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2 GIFFORD COURT - BUILDING INSPECTION The Commonwealth of Massachusetts 'I f r'?, !I, !:� Board of Building Regulations and Standards *:m; EC #(3A11 S� it OF Q ! � Massachusetts State Building Code, 780 CNLR S�,11,r Q[, �zv�,recf 1�(ar 2011 Building Permit Application To Construct, Repair, Renovate Or���n�lpsl� L 4 r� One-or Two-Family Dwelling This Section For Official Use Only 1 Building Permit NUmber: Date plied: Building Official(Print Name) Signature to SECTION 1: SITE INFORNLATION L1 Pro erty Address: 1.2 Assessors Nlap& Parcel Numbers L la Is this an accepted street?yes_ no L\,Iap Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District 'Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard "Side Yards Rear Yard -_ Required Provided - Required Provided Required .µ .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? - t Check if yes❑ Municipal❑ On site disposal system ❑ a SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: I P� �i Ibnvlvla atEeS Sojem MA Cl l 9 70 Name(Print City, State, ZIP a c� �' �� (1�� 97R - 33S- 666 j No. and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK' (check all that apply) 0 New Construction ❑ Existing Building Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed W( rk' f5P dCP ll) l (t)bo ( �i61 l)LVE lJt 1 eVl CC,e �G�e 1 lQ L(kfr�{c t �6 li f�?;k CIO�J SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs:_ Labor and Materials) Official Use Only L Building $ U 1. Building Permit Fee: $ Indicate how fee isdetermined: 2. Electrical $ ❑ Standard City/Town Application Fee ❑ Total Project Cost' (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: pha 5. Mechanical (Fire. $ Suppression) Total All Fees: $ t Check No, Check Amount: Cash Amount: 6. Total Project Cost: $ y.(o 0, 0-0 ❑ Paid in Full ❑ Outstanding Balance Due: t SECTION 5i CONSTRUCTION SERVICES.: 5.1 nConstruction Supervisor License(CSL) r)hp A ZC)S2 Z f Lic=c(-'3-a.�-7-7.1 j Expiration Date Name of . - - q-7 T Description N erJ Q 1 / /U U Unrestricted to 35.000 Cu.FL Ad Restricted l&2 Family Dwelling M Masonry Only Signafare RC Residential Roofing Cowrin WS Residential Wmdow and Siding /1 -I ll O17 SF Residential Solid Fuel Burning Appliance Telephone D Residential Ikmolidon 5.2 Home Improvement Contractor Registration(HIC) t.4 Se)2 Registrational ()/ Eviration Date 6 HIC Com y N e or HIC RegistrankA t flame , IY ,r-i to lad 01 q-10 Ad Sigoan m Telephone SECTION 6:--;WORICEWS.COMPENSATIONINSURANCE AFFIDAVIT(M.G:L.X452. §25C(6)) Worker's Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide an insurance affi vit may result in the denial of a building permit Signed affidavit attached? Yes - No O SECTION 7a.-:-"OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTORAPPLIES FOR]BUILDING PERMIT I; as Owner of the subject property, hereby authorize R l)t ces to act on my behalf in all matters relevant to work authorized by this building permit application. SPp C-G� � Signature of Owner Date q. SECTION 7b:- OWNER OR A�U7THORIZ`E/D AGENT DECLARATION I, 0 1 Y; niiP r L-4 1('Z 'Y ,as Owner or Authorized Agent,hereby declare that the statements and informationl (hhe�fore�m,�application are true aftd:accurate,to the best of my knowledge and belief. i Signan,rn of Ovmer or A ori�ed ent (Signed order the pains and penalties of perjury) Date SECTION 8; DEBRIS DISPOSAL All dumpsters of six(6)cubic yards or more are required to have a permit from the Marblehead Fire department call 781-639-3428. In accordance with the provisions of 780 CMR and MGL c40,§54 a condition of issuance of this building permit is that debris resulting from any work performed shall be disposed of in aI?properly licensed solio waste disposal facility as defined by MGL