The URL can be used to link to this page

175 FEDERAL ST - BUILDING INSPECTION The Commonwealth of MusSaChusells .. 2� It )K 1 13o:ud of Building 1212gulatiuns and Stand:uds \II Nlt'll'.\I.I'll"\ y MaSS:lChLISCUS State Building Code. 780 ('MR. 7" cdititm tiff Buildin_ Permit Application Construct. 2epair. Rello%:Jte Or Demolish a Rcru ,/lrnu.n, 011C- ofTi o-Family )trellili.q "'his Se-tion For O"final Use Only —1 ----... —_ Building� Permit N D to Applied: brc Pf —"-- _— �i�/ag 11 Signature: --- I i u ommissioned Insp or of 1 ne SE A O SITE INFORMATION 1.1 Pro eriv Address: 1.2 Assessors Map & Parcel Numbers Sire e-i M1la N'iunher P:arel N umhcr I.to b this:m accepted snret? yes_ no_ P . 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq It) Frontage(It) _ 1.5 Building Setbacks (ft) j Front Yard Side Yards Rear Yard Required Provided Required Provided Required Pro%IJCd 1.6 Water Supply: (M.G.Le. 40. §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone' Municipal ❑ On site disposal system ❑ Public ❑ Pri rate❑ Check if yes❑ SECTION2: PROPERTY OWNERSHIP' L 2.1 pwnerrof Record: �5 F2d2-a N me 1 Pri 1 Address for Service: - •, -tea _ _�97R� '7HO 5Z3 Signature —Z G( Telephone S CTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction ❑ ExistingBuilding ❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) :\ddiiinn ❑ Demolition ClAccessory Bldg. ❑ Number of Units Other ❑ Specify: Brief p Descri tion of Propused ork': , uJOt� GJ/nC2�1�GJ � ��J� SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Official Use Only liem (Labor and Materials) L Building $ L Building Permit Fee: Indicate how fee is Jeieimined: ❑ Standard City/Town Application Fee ?. Electrical 5 ❑Total Project Costt (Item 6) x multiplier .r — i. Plumbing 5 2. Other Fees: S J. Mechanical iHV:\C) $ List: - i. Mechanical (Fire ,� Total :\II Pees: $ Su)tressinnl - � Check No. Check :\muurtt: (•.inh :\nxwnr.--_"- ', j 0. Folal Project Cost: ova L7 n 0 Paid in Full - 0 Outstanding Baktnre Due_— SECTION 5: CONSTRUCTION SF,RVICF,S 5.1 Licensed Construction Supervisor (CSL) 733 Mi License Nuinher H..Npirawm Daio Nano oI CS L I I der L.i,l CSL 7\'pc I>tc helukcl '\d�r4��A.`NI} i Dcs:n anon �.. (' X1 C L'nrcclnclyd�u�In:�.UUO Cu. hLi I R Raetnrled I.\' F:umh D\�rlhne .1'rvnut M "LlsResident Unls 12C Residential Huulinc C'a—cri m! felcpho1w N'S Rcadcuttal \\'ntdu�� .urd Sidinc S1= Residential S�did Purl Iiunune V r(lance In.t.ill.anai D Peadennal Ucmoliwm 5,2 Re�istered Ilotne Im ruvement Contractor (1110 J, r A SPrVttDS TIC _C0O_q_ HIC Comp;u y Nance or H C egistr a N'a 12aguuauun Number Addr•ss � _ ��(� Frpu':wun Date St¢ndtme Telepione SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted .kith this application. Failure to provide this affidavit will result in the denial of the Issuance of 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, {r , as Owner of the subject property hereby authorize �n to act on my behalf. in all matters relative it work authorized by this building permit�ppliration. off' Skmature of net - Date �J SECTION 7b: OWNERt1OR AUTHORIZED AGENT DECLARATION 1, as Owner or Authorized Agent hereby declare that the statements and information on the foreg ing application are true and accurate, to the best of my knowledge and behalf. Print Naine Signature of Owner of Author zed Agent Date (Signed under the pains and penalties of perjury) NOTES: 1. . An Owner who obtains a building permit to do his/her own rvork,.or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor (HIC) Program). will not have access tn,the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Progr:un and Construction Supervisor Licensing (CSL) can be found in 780 CMR Regulations I I0.R6 and 110.R5.'respectively '. When substantial work is planned, provide the information below: Cutal floors area (Sq. Ft.) (including garage, finished hasemenU:utics, decks or porch( Gros living area (Sq. Ft.) Habitable room count Number of fireplaces - Number of hedmums __ --.