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464 LAFAYETTE ST - BUILDING INSPECTION (2) i The Commonwealth of Massachusetts V Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Revised Mar 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date All lied: Building Official(Print Name) Siafiatffe Da e SECTION l:SITE INFORM 1.1 Property Add ss: 1.2 Assessors Map& Parcel Numbers 1.1 a Is this an accepte street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq it) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: Outside Flood Zone? Municipal ❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'o Record: ao hn S�%�g k C+a-N t f1' A t4 ©I 9 oy Name(Print) I City,State,ZIP No.and Street c 'I elephone Email Address- . SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ 1 Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work : ' r O iln SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials I.Building $7v3 l q&, 1. Building Permit Fee: $_ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ 3 ❑"total Project Cost (Item 6)x multiplier x _ 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All Fees: $ Su ression ,L Check No. Check Amount: Cash Amount: 6.Total Project Cost: $33 r Z (P, ❑Paid in Full ❑Outstanding Balance Due: ` , , x e SECTION 5: CONSTRUCTION SERVICES 5.11 ,Construction Supervisor License(CSL) Off--i �3.3 I� ,s s'f-EQk.2 r Z0l2�/ License Number Exp ration ate Name of CSL Hold r a�, [� List CSL Type(see below) LAl-[NO v, S+ Type Description No.and Street q� p U Unrestricted(Buildings up to 35,000 cu.ft. co -C w, D l r i � � -l� o R Restricted 1&2 Family Dwelling City/fown,State,' �/�ZIP M Mason ry RC Roofin Coverin WS Window and Sidin p p �f SF Solid Fuel Burning Appliances 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) ( D 16 09 rt +' 8 ! Qe xy 1 ce-s I AC_- HIC Registration Number Expiration Date HIC Corn any NaaT���e or��iilI��Registrant Name I 1 fir\ 01 �t Nod S eet �y M �O ' 9�T ry (r v Email address City/Town,State,ZIP V _I Tele hone I SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with 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,as Owner of the subject property,hereby authorize � , to act on my behalf, in all matters relative to work authorized by this building permit applic ion. (f2�- C-01+1r'acf Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contain in thi application is true and accurate to the best of my knowledge and understanding. Print Owner's or Authorize Agent's Name(Electronic Signature) Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at wyv .mass gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/at ics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF SALE11e NL LkSSACHLSETTS BUILDLNG DEPARTSTNr p< 120 WASHINGTON STREET,3'o FLOOR TES.. (978) 745-9595 FAx(9 7 8) 740-9846 KL\IBERLEY DRISCOLL MAYORTHowtAs ST.PIFRRF DIRECTOR OF PUBLIC PROPERTY/BCILDLNG CO>11MDSSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information (� Please Print Leeibly Naine(Business,organizatiomindividual): ft+TT C__9_AJ ( C J P_S AC- Address:I / Z NO✓tk <C:�4`- City/State/Zip: Soc -e-w,, Wit— O 1910 Phone H: 97 L 711-642-7 Are ou an employer9 Check the appropriate box: Type of project(required): �I. I am a employer with-3--_.__ 4, ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors ,,��� 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. I 7. E14emodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity, workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ i am a homeowner doing all work right of exemption per MGL I I.❑Plumbing repairs or additions myself.(No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.)i employees. [No workers' 13.0Other comp. insurance required.] 'Any applicant Thal checks box BI most also fill out the section below showing their workers'cumpensatiun Policy information. 'Homeowner,who submit this affidavit indicating they are doing all work and then hire outside contractors most submit anew affdavil indicating such. lCommolurs that cheek this box must attached an:ukliti.nal sheet showing the name of the sub-contmctom and thcl,workem'comp,policy infornwfion. I am an employer that is providing workers'compensation insurance for my employees. Below Is the policy and Job site information. Insurance Company Name: Policy#or Self-ins. Lie. 0:: T09ar4a�3-eMI�b�1 _��S _ Expiration Date: 9.