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2A DEWEY DR - BUILDING PERMIT APP (003) JACKET L�hw §' r'��fi�iEtl The Commonwealth of Massachusetts ` �rl, �` Department of Public Safe tyl�l'b OCT z I A �) Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling _ (This Section For Official Use Only) (� Building Permit Number: Date Applied: Building Official: y SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) ` fll d r No.and Street City/Torun Zip Code Name of Building(if applicable) 1`V SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ Alterations I Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No / Is an Independent Structural Engineering Peer Review required? Yes ❑ No �Y Brief Description of Proposed Wor� /rn a Qc ] �e4' t V N SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement I,eCels)&Area Per Floor(sq.ft.) Total Area(sq.ft.) and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Factory F-1 ❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1 ❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 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 ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ 1 IV ❑ 1 VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑ required❑or trench or specify: Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA 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 Group(s): Type of Construction: Occupant Load per Floor. Does the building contain an Sprinkler System?: Special Stipulations: lMlatt-100 totzS SECTION 9: PROPERTY OWNER AUTHORIZATION me and Addressi of Property Owner 9.1 �1970 Name(Print) .No.and Street f , . City/Town Zip Property Owner Contact Information: Paz Title elephone No. (business) Telephone No. (cell) e-mail address aplicable,the propertyowner hereby authorizes A Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu.ft.of enclosed s ace and/or not under Construction Control then check here❑and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control r r 9?k_J y ' - N me Telep�Z e-mail ata Regis tiCon Number � Registration Street Address City/Town State Discipline E3 3pna e 10.2 General Contractor —_14�4 41 s yl& � Co pany Name - - � rt;S-� tONplc �l�-Z`/ yl G Name of Pers Responsible for Construction License No. and Type if Applicable eet Address City/Town State Zip Tele hone No. (business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION NSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the iss nce of the building permit. Is a signed Affidavit submitted with this application? Yes No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$- 1.Budding $ Building Permit Fee=Total Construction Cost x'l. (Insert here 2.Electrical $ appropriate municipal factor)_$ ' 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ 13 Q g (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I herebv attest under the pains and penalties of perjury that all of the information contained in this application i e and accurate to the best of my knowledge and understanding. Peslde Please print and sign name G' rt er ZU Title Telephone No. Date Stet dr s Ci To n S ate Z10 AM* l Municipal Inspector to fill out this section upon application approval: 44 Name Date Appendix 1 For the demolition of structures the building permit applicant shall attest that utility and other service connections are properly addressed to ensure for public safety. Please fill in the information below and submit this appendix with the building permit application. The building permit applicant attests under the pains and penalties of perjury that the following is true and accurate. Property Location (Please indicate Block # and Lot # for locations for which a street address is not available) sinD No. and Street City /Town Zip Name of Building(if applicable) For the above described property the following action was taken: Water Shut Off? Yes ❑ No MI" Provider notified and Release obtained? Yes ❑ No ❑ Gas Shut Off? Yes ❑ No �/ Provider notified and Release obtained? Yes ❑ No ❑ Electricity Shut Off? Yes ❑ No per/Provider notified and Release obtained? Yes ❑ No Cl Yes ❑ No C5/ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Yes ❑ No Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) /�,, /� /1�0=v A & A SERVICES, INC. A&A SER`, yW 115 NORTH STREET, SALEM, MA 01970 Pill IVA I M I IVA I W'• 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 Bu r s Name Date of Contract SIB if/i /I -, Bu er s Street Address,City.State and Zip Code Z A eWe l AL SALewI kWilq oiq,70 Da ilea Tele hone Number EveningTelephone Number Mobile Telephone Number E-Mail Address 3Z �'25/3 awrcrts rNi 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 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 Buyer's address listed above.A&A Services,Inc.