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B-19-773 - 0042 BROAD STREET - Building Permit ,l,r The Commonwealth of Massachusetts ,i' Department of Public Safe }_ i%, Massachusetts State Building Code(7 0 C&IR) M Building Permit Application for any Building other than a One-or Two-Fanu V , ) v {ly' bveCr a j 7 (This Section For Official Use Only) Building Permit Number: Date Applied: Building Official: SECTIION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) Yoh p3 ro ad S4- ..a Nond Street Ci Tocvn tY/ Zip Code Name of Building(if applicable) SECTION 2:PROPOSED.WORK Edition of&1A State Code used ' If New Construction check here❑or check all that aPP 1 Y inthe two rows below Existing Building❑ Repair❑ Alteration Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ' 0 Other ❑ Specify: Are building plans and/or con'struction documents being supplied as part of this permit application' Yes ❑ No Is an Independent Structural Engineering Peer Review required? Brief Descri �tion of Proposed Work: Yes ❑ NA PO f1J c �U(`Il. l QCQ�/YLQ,f�2 ,cub �C/Yt N& SECTION 1 COWLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR ' CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Inyestigation and Evaluation is enclosed(See 780 CTVIR 34) ❑ Existing Use Group(s): Proposed Use Group(:): SECTION 4;BUILDING 'HEIGHT AN 'AREA Existing. Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.'.ft.) Total Area(sq.ft.)and Total Height SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4 0 A-5❑ B: Business ❑ F• Facto F-1❑ F2❑ E: Educational ❑ H: High Hazard 14-1❑ H-2❑ H-3 ❑ H-4❑ H-5.0 I: Institutional I-1❑ I-2❑ l-3 0 I-4 0 M: 14lercantile❑ R: Residential R-1� 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 ❑ IB ❑ HA D 11B [3 HIA dIIIB ❑ IV ❑ VA ❑ VB t] SECTION 7.SITE;IIVFORKATION(refer to.780 CMIZ.111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench�Pernut: Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal O A trench will not be Licensed Disposal Site 0 Private❑' or indentify Zone: or on site system❑ required❑'or trench or specify- permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: V[.�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 Grou s : i PO Type of Construction: �� Occupant Ldad per Floor: Does the building contain an Sprinkler System?: Special Stipulations: +7 z 5 M a um-) ru, rA > SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner #� � 1 ©�G) -t O wo I I C� �UC`/1 qot 6V 00 �S� Zip Name'(Pnnt) . ' No.and Street City/Town Property Owner Contact Information: e-mail'address Title Telephone No.(business) Telephone No. (cell) If applicable,the property owner-hereby authorizes M WUq ( i 3� S Cr Town State :Zip Name Street'Address Ci iy/ to act on the pro perty owner 's beh alf,in all mat ters relative to work authorized b this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) building is.less than 35,000 cu.ft of enclosed s ace and/or not under Construction Control then check here❑and ski Section 10.1 10.1 Re •stered Professional Res onsible for Constriction Control hris Zrsr q7g_7y�_ � _ 1 Tele`Bone No. a-mail address Registration Numbe j25 4 0 Name(Registrant) VY1 B��"i0 (('_ 1 L State Zip Discipline Expiration Date Street Address City/Town 10.2 General Contractor • "t - Company.Name 06-7�3 �S License No. and Type if Applicable Name of Person Responsib a for Construction Street- Address City/Town State Zip. �--= e-mail address. rTele hone No. usiness Tele honeNo. 'cellSECTION 11:WORKERS tb.* NSATION INSURANCE AFFIDAVIT M.G.L.c.152.§25C(6)) A Workers`Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and bmitted with this application. Failure to provide this affidavit will result in the denial of.the issuance of the building permit• Is a si ed Affidavit submitted with this:application?. Yesilk No ❑ 'SECTION 12 CONSTRUCTION COSTS AND PERAM FEE Estimated Costs (Labor Total Construction Cost(from Item 6)_$ Item {and Nlatenals) __:_.- 1.Building $ .l Building Permit Fee-Total Construction Cost x (Insert here $ appropriate municipal factor.)2.Electrical _$ 3.Plumbing _ Note:Minimum fee=$ (contact municipality) 4.Mechanical (HVAC) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost (contact municipality).and write check number here SECTION 13:SIGNATURE OF] UILDING PERMIT APPLICANT By entering my name below,I hereby under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the bes1 .t of ow,'edge and understanding. Pr Qs�d. qZB ��I_ oa Ve Title Telephone N _ . Please print and sign name d` rn dl , City/Town Street Address ' State Zip Inspector to fill out this section upon application approval: Municipal,.. p P PP iVame. Date . 