37 ENDICOTT ST - BUILDING JACKET The Commonwealth of Massachusetts
d Board of Building Regulations and Standad�SPECT IONA S ERV OF
Massachusetts State Building Code, 780 CMR SALEM
����tt Vls*lar 2011
Building Permit Application To Construct,Repair,Renovate(11llYfelilb'lish�a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION } '
1.1 Prroperty ddresst ('l 1.2 Assessors Map&Parcel Numbers
rwf9f
1.1 a 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? Municipal ❑ On site disposal system ❑
Check if yes❑
' SECTION 2: PROPERTY OWNERSHIP'
2.1 O}{nerPorgRec d:
�� ) City,State,ZIP
37 FAJiro S�•
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) 11,
F
New Construction❑ Existing Building❑ 1 Owner-Occupied ❑ Repairs(s) ❑ eration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units Other Specify:
Brief Description of Proposed Work': -
��y"vc W
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs: 4
Item Labor and Materials Official Use Only ,
1.Building $ 1. Building Permit Fee $P - 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: $ a l ❑Paid in Full ❑Outstanding Balance Due,
SzNT TO )Ne� L. W111
SECTION 5: CONSTRUCTION SERVICES
1 5.1 Construction Supervisor License(CSL) �j —7
License Number Expiration Date
Name of CSL Holder Z,. Eric W.Palm -
List CSL Type(see below) (/t.,
3 Milton Sheet
No.and Street Safm MA01970 Type - Description
U Unrestricted(Buildings up to 35,000 cu.ft.
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Mason
ry
RC Roofing Covering
WS Window and Siding
—7 �y SF Solid Fuel Burning Appliances
1 Insulation
Tele hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 1 / `�
HIC Registration Number Expiration Date
HIC Company Name or HIC eg,st nt ate AwnUe
No.and,Street OYS 1C�I1Ci�A 01970 *7"!i'/' I" �v{ 5 9 q Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,cr 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 Issuimj9wof the building permit.
Signed Affidavit Attached? Yes .......... No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN .' t
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize C r�C 1 JCt,(/Vw)
to act on my
behalf,in all matters relative to work authorized by this building permit application. I r
�ln-11% L( l �6 PL) 101L
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
t
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is a and accurate to the best of my knowledge and understanding.
S2-G eGt I{'1'1
1 n 1o (� l��
Print Owner's or Authorized Agent's Name(Electronic Signaturo�� Date
&m� NOTES. v I
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. og v/dos
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"maybe substituted for"Total Project Cost"
�\ The Commomcealth of Massachusetts
1^ t Board of Building RcgulWiuns :md Staildalds \II 'NI( LI'.\I.fll
Massachusetts State Building Code. 780 CMR, 7°i edition
131.lildim_ Permit Application To Construct, Repair. Renovate Or Demolish a Rrrur,l.holual
One- or Tit o-Fumih' Dite lin.q
This Sectio or O icial Use Only
Building Permit Numb ❑ Applied: -- — —�
Building Commissions Ins)ector of B uldin Dale
SECTI : SITE INFORMATION
1-1 Propertr :\ddress: 1.2 Assessors Map & Parcel Numbers
Z �V1Q�f C (�t t �7IYP P �h�. i-4 oZ --- -
t? yes ✓ na— Map Number Parcel Number
I.I a Is this:m accepted sure y
1.3 Zoning Information: 1.4 Property Dimensions:
Lot Area Isy fit) Frontage slit
Zoning District Proposed Use _
1.5 Building Setbacks (ft)
Front Yard Side Yards Rear Yard
! Required Provided Required Provided Required ProaidcJ
1.6 Water Supply: (M.G.L c. 40, §54) 1.7 Flood Zone Information: - 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone" Municipal disposal
On site dissal .system ❑
Public❑ Private ❑ Check it yes[] -
SECTION 2: PROPERTY OWNERSHIP'
Owne 'ofRecord: Eryd1rr)t' Sty-ea Unit
Address for Service:
Name i��.r� /J� re � (q I O) 7,YpJ - IS 25
��Si¢nature / Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK 2(check all that apply)
New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairsls) ❑ .Alteration(s) Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
�,Sfiail rUA�S-
I rep
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs: Official Use Only
I- Item - (Labor:md Materials)
L Building $ q '� 1. Building Permit Fee: $ Indicate hum lee is Jelerinined:
❑ Standard City/Town Application Fee
2. Electrical S ❑Total Project Cost' (Item 6) x multiplier s
i
7. Plumbing S 2. Other Fees: $
4. Mechanical (HVAC) S List: —
S. Mechanical (Fire S I Total :%II Fees: S
Su. ression) -
� � Check No. Check :\mount (',uh Amount:_--_ :
Total Pro ect Cost: /1 D35. -__
J " U V ❑ Paid m Full ❑ Ouuumding Bul:mre.Dur _�.__
SECTION 5: CONSTRUCTION SERVICES
i.I Licensed Construction Supervisor(CSIJ -51733
f �rI_ SIP r License Number F.\In//r:/w!n
Nameof('SL- Ilolder List CS I.'rrpe(we hehm) l�
�'�, e Dcscri sUrtn - .
