60 BAY VIEW AVE - BPA-15-606 SIDING The Commonwealth ofNlassachusett RECEIVED
r� PECTIONAL SE VIC TYOF
5° L Board of Building Regulations and Stand'ar s
I Massachusetts State Building Code, 780 CMR SALEN[
�- '� � bp Revised War2011
e m It
Building Permit Application To Construct, Repair, Renov sh a� 1' 31
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date p lied:
da
Building Official(Print Name) _Signature Date
SECTION 1: SITE INFORMATION
l.1Oropew Address: my� 1.2 Assessors Map& Parcel Numbers
" V
I.1a Is this an accepted street?yes no Map 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 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?Check if yes❑ Municipal ❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
N�a _n7k , ✓a 50 MA-o 19-10
Name(Print) City,State,ZIP
(W Bay vi-p-w Ave &i7,'79"1 -(aY9
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORKz(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alwration(s)-51" Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work'-: &S+CjL 1 A e. xJi t1 i
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ S �- 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: $ i11
(j��• 0 Paid in Full 0 Outstanding Balance Due:
CL311 ) vk7 l -
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
GS-r-1(s r ��v-i5"
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
NO
No. and Street Type Description
( U Unrestricted(Buildings u to 3i,000 cu.ft.)� ,7
R Restricted 1&2 Family Dwelling
Ciry/Town. State,ZIP NI Mason
ry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
74/ 1 Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
A >r "�✓ i S Inc l D f too 9 l� a-C, -1(a
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
S 1V o/�l2 5--
No rid Street
�a C) 0 Email address
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 .......... 12 No........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject property,hereby authorize (�GI y r S 20✓2
to act on my behalf, in all matters relative to work authorized by this building per it application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
Bye Mring my name below, I hereby attest under the pains and penalties of perjury that all of the information
cont ' d this a lication is true and accurate to the best of my knowledge and understanding.
TV, 1,- 19 - fT-
Print Owner's or Authorized gent's Name(Electronic Signature) 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.,o�os
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"
The Commonwealth of Massachusetts
a r / Department of Industrial Accidents
office ofinues6gaffons
fir:4- -/
' 600 Washington Street, 7 Floor
q-` j,:.-' Boston, Mass. 02111
Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors
Applicant information: Please PRINT legibly
name: Ghr'i 5-1?,0k' `✓ C)-::7
address: l/,5 l vO t�l Gt r 7l ir2Q% t
city 6aI2 t"'s state M✓} -tin: 01970 phone / 7F-7V1 07r�7
work site location(full address): (a0 :ZO�VV i-C 1 4� S0,kI--W1 All 61Ct77n
❑ 1 am a homeowner performing all work myAelf. Project Type: ❑New Construction ❑Remodel
❑ I am a sole proprietor and have no one working in any capacity. ❑ Building Addition
[6 I am an employer providing workers' compensation for my employees working on thisjob.
company name A 'f� ���{��Q 0-V! ��S r /sit C
address:
`( L6J t10 ✓�nF �"1 S4I - (] p -7�[ + /
city' !�Q. l � treip At A- phone#: -f 70 - /n�7 1(y'/6 7-7
insurance co -rL,e. T -a ve (-eras policv# 0�q 3 A l 6 1 5
❑ 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:
company name'
address:
city phone#:
insurance co policy#
company name'
address:
city phone#:
insurance co police#
.Attach additional sheet if necessary
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of it fine up to S1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a SOP WORK ORDER and it time of S100.00 it day against me. 1 understand that a
copy of this statement may be forwarded to the rice of Investigations of the DIA for coverage verification.
l do hereby certify unr a th pains and p nalties of perjury that the information provided above is trite and correct.
SignaturcV ' .191- �7 Date b < jq- L S
Print name ✓%s S oa Phone# 7 D -7 v i
..- ..' v
official use only do not write in this area to be completed by city or town official
city or town: permit/license# ❑Building Department
❑Licensing Board
❑check if immediate response is required [-]Selectmen's Office
❑llealth Department
contact person: phone#; ❑Other
' (revised Sept.zoo)
r7
,n •', I'.0h � ,-•y _.4 _. ..
rmlMv9� S!��•7�y.� ai.�� � �?�7y1';f.liy7a��•� i�y'il!?j=� ��� ��,��?k'�, �, ��
5"Wi-lod by
V�'a
a—fiz
Data ---_
Yea 7= 4;Par ir�ii
A A
afe
•;oa» :3�j=C3, Aire �'+ �A'� .
p
cem.-ate ;Nj AN30-05
TILE COW 10MI,E.ALTH Oi= ,LASSACFILFSETTS
E'��CI_'Ti`.E OFFD-E Ca= LAB;15.AEU 11:0f, :FORC� DE6-ELG°\fL`;T
DEP.ARTMEINT OF LABOR ST.V'DARDS
19 ST:orlsorD STr_ET, BOSTC) . M1,55>CH!ISETTS 02114
DELEADER CONTPLACTOR LICENSE
A &- :A SERVICES, INC.