42 Broad Street Condominium Trust July 3,2019 42 Broad Street Salem,MA 01970 To Whom it May Concern, The trustees of 42 Broad Street Condominium Trust approve the installation of Harvey Majesty brand replacement vAndows with simulated divided lines for Unit 2, Signed, 1 rustee Repr ative Printed/Signature Date f}� Awe A & A SERVICES, sxe teen 115 NORTH STREET,SALEM, INC.MA 01970 A&A SERVICES Telephone:(978)741-0424 Fax:(978)7.41-2012 Contractor Registration No.101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 CUSTOM REMOOELING AND IMPROVEMENT AGREEMENT Buyer(s)Name Date of Contract L vi ". Li KO& Buyer(s)Street Address,City,State and Zip Code L 6T -# "Z s�N� NO o 1.9 Daytime Telephone Number Evening.Telephone Number' Mobile Telephone Number' E-Mail Address TES 1-SuN—aYZ 1 wui.F4 +u11 r�3,KOCH. E? f` � . 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 reverse of this Agreement and any specification sheets(this"Agreement'),and Buyer(s)have requested that 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 Buyer(s)agree to pay in cash the cost of the goods and services purchased as described herein,regardless of timin or approval of any financing Buyer(s) may seek for their purchase. t W C L V7 �V�I.S�� S�tiv t Purchase Price: (U r Est.Starting Date: 19-2 8— Down Payment: 2315 Est.Completion Date:41"3O- ❑ ash Check. , Amount Due on Start of Job: ❑Credit Card Amount Due on of Completion: No. Amount Due on' of Completion: Expiration Date. Balance Due Upon Completion: L 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 acknowl- edge that Buyer(s)has read the front and reverse of this Agreement and has received a completed,signed and dated copy of this Agreement,In- cluding the two attached Notice of Cancellation forms,on the date first written above. Buyer(s)also(1)acknowledge that they were orally,informed of their right to cancel this transaction;and(II)request that they be contacted via their telephone numbers or email;as listed above,in the event Contractor believes Buyer(s),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 Services Inc. Buyer(s By: K Signature Signature D f3oul ll;F > Wa(L0014 Q, 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 date of this transaction. See the following Notice of Cancellation form for an explanation of this right. ARBITRATION:The Contractor and the Homeowner hereby mutually agree in advance that in the event either.party,has a.dispute conceming this contract,either parry may wbmd such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Reguletiops and the other parry shall be required to submit to such arbitration as proved by M.G.L.c.142A. t�j'(,/) Contractor Initials: !/ Buyer's Initials:'' - Data; Date: t W L A i�NO'0.TICE OF CANCELLATION -NOTICE OF CANCELLATION. Date of Transaction(Q f11� You may cancel this transaction,without penalty or Date of Transaction(O—G 14 . You may cancel this transaction,without penalty or obligation,within three business days from the above date. It you cancel,any property obligation,_within three business days from the above date. If you cancel,any property traded in,any payments made by you under the Contract or Sale,and any negotiable traded in,any payments made by you under the Contract or Sale,and any.negotiable - instrument executed by you will be returned within 10 days following receipt by the Seller instrument executed by you will be returned within 10 days following receipt by the Seller of your cancellation notice,and any security Interest arising out of the transaction will be of your cancellation notice,and any security interest arising out of the transaction will be cancelled. If you cancel,you must make available to the Seller at your residence,and cancelled. It you cancel,you must make available to the Seller at your residence,and substantially in as good condition as when received,any goods delivered to you-under this substantially in as good conddion as when received,any goods delivered to you under this Contract or Sale;or you may,it you wish,comply with the instructions of the Seller regarding Contract or Sale;or you may,it you wish,comply with the instructions of the Seller regarding the return shipment of the goods at the Seller's expense and risk.If you do make the goods the return shipment of the.goods at the Seller's expense and risk.If you