5 HAWTHORNE BLVD - BUILDING INSPECTION DATE: 1
Citp Df 6&afe Ti, JRAE;!5AL Ugettaq
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building 64 1' �>� 10 rry.- n� /�P i/ard
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install Si ' ct Deck, Shed, Pool
Addition, Alteration, epair/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: 54m Fv)KM Contractor: ChristnnnPr 7.nr7.g
Streets City 51IPm Street 115 North Straat Clly�a7Pm
State /I Phone (RFM 74-I--7535L State MA Phone(978) 741 -0424
Architect: City of Salem Lic# 1405
Street
City State Lic#057733, HIP# 101609
State Phone ( ) Homeowners Exempt Form _yes no
Structure: (please circle) Single Family, Multi Famil 3 Other
Estimated Cost of job $_I XZ
Will building confirm to law? yes no
Asbestos? es y/ no
Description of work to be done:
Ivy r I l I(r;i ✓h� - �/vr� ( �7� Vi ac ornPn+
Drawings ub i ed: yes no Mail Permit to: 1.16 NORTH STREET
_ % per-FIIR r�A>t879
Signature of W11 on,SIGNED UNDER THE PENALTY OF PERJURY » a
CONSTRUCTION TO BE COMPLETED WITHIN SIX (6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# Zoning Map/Lot I
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Permit fee$
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DIS?OSAL 0: DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40 , 554, 1 acknovledge that as a
condition of Building Permit v all debris resulting from the
construction activity governed by this Building Permit shall be disposed of =:
a properly licensed solid waste disposal facility, as defined by MGL c III,
S 150A. Salem Transfer Station owned by:
The debris will be disposed of at: Northside Carting
location of facility
T 1 Date
ignature of P4 e /—: ,7
Aplicant
Fully complete the following information:
(?lease print clearly)
ChkiAtBphetcZe;iyc.
Name of Permit Applicant
A & A Services, Inc .
Fir= flame, if any
115 North Street , Salem, MA 01970
Address , City 6 State
I
The above stnrLt a 'a7uire5 ;hat debris from the demolition. renovation, reha'
or other alteration of building or structure be disposed of in a properly
licensed solid waste disposal facility as defined by MCL cIII. S150A and tha
building perils or licenses are to indicate the' iocztion of the facility at
,
The Commonwealth of Massachusetts
Department of IndustrialAccidents
0f%el1aresUpeUeos
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
name;
location:
city phone a
I am a homeowner performing all work myself.
❑ 1 am a sole proprietor and have no one working in any capacity
0 1 am an employer providing workers compensation for my employees working on this job.
comoanvinme; A &, A •$ervlCes , Inc . ry,
address: 115 North Street t*� 'T r'� 1
',si'yiv t
city: Salem 'MA 01970 kttln'e� i
ohonea 978-741=Q424 4�`t(t'�" 2i
insuranceco hP Tradelers oolicva WC939X1256 ' "�•3 Y'f 3 "`' i`
1t
L J I 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: , ;'i �L...... , '
t5
address: ,fu'SP?!k
city:
hone a• 'trd '
insurance co:
Company name
J 5'
address.:'
y
city:
'hone q:, ,J.'yAa�'t��!�•r, s:
insurance co. . nolliv a
r r ttS a9k�` '
Failure to secure coverage w required under Section 25A of MGL 152 can lead to the imposition of criminal penalties a oft fine up to SI,S00.00 and/or
f a me. I understand that a
copy of this statement may be f rward to the Office of Investigations of the DIA for coverage verification.
l do hereby certify undo th - and aloe jper)uiy that the Information provided above Is true and correct.
Signature` -~- - ) I (7
Date
Printname Christopher Zorzv President phonea978-741-0424
official use only do not write In this area to be completed by city or town official
city or town: permittlicense N ilBuilding Department
❑check If Immediate response is required 0114eafag Board
❑selectato's Omce
contact person: 0ifealth Department
phone N; flOther
f.
I
I
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR y
- Number 057733 fi
Birt 05136k 958 s
60 Tr.no: 12633
yy Re ^
CHRISTOPHER F — r
t 115 NORTH ST G-
-,. n i, SALEM MA 01970 ^w -
p,.