I I ; NORTH STREET
SALEIM MA 01970
LICENSE: DC000440 EXPIRES: Sunday, June 07, 20I5
FN ACCORDANCE bl`'iTH IV G.L. CH. III, § 1978(b) ,AND 454 CiiMR 23.03, THIS LICENSE IS ISSUED BY'
THE DE oA o TVFNT OF L:-`.50.^. ST;A\,D.A sDS TO THE CO\;TF_4CTOP.ABOVE FOE THE PL P oOS='OF
ENTERNG INTO OR ENGAGNG FN DELEADN`G WOR-K.
THIS LICENSE IS VALID FOR A PERIOD OF ONE YEAR.
TiliS LFCE :'SE MUST BE V:\F`;TAI`;ED BY THE Ci NTF_4CTO" P HEN ENGAGED M DELEADIWJ
VVORK IN ACCORDANCE WITH L .G.L. CH. I I I 197B(b)(2) :AND 434 CiIR 22.03,
HE,\rF—IF r E. F,oA=, —Di recLiP,--
1 ! `.Ili i3:; •. a ]-_^e' - -
Oilice al Coa;umer affair
( n rr n n ti i —HOMc Ind°ROVEid_VT COPITRA^
_ -'I,= CS-057737 R gie,rrion TJ?
a:' ye.
CFQ2ISTOPHER ZORZY
I I5 NORTH .4.3A S_RVICE3, INC
Salem bCL 0191970' i' � "
Cnri„ocher Z]rzy
113 Morin Slreel
Salem. MA 01970
05/26/2015 Cndervccr<ra_n_
Ae pli e,J
-f�r - 5-eO
haps:/ielicense.chs.s tate.nla.us/eGov/Web/PavmentResult.aspx?answ.
Application Submitted
Your application has been submitted and all fees have been applied to your credit card. Please print this page as
your proof of submission and receipt of payment.
Application Information
IDatz Submittzd: Wednesday, Play Go. 2G15 -- —
�Applicant Name: CHRISTOPHER ZORZY
:License Number: CS-057733
Agency: MADPS -
Process: Renew License process
Payment Information
Authorization Code. 12 004
Received Date: 5/E/2015 9:26:33 AM
Received Amount: $100.00
MAY 0 6 2015
of
: F9 30(=
A �+�p /„�°� A & A SERVICES, INC.
A&A SERVICES IIS NORTH STREET, SALEM, NIA 01970
•]LTAI:mlivAi W-209 RATME Telephord:(978) 741-0424 Fax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
ant
u er s Name Date of Contract
-S 6
Bowels) Street Address.Cil State and Zip Code
O
Da Ime Telephone Number EvCrgnq Telephone Number Mobile Telephone Number E-Mail Address
'7 7U-7
The Boyer(s)listed above hereby jointly and severally agree to purchase the goods andlor 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 Buyers)have requested
that such goods or services be installed or provided at Buyers address listed above.ASA Services,Inc ('Contractor"),hereby agrees to install or cause to be installed
the products or services listed in this Agreement at the Buyers)address voider 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. �
Purchase Pdc —/'/JV� �1 CL y S 7 ! Est.Starting Dater
T� /1 O�/. " `
Dom Payment IZfSCGLk/>�7r�n/'�O Est Completion Date
xpN( r $ "Cash
Amount Due on SO of l - (^ (Check
f RO S'r V Cz-0 Credit Card
Amount Due on Completion: T No.
Amount Due on of Completion: Expiration Date'
Balance Due on Upon Completion: / CVC Code
It is agreed and understood by and between fine 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.Buyers)
hereby acknowledge that Buyers)has read the front and the reverse of this agreement and has received a completed,signed and dated copy of this
Agreement including the two attached Notice of Cancellation forms,on the date first written above.Buyers)also(i)acknowledge that they were orally
informed of their right to Cancel this transaction;and(it)request that grey 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 Servi s,Incc...,//// Buyeti
By:_ 2 _ VLf—.
Signature
�N Signature
Print Name � Sd`lt }'l
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.
