22 WILLOW AVE - BUILDING INSPECTION (5) PP t{ a
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DATE:
Citp of fF)aI' i, 1%!�5arbm;Etta
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building
Building Permit Application For:
Circle whichever applies) Roof, Reroof, Install Siding, Construct Deck, Shed,Pool
Addition, Alteration, epairMepla , Foundation Only, Wrecking
Other:
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: Tows neiflnak-PJJ Contractor: Christopher Znrz;.
Street 2Z2. W�1l '
� ($JQ City Street 11 5 Nnrth Straat City Salam
State UkO,_ Phone "?&) �qS -W 99 State MA Phone(978) 741-0424
Architect: City of Salem Licq 14 0 5
Street City State Lic#0 5 7 7 3 3 HIP# 101609
State Phone ( ) Homeowners Exempt Formes no
Structure: (please circle) Single
tt Family, Multi Family# Other Ca d o
Estimated Cost of job S.
Will building confirm to 1�w? yes no I v U
Asbestos?__yes 1/00 � � Cn� 6 1 � ��� D Oe J
Description of work to be done:_
00Wg V-4., L ' wl S A-L
SERVICES
Drawings bmitted: Yes no Mail Permit to: 116 NORTH STREET
X aer.FM A1.4 gs,
X
Signature of Application,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# Zoning Map/Lot
Permit fee$
COMMENTS: -
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Litt? f1 SziiPnz. : aEsarj71j5Ett5
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: . � „ • �� 1p3IL12L loIIIpZIYil "—SII�r'InIIIi
. '�,T�yT' 11llIll�lI]R ��3t'III'IZIII
(gas pair= ro z n -
5D8-735-3:�5 sS:. 3a13
DIS?OSAL OF Dc33IS AFFIDAVIT
In accordance with the provisions of MGL c 40 , S54 , I acknocrledge 'that as a
condition 01 Build=ng Permit U all debris resulting from the
construction Activity governed by this Building Permit shall be disposed of
a properly licensed solid taste disposal facility, as defined by MGL c III,
S 150. . Salem Transfer Station owned by:
The debris v-411 be disposed of at: Northside Carting
location of faci_ay
Signature of ?e- - App 1-2C2IIL Date
Fuiiy complete the following iniormazion:
(?lease print clearly)
Chiibt6pheicSo;iyc.
Name of Permit Applicant
A & A Services , Inc .
Firm Name, if any
115 North Street , Salem, MA 01970
Address. City L Srare
The apOVe statL'te 7e1lllt=5 that debris from the demolition. renovat-; reha
or other alteration of building or structure be disposed of in a properly
licensed solid waste disposal facility as defined by MCL cIII. S150A and tha
building permits or licenses pre to indicate t.he' location of the facility at
�—\ The Commonwealth of Massachusetts
' Department of Industrial Accidents
0/1/ef 0110 0stlO8tloss
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.
companyname: A &, A Services , Inc.
address: 115 North Street �bw !rC's:ipi,.
city: Salem, MA 01970 1e: 'irw' i "mod
ohoneN . 978-741=Q424`s, �,,AZa � •A
insurance co. The Travelers policy# WC939X1256
❑ 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:
P
company name.
11�'47 !t
address: a�, :'+°,�sSS+�''•'�4a� 'z
city- hone#• rr e7r�
insurance conollev#
company name
4• , i.
address:
"hone#: txatii 'aR W
x
.u•i r tiy,
insurance co.
polio#':.�
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1400.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand That a
copy of this statement may be forwarded to the Omce of Investigations of the DIA for coverage verification.
t do hereby certify and (Vepal, andpenalties of perjury that the Information provided above Is true and correct.
Signature Date
Printname Christopher Zorzv, President Phone# 978-741-0424
otliclal use only do not write In this area to be completed by city or town official
city or town: permiNicense# riBuilding Department
❑Liceasing Board
check if immediate response is required ❑Selectmen's 011iee _
011lealth Department
contact person: phone#; - f—lOther
✓� l�JdIIL)I[OfNIM,¢L[It O�/!''.Q�Q�/t(IJC�Ib
Board of Building Weolalions and Standards
u HOME IMPROVEMENT CONTRACTOR
Registration: 101609
Expiration: 6/26/2006
Type: Private Corporation
A&A SERVICES, INC
Christopher Zorzy
115 North Street r- ��✓
Salem,MA 01970 -
Administrator
Commonwealth of Massachusetts��~
Division of Occupational Safety
Robert J.Rezioso,Deputy Dvedor Q .
Deleader-Contractor tpUf�t1
CHRISTOPHER ZORZY
Eff.Date 12/19/03
Dale 12/20/04
DCO ry
' DC000440 '
*fnbffdC.ON.E.S.T. +
BO
BOSTO EW
' ? BOARD OF BUILDING REGULATIONS t
License: CONSTRUCTION SUPERVISOR
Number: CS 057733 x:
Blrthdate: 05/26/1958
Expires: 05/26/2005 Tr.no: 12224
Restricted: 00
o CHRISTOPHER ZORZY
115 NORTH ST Z2"�+
SALEM, MA 01970 Administrator
� J
U-VALUES AND R-VALUES Ji•
N A ENERGY S TAR
'HARVSY INDUSTRIES Harvey Manufactured PARTNER
�• Windows and Doors
WHOLESALE PRICING
• 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 qualify for the ENERGY STAR® program throughout the U.S.' isoeam
Clear Insulated Low-E* Low-E/Argon*
YLWINDOWS U-Value R-Value U-Value R-Value U-Value R-value
Classic Double Hung (Mechanical) 0.50 2.00 0.37 2.70 0.34 2.94
Classic l;lo--p;IrHung (WeIdad cash) 0.50 2.00 0.36 2.78 0.33 3.03
Classic Double Hung (Welded•S-ash & Frame) 0.40- -2.04 r , 0:3e-0.79.- ,6. 4q-3.03�
Classic Acoustical Double Hung STC40 0.23 4.35 0.18 5.56 6.17 5.86
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(pg190-231) it-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(Welded Sash&Frame) 0.49 2.04 0.36 2.78 0.33 3.03
Vicon Casement/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.
For current pricing, call your local branch or visit www.harveyind.com. .
active 3I17/03 256
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