-- tA'umber of b:uhrooms Number of hall/hath, -- ._ _-- fvpe of heating system — — Number ofleeks/ p rchcs J fvpe of cooling s)'stem Enclosed Open 3. "Total Project Square Footage" may be Substituted N)i 'rotal Project Corot" _J CITY OF SALEM 07Al PUBLIC PROPRERTY DEPARTMENT ,.scnnu r't i'nr, ,'I i \L\`"n 1_' \\'��I il��,:��i;atl- I • 1.�I ill. \1.�•�Ar Ill �i I :.�l•r-: I'pl . )-8- ii-•)SYS Workers' Compensation Insurance :\fiidaxit: Guilders/Contractors/ElectriciansiPlumbers Please Print Legibly \ t lhtant Information //\\ �+ y( Nall Ile ,nu>in A �e,; lhgant[au,nt Iudns.Juall: A US �Fnc- ddress: 115 ►re e-+ City,State;'Zip: �n l o im t-l)q of c1-1 D Phone0� 1 .\r�eyou an employer? Check the appropriate box: rvpe of project (required): I.lJ I all, a employer with_- 4. ❑ 1 ant a general contractor and 1 b ❑ New construction employees(full andror part-time).` have hired the sub-contractors 7. ❑ Remodeling listed on the attached sheet. '.❑ I i a sole proprietor partner- .1-hese sub-contractors have 8. ❑ Demolition shil)p and have emploo yees working fir me in any capacity. workers' comp. insurance. 9, ❑ Building addition j, ❑ We area corporation and its [No workers' comp. insurance ID.❑ Electrical repairs or additions required.[ officers have exercised their n>ht of exemption per bIGL I L❑ Plumbing repairs or additions t.❑ 1 am a homeowner doing all work 6 P P ❑ Roof re myself. [No workers' comp. c. 152, 12.0 pairs 1(4), and we have no insurance required.) f employees. [No workers 13.ZOther k11ran 16KS comp. insurance required.] •,,\uy applicant that checks bon p 1 must also fill out the section below showing their workers'compensation policy information. leowncrs who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new alfidavit indicating such. ('ontru I that check this bus must attached an additional sheet showing the name of the sub-cuntractors and their workers'comp. policy information. I am mr employer that is providing rvnrkers'cantperr cation insurance for my enrp(n},eec. He-1— is the policy and job site information. Insurance Company Name: Policy # tit Selt=ins. Lic. 4: Expiration Date: `- Job Site Address: J76— 11 e-YQl -SAe— T City/State/Zip:� IPm Attach a copy of the workers'compensation policy declaration page (showing the policy numberand expiration date). Failure to secure coverage as required under Section 25A of bIGL c. 152 can lead to the imposition of criminal penalties of a tine up to S I,Soom) and/or one-year imprisonment. as well as civil penalties in the firm of a STOP WORK ORDER and a fine t d up to S 1_50.110 a day against the violator. lie advised that a copy of this statement may be forwarded to the Office of Inse.,tic:uions of the DI.\ tin insurance coserage verification. - /do hereby cvvvi/1' tun tl puins and penultie.s of perjury that the information provided above is true and correct. Date: �jgn,iuoe, _ Do not tcrite in this area. to be ion ipleted by city or town oJJiciU1 Cite or Turn: - .__ - --- Issuing \uthority (circle one): 6 5. Plumbing Inspector I. Board of lieallh 2. Building Department 3, CihiTuwn Clerk 4. Electrical Inspector P'" 6. other Phone q: Cnutact Information and Instructions \Lis..lchu>c Is ( eneral 1..;nvs :hapicr I rrgwres I cinpIoxers to prep ide workers' compensation fi)r IIieir eniploytes. I':.it suant to eh is ar lute. .in employee is ,lain ed as c�crx person in the 'el ice of.urether under anv :oniract of It .