cIII,§ i 1502. Zurf.Sltt A.t llS/VoiC Uri Sotle�; 1-1,4 01976 DEBRIS DISPOSAL LOCATION 1 SIGNATURE OF APPLICANT NOTE 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations. • pA e^ AA �+�p�/ /7 �+ A & A SERVICES; INC. A&A SER �\/��7 115 NORTH STREET, SALEM, MA 01970 • '• rye Tele-p/fhhoone:(978) 7741-0424 Fax: (978) 741-21012 w�(fC`/'��UI - -c �Contractor Registration No. 101609 (5I T COrq- I 6A Construction Supervisor No.CS057733 Federal EIN: 04-3090162 CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Guyana) Name I Date of Co rant 022114 Bu ens Street Address, 6ity State and Zip Code -� Da 'me Tele hone Number Evenin Telephone Number Mobile Telephone Number E-Mail Address 335= The Buyer(s)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 terms described on the front and the revenue of this agreement and any specification sheets(this'Agreement"),and Buyers)have requested Nat such goods or services be installed or provided—at Buyer's address listed above.A&A 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 cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyerls)may seek for their purchase. Q)W� er�U u r+yrL d. (Jl[�V Purchase Pace: 12,�� -rp Est.Staling Date' P/ `^'N `Jf / 7 Down Polymer t (�)�1�� Est Completion Date: l --0a, gW. o� i2Lt ��� °�� Amount Due on Start of Job' Check El Credit Card Amount Due on Completion: /"a"I•W 1- No. mount Due on of Completion LlAOY� Expiration Date �+1 Q /1/J A r U int Balance Due on IN Upon Completion !� CVC Cotle' s �( r 7 7V It is agreed and understood by and between the parties that this Agreement, IN, and back and any addentlu constitute M1 mire�t understanding between the parties,and there are no verbal understandings changing or modifying any of the terms of this Agreement.Buyerls) hereby acknowledge that Buyerls)has read Ne front and the reverse of this agreement and has received a completed,signed and dated copy of this Agreement,including Ne two attached Notice of Cancellation forms,on the date first written above.Buyerls)also(I)acknowledge that they were orally informed of their right to cancel this transaction;and(it)request that they be contacted via their telephone numbers or email,as listed above,in the event Contractor believes Buyerls)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 Ser ri ,Inc. Buyer(s) Signature - Signature S'vAiL ddb �o� � vl� Print Name Pnnl 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. ARaORATON:The mmnnorand me nonnaimer herebylmuwally agree in advance that in the event either party has a&pate con®ming this comforather pant nay wbint such dispute w a Sanerarbitraro tion service"i.has been appved by Ne SacmUd tithe Bananas oMw on CpnwR%MePS and Business Raguladdns and the other pay shall be assured wMd ired to t to such aroatimasprovedin N,G.Lc142A. ` C/ fnnl,azbrinitials' J _ Buye.'1 fatal,m..: Fj Dale: J P-.r / a c mN Ode Data a neneanuon ! vfa may cancel can vfnxction.wMow any cenay or Dam of rmn:angon mtr may ramal Mi¢o-anaamm�Mmool any penalty or obligatibn.within lhrea0 tlays M1dm me aMve lea.if you canal,any propertybatled in, obligation.xiMin Nrea ¢sdayshom meaM,re_I. llyau anwl,any property tratled in, aoypry enomandedy on oder Ne Contract or Sale,and any npofiade insbvrrenteaecukd any payments made un der Ne Carl Sale,and any negotiable merriment wandam by you will be relurned wim'm 10 days bilhomng oral by me Seller of your cancellation recce, by you will be reversed an"10 days(clawing receipt by the seller of your coordination notice, antl army scorn,Insurers alining Out of the transaction vall be cancelled.If you cancel,you must and any sewdty Interest adyrg out OI me transaction wtll be ranralled.II you formal,you must nuke available b me seller in your resitlenro,and mostanealy In