('Contractor"),hereby agrees to install or cause to be installed Me products or Services listed in this Agreement at the Buyers)address written above.This Agreement represents a cash sale of goods and services.The Buyerts) agree to pay in cash the cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyers)may seek for their purchase. fic" Purchase Price:0/17 x Est.Sterling Date' _S ��- Down Payment -70 Est.Completion Date: EI' Cash Amount Due on Stan of Job: Check Credit Card Amount Due on_of Completion: No Amount Due on_of Completion' Expiration Date' mpl Balance Due on Upon Coetion /3Of��]k 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 acknowledge that Buyer(s)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 wrftmn above.Buyeds)also(I)acknowledge that they were orally informed of their right to cancel this 4ansaction;and(ii)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 Service Inc Buyer(s) /, By: h t lux'a- -� Y400 -Signature yy� S Signature Print Nam � X I ffm�el 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 wnhadde and ed homeowner hereby muluellyagroo m atl,scranat In Pe even)ether party has a dllcpute wnceming this conhacho user party trey submit such corrosion dr—he atihation semre Anot has been approved by Me Senelaryof me Executive Ofire d Consumer Affairs and Business Regulations and Me o0er party shall be requires to submit anchor arbitration as proved in M G L c.112g. Cotmumriniiials /�� Seat lni tat] hate l0m y� dme'.�� NOTICE OF CANCELLATON // NOTICE OF CANCELLATION Dare of Transaction 0'S -/(D You may th cep this flans don,Arnow any penalty or Date et Tmns do�pp-��/6You may cancel this transaction voth as any penalty o obligation,within three business days fmm the above has.Ify cncel,anypropeMtradedlnr Obligation.Affin area business days from the above date.lfyoufsncer enyprepemytradedin, any peymers made by you under the contract Or sale,and any reasonable Instrument exacted any payments made by you under me eonhan or sale,and any negooade northeast executed by you At be mourned edmm 10 days following costs by me seller of your cameallatmm note, by you win be hemmed mom 10 days fonoveng mmq by me Seller of your canceaamd notice, and any security interest anane out of Me transaction All be rvncened.If you cancel,you nnst and any security interest easing out of Me hansacnon All be mnc lied.If you cancel,you must make,ova loblo t0 the seer M your roudence,and substannady in as good eandiuon as Amon made availabe to me Serer at your ma derne.and eubsmrnally in as good candmeo as when daidersed deliveredii under this convert or sale:or you may,if you wash,rompy handived,any goods delivered to you under this contract or sale:or you may,if you Ash,comply wire the rondo ens of the Senn,regaining me return shipment of Ire .its at me se0ws An are mehucnens of the Serer regarding the return shipment of the goods at me Se ers expense and nek.It you do make the goods available to no super and 0e seller does nor pick expense and ask.If you d0 make to goods invariably to the seller and Ire Serer uses not pick Main upvethin 20 days of me data of your Heads d canerantin.you may repaid or dispessofMe Them up exists 20 days of He date of your Notions of connotation,you may reran or dispusa of godds modest any NMtt obligation.If you fail to make Me goods available to to Soon or n you IhesoodswiranduryfunMrobfgation.Ifywfaillomekethegmdsevailableto Ne SelleSord agree to return the goods to the Seller and tail to do no Men you certain liable for performance of you agree be return the goods m the Seller and fail W do so.then you rennin liable for perlomnanca all sessions under me contract,To cancel this transaction,mail or defeat a signed and dated of all obligan0ns under me conlrest To carnal this transaction,manordeliverasignedand dated mpy of the cancellaYon nonce b any other wntlen notice,w senor a teal Io A&A the mpy of the surrender nonce or any other—Man nonce,or send a lelegr m,to A&A Services. 