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14 FLYING CLOUD LN - BUILDING INSPECTION DATE: C, itp Df gbal,ni, y PLANS MUST BE FILED AND APPROVED BY THE INSPECTOR PRIOR TO A PERMIT BEING GRANTED Location of Building /y F1 UIYX) Cfn(Ili Mn Building Permit Application For: '(Circle whichever applies) Roof, Reroof, Install Sidin ct Deck, Shed,Pool Addition Alteration, a air/Repl e, oundation 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: OwnersName:BjrlCQe1 O 'HahweL1 Contractor: A eA Set"ytceS'(t}1n5 ZbtA sweet__LH I�aty,ra('Irnt 'Llt/iPcin 'yUrn Street-1115 Narkh City- lam-, State N`(1� Phone State Mfl Phone. (q78 77 Architect: City of Salem Lick- PHo5 Street City State Lic b57 HIP 4 ©1(0 09 State Phone ( ) _ Homeowners Exempt Form_yes__I/no Structure: (please circle) Single Family, Multi Family# Othe C� n�TbL<Y7hOLCS2 Estimated Cost of job S_ 5 q,( , Will building confirm tt law?_t/ ves no Asbestos?_des ✓ no Description of work to be done: A&A SERVICES, INC. Drawin $ b fitted: ves no Mail Permit to: 1 SALEM,MA 01970 X W5 VQWW.A-A tnvic Signature of Applic lion,SIGNED UNDER THE PENALTY OF PERJURY CONSTRUCTION TO BE COMPLETED WITHIN SIX (6)MONTHS OF PERMIT ISSUED DATE No '? APPLICATION FOR LOC TION :. PEg�}MIT GRANTED I• APPROVfD CTOP OF UILDINGS CERTIFICATE OF OCCUPANCY . YES 1 NO /O q' American Properties Team, Inc. /\ June 27, 2007 Ms. Bridget M. O'Mahoney 14 Flying Cloud Lane Salem MA 01970 RE: Request for new windows Dear Ms. O'Mahoney: Thank you for your request for permission to replace the windows in your unit. Please be advised,the Board has no objections to the replacement of these windows. You will need to pull a permit from Salem City Hall prior to having this work take place and a copy of the permit must be sent to my office upon completion. The new windows must be the same in appearance as the existing windows. No grids and no crank out windows will be allowed. The new windows must also fit the same opening. Any damage to the building and/or clapboards must be repaired by the contractor. If the association needs to replace clapboards as a result of this work, it will be charged back to the owner. Should you have any questions or concerns, please feel free to call me directly. kamroper�ty incerely, a Manager American Properties Team, Inc. Managing Agent for the Sanctuary cc: File 500 WEST CUMMINGS PARK • SUITE 6050 • WOBURN • MA • 01801 781-932-9229 FAX 781-935-4289 NThe Commonwealth of Massachusetts m^t - Department of Industrial Accidents 1'I t 6 Office of Investigations �l. 600 Washington Street - - - - %o/ - - - - - Boston,MA 02111 - r+ www.mass.gov/dia. Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /t Please Print Le t,i biv Name(Business/Organization/individual): A QJ A Cjor yi(a t T n o_ Address: 1 15 rJ or+h 11 r(f e � City/State/Zip: :5pj p pA M Kl Of 9-70 Phone #: 21-I I - 0<1 a N J A remployer?Check the appropriate box: Type of project(required): mployer with �� 4. ❑ I am a general contractor and 1 6. ❑New construction es(full and/or part-time).' have hired the sub-contractors le proprietor or partner- listed on the attached sheet. t 7• ❑ Remodeling have no.employees These sub-contractors have 8. ❑Demolition for me in any capacity. workers' comp.insurance9. ❑Building addition oworkers'comp. insurance 5. ❑ We are a corporation and its 10. required.] officers have exercised their ❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 11 _ O.therr/�t! Jq/p comp,insurance required.] •Any applicant that checks box#1 must also fill out.the section below showing their workers'.compensation policy information. t itomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. te.ontractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees Below is the policy and job site . information. "r—f� Insurance Company Name: t 1e__ Tm y l e Policy#or Self-ins.Lic.