65B WHARF ST - BUILDING INSPECTION 2S 6 (o � 1
The Commonwealth of Massachusetts
° Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied
Building Official(Print Name) Signature ale
`-y
SECTION 1:SITE INFORMATION
1.1 Pro�pperty Address: rL 1.2 Assessors Map&Parcel Numbers
�0513 ltlhar-F c.�1 'r�
L l a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: _ p,� 1.4 Property Dimensions:
'
Zoning tstricFl Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑
Check if yes❑
SECTION2: PROPERTY OWNERSHIP'
2.1 Owner of Record:
Fl I I.Le ✓i yyl oor P a 12 vtil M 1q 0 l9?O
Name(Print) City,State,ZIP
(.eS6 (. kcty-:ES - y1?-ny- /38f
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building❑ 1 Owner-Occupied ❑ I Repairs(s) ❑ 1 Alteration(s) Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work': " 6 !/ i r C wilqda js Q
-1" 10vJS -00. - i-el J 0of ILJ i %Yt
W S' 0 .a. S W i
CIA, I i J Q 0 1 0 19/S
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: -
Labor and Materials Official Use Only
1.Building $ i 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ a s $ / ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES r�
5.1 Construction Supervisor License(CSL) O S 1 1 3 3 �J
ari J License Number Expiration Date
Name of CSL Holder
'/�— No✓yr . I List CSL Type(see below) U
No.and Street r', C3T Type Description
S��� M Q` D U Unrestricted(Buildings u to 35,000 cu.ft.
/'t / R Restricted 1&2 Family Dwelling
Cityrrown,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
p�p SF Solid Fuel Burning Appliances
1 I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
A -A-S IBC 2ry�ZFS �>2C • 1IC (Q9q la' �o��
HIC Compan Nam or HIC egistrant Name Registration Number Expiation Date
i 15 NYor
No. d Street Email address
taLe-,rr, f✓tlk o 19-7 0
City/Town,State,ZIP 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
I,as Owner of the subject property,hereby authorize r;S 70 r2�/
to act on my behalf,in all matters relative to work authorized by this building pe it application.
<� U,}v-Cl-C - 9-3O-13
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contppfined in th' application is true and accurate to t best of my knowledge and understanding.
Ghr, o �1 o-e- %'30-) 3
Print Owner'9 or Authorized Agent's N.me(Electr me Signat re) 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.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
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"
PICKERING WHARF CONDOMINIUM ASSOCIATION
57 WHARF STREET, STE. 2E
SALEM,MA 01970
Tel. (978) 745-9540
Fax (978) 740-6728
Trustees October 7, 2013
Richard Rockett
Michael Rockett
Timothy Shea
David Saia
Tong Zhang
Albert Moore
Ut. B-3, 65B Wharf St.
Salem,MA 01970
Dear Al:
This is notification that the Trustees have approved your request to install new
windows in your bedroom, replace two deck doors and repair dining room window in
your unit with the following conditions:
1. You are responsible for paying for this work.
2. If,within thirty(30)days after work has begun,the work has.not been
completed, the Condominium Association reserves the rights to either finish
the work or bring it back to its original state. You will be billed for such
work,plus 25% overhead.
3. All work must be performed in a workmanlike manner by a reputable
company licensed to do such work.
4. All proper permits will be obtained prior to installation.
S. You will be held responsible for any damage that occurs as a result of this
work including any leaks attributed to the new windows and doors and if
you sell your unit,the new owners would take on the same responsibility.
6. Windows and Doors will be exactly the same as existing or as close to what
is presently there. You indicated windows and doors would be Anderson
400 series products.
Please sign this notice and return it to my office. As soon as this document is
signed and paperwork received,work may begin.
A Albert Moore
Richard Rocke
cc: Residential stees
P
A SERV Phone 978-741-0424
Fax: 978-747-2012
2012
www,a-aseNices.com
HE 101MA114 I IMMENERM 115 North Street
Salem,MA 01970
September 19, 2013 Page 1 of 2
PROPOSAL FOR WORK TO BE DONE FOR
Albert Moore
at
65B Wharf Street
Salem, MA 01970
WINDOW/DOOR REPLACEMENT WORK SPECIFICATION SHEET
WINDOW REPLACEMENT
1. Remove and dispose of two (2) large picture windows with two (2)
awnings, including interior and exterior trim.