WJrees L lnrc5lnC0.•d II lU 3i.lN)L)( u. Fl.
R Restricted I&'_ Funnl\ Dskelhtn,
f S!_natU /� M Nlasonn Onk
V � RC Res!deniial Ruufiku Cotc one
Telephone N'S Resuleuual \\
Re inJu.s end SiJua_
SF sidential Solid Fuel Runung \tth:mrc In.a.ill.m��u
- D Rro!deuual Ucmoliunu
i.� RegXered home Improvement Contractor 011C) 1 olIo09
rJ .fV1�D� =Y1C' I2egtstratiun Number
HIC Comp;ury.Name or HIC R-gisuani Name
�0�aCo ll�
Address - oat)7HI �642-q F j.oatiun Date
Saenuturc 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-:.........-It?--_ ..__..No_._. ...,_ p._ . _
SECTION 7af OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1 as Owner of the subject property hereby
authorize ✓{r� y-)e 2cr z..T__
r to act on my behalf. in all matters
relative
en t/o�work authorized by this
building permit a Iy
pplication.
Siature of Owner J 1// ��— Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
1, /'Snr�tJ,�-�(,�� Zr�1�Z(.�1 , as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and
behalf.
b'Z —
Print Na a
Signature of Own r or Autl orized .Agent Date
(Signed under the pains and eenalties of 2er ti )
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 arbin'auun
program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program and
Construction Supervisor Licensing (CSL) can be fiwnd in 780 C'MR Regulations 110.R6 and I ICQRS. respectively
'. When substantial work is planned, provide the information below:
Vital flours area (Sq. Ft.) iincluding garage, finished hasement/attics, decks or purchi
Gross living area lSq. Ft.) Habitable room count _-
Number of fireplaces Number of bedrooms ----
Number of bathrooms Number of halt/haths
fvpe of heating system Number tit deck,/ p,uchcs _-- .--------
. . f_nClmed __ Open____
TVpe of cooling system - — --
3. "Total Project Square Footage- may be substituted for "Tonal Project Cost-
CITY OF SALENI
s� PUBLIC PROPRERTY
a,t�ir
DEPARTMENT
gum
12 W\,Ii;,i, ,��l;fthfl ♦ tiAlfil, \fit„�i111 ,b1 :,:1'r�=
Workers' Compensation Insurance Affldasit: Builders/Contractors/Electrici Print Lei rs
k 1 licant Inform.ttion bl
/,
`:II11J 1liu.mc,; l hgantc:uunt InJn tdual l: A e A
City,Stute;'Zip: Gn 1 e VYl t a bl cum
Phone #: L �7SS ) 7N I - CPA 1
.\rrc l ou an employer? Check he appropriate box: Type of project (required):
1.LJ 1 am a employer with_A5-- 4 1 am a general contractor and 1 6. New construction
employees(full and/or part-time).' hate hired the sub-contractors Remodeling
I ant a sole proprietor or partner-
listed on the attached sheet. t
ship and have no emplovees rhese sub-contractors have 8. ❑ Demolition
..T._-.w.urking_for me in-any c'QAnty-•_W _ workers' comp insurance. 9. Building addition
-- ---[No.workzrs' sump. insurance - - ?___�-\Ve.ire a curpur�iiun and its _ IO..Q_Electrical repairs or additions
roquirzdk officers have exercised their
right of exemption per MGL 11.0 Plumbing repairs or additions
3.❑ 1 am a homeowner doing all work S
myself. [No workers' comp. C. ploy employees.
[ and or have no 13. Roof repairs
insurance required.] ' employees. nc workers' I3.[•�Other)/\IIYI�OWrJ
.comp. insurance required.]
•;\ny applicant that checks box#I must also till out the section below showing their workers'compensation policy information.
I lomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
(lmtractnrs that cheek this hox must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
l inn an employer that is providing workers'cotnpe,tsation insurmtc•e for my employees. Below is the policy and job site
information, --r1�
Insurance Company Name: 1 Y t6, I r�A V ��>✓:�„'
r q Expiration Date: �('
Policy # or Self-ins. Lic. #:rV�1C—I ��'1x ICy,l��o p . -
Job Site •\ddressAl EndI onTI ,1►�� City/State/Zip:�'[{� M��70
Attach 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
ER and a fine
tine up to S I.5U0.01) and;'or one-year imprisonment. as well ;ts civil penalties in the firm of a STOP WORK ORD
tf up to S_'i0.(10 a day against the violator. Be advised that a copy of this statement may be titrwarded to the Office of
Imrstiaalwils of the DIA for insurance cuserage cerificauon.
l do hereby rc i-61..i- r t r rep i is m d penalties of perjury that the inform atlon provider/above is true and correct.
