6 HAWTHORNE BLVD - BUILDING INSPECTION DATE: / oZ 05
Citp Df dal, M, 1.a55arbU'gttt'q
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building ip t4Q 6c) hi)rrn
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install S' ' ct Deck, Shed, Pool
Addition, Alteratio Repair/Iteplace 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:
Owners Na�tme: ka.l van � 0,h �) �-�a Contractor: C h r i s r o n h P r 7.n r7.y
S _
Streetq �'lr vipU City Street I19 North Rtraat City Galam
State.Ma Phone RIO) 6AI- 91acD State MA Phone(978) 741-0424
Architect: City of Salem Licq 1405
Street
City State Lic#0 5 7 7 3 3 HIP# 101609 9
State Phone ( ) Homeowners Exempt Formes V no
Structure: (please circle) Single Family, Multi Family#__ Othe l ,pyy9yyi0rr� �jf�y��y(Sp�
Estimated Cost of job$_3 ram_
Will building confirm to law? yes no
Asbestos?_yes—/—no
Description of work to be done:
10clall S1X ( U) Vltll,li Le4ILJUM& - 1.t)Ir 'aQL S
SERVICES
Drawings m' ed: es no Mail Permit to:g hefi FORTH STREET
S- 1TJIR,4 9:870--
�{ ;3r
Signature of Application,SIGNED UNDER THE PENALTY OF PERJURY --- -rn-
CONSTRUCTION TO BE COMPLETED WITHIN SIX (6)MONTHS OF PERMIT ISSUED DATE
Department use o ,nnil# Zoning Map/Lot i
Permit fee$�=X"
CONKMS:
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DIS?OSAL OF D_B.— AFf1DAVIT
In accordance with the provisions of MCL c 40, S54, 1 ackno::ledge that as a
condition of Building Permit 1 _# . all debris resulting from the
construction zctivity governed by this Building Permit shall be disposed oI
a properly licensed solid waste disposal facility, as defined by MCL c III,
S 150A. I
Salem Transfer Station owned by:
The debris will be disposed of at: Northside Carting
location of I2c1_1ty
9-aa-os
Signature of ?e = ;applicant Date
Fully co=plete the follocing information:
(?lease print clearly)
Chki§t6pheicZoriyc.
Name of Permit ApD__tant
A & A Services, Inc.
Firm Name, if any
115 North Street , Salem, MA 01970
Address. City d State
The above 5rz zu1:e 7e?uir`_s :hat debris front the demolition. renovation, reba.`
or other alteration of building or structure be disposed of in 2 properly
licensed solid _aste disposal facility as defined by MCL cII1. S150A and tha,
building permits or license5 are to indicate the' location of the Iacility at
The Commonwealth ofMassachusetts
Department of industrial Accidents
Ofl/ce0{/oreStlDs000s
600 Washington Street
Boston,Mass. 02111
Workers'Compensation Insurance Affidavit
name:
location:
city phone#
1 am a homeowner performing all work myself.
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.
comoanvname: A & ,.A'Seryices , Inc . k , q„t , 2alr
t a
address: 115 North Street ix$ fl3ar ' '
city:_ _ Salem, MA 01970
phone# 978-741=Q424 v v iti nit Jt
insurance co. The TraSelers ooliev# WC939X1256
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 F.,t:''°t•
address rt` 31k
city: .,.;., htineq• %'rrtt-0h
insurance co: D0IiCV#
company name
address:
+ i
1
.: {[�.�y in it�. '_'J15U
city: ;- 1 ., : "hone k: -,.^yAabr a' .
insurance co: .
olf
#
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. 1 understand that a
copy of this statement aye
forwarded to the Office of Investigations of the DIA for coverage verification.
t do hereby certify u d r t pains and penalties ojper)ury that the Information provided above is true and correct.
Signature Date 9-22 -os
Printname Christopher Zorzy, President —Phone#978-741-0424
official use only do not write in this area to be completed by city or town official
city or town: permit/license# I—IBuilding Department
❑6lcenslog Board
❑cheek irimmediate response is required ❑Selectmen's Office
contact person: phone#• ❑Health Department
nOther
,..,/!(re L/bnLJ)to9 "" 0�✓�.6dJ[!f/Nrd� C
BOARD OF BUILDING REGULATIONS t
license: CONSTRUCTION SUPERVISOR `
- Number: CS 057733 ,
Birthdate: 0512611958-
Expires: 0 5/2 612 0 0 5 Tr.no: 12224
Restricted: 00
CHRISTOPHER ZORZY.