2. Install two (2) pressure treated sills; cover with 15# felt roofing paper; cap
sill with white aluminum coil stock.
3. Install two (2) Andersen 400 Series with Low-E4 Glass (.29 U-Factor)
consisting of one (1) large picture window with two (2) awning windows at
base. Exterior is white-clad maintenance-free and interior is pre-finished
white.
4. Shim windows level in opening and insulate around window using
insulating foam.
5. Install (PVC) maintenance-free trim on exterior to match existing trim.
6. Install new colonial clear pine trim, interior stops, sill, and apron around
new windows.
7. Caulk and seal trim on interior and exterior using Weathermaster caulking.
8. Install two (2) new Andersen sashes to one (1) double-hung window in
dining room./ po; �;ri`n{ y, , /l/ /-1-"% r-
9. Please note, painting is not included and center mullion may be a little
wider than existing.
Page 2 of 2
Moore
9-19-2013
DOOR REPLACEMENT
1. Remove and dispose of existing doors.
2. Install two (2) Andersen French Wood Hinged Patio Doors; inswing with
double outswing screens, Low-E4 tempered glass, maintenance-free
exterior. Color: White. Interior is pre-finished white. The hardware
included will be Encino color distressed bronze with matching hinges.
Both doors do not include grids.
3. Level doors in opening and shim. Add foam insulation around opening.
4. Install (PVC) maintenance-free trim on exterior of doors, matching existing
trim.
5. Install new clear pine colonial trim on interior door, to match existing or we
will try to save interior trim for both doors.
6. Caulk all interior and exterior seams with Weather Master Caulking.
7. Painting is not included.
(ae
InitialsInitials
Moore, Customer Chris Zorzy, President
I
I
a, �{ �+�p T A & A SERVICES, INC.
A&A S� S 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
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
Barren.) Name Date of Contract
Bu r s Street Address, Cit,Stale and Zi Coda
5—r3 liv ,1 w Gw[[II p d/77v
Da ime Tel Even TNo Nmber Mo"1yt1e TeAle M1Dne Nu�bBer E-Mail Address
um 91$ ' s 1 sYo2 aan7v-41T"I� edp.h�
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 terns described on the front and the reverse of this agreement and any specification sheets(this"Agreement"),and Buyers)have requested
Mat such goods or services be installed or provided at Buyer's address listed above.ALA Services,Inc.("Contractor),hereby agrees to Install or Cause to be installed
the products or services listed in this Agreement at the Buyer(s)address written above.This Agreement represents a cash sale of goods and services.The Buyers)
agree to pay in Cash the coat of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyer(S)may seek for their
purchase. Purchase PdCax�rqq.�?J /O./�
Est.Starting Data W06;I'
T—Down Payment: 7�u�w Est.Completion DateZV""'115/13
..���Y++ ®Cash
Amount Due on Start of Job:LLrW��� ❑ Check
❑" Credit Card
Amount Due onof Completion: No
Amount Due on_of Completion: Expiration Date:
Balance Due on Upon Completion'7�2a91'+00 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 Me parties, and there are no verbal understandings changing or modifying any of Me terms of ude Agreement.Boyers)
hereby acknowledge that Bursa l has read Me from]and M.reverse oflhis agreement and has received a completed,signed and dated copy of this
Agreement,including the two attached Notice of Cancellation forms,on the date Mat written above.Buyer(s)also(1)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 Contractor.DO NOT SIGN THIS CONTRACT IF IT
CONTAINS ANY BLANK SPACES.