ARBTRATION The mmac er and Me bmrepvmer hereby mumalp agree m aawnu that in Me evere offier party had a dispute mnreming the mnnaa.eiNervam—1 American thus.to a
priwte arbitration service Mltli has Eeen elgmved by Ne Senemryal Ne Euative ONce of Go Affairs a Buyness Regulations and Ne omer parry shall be repuiretl to sutmlt m such
arbitration as pmvetl in M,G L c.t@A.
cant /y�. I � aaycr:Imml�
Earc��"rI s f Oatc )C
NOTICE OF CANCELLATION J NOTICE OF CANCELLATION
Dale of Tranaypn You may Wn Wl this vanmoon,vnuold any bar or Dale m Tensac4cn �mav canml is m--dmm vndems any cenals,or
Wigation,eittun lMee bays M1omtlle above tlate.It you onceL any propeMvetled in. oGigation.vnNin Nree sne days kom Ne abovedare.Il you motel,tiny propenY lrztled in.
any payments matleb der Na Gonoatl or Sale.and any negotiable lnsWlremeremed any payments made you antler Me Intrecr or Sale,and any negotiadle instmment eaeated
by You MII de soldmetl mor 10 days lolld"I'M receipt by Me seller M your cancellation noun, by You¢ill be retumed man 10 days herein,
and any form,Interco edsing out of Me Imnsested Nor be mnc tied.II you cancel,you must and any securi remlpl ay too oosted your u faect y notice,
Iy inthe Seller an9ng out or re transaction ud am mncellas ((you ondito as must
maMe ed.angle m Ne Seekment m ywr heareenundertm,and subset Sally In as 0md Wour weas Man make ad.any a ea toe Shoe at your under nw,and sudsy Sally In as gwd fYou on as comply
c,the
goods elemental Me com
or strale;t a u my if Me
ar Me,condacker a recevoldteinstructions
nstr0mtls cautioned the Slier regarding
this Commonor shipe;or you may,odsavthe comply
ems Ise Ind ask,
of the Seller regarding 9 the return the Sent 01 Ne golds al es of pits vile the in d ask If of the Seller regarding the return thi Sole of Me goods at the et ran,
expense and dsk,If you do dataake the goodsm available Io the seller and we Seller dce5 not and them up and dsk.If you do make to yours available to the Seller and Me Solerin does not a of
Nem upllem, rdays urnmebedment yourand e of 1.mCancell goods ation,youmayr¢aainindill of Ne Memod"rems days pleofte WyoN Notice
. ake Imtioodesen am ihybeto to Sil....of
goldsarme Me any goods btheS llr yet fail M do make the,youre arinhan Na seller.aril you Me agree Mhum any hoses to ie Sall.Ityouot to make the gmderronade to to
agree Nremrnnder me Common
oBeTo and fallred
the,youremaervera ar Signed
nrw ofd dated you a grremrns mNa the ds cm itTo b antl hot so you remaider blebeperformance addtd
ell odigations antler me COnuatl.To cancel Nls vansactiory mail or bHrvcasignatl and dated of all obligations under the Convap.To rsnwl Nls transaction,mall or defvera 9gned and dated
may of Me canmllamor notim or any ONar anden notice.Or send a telegm net A Sa copy or the cancellation notice or any olhb Mryen notice,or send a arigr
115 None Street,Salem M,01W0,NOT LATER THAN MIDNIGHT OF 115Nonh Smet Belem MA019lO,NOT LATER THAN MIDNIGHT OF
I HEREBY CANCEL THIS TRANSACTION I HEREBY CANCEL THIS TRANSACTION
Consumer'a Signature Dale: Consurour'a Slgnewra Dare'.
w�,^, /A� Cp A & A SERVICES, INC.
A&A SERVICES 115 NORTH STREET,SALEM,MA 01970
fk I Telephone:(978)741-0424 Fax: (978)741-2012
Contractor Registration No. 101609
Federal EIN:04-3 09 01 6 2 Construction Supervisor No. CS057733
VINYL SIDING SPECIFICATION SHEET
Buyers)Name Date of Contract
Sco (X�tY 6
Buyer(s)Street Address,City,State and Zip Code
late; SAAgik A/bf- nL274
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
F / 7 Wi-7 g
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 IMPROVEMENT AGREEMENT,of which this Specification
Sheet is a part.
VINYL SIDING
�# Remove and dispose of existing N ing V t L1 I S\d.i of siding.