as good wndifiw as when r make available to 1M Seller at your re9denm,and substantially in as good compon as when ceived,anygoodsdrsivere wt uunmrNis Cmvecor Salei oryouney,ilycuvnsh,amply receirel anygro]s delivered total under this Conlrec or5ale:or you may,if you wish,amply vAN the insbucdms of Ne Sellar exroang me afters shipment of the goods at the Salters ver me msWctions of the Seller regarding the rewm origins l of the gaWs at she Bathers expense and risk.If you do make Me ..as availed.to Me Sella aro the seller does not ryck ehpmse and ask.If you do Tike the goods available to the Seller alp me Seller does not pick memup ava n 20 days of Mf anile 0 your Nodm of Connotation,you may retain or disease at the them up wimin 20 days of Me data of your Harbor of Conclusion.you may retain oar dispose of ' gmds vnMdm any water cdigalim.If you for to make the goods available 0 MO Soleror if you the goods whout any framer obligation.If you fail to Make the goods available to the Color,ori agree to rewm me goods to me 5elwr and NO to do ad,then yremain liable for perbmance of you agreero Mum Me goods to Me Solerand(ait W do so,than you person able fairmHomanm r a 11 odigadons under the Correct.To cancel this transaction,mail or deliver a signed and dated ofatobligarnsurserareCormad.To cancel this bansallon.mall wdellver a signed and dead dopy of the cancellation nOdm ar any other famen nal or send a tel copy of Me't ancNlation sere da any Other waMn name,or send a lelegra l W a 115 Noun Street.Salem MA grant NOT LATER THAN MI DNIGHT OF ter 115 Bonn Street,Salam MA 01970,NOT LATER THAN MIDNIGHTOF lum I HEREBY CANCEL THIS TRANSACTION •H I HEREBY CANCEL THIS TRANSACTION Cdnsumeh SignaWre Dane: consumer's5ignawm Cate: �, p �pn ''�=°c9�+0 A & A SERVICES, INC. 115 01970 A&A SER ICES 4 Telephone:NORTH)741-0424 SALEM,MA • • we `d c) Z 0 61�d Contractor Registration No. 101609 Federal Ell 04-3090162 il %59/,�l,.Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET Buyers)Name Date of Contract h 1 h Buyers)Street Address,City,State and Zip Code Z , [reu AA4, O 1" 770 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address 6 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 IMPROVEM ENT,of which this Specification Sheet Is a part. WINDOW REPLACEMENT (20 / �We*�IM4,rl Remove and tlispose of# tl.�/7 existing windows. C$451 Alli Install # new BMCICw l/ &or, 2 windows: If Vinyl < t food ^� (M n facturer) `T—1,0 Options: style 'T�,IubleFFWJO Grid pattern oZOVefTWO Color Interior BA 00- Color ExteriorVis% Glass Type �S�, It Wrap exterior trim with aluminum: Style Color 1 r1 }\ All windows will be installed according to the�inSstallation procedures in the portfolio. LOCs4+0!J e UO-T c- aAMi (VCaumI� nterior art¢sdlllll - S.lpf un r`4- If � 1 If Insulate where possible around new units. 1 W-i ri2J}f"' t .nsulate window weight pockets if exist,and around new window units where possible. C�r/tl2-lj W'1 pal's COIncluded in this proposal are set up,clean up,Heps vacuum a�n�tl/Iccl�lea�nni{ing windows inside and out. 5/FN�-� ✓� III, wilding permit in uded. 'OT41 g (� 10i wU� Oil f�11'Sx s- ,CJD �� AY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS `oNRCgbk}Slj f Create new window opening by cutting through existing home and framing in opening. / If Remove and dispose of existing unit(s)in its entirety. Note:Electric and plumbing may exist In wall and will require additional costs to customer if need to be dealt with. Ir Install windows)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. It Bay t Bow t Casement t Other window(s)to include new interior style trim and new exterior style trim and head flashing as needed. If Note: Painting and staining not included. �7 STORM PRODUCTS l i J Remove and dispose of# !i- existinggt $C/il .