—) 3- 13 Job Site Address:q(,eq Lo,_ Q 4,c S4— City/State/Zip:� b_—VIAI MA-0 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 2:;A of NIGL c. 152 can lead to the imposition of criminal penalties of a f nc up to S1,500,00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may tte forwarded to the Office of Investigations of dtc DIA for insurance coverage verification. l do hereby certify under the pains nd yenahies of perfury that the information provider!above is true and correct S'„ngitire: �p Date: Phoned: Qficial use ady. Do not write in this area,to be completed by city or town offic•iat Cityor,ruwn: __„ __ Permit/i.icense# Issuing Aulhorily(circle one): 1. Board of liealth 2. Building Department 3.City/Town Clerk 4.Flectrical Inspector 5. Plumbing Inspector 6.Other Contact Person: __.._......__...____..._.. Phone#: A & A SERVICES, INC. A&A SERVICES 115 NORTH STREET,SALEM,MA 01970 uzlz• Telephone:(978)741-0424 Fax:(978)741-2012 Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 VINYL SIDING SPECIFICATION SHEET Buyer(s)Name Date of Contract Ts H J t ReZ, Div Le To 1U Buyer(s)Street Address,City,State and Zip Code qt q Lj4,fCg IETi E ST S,qL-L-- ! I'W)4 0/970 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address 74/- � 3 to i7-loos-3io y y The Buyer(s)listed above hereby jointly and severally agree to purchase the goods server services listed below,in accordance with the prices and terms described on this Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT of which this Specification Sheet is a part. VINYL SIDING Remove and dispose of existing siding. NoIe:XXyS"7Ny /l'GiiM/Nax fyi)�}�ou pzel 'Asa7.zr-vSy J1_i1v Zrwt�t 70 L MiFfIAI/ Jtj4Remove and dispose of old wooden gutters. ®Remove and dispose of aluminum gutters. /{3'x y;rr ^ ' 6F Install new.032 gauge aluminum seamless gutters and flown spou s as follows: D Sipes ®Open Gutter i The Gutter Shutter Color:/d/R, Afl S`✓-Itnee- ®Cover body of home with 3/8 inch thick Dow High Performance Insulating Board. ©Coveparrtrim with aluminum coil stock including the following: Color:..SL✓t't nT YL 6uN 1 17- t window trim U deluxe window trim45kz1, ®upper porch trim 'SEyy�L, &fascia boards Of trim `wtra,N T" Other: /71"11 W/ft/oor✓ f frieze boards rake boards Ci /,JA'Install Soffit Panels: Style: Color: T Install vinyl siding to body of home as follows: Manufacturer:G'y'n-7Tr>..71'-tip Style:C2/7�/ "P J—JColor: /11>:l 7'VrtW-L CLA q Replace existing wooden attic louver vents with vinyl vents. r rr . f Cover porch ceilings with Gemini beaded porch panels. (6r P 5i v a Remove and re-install existing shutters. &Install# // pair ofGirardin new vinyl shutters.(1>vg-Are7vo-vp Qum) �Coer Post style: C,2, N'!/772-E­ Color: f rnClean debris from grounds on a daily basis;clean grounds thoroughly at completion. If Included in this proposal are the following items: OBuilding and Electrical Permits ®Basic Electrical work including removal and remounting of fixtures electric service,and wires. Basic siding accessories including light,outlet,spigot blocks,dryer vents,and exhaust vents. SPECIAL INSTRUCTIONS: — /E-tvnwP 41,L (NJA ticw' .SiLLS /Nth exe577A.(4 FFL✓ 4r Lr rvn.�1�, n , - 12�- �ZK+-sN bor�wL r-rL my /5 �S10e'oF ICE A3m.1;- sin.N or,-r✓!. P€PV&- /Lc-j or/ "D"Sioc FnCl1Ll 13;4cG cpI-- INS-/74Gt-- GEYINY/_ 1MP2r"3S1dxI3 7-o ( 7Jpj A e5i ecv/-A IJL/v F?+?1Gcs b&-,J✓��S Gve� A-r vnwlrAivr�r e.-7t_ �d-wit,aP L lsE.✓t7 w•••�vn..,, s:�Ls AAy� /LW'71/L /hlV P-.a &Yy Fj45C14 A&A Services, Inc. provides a five-year labor warranty on vinyl siding installation to include any re•rnstaliatron of any vinyl siding, gutters,and aluminum coverage work due to any faulty workmanship. This warranty does not cover any Acts of God Including ice dams,lightning strikes,falling trees,damage from vandalism,or improper use. it is agreed and understood by and between the ponies that this Specification Sheet along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,convention the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terns. This contract may not be changed or ifs Were modified or varied in any way unless such changes are In wdting and signed by both the Buyer(s)and the Contractor, auyens)hereby acknowledge that Buyers) has read this Specification Sheet. y-ate/3 NSVVG� Contractor Initials: Date: Buyer's Initials: x/I�J Date:x `t �- L"3 `/J C�Cm A & A SERVICES, INC. At&A SER V ICW 115 NORTH STREET,SALEM,MA 01970 17,11 at 11190101CLIM IN 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 Buyer(s)Street Address,City,state and ZipCode r� Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address: p '0Mv �y t c >v a sna �s eti 6l7-791-/ti 3 (pf?-6oS-3b9y The Buyer(s)listetl 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 the front and the reverse of this agreement and any specification sheets(this°Agreement7,and Buyers)have requested that such goods or services be installed or provided at Buyer's address listed above.A&A Services,Inc.