Date: � O
t;.uure:tthoilc =: 973
U /'7
I)f/trio!use only. Do nut write in dri.r area. to be compered by city ur rown ujJiria[.
Per ntiti Lic ense #_.._—.—. ..- --- ------------
Isnuing luthority (circle one):
1. Board of ilealth 2. Building,Department 3. City/Town Clerk J. Electrical Inspector 5. Plumbing Inspector
b. Other -- --
Contact Person:_ --- _-- Phone
Information and Instructions
\L(S..(chuscuS (;cneraI l_;tws chapter I�' rrywreS :;II cmple%ers it)pro\ide workers' compensation for their employees.
I'!.tr;u.0 It o III is Scuute, an em pG{ree is defined as c%ery person in the set\ice fitmolhcr under any contract of hire,
c\It:cSs or implied. oral or written."
\n :nrplrtr'er is defined as "an ind;vdual. p.;nnership, .issuc(atiun, corporation or other la_al entity. or any hvo or store
of the I'orgoina engaged in a joint enterprise. and-Including the IegaI rcpresen(at i%es of a deceased enipluver, or the
rccei%cr or trustee of;m individual, partnership. association or other legal entity, employ ing clip Iovees. I-luwe%er the
WA ter of a dwelling house h:n In I! no more than three apartments and who resides therein, or the occupant of the
duelling house o(:mother who employs persons to do maintenance, construction or repair work on Such dwelling house
or on (he grotmds or but Idin.g appurtenant (hereto shall not because of such employ iuent be deemed to be in employer." -
\1(iL chapter 152, �s25C(6) also States that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage re(luired."
.Wditionally, .MGL chapter 152, ii2�07)states "Neither die commonwealth nor any of its political subdivisions shall
enter into anv contract for the pertonnance of:public .wik until acceptable e,L idence of compliance whh the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary,_supply sub-contractor(s).name(s), address(I s) and phone numbers) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employeesother than the -- - -- _
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the.Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license isheing requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' -
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please he sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permiu'license number which will be used as a reference number. In addition, an applicant
that must submit multiple pe=iulicense applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under"Job Site Address"the applicant should write "all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
Near. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. it dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit.
File ullice of Invcshgations would like to thank you in advance for your cooperation and should you have any questions,
plc:ue do not hesitate to give us a call.
the Dcpartnwrit's address. telephone and tax number.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigs'lons
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
www.mass.gov/dia
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 properly licensed facility as defined.by M. G. L. c. 111, Seca
150a.
The debris will be disposed at: Salem Transfer Station
owned by Northside Carting -
S� n turb of P rmit Applicant
9/8ID6
Dates
Christopher Zorzy
Name of Permit Applicant
A &A Services, Inc.
Firm Name
115 North Street. Salem, MA 01970
Address, City, State, Zip Code
j Board of Building Regulations and Standards
Construction Supervisor License
License: CS 57733 ,
Bi rth date:_.5_/26/1958
E-airatton 5/26/2009 Tr# 13739 J
+R25tnction 00'.,
CHRISTOPHER ZORZY
115 NORTH ST
SALEM, MA 01970 `" Commissioner
_a. _ _....,._.._....,.._,._._..�.a_�...a_ w_.-�__r.._., _._�...__ -._ _ ,._ ._.._ .✓!� - ammo..... �-o�✓��aaeaCl,,,.,eetta.�<.._.
- --. -Q�' _Board of Building Regulations and Standards - '- -
HOME IMPROVEMENT CONTRACTOR
Registration: 101609
Expiration: 6/26/2010 - Tr# 267870
=Type: ,.Private Corporation
A&A SERVICES,INC =
Christopher Zorzy1.
115 North Street
Salem, MA 01970 Administrator
Commonwealth of Massachusetts
_ Division of occupational Safety
Laura M.Martin,Commissioner Tj
Deleader-Contractor
CHRISTOPHER ZORZY 4
Eff.Date 04/09/08
Date 04/08/09
OCO
' DC000440
Vemberof C.O.N.E.S.T. 09
30
IIIII IIIII IIIII IIIII IIIIIIIIIIIIIII IIIII IIII)IIII IIII eOSTON RENEW
L
U-VALUES AND R-VALUES
ENERGY STAR
a inousrREs 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 �p
r
Low-E/Krypton qualify for the ENERGY STAR® program throughout the U.S.*
Clear Insulated Low-E* Low-E/Argon*
U-Value R-Value U-Value R-Value U-Value R-Value
VINYL WINDOWS
Classic Double Hung (Mechanical) 0.50 2.00 0.37 2.70 0.34 2.94
Classic Double Hung (Welded Sash) 0.50 2.00 0.36 2.78 0.33 3.03
Classic Double Hung (Welded Sash & Frame) 0.49 2.04 0.36 2.78 0.33 3.03
Classic Acoustical Double Hung STC40 0.23 4.35 0.18 5.56 0.17 5.88
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
f
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) U-Value R-Value O-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 CasemenVAwning 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.