•\press or iniplicd. oral or written.•' . An enrplorrr is delined as ",in indit;dual. p.untenhip. .tssoccnion. corporation or ether legal entity. or ;sty Iwo or more ,d the fbrcgoing engaged in ajoint enterprise, and including [lie legal represcntatixcs of a deceased employer, or the r::ci�er or trustee of an indiv Waal, partner>hip. .ssoeiation or other Icgal entity, enhploy ine employees. Howr�er the ,�•s ner of❑ dwelling house haxine not more Ihan three aparnncnts and who resides therein, or the occupant of the d%.e clling house ofanother who employs persons Io do maintenance, construction or repair work on such dwelling house ,n on the grounds or huilding appurtenant thereto shall not because of such employment be deemed to he an eniplo%er." \161 :hapter I5?, �25C(6) also states chat "every state or local licensing agency shall withhold the issuance or renewal of a license or pennitto 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 required." Additionally, \IGL chapter 152, ss_'S( I7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfoiniance of public %%oik until acceptable et idence of compliance with the insurance reyuirenhents of this chapter-hate been presented to the contracting authority.*' - Applicants Please fill out tlhe workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, Supply sub-contractors) name(s), address(es) and phone nuniber(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LIP) with no employees other 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 is'being 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 -f the affidavit for you to till out in the exent the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license 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 year. where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leases etc.) said person is \'OT required to complete this affidavit. -fhe I)Bice of Investigations would like to thank you in advance for your cooperation and should you hax'e any questions, pleJbC do net heSitatC to glx'e US a :all. I he Dcparunent's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 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, Sec. 150a. The debris will be disposed at: Salem Transfer Station owned by Northside Carting - Signature of Pekmit Applicant Date Christopher Zorzy Name of Permit Applicant A & A Services, Inc. Firm Name 115 North Street, Salem, MA 01970 Address, City, State, Zip Code ✓lee 'fJomLlnn9u/lea�Uc li��CIaG.CId ' c-- Board of Building Regulations and Standards Construction Supervisor License License: CS 57733 _Birthdate 5/26/1958 } Expiration 6/26/2009 Tr# 13739 � Restnctlon 00' rF CHRISTOPHER Z RZY ir' 6 iI 115 NORTH ST SALEM, MA 01970 ` Commissioner 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 Zorzya 115 North Street •� i Salem, MA 01970 Administrator Commonwealth of Massachusetts .. Division of Occupational Safety Laura M Marlin,Commissioner �u Deleader-Contractor CHRISTOPHER ZORZY Eff. Date 04/09/08 Exp. Date 04/08109 ' DC000490 Member of C.0.N.E.S.T. 09 $, 80 IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII STON RENEW ' t A & A SERVICES, INC. Y 0CES 115 NORTH STREET,SALEM,MA 01970 Telephone:(978)741-0424 Fax:(978)741-2012 - - - Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET auyer(s)Name Data of Contrail _ Buyers)Street Address,City,State and Zip Code -ecYe S i,P,q AU, 0 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address -7?