�- U 71mi gyp/ Install new storm windows# Z#= Manufacturer StyleTfdCL/M�N t Color WhlfrlP Option Gof6lBrd /1�n �np% It Remove and dispose of# existing storm debris). H I / It Install new storm doors# Manufacturer ---- Style Color Type: t Aluminum f Solid Core S 0WNerunt-}rl0\ ' SPECIAL INSTRUCTIONS: IF,(11 P� �n1-� LI dA H--V - r Y wed-FE1ot Sir, S A{I is}t 2nei�L not-darn 2onl It Is agreed and understood by and between the parties that this Speclucatlon Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,consul the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms.This contract may not be changed or Its terms modified or varied in any way unless such changes are in writing and signed by both the Buyers)and the Contractor. Buyers)hereby acknowledge that Buyers) result this Specification Sheet. - ",,ntractor Initials: SL-- Date: _ %/ �/(j Buyer's Initials: Date: 6 /L� CITY OF S.u.E.Nvl, -NAAsSACHLSETTS BL'II.DNG DEPARTMENT P 120 WASHNGTON STREET, 3' FLOOR .sof TFL (978) 745-9595 FAA(978) 740-9846 KI-,iBERIBY DRISCOLL MAYOR THouas ST.PMRRE DIRECTOR OF PUBLIC PROPERTY/BUU-DNG CONO(ISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CNIR section 1 11.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: (name of hauler) The debris will be disposed of in : 1-o�e 7rxokl.r ( l0✓1 (name of facility) ILn , VVer IIS (address of facility - � Mov4[ � s+ �e M-A signature of permit applicant date Jc6risatr.dix I CITY OF S.XIE.Nk1,, UNSSACHUSETTS BUILDING DEPART$W.NT \ =�f 120 W.ASHLNGTON STREET, 3se FLOOR TFj.. (978) 745-9595 F.ALx(978) 740-98.16 KI,.%IBERLEY DRISCOLL MAYOR THOA us ST.Pmmm DIRECTOR OF PUBLIC PROPERTY/BL•ILDLNG COMMISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Busintss:OrganizatioNindividual): —g i .,4 Address: II C�_ L oak -N aA City/State/Zip: Phone #: } — [ --® VQ L� Are ou as employer?Check the appropriate box: Type of project(required): 1. I am a employer with_�_ 4. ❑ I am a general contractor and 1 employees(full and/or part-time).' have hired the sub contractors 6. El New construction 2_❑ I am a sole proprietor or partner- listed on the attached sheeL: 7• ❑Remodeling ship and have no employees These sub-contractors 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 required.] officers have exercised their 10.❑ Electrical repairs or additions 3. 1 am a homeowner doing all work right of exemption per MGL 1 I.Q 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' comp. insurance required_] l3.❑Other. •Any appliraM that checks has el mutt 21Wfill uut the section below showing their workers'compensation policy information. f I(omeuwrwts who submit this afridav"a indicating they are doing all work aml then hire outs"lldcmnraea0m moat submit anew affidavit indicating such. :C0R1n`cton that cheek this bwe most anachcd an additionul sheet showing the name of rho mb,,aaumctors and their workers'comp,policy inromration. I am an employer that is providing workers'compensation insurance for my entplayees. Below is the polity gxdJab site information )� —y — Insurance Company Ne__ t amAUel'pl Policy All or Self-ins.Lie. #:--..Q Expiration Date: Job Site Address: / s -' ' Vf /1Ar+ City/State/Zi :teSI . A off q7 rI —Attach a copy of the workers'compensation policy declarationshowin a e P tI (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 S 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 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 lrereby certify U1 r tK91d penalties of perjury that the information provided above is true and correct. _ i�nt tee• � ' /' Date:PhonOjfcial use only. Do not write in thin area,to be completed by city or Iowa o=: =-pector City or Town: Permit/License# Issuing Authority(circle one): I. Board of lleahh 2.Building Department 