115 Norm Sides.Salem MA 01970.NOT LATER THAN MIDNIGHT OF;T-j-1 115 Nodh 5Neet,Salem MA 019T0,NOT LAlE0.THAN MIONIGHT or jO—'7�/L meet mw.1 I HEREBY CANCEL THIS TRANSACTION I HEREBY CANCEL THIS TRANSACTION • consumers signature date: Consumer's Signature Date'. t� + Astute Q =°Ce19B3 A & A SERVICES, INC. 115 NORTH ET,SALEM,MA 01970 A&A SERVICES Telepbonne:(9 8)74�1--0 24 Fax:(978)741-2012 Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET Buyers)Name Date of Contract SAfi P0OPR� Buyers)Street Address,City,State and Zip Code 2- A 1>ew9"1 D2 SAL,eolI MA 0l97o Daytime Telephone Number Evening Telephone Number Mobile Telephone Number -E-Mail Address 979-7NN-(a3 27 The Buyegs)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. / WINDOW REPLACEMENT ® Remove and dispose of# io existing w/IPtlows. Install # z62 new .S✓NQ/SL7 �fl'N E&L2•n windows:At Vinyl If Wood (Manufacturer) Options: Style 1 Grid pattern AI0'— Color Interior WH/71:% Color Exterior aU%h ME Glass Type&2"4b/T1�'i'pN�.�"13� 1464Wrap exterior trim with aluminum: Style Color ,r--yalJro- Q All windows will be installed according to the installation procedures in the portfolio. ® Caulk all interior and exterior edges. ®A�^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,Helps vacuum and cleaning windows inside and out. ® Building permit included. BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS If Create new window opening by cutting through existing home and framing in opening. f 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. If Install window(s)into opening(s). Note: if Bay or Bow installation to include cable support system,new root system(matching color as close as possible) or tie into existing soffit system. f Bay If Bow f Casement f Other windows)to include new interior style trim and new exterior style trim and head flashing as needed. Note: Painting and staining not included. STORM PRODUCTS If Remove and dispose of# existing storm window(s). If Install new storm windows At Manufacturer Style Color Option If Remove and dispose of# existing storm Coons). If Install new storm doors# Manufacturer Style Color Type: If Aluminum If Solid Core SPECIAL INSTRUCTIONS: /etrS�L �Li� W/,yDo✓VS �wti L�?vi"E'YG�te'� /NSi7�LL N[_}Lt/ UM1�n - �14L w c yL, Ph,(_i =j /SYy3 . — .DiS • / 2 ®iSCavn! &CLr= /`1YY3, pIN✓� over W/NDBVII � -TJS = 7Z�7NL O/SCD✓NTyi /3 09, It is agreed and understood by and between theprhea that this Specification Sheet,along with CUSTOM REMODELING AND PROaMENT AGREEMENT,eonstietes the entire understanding between the parties,and there am no verbal understandings changing or modifying any of the terms. This contact may not be changed or its a terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s7 and the Contractor. Buyers)hereby acknowledge that Buyers) hes read this s,mogcatlon Sheet. pp / Contractor Initials: — Vb Date: �!(� Buyer's Initials: X 311 Date:24i American Properties Team, Inc. TO: 2A Dewey Drive FROM: Jennifer Pappas, Property Manager RE: Window Replacement DATE: September 27, 2016 Please be advised that the Board of Trustees for Pickman Park has approved replacement windows for the above referenced unit. This approval is contingent upon them matching the existing windows and that they fit in the existing opening. Installation of the windows must be completed from the interior of the unit and they must be the same in appearance from the exterior. Should the installation be completed from the exterior of the unit, you will be responsible for any damage that your contractor might cause (this includes painting). The Board will not allow windows with grids, crank outs, etc. Should you contractor find any rot or damage during the window installation,please make sure that it is reported to my office immediately. We also require that permits be pulled in advance (regardless of what your contractor may tell you), and then a copy of the final approved permit once completed must be sent to APT for the unit file as well. We also recommend that owners obtain a certificate of insurance from the licensed contractor. You will need to bring a copy of this letter to the Salem Building Department in order to receive your permit. Should you have any questions or require additional information, please feel free to call me directly at(781)569-2675. cc: Unit File SOO WEST CUMMINGS PARK-SUITE 6050• WOBURN •MA -01801-781-932-9229 •FAX 781-935-4289 What is the current use of the Building? Material of Building? It dwelling. haw many units?� win the Building Conform to Law? Asbestos? Architect's Name oleVo Address and Phone Mechanic's Name Address and Phone Construction Supervisors License 0 HIC Registration# Estimated Cost of Project S /O yO Permit Fee Cab Won Permit Fee$ Estimated Cost X$7/$1000 Residential Estimated Cost X$11/$1000 Commercial An Additional $5.00 is added as an Administrative charge. Make sure that all fields are property and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above /stated specifications. Signed under penalty of perjury Date a3 NJ +` N 06* l \ y 0 CL i -OFS7PLTBZCPROPER DEPART Kl.