
;Contactors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. —t�
Insurance Company Name: trAe-- Tr'QyO I e :S
Policy#or Self-ins. Lie. #:_ W C 9 �C? X 1�`o� (O Expiration Date: q{ "l- .1 Q-7
Job Site Address: 5TIY
l {r U P-eqL City/State/Zip: Satx,M t UP o (q 70
Attach a copy of the workers'co4ensation 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 P p ]hes of a
fine up to $1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of tip to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
lnvestigations of the DIA for insurance coverage verification.
:1do hereby certify u eFepainspenalties ofperjury that the information provid�e?d above is true and correct.
ature: Date: d 7 Q
Phone#: {
[=a
only. Do not write in this area,to be completed by city or town official,
n: Permit/License#
hority(circle one):Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
son: Phone#:
i
Information and Instructions
.Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the
members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-26-05 Fax # 617-727-7749
www.mass.gov/dia
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. 111, Sec.
150a.
The debris will be disposed at: Salem Transfer Station
owned by Northside Carting -
fill
S�igngtft of Permit pplicant
Date
Christopher Zorzy
Name of Permit Applicant
A &A Services, Inc.
Firm Name
115 North Street, Salem, MA 01970
Address, City, State, Zip Code
s
Board of Building Regulations and Standards
Construction Supervisor License
License: CS 57733
�9irfhda-te_5/26/1958
y Expication 5/?612009 Tr# 13739
-
CHRISTOPHER -
115 NORTH ST
SALEM, MA 01970 Commissioner '
Commonwealth of Massachusetts
Division of Occupational Safety
Robert J.Prezioso,Commissioner
Deleader-Contractor
CHRISTOPHER ZORZY
_ Eff.Date OM02107
Exp.Date 0M01/08
_ DC000440
Member ofCO.N.E.ST. 08
-- 1
80
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII BOSTRENEW.
�anuYLuu r.
I
. I� _,.P_�_._ �rze -�omrmxoouoe¢C(�i a�./�aaoaolzeeaeGYa
�\ Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration 101609
Expiration: 6/.26/2008 i
1 Type: Private Corporation - �
I A&A SERVICES, INC_ -
III1I Christopher Zorzy -
1 115 North Street
:Sale ;.MA01970
m
m Deputy Admrstr:,lor,..
A & A SERVICES, INC.
A&ASERMCES 115 NORTH STREET,SALEM,MA 01970
g• 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
Buyerls)Na / Date of Contras _
V�'� iI Clal�fL 7 -20 -o;z--
Buyer(s)Street Address,Cl State and Zip Code
12 / am jZron 5� • o/R7o
Daytime Telephone Number E ling Telephone Number Mobile Telephone Number E-Mail Adore.
I 9�F"-'Jy�l-61B'9 SoB- 633-��
The Buyerls)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 pat
do_.,� I' ACEMENT
Remove and dispo of# � ' tin7717 ,5/-55
.dlnstall # �� new -- c wind inyl ❑Wood -
(Manufacturer)
Options: Style-- _N 2:'_._46 aGrid pattern
Color Interior d Color Exterior Glass Type OlJ -G�r-1i
1 -❑ Wfap exterior trim with aluminum: Style Color
'[ :q_V//µ-windows will be installed according to the installation procedures in the portfolio.
Caulk all interior and exterior edges. ^� ^1'
j W. r/sulate where possible around new units. 9 1-�
p �/In Mate window weight pockets if exist,and around new window units where possible. __�__1�0�t<1p r.S�e
i I /peluded in this proposal are set up,clean up,Hepa vacuum and cleaning windows inside and put. 1 i�'"
Building permit included. - Se— 54
BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS
❑ Create new window opening by cutting through existing home and framing in opening.
❑ Remove and dispose of existing - mills)in its entirety.
Note:Electric and plumbing may exist in wall and will require additional costs to customer if need to be dealt with.
❑ Install window(s)into opening(s).