A&A S ,L Buye )
By: � ��
Signal re
Signature
y,5 �>r Zorn l �. Al 4-nacre
Pont 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,
ARBITRATION:The mno-aMr and the removal hereby annual ogres In atlranm mad In Me event eilner,opme bass a depute mnmming IM1is ccntran,eilnerpany easy su pro vern dopme m a
'!cede orsonsan seMes Aradvasbeen approved terms SO.WU ofM.Eeemdve omenof Consumer:Aflairsantl ausmxa Regwatimeantl ma otherpam.ball beregmred sisubmtmvesh
monsoon as proved In M.G.L c.142A y
Chounhaperma
code: `J 02/—/3 Dmea7-20- I'
���II////�B/O2 CE OF CANCFLIAT ON NOTICE OF OANCELLAT oN
Data N Tmnaaction�3 You may cancel Iles mmvdAon,MIh ps any parity ar Date of Transaction Y�"/Zu nay rarcel this marathon,Atbout any penalty or
abligmar,Amid three business days from Me abmre data If you aanreL any proceM1y lrztled in, abligadon,uimin tnree busiresstlayy ppm the eMve date.Nymmncel,anypmpeMardedin,
any paymnts made by you under Me Consist or Sale,and any negoGade instrument exewted any payments may by you under Me Gravel or Sale,and any negotiable instrument examined
by you All the returned within 10 days formlg reader by the Seller of your cancellation roar¢, by you will be reWmed wihin 10dayfdlwngreceioby NeSlerofymrc mlUdonrgW,
end am,sell Inverse specs oN of Me numerous All be damelled.It you rua 1,you mat and any art modest sodas Out of the nanoyake As be mmvted.If you cancel,you ment
make reaiable to the sprat at your residence,and subearmally in as grad mndsma as Atten make available to the Seller at yourresldenm,and subslantally In as Fred mnaisan as Aver
eivetl,any g.do dprvered tD ye,under this Contrail or sale;or you may,N you Am,opedy real anygoMsdelivered toyou untlermis Connetla5ale;ayou may,if you M.M1,Amply
,tint Me Minimaons Of Me Seller morn ing the return shipment at Me goods et me Seller's Aim the Instructions of he Seller Install Me room shipment of Me years at Me Seller's
e venm and risk.N yen do make Me goods available b to Seiler and Me Seller tlees not pid expense and risk.It you do make the goods available to Me Seller and Me Seller tlms not pick
Mein up Aims 20 days of Me data of your Noow of Compounds,,you may retain or parody of Me Mom up Also 20 days of the data of rare names of Cencellaom,you nay retain or dspmeW
grads aname any harimabll,man.If you as to make me grads lesm.b me Sop[or Nyou Me series All any tubber oblrgatim_If tax or to hard the gross avol]ble,to to Seller or
agree he realm Me goods to me seller are fall to do sr,Men rat remain liable for personalM yw al to return the gxds to the Sellerand oil 0 do so,then I renein It for pertomance
all cdlgaams under Me Caron.To canoel this vapprouoa all or deliver a named and dated titan daemon.mar me ContrardTom¢el this baphdon,anal or deiver a pll and dated
copy M the ranrellaoon roam or any other writon notim,or aerN a teee�r tR p.SA 5@ rally of he wnMlaoon no ce or any tide Asian nonce,w send a teettyg As Semmes.
115 North Straal.Salem MA01970,NOT LATER THAN MIDNIGHT OF/`L�N( s 115 NOMStreel Salem MA019T0,NOT LATER THAN MIDNIGHT OFYY nL/f
,me., mass,
I HEREBY CANCEL THIS TRANSACTNN I HEREBY CANCEL THIS TRANSACTION
Cmsmrer's Signature Data Consumer 9gnature Oade'.
Print Form
f The Commonwealth of Massachusetts
--
.=� Department of Industrial Accidents
Office of Investigations
i} I Congress Street, Suite 100
Boston, MA 02114-20I7
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: General Businesses
Applicant Information Please Print Legibly
Business/Organization Name:A&A Services,Inc.