#: �f(_' G]�q X I a LO Expiration Date:: Q ha os Job Site Address: IN E2Ulf7 Q CAL � � City/State/Zip: X-I/eM M149 0/9P�o 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 fine up to$1,500.00 and/or one-year.imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of tip 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 d th ains and penafties of perjury that the information provided above is true and correct: Signature: L O 1) Date: _Phone#: P "18) 76�I D f { '�1 } Official use only. Do not write in this area,to be completed by city or town offrciaL City or Town Permit/License# Issuing AF ity(circle one): -- 1.Boardalth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person• Phone# Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two of more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(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 required." Additionally, MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter-have been.,presented to the-,contracting authority." e t 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(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)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 be 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department'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 Revised 5-26-05 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 - Signdfurie of Perrmit Applicant ll- L07 Date Christopher Zorzy Name of Permit Applicant A & A Services, Inc. Firm Name 115 North Street, Salem, MA 01970 Address, City, State, Zip Code ✓k lOomvmaow�ea i o�✓�Gam¢chuaedd Board of Building Regulations and Standards Construction Supervisor License .. License: CS 57733 Bidda &26/1958 tl i2p2009 Trll 13739 �i2�rtst��Od� ! 'k W� di CHRISTOPHER Z© �_ 115 NORTH ST SALEM,MA 01970 Commissioner setts of Massachusetts u Division of Occupational Safety Robert J.Rezioso,Commissioner R Deleader-Contractor (�Q CHRISTOPHER ZORZY Eff.Date 04/02/07 Aftk Exp.Date 04/01/08 an n w DC000440 . s wriberof C.O.N.ES.T. 8 vv - BO 1111IN11111111111111111111 BOSTON-RENEW S �J�tB "100�)tmtMu!/e¢GI/L O�✓//LadOtldLttQe�d''' Board of Building Regulations and Standards I HOME IMPROVEMENT CONTRACTOR Registration: .]01609-_ Ezp1ratiow.:6/26/2008 1 Types;,PriJate Corporation -" ! ABA SERVICES, INC Christopher Zorzy; 115 North Stree4 Zalem, MA 01970 Depnty AdnrmsL-1:or • � p,,, wr�T�pg,/���A A & A SERVICES; INC. �&A.a��QEiI10ES 115 NORTH STREET,SALEM,MA 01970 Romiromm Telephone:(978)741-0424 Fax:(978)741-2012 Contractor Registration No. 101609 Federal EIN:04-30 901 6 2 Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET - Buyer(s)((NN�ame ll Date of Contract Buyers)Street Address,City,State and Tip Code M Ga/otnc( L-,nc 5Zlcyn Isla O{9 70 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address ` 70 '7'/O-L376 The auyeds)listed above hereby jointly and severally agree to purchase the goods armor services listed below,in accordance with Me prices and terms described on Ibis Specification sheet and the front and the reverse of Me accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Spe,ifical on Sheet is a part. WINDOW REPLACEMENT OqH/ Remove and dispose of at Z existing windows. r� Install # Z new 5"UVRI5£ VAIJ6- Kl windows: Avinyl ❑Wood (Manufacturer) Options: Style To Lil—f SLIgaL(Z Grid pattern Color Interior uJef/7'�. Color Exterior 6,)4 yT`G Glass Type Z PANf- LG 4..%AR6oN ❑ Wrap exterior trim with aluminum: Style /VO Color , All windows will be installed according to the installation procedures in the portfolio. (7� Caulk all interior and exterior edges. Insulate where possible around new units. A( Insulate window weight pockets it exist,and around new window units where possible. ik 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 ❑ Create new window opening by cutting through existing home and framing in opening. ❑ 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. O 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 window(s)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 storm window(s). ❑ Install new storm windows# Manufacturer Style Color Option ❑ Remove and dispose of 0 existing storm door(s). ❑ Install new storm doors# Manufacturer Style Color Type: ❑Aluminum ❑Solid Core SPECIAL INSTRUCTIONS: I MI fleation Sheet along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT cantonal 'It a etal u and standing btl by end between,a part<s Mel a Spec L 9 Me s Metal understanding between Me less such them s a e I variant understandings and signed by changing the or modBran and any of Me torma.Tllla hereby may not bge that Suriname) na be ) terse ad this tl e varied in any way unless sucM1 changes are In writing and signed by boM the Buye4c)and Ma contractor. Buyer(e)M1emby acknowledge that Buye4s) M1ec matl Mla Spedflcetlon Sheet Contractor Initials: 12 Date: Buyer's Initials: Date: A. A & A SERVICES, INC. A&ASMICES 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- - -- CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Buyers)Name Date of Contract y Buyer(s)Street Address,City State and Lp Cade /y F! i✓I Cictud Lime 6;-,) [em iY)A o7gr/o Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address: 978 '790 L31 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 Me front sold the reverse of this agreement and any specification sheets(this"Agreement),and Buyer(sl 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 insW I or Cause to be installed the products Or services listed in this Agreement at the Buyers)address written 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 fireing or approval of any financing Buyers)may seek for their purchase. Purchase Price: Jw344..4`0 Kp-.QlFICP_ Z Est.Starting Date' Down Payment: w$-)$,00 /J�iN DO�J y Es[.ComPletian Date:l!-Z�-C7 ❑Cash Amount Due on Start of Job: O Check O Credit Card Amount due on of Completion: No. Amount Due on of Completion: Expiration Date: _ Balance Due an Upon Completion: J 031,00 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. 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. Buyer(s)also (I)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 e-mail,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 TBIS CONTRACT IF IT CONTAINS ANY BLANK SPACES. Services,Inc. 'Buyer(By: Sign [e Signature J. '011Ias: * �� DIET 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',Themnoxtnmd Ne MnaowrcrherebymmuellyewinsWeamw lnrremaniNmerpanyhasadlspNmnmmireeswntml.enherpc mey:utftanda to . a pirvale ar iharim eeMm which has been amememe"a a1 Me Evetullea Cole a ComumerAftm amatiuslnem resume-one Na or party cast hawul.1.stadia he Bch abandon as paved In M.G.L c.14m. lon _lost A'] 7 Gap, uu'vL:,gN dowlime beNl D.w: lOu_7 7_O�- Dee. NOTE O�Lr ATION NOMQF OF r'AN r Oa1e or Travel P-'I -C You may chmi MIS aviseclmn,wines any p pple or Data or Tanzman)0-17-0Y.,Yoe may cancel Mist 4armhuh,wNaur any penalty or cbllfraNpn MmmiremixslneNdenhure eeCpvedae.awmmnmL" ropeMlr lMkn, obtieal n,when three drs n daw man tlw stave date.11 you camel.arty,pmceM a WIn, any payments made by you under Me Conmtl or able,eM any nppardw immumem e6tutee arty peymena made by y antler the Compact a Sete,and my raximatle msWmem eRcsM by Wu mice-r.am.w1am 1.days1.1.1,receipt by the Saner of your cenculation mace, by you Mn be marred wMm to days farmers except by the selx of your computation Write. and my mmdly IntV se est arise,Wt of Me bmsetlM mn n will be mllm, ifmr you i,you mum ane my SecurityIdeream arms capof Me tnnmRm well be anem p, moll ed. If . you must nake awmeae orMe s4lw at yowre90....M LM un as of Matson m cone wswm, nwke whimphe M Me sever N your 2 .in submantia aagaad coamom AS whonreaNed, any seem.beer...o.code MIS Commit or see:or you may n you war.¢mpN MM Me Am, mat dehhoem to yw ardor me Comet m scab:w you may,if you war,¢mrly with Me ins9ucmns of the aelkr reparderq Me rewm shipment of Me gems al Me SNlere ogeme,and machadlbna N Me SWISS remrdkng Ma relum Im mom M Me,cods N Me seem emenee and Rsk. n you do make Me gTtla Miami m Me sNk,and Me saner...nm may M.m up MM. n you Me make the pwme avtilace m the Seller me Me sane'does not pick them up within al more of the dataof year Notice of Can,Yu9lM.you May reran or dlapose of Meg os Amon M clan 0 Me dam at your Name of Cenmllauon,you may ease n do,..1 me am6s whout vy W.odia.um.Il you tail to make Me gate armu a to Me Salk,o,it,.aflxe w^Maut pry limner musumM.Il you fist M make Me g66s uppolle m the Senn.or s you Berea to pure Me¢Wa of Me same are me he ad be man you M con liable far mdwmvwe of NI bneum my g»me to Ma sell cane fear to do AS,Mm yw a me.link or pedorm can m.1 NI WIIg ns mom Me Coned To canal MIS transaction.mail o,dNivea simea LM dated may Some dv ardor the Coral hec 1 be.lavamkn,nisi par dNNxr A NgWa me eatMmpy .11a aew.1.net—ar an,nMm wdlbn mum,or pone.iNagrom,ksseserema.Its of Me cataM on mdce m my All when recall,or and a klp2m,to ABA Swerme.its NpM$ttm.Sam.MAAMx Nusalte plaid.NOT LATER THAN MIDNIGHT OF JO-LO-Q'; real street,Spam,Ma9etluwal4.01 See.NOT LATER MAN W.mGHT OF G.; (DN.) I HEREBY CANCEL THIS TMNSACTION. defamers siemu. 6.1. 1H ERE51 CANCEL M.TRANSACTON. CanwmmY BgewWk Dam