%QWJU N p,IVYL 1 &ntsK SlnssaalLsti'Is 01970 1419'L7i5-9S" *FNt 97s.740.91N - APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION, DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUMDING 1.0 SITE INFORMATION Location Name: Building: a -A Property Address: art Property Is located in a;Conservation Ares Historic District Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land Name: _ Address: Telephone: Oc: .' 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition rExisting Renovation �/ Number of Stories Change in Use Demolition Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New Brief Description of Proposed Work: �//�� Mail Permit to: •n O 0�2 _. The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF SALEM Massachusetts State Building Code, 780 CMR, 71h edition Revised January I� Building Permit Application To Construct, Repair, Renov to Or Demolish a 1, 2008 1, One- or -Family Dwelling rs Seci.iop For Official Xe Only Building Permit Number: Date plied: /- Signature: �-e l(�f(op/1/) Building Commissioner/Inspecto f ildings Date SEC ION 1: SITE INFORMATION 1.3,P�ropett�y Address: t 1.2 Assessors Map &Parcel Numbers dj �L.1 / i 1.1a Is this an accepted sou et?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) r Front Yard Side Yards Rear Yard PRequired 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: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if yes❑ Municipal ❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP` k 2.1nOwnerl ofReco/ y 6 am C [/1 Name(Print) ''// AddT/��Js/for ryService* /'� del- nl B. HcsrAnn , / /O / l OI y Signature Telephone I SECTION 3: DESCRIPTION OF PROPOSED WORKZ(check all that apply) New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Pro osed yvor Z• O AA Z �/ L CL 7'7 d 6 ao SECTION 4: ESTIMATED CONS/TRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2. Electrical $ s ❑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: $y��1 -00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 57733 5 License Number Ex iration at N me of CSL-Holde List CSL Type(see below) Address Tye Description U Unrestricted(up to 35,000 Cu.Ft. R Restricted 1&2 Family Dwelling i nature J / /l / M Masonry Only RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel BurningAppliance Installation D Residential Demolition 5.2 giste d ome Improv men on ac (HIC) Q HI p y e IC R ant Naf ne Registration Number Address Expiration Da e Signature Telephone SECTION 6: WO RS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be comuleted and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance 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 1, rl ''4 �' , as Owner of the subject property hereby authorize 9/7 � 7 4 , to act on my behalf, in all matters relative to work authorized by this building permit applicatir t. !'n.—., 1 . goon e yJa.P/,-�a/O Signature of Owner — Date/ SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION I, (�hl7l c t� aoC , as Owner or Authorized Agent hereby declare that the statements and information on the foregoing applicaf are true and accurate,to the best of my knowledge and behalf. Print Name_ Signature of caner or Author d Agent Date J '/ i 1 Si ned under the pains and "aloes of erju 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.R6 and 110.R5,respectively. 2. When substantial work is planned,provide the information below: Total floors 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" American Properties Team, Inc. TO: Sarah Hooper--2A Dewey Drive FROM: Jennifer Pappas,Property Manager RE: SIider Replacement DATE: September 14,2010 Please be advised that the Board of Trustees for Pickman Park has approved a replacement slider for the above referenced unit. This approval is contingent upon it matching the existing slider and that it fits in the existing opening. it must be the same in appearance from the exterior. The Board will not allow grids,etc. unless they are removable. We also require that permits be pulled in advance(regardless of what your contractor may tell you), and then a copy of the final approved permit once completed must be sent to APT for the unit file as well. We also recommend that owners obtain a certificate of insurance from the licensed contractor. You will need to bring a copy of this letter to the Salem Building Department in order to receive your permit. Should you have any questions or require additional information,please feel free to call me directly at(781)932-9229 x675. cc: Unit File 500 WEST CUMMINGS PARK-SUITE 6050- WOBURN -MA .01801-781-932-9229 -FAX 781-935-4289