Note: If Bay or Bow installation to include cable support system,new roof system(matching color as close as possible)
or tie into existing soffit system.
❑ Bay ❑Bow ❑Casement ❑Other window(s)to include new interior style trim and new exterior style trim and head
flashing as needed.
❑ Note: Painting and staining not included.
STORM PRODUCTS
❑ Remove and dispose of# existing storm window(s).
❑ Install new storm windows# Manufacturer -
Style Color Option
❑ Remove and dispose of# existing storm doors s).
❑ Install new storm doors# Manufacturer
Style Color Type: ❑Aluminum ❑Solid Core
SPECIAL INSTRUCTIONS: , _ , r w
lam ' a xf
XZ✓.M astJY. . �(— _. on 147e Ag, .3r
/� 1 �+
N le agreed and understand by end between the Patlee that this SpecMcation Sheet,along ends CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
me Maine understanding between the parties,and Men era no verbal understandings charging Or rocal"ing any of the home.This aaaraa may rut be changed or Its
terms,modified or vae i in any way unless,such changes are In writing and signed by both the Buyer(s)and the Contractor. Mayans)hereby acl ndra edge that eugenic)
has need this Specification Shhas\/y��
Contractor Initials:_ i Jpa / Date: -7-2 c) Buyer's Initials: ad. Date: �Y
Ap � — @�iC��+� A & A SERVICES, INC.
I't.0 Ih S CES 115 NORTH STREET,SALEM,MA 01970
T139roM Telephone:(978)741-0424 Fax:(978)741-2012
Contractor Registration No. 101609
Federal EIN:04-3090162 Construction Supervisor No.GS057733
ENTRY DOOR SPECIFICATION SHEET -
Buyer(s)Name Date of Contract
Buyers)Street Address,City,State and Zip Code
� I a r olq�o
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address A
S08 633-6020
The Buyer(s)listed above hereby jointly are severally agree to purchase the goods anNor services listed below,in accordance with the prices and terms described on
this Specification sheet and the front and Me reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Speorcalion _
Sheet is a part.
ENTRY DOOR
¢/5emove and dispose of# — existing entry door unit/t
Install new entry doors k Manufacturer ' ^r M c- — /r'~
Location F a� a tia 4'rTe,•+e�-
fType: ❑Steel SmoothStar ❑Fiberclassic ❑ClassicCraft O Sliding Patio Door ❑French Hinged Patio Door
Model# Sidelight(s)# Sidelight(s)type/model#
OP�7IONS:
Adjustable threshold for ThermaTru Door ❑Grids for patio doors: Style:
ti ❑ Stain Kit: Supplied to owner
❑ Expand or shrink the size of the opening Details 1 1❑ Cover exterior trim with aluminum coil stock: Style h/f TI^ 5 rsg /`Z Color
Har ware: ❑Handelset �atlbolt ❑Foot6olt ❑Mail Slot ❑Peepsite
ji'stall oak strip at floor as needed.
/Caulk interior and exterior edges.
1Y Insulate around new door unit where possible.
✓P Inlln 'is ncluded.
Included in this proposal are set up and clean up. -
k STORM DOOR
(I
❑ Remove and dispose of# existing storm door(s).
❑ Install new storm doors# Manufacturer I
Style Color Type: ❑Aluminum ❑Solid Care
❑ Location:
SPECIAL INSTRUCTIONS: ("' •-'f tl �` `'"' �' r ^w;ezr:'a�
��YIOIP¢ %�Y li". ( a"fit t /eye
It lee reed and understood b and barween the artles Mal this S • ilicetion srreeR along with the CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,eonell ,
9 Y P Pa 9
or be the s media or Valli
In any n the unless
s and chore ere m verbal ng and signed y charging M or uymodifyings)an any er on demo.Thie wmnd may net be dge t ed
Pr ye derma need this
or veiled In any way unlace such changes ere in writing end signed by boN Me euyegel end Me CPntredor, auyer(a)heroby acknowledge that
Co tra hoe read iala Specification
Contractor Initials: Date: �2� Buyer's Initials: Date: -7 20
/�.� � �1 A & A SERVICES, INC.