do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice of Cancellation,you may re Lain or dispose of the goods without any further obligation. Notice of Cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Seller,or if you agree to return the goods to the If you fail to make the goods available to the Seller,or if you agree to return the goods to the Seller and fail to do so,then you.remain liable for performance of all obligations under the Seller and fail to do so,then you remain liable for performance of all obligations under the Contract.To cancel this transaction,mail or deliver a signed and dated copy of the cancella- Contract.To cancel this transaction,mail or deliver a signed and dated copy of the cancella- tion notice or any other written notice,or send a telegramr t_o_A&�A S�e ices 115 North Street, lion notice or any other written notice,or send a telegra to A8A Services,115 North Street, Salem,MA 01970,NOT LATER THAN MIDNIGHT OF =1'�9 Salem,MA 01970,NOT LATER THAN MIDNIGHT OF �� (Date) I (Date) I HEREBY CANCEL THIS TRANSACTION - I HEREBY CANCEL THIS TRANSACTION Consumer's Signature Date: Consumer's Signature Date: Above Since 7982 A & A SERVICES, INC. 115 NORTH STREET,4ALE ,)70 SERVICESTelephone: 97841-2012 III Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET Buyer(s)Name Date of Contract FW_0t _r_6 J,N Koch Buyer(s)Street Address,City,State and Zip Code F7L1.2_ Q►2o#4►l S T -4 2- dw1 rn n 01970 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address 6s_7-S44-0t{2_l 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. WINDb1N REPLACEMENT QRemove and dispose of# 3 existing windows. Install # new kfiV94 /L4ti JOMPvJ windows: 4 Vinyl (0Wood1*L-11,*1 CV O (Manufacturer) / Options: Style PR Grid pattern �L 1 gll S 1 Color Interior P1Klg-k.J ? Color Exterior -W%11)- Glass Type Q7v3Lfl%iN�r E gWrap exterior trim with aluminum: Style Color ` 12,1 ow�*�s ® All windows will be installed according to the installation procedures in the portfolio. ® Caulk all interior and exterior edges. Insulate where possible around new units. Insulate window weight pockets if exist,and around new window units where possible. Included in this proposal are set up,clean up,Hepa vacuum and cleaning windows inside and out. Building permit included. BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS t Create new window opening by cutting through existing home and framing in opening. t 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. 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. ft Bay tt Bow 4 Casement f Other window(s)to include new interior style trim and new exterior style trim and head flashing as needed. t Note: Painting and staining not included. e STORM PRODUCTS ft Remove and dispose of# existing storm wind' Yto'wn-(s.). AN Install new storm windows# l Manufacturer lrr I A -- -- t Style C Color by b4 Tiff- Option 1_-QkjJ-1;�71 �5 �(LA-S-S 4 Remove and dispose of# existing storm door(s). 1, Install new storm doors# Manufacturer Style Color Type: t Aluminum ft Solid Core SPECIAL INSTRUCTIONS: ptrm4V6 + aee�-1 of I ifi reel W2—CA-,1_1�S f K 6 f+afil be /T V L T W I N�'fMJ :r/r1-rr111"r,ILUK r L� n `aN LM LG� 6� —1 ' alc = 7 aS, tat f Cu✓rv'r - l 7r (v► w I jLHJ f Al t = 7 I l lo, - GwwTPn, 2 LoSr v - 2315,� D00-54f It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMO LING AND IMPROVEMENT AGREEMENT,con titutes 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 Buyer(s)and the Contractor.Buyer(s)hereby acknowledge that Buyer(s) has read this Specification Sheet. Contractor Initials: e " ) Date: r-2 - Buyer's Initials: )0 w Date: The Commonwealth of Massacilusetts Department of Industrial Accidents Office oflnvestigadons 600 Washington Street Boston,MA 02111 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization/fndividual):_� �y�1 �S �h C Address:_ ( (S�fC f{� +.& City/State/Zip:_ c GL2-vn.\, M 11O9�OPhone#: Are you an employer?Check the appropriate box: Type of project(required): [3. . I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).' have hired the sub-contractors 6. r21New construction E3 I am a sole proprietor or partner- listed on the attached sheet.I �• tJ Remodeling ship and have no employees These sub-contractors have S. []Demolition working.for me in any capacity. workers'comp.insurance. � p.insurance 5. ❑We are a corporation and its 4• ❑Building addition o workers'comp. required.] officers have exercised their 10.0 Electrical repairs or additions ❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees.(No workers' comp.insurance required.] 13.0 Other 'Any applicant that checks box ill must also fill out the section below showing their workers comp ensati on policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outsidecomracto�s must submit anew affidavit indicating such 'Cotptractors that cheek this box must attached an additional sheet showing the name of the subcontractors and their workers'comp,policy information. I am an employer that is providing workers,compensation insurance for my employees. Below is the polit y and job site irrfarmatlon. rs Ins4rance Company Name:-T—r`U Policy#or Self-ins.Lic.#: 0O-`13g ( � Expiration Date: Job Site Address: �a. li Q S�- 2— City/State/Zip:, �alX t r jP- 0 R 7(J'1 At4ch 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 imprisomnent,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 hereby certify r e pains and penalties of perjury that the information provided above is and correct Sii -.lure: Date: Phone#: [6. ]ic. use only. Do not write in this area,to be completed by city or town official y or Town:. Permit/License# uing Authority(circle one): -77- Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Otherntact Person: Phone#: 0 O l Phone: 978-741-0424 1982'�012 Fax: 978-741-2012 t�E www.a-aservices.com A&A SERVr 115 North Street W RUN Salem,MA 01970 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 property licensed facility as defined by M.G.L.c.. 111, Sec. 150a. The debris will be disposed at: Waste Management 877-515-2845 c/o Melrose Transfer Station 740 Broadway Melrose, MA 02176 or Waste Management, Dumpster Service at 115 North Street Salem, MA 01970 � 1� t�l Signature of rmit Applicant Christopher Zorzy, President Name of Permit Applicant `7 ( 8'I(9 Date snFs Certificate No: A 044625 + THE COMMONWEALTH OF MASSACHUSETTS EXFCUTIVE OFFICF OF LABOR AND WORKFORCE,DEVELOPMENT DEPARTMENT OF LABOR STANDARDS ` :r...c�je' 19 S'I'Amr-ORD STREET,Bow')N,MASSACHUSETTS 02114 ! 1 LEAD-SAFE RENOVATION CONTRACTOR LICENSE A &A SERVICES;INC. 115 NORTH STREET ; SALEM MA 01970 LICENSE: LR002749 EXPIRES: Thursday,August 20,2020 1N ACCORDANCE WITH M.G.L.C. 11 I,§ 19713(b)AND 454 CMR 22.( THIS LICENSE IS ISSUED BY THE DEPARTMENT OF LABOR STANDARDS TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF ! ENGAGING IN LEAD-SAFE RENOVATION. i 1 i THIS LICENSE IS VALID FOR A PERIOD OF FIVE(5)YFARS. THIS LICENSE MUST BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCI:WITH M.G.L.C. 11 I. j § 197B(b)(2)AND 454 CMR 22.04 WHEN ENGAGED IN LEAD-SAFE RENOVATION AND/OR MODERATE-RISK DELEADING WORK.LEAD SAFE RENOVATION CONTRACTORS MAY NOT j PERFORM MODERATE RISK DELEADING WORK UNLESS THEY EMPLOY A SUPERVISOR,WHO HAS ` TAKEN THE REQUISITE TRAINING AS REQUIRED BY 454 CMR 22.00,1.0 OVERSEE THE,WORK. WILLIAM D.MCKINNEY,DIRE Commonwealth of Massachusetts 0"Im of Consuewr IT&Irs i 9"Jimss Regigruon Division of Professional Licensure HOME IMPROVE MENT CONTRACTOR Board Of Building Regulations and Standards TYPE:Caroorman I ` Matra= &=kWQn F Cons r, i r� doTisor 101809 005r2020 512612021 A&A SERVICES,INC CS-057733 7� v Tres;0 CHRISTOPFR ZORZY i 115 NORTH SST l� ' CHRISTOPHER ZORZY i SALEM MA 115 NORTH STREET { � SALEM,MA 01970 Uwe fetsly l ' Commissioner i i S l Salem Historical Commission 98 WASHINGTON STREET, SALEM.MASSACHUSET7S 01970 (978)619-5685 CERTIFICATE OF APPROPRIATENESS 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 will be appropriate to the preservation of said Historic District,as per the requirements set forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: McIntire District Address of Property•. ,42 Rljj d Streer-t1 i'it 2 Name of Record Owner:: Wolfgang-Koch. Description of Approval of Work: Replace existing windows in unit with new Harvey Majesty aluminum clad SDL windows to match existing 811 configuration with the following conditions: ■ Exterior of windows to be brush painted in white to match existing trim color; ■ All trim at brick molding to be preserved intact; ■ Any gaps at muntins to be filled and painted; ■ Windows to be installed per details shown on attached drawing detail. This approval is based on the age, materials,and location of the subject building. Upon completion of work,please notify Historical Commission staff as final sign-off is required to documeynt compliance with this Certificate. Dated:.. July 18, 2019 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. � `-�� "�+r...'� _ „ter, - i ,� - .w'��•: jg <.src . Apt S .,r J