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1 GALLOWS HILL RD - BUILDING INSPECTION (2) 1 AF,PL_ICATTION FOR ' PPRW Tn d LOCATION - �.-- PE MIT GRANTED V3 E) IL9 APPROp j F INSPECTOP OF UILDINGS CERTIFICATE OF OCCUPANCY y a , YES NO s. d DATE: Citp Df �azm, fiaaLjuEtt PLANS MUST BE FILED AND APPROVED BY THE INSPECTOR PRIOR TO A PERMIT BEING GRANTED I QQ t Location of Building ( Cx_ t b)35 LU n Building Permit Application For: '(Circle whichever applies) Roof, Reroof, Install Sid' ct Deck, Shed, Pool Addition, Alteration, epair/Replace, undation Only, Wrecking v 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 t( (ry1Q .l MPr� h� Contractor: Chr; stnohar Zor7.;. _ Street . Cit} Street115 North StraatCity .Salam State M(:1 Phone ) '7HH-5 957 State MA Phone (978) 741-0424 Architect: City of Salem Lic# 14 0 5 Street City State Lic#0 5 7 7 3 3 HIP# 101609 State Phone ( ) Homeowners Exempt Form_yes�no Structure: (please circl Single Fami Multi Family# Other Estimated Cost of job $ 1 D'-1Qn.n(7 Will building confirm to law? yes no Asbestos?_yes/no rr \ Description of work to be done:�l 'F()I)��eP1�1 f i H 1 SERVICES Drawings Submitted:_des no Mail Permit to: 116 NORTH STREET % g.er.P.�r r 8�8^e8 X Signature of Appli ation,SIGNED UNDER THE PENALTY OF PERJURY CONSTRUCTION TO BE COMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE Department use only: Permit# Zoning Map/Lot Permit fee$ COMMENTS: The Commonwealth o Massachusetts usetts Department of Industrial Accidents 0///000/%YOStl08U00S 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location: city Phone# ❑ I am a homeowner performing all work myself. p 1 am a sole proprietor and have no one working in any capacity ❑ 1 am an employer providing workers' compensation for my employees working on this job. compturname: A & , A: Services , Inc. address: 115 North Street city: Salem', MA 01970 ohone# 978-741 0424;`5} "�`"t ` y}}B''` insurance co. The TraPlersDolicv# WC939X1256 ❑ 1 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: yts address: `{{t���Fri city-phone M• insurance co: Doliev,# company name• address. -airy city: hone#. 1$a`fr�lw�«J, qt': insurance co. .. I�I �`, sy noliev.q Failure to acture coverage u required under Section 25A of MCL 152 can lead to the imposition of criminal penalties of a nae up to 51,500.00 and/or one years,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a nue of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. Ida hereby certify u e the ains aand penalties ojperjuty that the information provided above is true and corre'ct.. J Signature a . R i] / Date Printname_Christopher Zorzv President Phone# 978-741-0424 F only do not write in this area to be completed by city or town official : permit/license# I'•IBuilding Department QUcemlogffoard o immedhte response b required Qseleetmens OfBee Qlfalth Department rson: phone#• r'IOther 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. 119, Sec. 150a. The debris will be disposed at: Salem Transfer Stadon owned by Northside Carting - Signa ure of P it 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 U-VALUES AND R-VALUES ENERGY STAR Rv�•INOVSTRIES Harvey Manufactured PARTNER Windows and Doors + WHOLESALE PRICING • U-Values in accordance with NFRC-100 • Based on residential sizes Aft • 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 Low-E/Krypton qualify for the ENERGY STAR* program throughout the U.S.' Mai Clear Insulated Low-E* Low-E/Argon* VINYL WINDOWS U-Value R-Value U-Value- R-Value U-Value R-Value 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 Vinyl Roller- 2 Lite and 3 Lite 0.50 2.00 0.36 2.78 0.33 3.03 Clear Insulated Low-E* Low-FJArgon* VINYL NEW CONSTRUCTION WINDOWS(P9190-231) U-Value R-Value U-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-Vatue 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-FJArgon* 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 CasemenVAwning 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. 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 region. ve 3/17/03 w For current pricing,call your local branch or visit wwharveyind.corn. EMec6 +� 1111a rd of Ileildi nI Rcgnlations wW Standards HOME IMPROVEMENT CONTRACTOR l = Registration:9 101609 Expiration: 6/26/2006 Type: Private Corporation A&A SERVICES, INC Christopher Zorzy 115 North Street Zz `fry✓ Salem, MA 01970 Administrator Commonwealth of Massachusetts Division of Occupational Safety Roberti Prezioso,Deputy Direofa Deleader-Contractor CHRISTOPHER ZORZY Eft.Date 1219/03 Exp. Date 1220/04 ' DC000440 ,} Membe of C.O.N.E.S T. 7 NO IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII BOSTON-RENEW j BOARD OF BUILDING REGULATIONS `-r License: CONSTRUCTION SUPERVISOR { i' Number: CS 057733 Birthdate: 05/26/1958 Expires: 05/26/2005 Tr.no: 12224 Restricted: 00 CHRISTOPHER ZORZY / 115 NORTH ST rz..aa SALEM, MA 01970 Administrator