AiASUq®W ICES 115 NORTH STREET,SALEM,MA 01970
a a a Telephone:(978)741-0424 Fax:(978)741-2012
Contractor Registration No. 101609
Federal EIN:04-3090162 Construction Supervisor No.CS057733
VINYL SIDING SPECIFICATION SHEET
Buyer(sLyime Date of Contract -
7. Zp -0�-
Buyer(s)Street Address,City,State and Zip Code /
91 , ! d1 -
i
Daytime Telephone Number Even g Telephone Number Mobile Telephone Number E-Mail Address
Sog-/33(dW
The Buyer(s)listed above hereby jointly and severalty agree to purchase the goods and/or services listed below,in accordance wiM 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.
VINYL SIDING -
N C) ❑ Remove antl dispose of g siding.
Note: �O dV existinI-5A, a 1 -
❑ Remove and dispose of old wooden gutters.
Remove and dispose of aluminum gutters.
❑ Install new.032 gauge��luminum seamless gutters and d win/spouts as follows:
❑ Olfen Gutter W'The Gutter Shutter Color: +
p Cover body of home with 3/8 inch thick Dow High Performance Insulating Bo rd. A
yr Cover all trim with aluminum coil stock including the following: Color: 1 e�
❑ window trim �n+ deluxe window him ❑ upper porch trim -
fascia boards o1$ t+ ❑ door trim Cl Other:
❑ frieze boards ❑ rake boards -
NU Install Soffit Panels: Style: Color: re.4OIy °Je—
p'Install vinyl Sidi9Bto body of home as follows: �-
Manufacturer: Color:
❑ Replace existing wooden attic louver vents with vinyl vents.
O Cover porch ceilings with Certain-reed beaded porch panels. -
❑ emove and r II existing shutters. r O N 1
�1'stall 8 air of lira in_ne.w.yJvinyl shutters. //Zrner Post style: ��a. z'F Color:
VlClgan debris from grounds on a daily basis;clean grounds thoroughly at completion.
Included in this proposal are the following items:
Ailding and Electrical Permits
e IX c Electrical work including removal and remounting of fixtures electric service,and wires.
asic siding accessories including light,outlet,spigot blocks,dryer vents,and exhaust vents.
SPECIAL INSTRUCTIONS: �.,n.•.,-
L�/ / �C� . . �. �Al'e/1 if Id}� ✓lam
fRIEZ
A&A Services, Inc. provides a five-year labor warranty on vinyl siding Installation to Include any re-Installation of any vinyl
siding,gutters, and aluminum coverage work due to any faulty workmanship. This warranty does not cover any Acts of God
Including Ice dams,lightning strikes,falling trees,ddmage from vandalism,or Improper use.
N la agnetl and understood by and between Ms parties that thls Specification Sheet along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT constitutes
Me dorm understanding between the parties and Mere am no verbal underetendinga changing or modifying any of the terms.This contract may not be changed or for
terms modlfied or vaded in any way unless such changes am In writing and signed by both the aurarm)and the Contmclor.Buyerts)hereby sclmawiedge mat Buyans)
has reed Mls Specification Sheet $� -
Connector Initials: Date: -7-�-c_/ Buyer's Initials:�(J`�. Date: .7-21,
A & A SERVICES, INC.
M SEWCES 115 NORTH STREET,SALEM,MA 01970
Telephone:(978)741-0424 Fax:(978)741-2012
Contractor Registration No. 101609
Federal EIN:04-3090162 Construction Supervisor No.CS057733
ROOFING SPECIFICATION SHEET .