- -7qO- The 9uyens)listed above hereby jointly and severally agree to pumhase the goods and/or services listed below,in accordance with Me prices and terms described on Mrs Specification sheet and Me front and the reverse of the aaompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,'of which this Specification Sheet is a part. / WINDOW REPLACEMENT ar R move and dis ose of# Fl y/� existing windows. Install # f V� new I') 'n rcO windows: ❑Vinyl "God (Manufacturer) -{-•(ti-a- Options: Style f Grid pattern $ tkUwG ,4! �! Color Interior �%,e Color Exterior t P9A idle 1 h2. Glass Type 5j Ijqje S ❑ Wrap exterior trim with aluminum: Style /Color Cl All windows will be installed according to the installation procedures in the portfolio. ❑ Caulk all interior and exterior edges. _,I, '1`i..y W-5 A-fW—V , •D Shs-�s W, t14. +U)D ❑ Insulate where possible around new units B N�7�/ l!" Yex'e" '1 Ww� bmAw� LYA K c ❑ 1aSulale window weight pockets if exist,and around new window units where possible. AA�a `-1`� 1,pA rc�7 R"/ luded in this proposal are set up,clean up,Hepa vacuum and cleaning windows inside and out. J ✓'I��T� Building permit included. BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS ❑ Create new window opening by cutting through existing home and framing in opening. ❑ Remove and dispose of existing units)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. ❑ Bay ❑Bow ❑Casement ❑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 ❑ Remove and dispose of# existing stone window(s). ❑ Install new storm windows# Manufacturer A . Style Color Option ❑ Remove and dispose of# existing stone door(s). ❑ Install new storm doors# Manufacturer Style Color Type: ❑Aluminum ❑Solid Core SPECIAL INSTRUCTIONS: (_ln� vl"o �110� L5�1lco' �Tuoon coYt� site_ F�cm.cn� r;�4t4 s.d¢aEflazu� �li�I c o r �rsn4� � A>n a.Po4 1 S l i e"Or W W ll,�tl/ UA•GNYi�Od P n i N'F tr�mS �a 1hc1O C Caulk VWW fm}eli if-5.1 •.P' ems' tit 41,1 p I'nFligg for&44I d t is agreed and understood by and between Me pardes that this Specification Shaet along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,consulates the entire understanding between Me panlee,and mere are no verbal understandings&engine or modifying any of Me terms.This contract may not co changed or Its terms modelled or varied in any way unless such changes ere in sell and signed by both tlm Buyer(.)and the Contactor.Beanie)hereby acknowledge Mat Buyerle) nee read Mis SWilieadon Sheet- Contractor Initials: S L— Date: 13 OFF Buyer's Initials: DLILLLt) Date:-1.�2�13-06C� V Ate— ahoe19N A & A SERVICES, INC. A. SERVICES ICES 115 NORTH STREET,SALEM,MA 61970 059wieTeR7011100FINNUMM Telephone:(978)741-0424 Fax:(978)741-2012 . Contractor Registration No. 101609 - Federal EIN:04-3090162 Construction Supervisor No.CS057733 CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Buyer(s)Name Date of Contract Buyer(s)Street Address,City,State and Zip Code I7S-- e3er,4IS-[ of Daytime TelephoneNumber Evening Telephone Number Mobile Telephone Number E-Mail Adore. (O OHO The Boyer(a)listed above hereby jointly and severally agree to purchase the goods antler services listed on the accompanying specification sheets,in accordance wen the prices and terms described on the from anal Me reverse of this agreement and any specification sheets(this'Agreemenr),and Buyer(s)have requested that such goods or samiwa be installed or provided at Buyer's address listed above.A&A Services,Inc('CDntracmn,hereby agrees to Install or cause to be installed the products or services listed in Mien 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 