Address:115 North Street
City/State/Zip:
Salem, MA 01970 Phone 4:(978) 741-0424
F[No
mployer? Check the appropriate box: Business Type(required):
g 5. ❑ Retail
employer with employees(full and/
time).* 6. ❑ Restaurant/Bar/Eating Establishment
sole proprietor or partnership and have no �. office and/or Sales (incl. real estate, auto, etc.)
ees working for me in any capacity. g Non-profit
orkers' comp. insurance required]
3.❑ W e are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152, §1(4), and we have 10.❑ Manufacturing
no employees. [No workers' comp. insurance required]* 11.❑ Health Care
4.❑ We are a non-profit organization, staffed by volunteers, 12.❑ Other
with no employees. [No workers' comp. insurance req.]
Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information.
**If the corporate officers have exempted themselves,but the corporation has other employees,a workers'corpensation policy is required and such an
organization should check box#1.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name The Traveler's
Insurer's Address:PO Box 3556,
City/State/Zip: Orlando, FL 32802
Ex iration Date:g/13/201�'
� ��
Policy #or Self-ins. Lic. # q'� M g I S P
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$1,500.00 and/or one-year imprisonment, as well as civil penalties in the forth of a STOP WORK ORDER and a fine
of up to $250.00 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.
I do hereby certify, er the pains V penalties of perjury that the information provided above is true and correct.
tSiQnature-7 _ Date:
Phone#:(978) 741-0424
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: PermitiLicense#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3. City/Town Clerk 4. Licensing Board 5. Selectmen's Office
]
6. Other
Contact Person: Phone#:
www.mws.gov/dia
THE COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT
?' 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 DELEADING
WORK IN ACCORDANCE WITH M.G.L.CH. 111 § 19713(b)(2)AND 454 CMR 22.03,
HEATHER E.ROwE,DIRECTOR
e�pnrronwreroeall/za�C'��aucae/rr:relt� 42f Massachusetts -Department of Public Safety
Office of Consumer Affairs&Busi Less Regulation Board of Building Regulations and Standards
VOME IMPROVEMENT CONTRACTOR Construction Supen isor
gistratlon 101609 Type: License: CS-057733
piration: 6/2�6/2014. Private Corporatie
A&A SERVICES, INC..::.::.: - o CMUSTOPHER ZORZY
115 NORTH
Salem MA 01970�
Christopher Zorzy
{ +
115 North Street
Salem, MA 01970 Undersecretary c-� Expiration
C I -�-� �` �
Commissioner 0 512 61201 5
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PuF IY !iR`, I
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�r q 26000840
Christopher Zorzy #zo1zp 4t26/2017
A&A Services Inc Exp 4/26/2017
115 North St
- ZC�R4 CHRI 1 Salem, MA 01970
BPS UIX:."T= _ ..- _
--- Matthew J;Gibson
DISPOSAL 'OF DEBRIS AFFIDAVIT
In Me provisions ®p M. M L c, 40, S9% 54, a condiion D
Building Permit N'umbsr is that 6® debris resul$ing from this work shall
be disposed ®fin a pe®pMyld�e�s®d ��ilitr as defined.by M'. 0. I=, �o f 19, Sec." : . .
he debris will be ®IsPDjed at Salem grafts gF'8,&Van
OW09d by L"Fonda chair
ignst re ®f Par7MI A ucan$
to
Date ;
Waffle
FFr Ate®
118 O � OIL Salem, MA 01970
Addrega, 014f, SWg, dip Cods
i
30
9 J
���� Phone: 978-741-0424
Fax: 978-741-2012
A&Awww.a-aseNices.com
115 North Street
Salem,MA 01970
October 14, 2013
City of Salem
Building Dept.
120 Washington Street
Salem, MA 01970
To Whom It May Concern:
Enclosed please find the permit application for Donna Albino at 1 Beacon
Avenue, Salem, MA to replace the ro/oof:
I have enclosed a check for$258 based on your fee schedule�f$11 per$1,000.00
plus a$5 administrative fee. The�total for the j b was $22,598.006.
Please send the completed permit to A &A Services, Inc. at 115 North Street,
Salem, MA 01970. C
If you have any,questions, please contact me at (978) 741-0424.
Thank you for your assistance.
Sincerely, �
Barbara Zorzy 4 r
Office Manager
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