Buyers)501Date of Contract
aWr� Sind-/ 1' -7- 2d-O
Buyer(s)Street Address,City,State and Zip Code
Qr^NE
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
9-7Y-7,qy-6/8 633-6OZ0
The Buyers)fisted above hereby jointly and severally agree to purchase the goods andtor services listed below,in accordance wit the prices and terns described an
this Specification sheet and the front and to reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which Nis Specification
Sheet Is a parL
ROOFING SPECIFICATION
Strip oof of# layers of shingles lZ -SQ,-��;
nstall 6'Of ice and water shield at base of roof where stall 15.b felt paper to roof..
possible. Install 18-24"of ice and water shield in valleys.Fol -
lash chimney as needed(no repainting included). nstall 6"perimeter drip edge to rakes and fascia areas.
A
❑ Install vent pipe boots and seal as needed. A-1 ❑ Flash valleys as needed /V ,4
❑ Install rollout type ridge vent. ik; tanks/plywood replacement under 32 SO FT included,
N/ *If more is needed there will be an extra charge of$
per hour for labor plus the cost of materials.
Dumpster/Di osal Included:q n ❑Other: ^�— �'.'k} rr -'
Location: 4 i pet sicQ¢.. A "SoiJ�
Install new roof: Manufacturer cc,kixived yr Style/type S- a b
Included in this proposal are thorough cleanup,building permit,and company/manufacturer warranties. �•
RUBBER ROOFING SPECIFICATION
O Strip Roof ❑Not Strip Roof -
❑ Install 1/2"High Density Fiberboard to existing roof using ❑Flash obstacles as needed.
screws and plates.
❑ Install.060 membrane EPDM(Black)rubber roofing to O Install 3x3 aluminum drip edge to perimeter of roof with
fiberboard.s seam tape.
❑ Flash up sidewall as needed.
Included in this proposal are thorough cleanup,building permit,and company/manufacturer warranties. -
SPECIAL INSTRUCTIONS. -yvw+1R/ '+.*mas,�a'"me` '"a'v"°r''a:"`"a,a'°w""' +r/1' rmlinxar ounna v -
.�/Ul�;l��aV
/S.,
I
It le agreed and understood by and between the podW Nat this Specification Shoo,along whin CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constituMa
the«tire understanding(between the parties,and there are no verbal unaeraMnafngs changing or modifying any of Me some.This contract may not be changed or Its
Motu modified or vanes In any way unless such mango ere In writing and signed by both Na auyer(n)and the Contractor-Footnote)hereby nclmowladge Net Buyers) ..
na.rate this Specification sines �} �y�/ - A -
Contractor Initials: Date: !' 7%{� Buyer's Initials: d/ Date: Zd
• Notes FN
A & A SERVICES, INC.
AiASaIMCES 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 n
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT .
Buyers)N / Data of Contract
Buyers)Street Address,City,State and Zip Cade -
0'2 Rr r� 7 all
Daytime Telephone Number Evening Te ephone Number Mobile Telephone Number E-Mail Address: '
49$�7yS/-o/8 So8'-633-(0620
The Buyers)listed above hereby jointly and severally agree to purchase Me goods and/or services listed on the accompanying specification sheets,in accordance with
Me prices and terms described on the front and the reverse of this agreement antl any specification sheets(Nis"Agreement),and Buyers)have requested Mat such
goods or servers be installed or provided at Buyer's address listed above.A&A Services,Inc.('Contractor),hereby agrees to Install or cause to be installed Me product
or services listed In this Agreement at Me Buyers)address written above.This Agreement represents a cash sale of goods and services. The Buyers)agree to pay in
cash Me cost of Me goods and services purchased as described herein,regardless of timing or approval of any financing Buyer(s)may seek for I purchase.