115 NORTH ST
SALEM, MA 01970 rustrator
/, �onrmw o�✓Ll ezac%(a
- Board of Building Regulations and Standards
,1 = HOME IMPROVEMENT CONTRACTOR -
Registration: 101609
Expiration: 6/26/2006
- Type: Private Corporation
ABA SERVICES.INC
Christopher Zorzy
115 North Street
Salem,MA 01970 Administrator
Commonwealth of Massachusetts
.............
Division of Occupational Safety
Robert J prezioso,Commissioner
Deleader-Contractor
CHRISTOPHER ZORZY
Eff.Date 01/14%1
DC000 te01/1306 O �
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BayShore GREAT IA
NFRC Certified Solar Heat
Product Directory Gain Visible Light Condesation Energy Star
Product Type/Popular Glazing Options Number U-value CoeHicent Transmission Resistance Approved Report a Expirafion Date
Double Hun GLW-DH-131 ETC-04-552-15669.0 11/30/2008
Clear IGU - 0A7 0.59 0.62 42.00 No
All Grids idth<1' 0.47 0.53 0.55 42.00 No
Hi-R Plus Low E Argon IGU 0.31 0.30 0.55 53.00 Yes
Al Grids idth<7' 0.31 0.27 0.49 53.00 Yes
Maxuus Double Low E Argon IGU 0.31 0.28 0.49 53.00 Yes
All Grids idth<7' 0.31 0.25 0.43 63.00 Yes
Slider GLWSL-131 I ETC-04-552-15791.0 12/28/2008
Clear IGU 0.47 0.56 0.59 42.00 No
All Grids idth<7' 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
AM Grids idth<1" 0.31 0.24 0.41 55.00 Yes
Picture GLW-PI-131 ETC-04-552-15753.0 12/10/2008
Clear IGU 0.47 0.66 0.69 44.00 No
All Grids idth<7' 0.47 0.59 1 0.62 44.00 No
Hi-R Plus Low E Argon IGU 0.30 0.33 0.61 56.00 Yes
All Grids 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<t' 0.29 0.28 0.49 57.00 Yes
Casement GLW-N-033 ETC-02552-12497 11l7/2006
Clear IGU GLW N 033 001 0.45 0.51 0.54 No
All Grids idth<1' 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
Al Grids idth<1" 0.30 0.25 1 0.43 Yes
Fixed Casement GLW-N-001 ETC-02552-12499.0 11/8/2006
Clear IGU GLW N 001 G01 0.50 0.63 0.67 No
All Grids idth<7' GLW N 001 002 0.50 0.57 0.60 No
Hi-R Plus Low E Argon IGU GLW N 001 005 0.31 0.33 0.59 Yes
All Grids idth<7' GLW N 001 006 0.32 0.30 0.53 Yes
Awning 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<t" 0.45 0.47 0.49 No
Hi-R Plus Law E on IGU GLW N 034 083 0.30 0.27 0A7 Yes
BayShore
Ba Shore AREA LAKE ®
DOW
NFRC Cerfifiled Solar Heat
Product Directory Gain Visible Light Condesation Energy Star
Product Type/Popu/ar Glazing Options Number U-value Coefficent Transmission Resistance Approved Report# Expiration Date
All Grids idth<7' 0.31 0.25 0.43 Yes
SlIdIna Patio Door
New Construction Door(APD) GLW N O50 ETC-03 652-14461-3 11/18/2007
Clear IGU 0.47 0.62 0.66 46.00 No
All Grids idth<7' 0.47 0.55 0.58 46.00 No
Hi-R Plus Low E Argon IGU) 0.30 0.32 0.58 58.00 Yes
All Grids idth<t' 0.30 0.29 0.51 58.00 Yes
vrnc
Footnotes: Residential values single st ngth glass U-values w/o grids
total unit values DS or TS worst U-value w/odds
BayShom