me goods and rvrices purchased az described her��a n,�r��ardless of timing or a r val of arty financing Buyers)may seek far their purchase. VA�j jqrW Purchase Peterw� Est.Starting Date: Down Payment: �.L Est.Completion Date: ❑ as Amount Due on Stan of Job: ❑ ck ✓1$A edit a d Amount due on of Completion: No. Amount Due on of Completion: Expiration Date:-�laJ O Balance Due on Upon Completion: CVC Code: L 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 mad 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 forma,on the date first written above. Buyer(s)also (1)acknowledge that they were orally informed of their right to cancel this transaction;and(11)request that they be contacted via their telephone numbers or a-mall,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 EF IT CONTAINS ANY BLANK SPACES. A&A Services, c. L Huyer(s) l _ By. Signature .. . . Signatur IjAlidl Print Name not 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. e ManR4PON:(lie ambecrol BM Ne M1omwwner M1ereby muNMN M,w In eEvBrce Net N Ne erect viper pvlY nee a NaWle cmceminp Mb contract eilMr OaM mry wbmH a 1F EbpNe ro e ghee vpincom mrcm enufn nu Ivan epp,wBJ try Ne s«retuy M Ne ExB.vM ofiw oI CanWmwnmlre/act stamens Rpuiate-e BM lle oNer perry meW Ire reryire0 m-unne m Wtli 0NNB4Jn 69 pmvM In M.G.1-e1iYA. ceenwuria., Due:•IupJa'./ t� eels M Tenvctlon u¢Ina4 mq see- NeCBMeI Nu bwBCtl�•��MrJ.J}w'Npul`/QBn�Y GB��nyN Or Dad o1 Twermen Nam.yauu may wo el ass be ppeopo n,whew any owner,a r Wl:;.,w him Meele dayoham Na.Jale.IIyup cM.,fensfeMpwledln, dMlpalbt wMM Nree piuinNtlW2 hpn NB eNve tlab.Il pu.I.Wryla2pMaBdedin. ,shrpens coed.,/ uMx Ne compon or aed,.any nepetlWa lnWu.exmle] aw prymeres male G'you under the contract Or ash.ud eq,vylMpb lnsWmeM eewNetl by you wN he returned wMm to hove amps a seems by Ne Soper d your caroollaM Mks, by you Mu the roamed w n1n to pays follows rsekt ty Na seller Of we mrellanon mLLe, are coy mone '.mend out of Ne ptlr3BBWn MIT M CBc.'ese. Hyou cws"you On. and any smuft lmeM wand out of Ne peneBClbn wN W 4er'owlel It you none.you must . .melded to ma Sorb W your ratleiv.maupad,NelfY as exd ow.-wen j'wd. mmv ev for Ne set.my-r,ew—ce,In suppe-hey he sued eMNot ee wM1n amvet my sscape"hwo.dyw und.she Coneas orSof a pu may.H you mv.comply wM de any pence cm-ne!of a uMa One Corbel or now;or you nun,H you MN,WmIMY wen me InBpu1Led lM swe"ugnMq Ne return sNpnem Of the swN at Ne Ses.wo—se eM livpuctlana al NB SNW,padl,th. bun element al me tWMe a em selMe exenee end ,bk II you do mW Na¢cQs-alable b the after and me seller dxa her him IMm up re. H ycu do make W gxW eveYapb b Pa$elNr eM NB SBIW dDn M BIG Nan up wIMN YO pap M NB had N your NdMe OfCercaIdXT vein Or me ve Or do,-011M gttN wMM op now 0 he de.of your nothe d cancel yn aren, u may van or expca of av Buy wltMal anyNMer Wigeticn.Xyou dilbmeke Nepude faaJebb to Me SNIn.aXyW esrw wMeutany Nw Mctogecon.Hyw leJbmWlM ao�da evMdbled MSelNr,orXyW epee he dNm lne yape to on,sae and al d do m.Iran you remMn Xage he penmman-o1 Ml b sum Ye gotle d the seer ytl fail d do W,inn you vmen rude he penwmaea Of d,thetlonewdn Ne Corbett Toeer henno.,he enil.tot' eel0,udeMNIB]mpy of fhetbns uMerWnce or my Other when name,Or worch ar p erfun,to A&ASd 11. sae�ilSaw.con Maom oranyan.r970.NOT LAMR ama MID.IG,d,w,s I come Spear She..MaoesOmare.,NOT-A, THAN t IDNIGIm man seeMo,ns tbM street Sadm.MevWvuN 019)O.NOT LATER TIAN MIDNIGHT OF� North Street SMun.MauarlamM O10I0,NOT LATER THAN MIpNIGHT OF ' (Dew) (Baal HEREBYCANCELTHISTRANSACTION. triremessnamv Dad IHhnEB1CANCELnfi.TRANSACTION. Conwmer§a'grelwe OM