e:-/Purchase Pric ^ Sl Cafe-- S3 1-3 - Esc Staring Date:
Duwn Payment: O 060 Rf�} pr!$IOUA�-/0,tab Est.Completion Date:
�}{�e2 C�rMaQ�rtr+� (p ) �j
ofW(ndow>+ /3,oaa 10 (b �n; 6P vwT _-Iaso ah
Amount Due on Star of Job: / heck
❑Credit Card 1 O '
Amount due on_of Completion: '- 0
i Amount Due on of Completion: Expiration Date:
Balance Due on Upon Completion:/ Q 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 -
Buyer(s)hereby acknowledge that Buyer(s)has mad the front and the reverse of this Agreement and has received a completed,signed
and dared copy of this Agreement,Including the two attached Notice of Cancellation forms,on the data first written above. Buyer(s)also
` (q acknowledge that they were orally Informed of their right to cancel this transaction;and(li)request that they be contacted via their
telephone numbers or e-mail,as listed above, In the event Contractor believes Buyers)would be Interested In any additional quality
products or services of Con or. O NOT SIGN THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES.
A&A Services,Inc. - Bu r(s)
6y. A
Signature Signature J
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 data of this
transaction. See the following Notice of Cancellation form for an explanation of this right. -
ARBITRATION:m.mnaawr one Ma Wm,wnm n.mevream 1,,Name ran h Ma m,am aiMea pmry rim a e almta rareammg Mi.mntra,,.M,er part'may wane amdn dwmm m -
apMateaRNaOonwMW which huspace room try Ne eecntary of Ne_ warm of Con¢umn A,a. 9ue1 uReaukerms and the Wrer party of he rcmbeed to crowd to
elan e2itration e¢prwred in M G.L C.1¢3A. -
Convss tiah: z. /
w : O ad
�/N�OT[E OF osNr FI I aTV1N �8 NERIOR OF QANfFl a
Oats dd Trarommo, ( .You rots muel Nie dan¢aclbn.Mt11oN any penHlly w Dem d Trv¢b a-��`O You rots MMI via hau4bn.me.any[enBlly or
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anyi,cranemadeI ,ca under NO Cerad de Sela,and any reartleeaverrumem eveeeee any payments made by you under M,Contract or Sale,and any nove le lnewmnt exauead _
d/you MY be reWm9e worm 10 days mllmmp rewipt by Me Seller of your WMellems,coca. by You ,If W resume ansin lO days blowing mortal by Me BNkr d per,moalletion mete.
and my ewurry(capper among cut of Me tlamamlwt van W tanaenM.If you mnwl,you mart and any roomy imen¢t maing our of Me Marconi von In conceded. H You cane.You coma
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and. 11 yw do mere MB Boma eve iMde m He Beeler and Me sense ems not part Mein up risk If You eo make Me g0.M9 evalade to Me Soler and Me Seller MM not pork Mein up -
afMtoFar mays of Me doe of your Node W excellence.You may mean or tliamu of Me grade wfMin al dame of Me date of your Soars of Careartabn yw may main or blared of Me people
vNtwt any hater me"Imm.Il Year mil mmake Me'eras available he he Se for.or it you pree wiMmad my NMer daemon,,You mil to make the goods avalebM to the Sanm,aril You agree
to rectum Me 9.m Me sure,LN 1y1 to do ao.than You camel,(bible M pM.—a Mal to return Me Bmea to Me seller aria or m w ad,Men v ou comae exida 1a pmltlrmwn or ell
oblgalans under Me Comets To wnwl Me tr8nsacCon mail or chimer a synN and"Ed copy obl'gadanaurder Me Canoed.Tam itistrenaaNen.m811ordNNwasigw dWWww ,
d vie WMe118tbn mtice w any oMm weM1en rotice,or ae,tl a Megrem,m A6A5 of Me m wiMan norm or any other wrhtm M cards,or ae a tm,mm,m AaA
NOM Steel.Salem.Maysommed 019M.NOT_eMR THAN MIDNIGM OF Nand Semt,Salem,MB.veaM1UmM 01970,NOT WEIR THAN MIONKI OF 2
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I HEREBY CANCEL THIS 711sMad T10N. Conmmer a agnmm Date I HEREBY CANCEL THIS T0.WBACPON. Censurer Is sgnaead Dee