3.City/Town Clerk 4. Electr 6.Other _ Contact Person: _ Phone# AC CERTIFICATE OF LIABILITY INSURANCE °"'�'M�°°"""' 9/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT The John M.Sullivan Insurance Agen NAME:PHONE 781-449-9330 FAX 781-449-3511P.O.Box 920047 INC.No AIC No: Needham,MA 02492 ao6AEss: sullivan.insadv@ver¢on.net INSURER(S) AFFORDING COVERAGENAIL INSURER A:The Travelers Indemnity Co 11347 INSURED INSURERS: A&A Services, Inc INsuRERc: 115 North Street NSURERD: Salem, MA 01970 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDL SUBR rotp LTR TYPE OF INSURANCE POLICY NUMBER MMRNY EFF MM POLICY YY` LIMITS GENERAL LMBILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE I--]OCCUR MED EXP(Any one person) $ PERSONAL a ADV INJURY $ GENERALAGGREGATE $ GEN'LAGGREGATEUMITECTAPPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY- PRO- LOC $ AUTOMOBILE LIABILITY (Ea COMBINED apWaM INGLE LIMB $ ANYAUTO BODILY INJURY((Per Person) $ ALL OWNED SCHEDULED AUTOS - AUTOS BODILYINJURY(Per aoadam) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Par aoadart) $ $ UMBRELLA LMB OCCUR EACH OCCURRENCE g EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- ANDEMPLOYERS'LMBIUTYYIN 9/13/2016 9/13/2017 ANY PROPRIETOR/PARTNER/FXECUTNE A OFFICER/MEMBER allUDEDI F—] EL EACH ACCIDENT $NIA 6KUB-0243MB1-5-16 500000 (Mandatory in NN) E.L.DISEASE-EA EMPLOYE $ If yes,desrnbe under — 500 000 DESCRIPTION OF OPERATIONS Oab1vEL.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks SGIedws,0 more space is returned) - CERTIFICATE HOLDER CANCELLATION City of Salem SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 120 Washington Street#4 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Salem,MA 01970 ACCORDANCE WITH THE POLICY PROVISIONS. ' AUTHORIZED REPRES ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards A&A SERVICES, INC Christopher Zorzy License: 115 North Street Salem, MA 01970 cluusroeHER�O MR11, ' 115 NORTH ST NMIa Salem MIA 019707 ` SC�1 ti 201005M Salem - J�_ � ' 'f iL 0 Expiration A, 05/26/2017 `'� Ofmce of Consumer Affairs&Ousiness Regulation Commissioner t iL HOME IMPROVEMENT CONTRACTOR l ( Registration 101609 Type' 4 Expiration:_-. .-61261201.8 Private Corporation , A&A SERVICES, ING) Christopher Zorzy - 115 North Street -- Salem, MA 01970 Undersecretary Salem Historical Commission 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (978)619-5685 FAX(978)740-0404 CERTIFICATE OF NON-APPLICABILITY It is hereby certified that the Salem Historical Commission has determined that the proposed: ❑ Construction ❑ Moving ✓ Reconstruction ❑ Alteration ❑ Demolition ❑ Painting ❑ Signage ❑ Other Work as described below does not involve an exterior architectural feature or involves a feature covered by the exemptions or limitations set forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: McIntire Address of Property:2-4 Gifford Court Name of Record Owner: Philip and Donna Yates Description of Work Proposed: Replacement of two (1) windows.- one window on Carpenter Street elevation and one window on Bridge Street elevation. Windows to match J. B. Sash Tilt Unit B-305 frame Tru-Divided-Lite windows previously installed at the property as approved by the Commission on June 3, 2004. There will be no change to the design, material, color or outward appearance. Non-applicable due to being in- kind replacement. Dated: September 12, 2016 SALEM HISTORICAL COMMISSION By: The homeowner has the option not to commence the work (unless it relates to resolving an outstanding violation). All work commenced must be completed within one year from this date unless otherwise indicated. THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Buildings (or any other necessary permits or approvals)prior to commencing work.