4 Commissioner
t.!
rl"
� '✓� L/04N/IIEO%LII/Pr(LC[� O�i�Q�(l!.'/tUWz(4 I
Board of Building Regulations and Standards
L
>i HOME IMPROVEMENT CONTRACTOR -
Registration: 101609
Expiration:_6%26/2006
.1 I ,Type:._Private Corporation. '
' A&A SERVICES;INC P 1 -I
Christopher Zorzy K t i -
115 North Street � p
y Salem;MA 01970
k„
Administrator
Commonwealth of Massachusetts
Division of Occupational Saf
ety
i
^' Robert J.Prezioso,Commissioner tits
+fkleader-Contractor
CHRISTOPHEKZORZY
Eft.Date 01114/05
Dale 01/13 DC f06 06 -
DC000440
Menbwof C.O.N.E.S.T.
BO
BOSTON-RENEW
,
Ba Shore GREAT LAIC
WINDOW
NFRC Certified Solar Heat -
Product Directory Gain Visible Light Condesation Energy Star
Product Type/Popular Glazing Options Number U-value Coetrcent Transmission Resistence Approved Report u Expiration Date
Double Hung GLW-DH-131 ETC-04-552-15669.0 11/30/2008
Clear IGU 0.47 0.59 0.62 42.00 No
All Gnds idth<l' 0.47 0.53 0.55 42.60 No
Hi-R Plus Low E Argon IGU 0.31 0.30 0.55 53.00 Yes
All Grids idth<l" 0.31 0.27 0.49 53.00 Yes
Maxuus Double Low E ATon IGU 0.31 0.28 0.49 53.00 Yes
All Grids idth<1" 0.31 0.25 0.43 53.00 Yes
Slider GLWSL-131 ETC-04-552-15791.01 12/28/2008
Clear IGU 0.47 0.56 0.59 42.00 No
All Grids idth<l") 0.47 0.50 0.52 42.00 No
Hi-R Plus Low E Argon IGU 0.32 0.28 0.52 54.00 Yes
All Grids idth<1" 0.32 0.25 0.46 54.00 Yes
Maxuus Double Low E Argon IGU 0.31 0.26 0.47 55. 00 Yes
All Grids idth<l" 0.31 0.24 0.41 55.00 Yes
Picture GLW-PI-131 ETC-04552-15753.0 12/10/2008
- Clear IGU 0.47 0.66 0.69 44.00 No
All Grids idth<l" 0.47 0.59 0.62 44.00 No
Hi-R Plus Low E Argon IGU 0.30 0.33 0.61 56.00 Yes
All Gnds idth<t" 0.30 0.30 0.55 56.00 Yes
Maxuus Double Low E Argon IGU) 0.29 0.31 0.54 57.00 Yes
All Grids idth<l" 0.29 0.28 0.49 57.06 Yes
Casement GLW-N-033 ETC-02552-12497 11/7/2006
Clear IGU GLW N 033 001 0.45 0.51 1 0.54 No
All Grids idth<l" 0.45 0.47 0.49 No
Hi-R Plus/ Low E Argon IGU GLW N 033 083 0.30 0.27 0.47 Yes
All Grids idth<l" 0.30 0.25 0.43 Yes
Fixed Casement GLW-N-001 ETC-02552-12499.0 11/8/2006
Clear IGU GLW N 001 001 0.50 0.63 0.67 No
All Grids idth<1' GLW N 001 002 0.50 a57 0.60 No
Hi-R Plus Low E Argon IGU GLW N 001 005 0.31 0.33 0.59 Yes
All Grids idth<l" GLW N 001 006 0.32 0.30 0.53 Yes
Awnin GLW-N-034 ETC-02552-12497 11/7/2006
Clear IGU GLW N 034 001 0.45 0.52 -0.54 No
All Grids idth<1' 0.45 0.47 0.49 No
Hi-R Plus Low E Ar on IGU GLW N 034 083 0.30 1 0.27 0.47 1 Yes
BayShore
Ba Shore GRFAT-. LAKES
... WINDOW
NFRC Certified Solar Heat -"
Product Directory Gain Visible Light Condesation Energy Star
Product Type/Popular Glazing Options INumber U-value Coelrcent Transmission Resistance Approved Report irationDate
7
All Grids idth<1" 0.31 0.25 0.43 Yes
V New Construction Door taro) GLW N 050 ETC-03552-144613 11/18/2007
Clear IGU 0.47 0.62 0.66 46.00 No
All Grids idth<l" 0.47 0.55 0.58 46.00 No
Hi-R Pius Low E Argon IGU 0.30 0.32 0.58 68.00 Yes
All Grids idth<l" 0.30 0.29 0.51 58.00 Yes
YFAC -
Footnotes: Residential values single strength lass U-values w/o grids
7----e-. ,r U-valuew/ rids
I
BayShore