Note: T 6 bdi ld furl er V R
emove and dispose of old wooden gu rs.
i emove and dispose of aluminum gutters.
stall new.032 gauge aluminum seamless gutters and down spouts as follows:
f pen Gutter If The Gutter Shutter Color: ID In I+iP—
over body of home with 3/8 inch thick-igh Performance Insulating Board, GraQlU 3t Ad
Cover all trim with aluminum coil stock including the following: Color:
If window trim Caeluxe window trim V (I,upper porch trim �•
Fascia boards (t' oor trim Other: [3j{S$ T;. A S F 1AS))
If frieze boards -See_ Qeke boards
I5flnstall Soffit Panels: Style: t'(\�.0 Vie t Color: (OW, I
nstall vinyl siding to body of home as follows:
Manufacturer: C¢� � yt�62A Style: hngrl2qRiM A4 C Ilor. wl, 111L�
It Replace existing wooden attic louver vents with vinyl vents,
Of Cover porch ceilings with CertainTeed beaded porch panels. 6.e1{�5 idC IOu>e( �1•e'I c j e 1 i n9 pA/Ly
f Remove and re-install existing shutters.
(27 Install# 10 pair of Girardin new vinyl shutters. Nµ✓{e1r 6r-09N SPf>9%�7f'b�lovvle 57`r�lP
f Dross Post style: �rA d i')f O 1'IA I Color. L1/
„I C4 Frank/� R}stde�
Ll;oC
lean debris from grounds on a daily basis;clean grounds thoroughly at completion. C F�
�cluded in this proposal are the following items: dui t;oyt�1 �t� tft
wilding and Electrical Permits /gy p pn;1 0 eYlQy
('93asic Electrical work including removal and remounting of fixtures electric service,and wires. I �e
f asic siding accessories including light,outlet,spigot blocks,dryer vents,and exhaust vents, i NS idteofxw5, 5c/7Anv
M iizY�d y ArderS i 1�(i�^
SPECIAL INSTRUCTIONS:
Vthtl)s;deotecleIi ruiiim-P Treize lard /rnk
rI.951i I.uinJew -r-Dwor +uwle-ny rA-i)e G&/ n i?ni4141 aN ",rrl
i--nicludedis R�rey ZL1 !vw hc�rr Or-sLziggnq oa<4za11)af ,1 tA�00�drri
vre ., Aaa
rov d� �ryu r t�nzt�Qr! / w i// be CIr C nrd
r C� CP i �,oeu soft }s �f��'7n ZX S-I`OC�k
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,damage from vandalism,or Improper use.
It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
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. Bu (s)hereby acknowledge that Buyers)
has read this Specification Sheet.
A91 ��( rlts
Contractor Initials. � �. Date: � Buyer's Initials: Dale:
�p��°— A & A SERVICES, INC. 9 Z� 3
A&A SGR 115 NORTH STREET, SALEM, MA 01970
11:1 1.rt a 1i Telephone;(978) 741-0424 Fax: (978) 741-2012
Contractor Registration No. 101609
Construction Supervisor No.CS057733
Federal EIN: 04-3090162
MISCELLANEOUS SPECIFICATION SHEET
Su er s Name 41 pate of Co ract
Bu ers Street Address,Chy.State and ZIP Code
Da ime Telephone Number Evenin Tele hone Number Mobile Telephone Number E-Mail Address
7 2f
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 IMPROVEMENT AGREEMENT,of which this Specification
Sheet Is a pan.
SPECIAL U
INSTRUCTIONS 1
rt „t ",1inrn s i�'Rrq i C�,+- ���P ra yt nL'Qj
I Sinus r I. bj<- 1141 �fl crn ` oc u-L-S F li rla 7 C}fnJ?piJ
{S b'A-CkP_r-S
® D AA r _s Fec i rcl udeeA ;Yi p(,a,jec_ 4p I,4r1 k s wyad -� ►
'A �s�e IIAl 4- f nc �e 8 nod
,nnn t � �e �u � F R Ira .1.e ) 1�
1k\lot e� `I {n In revtnueAO1U A reaulAf kti*sis
LA)GluC11r< i S -}t'i &AraVe`AJ- nC- /t/eLL) C •.IAr-"� W i rtdakJ
eep� le �'+ Strc)e C9'�' lilo/115-'
F a wo6 cluAe�r� n-Ler t rnnl+ tb(Cl e9C R_ Ah `1—
b ht
bc.7�ccL1
is agreed and understood by and between the ponies that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes
e entire understanding between the dames, and there are no verbal understandings changing or modifying any of the terms. This contract may not be changed or its
terms modified or vaned in any way unless such changes are in writing and signed by both the Buyers)and the Contractor auyens) hereby acknowledge that auyer(s)
has read this Specification Sheet,
Contractor Initials: �� Date: � 6�1y
r Buyers Initials: Dale:��
Barbara Zorry
To: Kevin Talbot C-+ ; C '
Subject: Scott Mountain Elec Permit Salem
Hi Kevin
Can you pull the electrical permit for:
Scott Mountain
60 Bayview Avenue
Salem, MA 01970
Thank you.
Barbara Zorzy
Office Manager
A&A Services, Inc.
115 North Street
Salem, MA 01970
(978) 741-0424
1