R; 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 regieh.
For current pricing, call your local branch or visit www.harveyind.com.
`Effective 3/17/03 256
07j* F,(Os 411 D�
PROPOSAL
�R A & A SERVICES, INC.
115 North Street -
Salem,MA 01970
- - -- Tel.:(978)741-0424 Fax:(978)741-2012
MA Home Improvement Contractor's License No.101609/MA Construction Supervisor License No.CS057733 -
Submitted to: efr J A 07-7-o Work to be performed at:
Street: I Street:
City: City
State: ZIP: 01q70 State: Zip:
Home Telephone: Work Telephone:
We hereby submit specifications and estimates for. ��C"-JPA�
WINDOWS: .
WINDOW& REPLACEMENT
r'�y16 eJ .
Storm Windows:# Carefree: 1:1 Tru-Channel:
Color: �1111,� HA C
Vinyl Windows:#fir_ SIimII"rie� Comfort Plus: Majesty:El
Color:ie2h1.'- Other:
Options for windows:
Grid Pattern 0/J_Low E/Argon Gas: E3"Foam Filling: ❑
Wrap,Exterior Trim with Aluminum Coil Stock:❑ Other: El .
DOORS:
Storm Doors:# Aluminum: Solid Core:
Style Name: Brass Hardware: 7 Beveled Glass:
SPECIAL INSTRUCTIONS:
Or
S h t eAJ I yS
N S sS
S S
C . .� yl' S
mg.'A zs re
S
All material is guaranteed to be as specified, and the abo work to be performed In accordance with the
- specifications submitted for above work and completed in-a pbstantial workmanlike manner for the su of." "_ -'---- -- - -- - '-- -
.* 2 as "o- - d c - _Dollars
with payments to be made as follows: P7ea,rolts `972
Any alteration edeiefion Ch ab ove specifications involving Respectfully submitted
extra costs,will be executed only upon written orders,and Sales Representative
will become an extra charge over and above the estimate. All Agent for A&A Services,Ina a _
agreements contingent upon strikes,accidents or delays beyond -
our control. Owner to carry fire,tornado and other necessary NOTE: This proposal my be withdrawn by us if not accepted
insurance upon above work. Workmen's Compensation and within ninety(90)days.
Public Liability Insurance on above work to be taken out by
A&A Services,Inc.
ACCEPTANCE OF PROPOSAL
The above prices,specifications, and conditions are satisfactory and are hereby accepted. You are
authorized to do the workk as
specified. Payment will be made as outlined above.
ell
Signature Date
Signature Date
—You may cancel this transaction,without any penalty or obligation,within three business days from the atgning of
this proposal.— -
DATE:
q o ta
Citp Df &afem, �ffla!�!arbu5ett5
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED I
Location of Building �� �ndl cOt I JtY?C , On, T
Building Permit Application For: 1 4 3
Circle whichever applies) Roof, Reroof, Install Si ct Deck, Shed, Pool
Addition, Alteration eparr/Replace 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:"Pa 01 -u Contractor: C h r i s t n n n a r 7.n r 7.y
)
Street 37 Yl(� I�f3f� 51reCk, City Ln Street115 North Straat City_ Salam
State.MR Phone 6%) I1M- q D�3 State MA Phone(97g) 741-0424
Architect: City of Salem Lic4 1405
Street City State Lic#0 5 7 7 3 3 HIP# 101609
State Phone ( ) Homeowners Exempt Form yes i/no
Structure: (please circle) Single Family, ulti Family# Other
Estimated Cost of job$ ►o l N l, t;C)
Will building confirm to law? yes no
Asbestos?_yesI/no
Description of work to be done:
_ Atl -+-wei* 4h )(- yintal ngr i(n( ov>nfI4 le)indbof)
ERVICES
Drawing b fitted: es • no Mail Permit to: 115 NORTH STREET
% r9AI E39 Af4-5:879
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 Mep/Lot
Permit fee$
COMMENTS:
I
No. (O
APPLICATION FOR
' PER Td . . .��
LOCATION
PE MIT GRANTED
� ) 7A0 1s
INSPECTO OF BUILDINGS -
CERTIFICATE OF OCCUPANCY .
YES
NO �• 1
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