("Contrasmi hereby agrees to Install 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 goads and services purchased as tlescribed herein,regardless of timing or approval Of any financing Buyer(s)may seek for their purchase. 331 N(O Est.Starting Date s-!3 s-2 0 7Due Price: -'f _ yment: I&570.O, Est,Completion Date:'S—3!'/3 Cl Cash of Job: _ Check r g,zSB r 1N Credit Cam FAmount ue an Zi of Completion: No. ue on of Completion: Expiration Date: op Balance Due on Upon Completion. � v" s 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. Buyer(s)hereby acknowledge that Buyer(s)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. Buyers)also (i)acknowledge that they were orally informed of their right to cancel this transaction;and(ti)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 THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES. A&A Services,Inc. �/ n Buyer(s) %/J h L By. �� QU12�3 E Si-r signature ,0 0 1,Zell Print Name Print Signet e �/�l(nJ a� Q,rT/(-J%h hron � �ri/ Print Narrie 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. AnenMTICN:The roniraaor and the Mmeoamar hereby muwaly agree in advance Nat in one award either parry has a dispute wrveMy this wm2c1.after parity may submit soon dispute to e private arbiVacon per ache which has been eppmved by Me Sfittetary of the Eves uve Office of Consumer Arms antl Success"oatbns a�e other paM evil W raoulretl to submit N such arGVadon as proved InMGL.c 1wit, ,6,PVd /' . Dru: for bill I, BuyvelviYak: ' ,LS, ZuL Om= —�_,--13 wen: 1 nN NOT NOTIQF OF CANCELLATION Date of Transaction f( 2 S/3 You may cancel NIs tramagloq without any penalty or pate of Transactipn .You may consul his transaction,will arty penalty or obligatlon,witM1ln Wee business tlary tram the abve tlate.Ilyuurancelanyproper muedlq aphorism,wiNln three business days from Na eWve date.It you cmxsl,any pmpeM traded Is, any payments mode by you under the conlrat or Sale.mad son,noshes.Immanent Nowboal any payments made by you under the CmMd or Sale.and any la'sioamiffiWment ensured by you will be resume]within 10 days tolbvAig rerelpt by Me seller of your cancellation notice, by you will be raWmed w irin 10 days fulawng'—"by e s Seller r,your scoot 1, rMicu, and Ny 6ecunry lnWresl arising Wlotpb Vanuclbn Wll he cancrelled. llyoucocaMyoumad and any sewrmy Income,anchor M of the transaction will be nncell%O. Il you ranml,yW must make mralabm to me Seller at ywr resaerre.In conspicuous as gxd condition as when receWed, make avahmmlathe Mier at your revdemu,in sohm"d y se gm]candxon is when recelve0, any golds detrained to you order the commd or Sete;or you may.it you wish,comply with the are goods deltre b you under this coned or Sale;or you may,it you wish.wmpty with Ne Indnesions of me Seller regarding me refuse shipment of the groups at the Sellers expanse and Inchura s of no Sailer eganche Me serum shipment at Pe gWds at the Sellers expense and risk It you tlo make the costs available to the Seller such me Selld does not pi them up risk. If you do make me gelds available to Me Seller and 09 Sister mans not pick them up within So days of Me data 0 your Notice of cancerous,you mayremin or dislsosn of the gate within to days of Medate of your Notice al contradictor,you may retain or discover of Me Maxis wisboNanyNMsron on.leaY If you talto make Me goods available to me seller or ityou agree wNwutanyNMarablgation.If you tail to make Negras%Available to Me Sellep or ll you agree to return ice goods to Me Seller and bull to do so,Men yw remain ImMe for performance a1 all b mom the goods to Me Seller and fall M do m,then you remain term for pedormanco of ell - obleasionsundertheContrao.Toma iNisVwseen,mail ortlehveraslgnedwd4Wetlmw oulgatlonsundertiv Caned.Toranwl Nis Vmvadbn,mailordeMerasignewddamdmpy of Nis carrallalion notice an any oNan wntlen notice,ar sentl a lelegmm,to A6A Berviw—s.�11115 o1 Ne cancellation ncum or any ether wdtten entice,or send a telegram,to A6 Sewl 115 NOM Street.Salem,Massausets Ol WO.NOT LATERTHAN MID",Hr oF(I77_$3 North Short.Semen,MasaaNuuM 01970.NOT IATER TIAN MIDNIGHT 00y27—/2 (oat.) (Dace) J HEREBY CANCELTHIS TRANSACTION. coreumer'ssigneture Date I HEREBY CANCELTHIS TRANSACTION. consumer's Sgnalum Data THE COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT ]DEPARTMENT OF LABOR STANDARDS 19 STANIFORD.STREET,BOSTON,MASSACHUSETTS 02114 IID]E1L]EAllD1ER CONTRACTOR LICENSE A &A SERVICES, INC. 115 NORTH STREET SALEM MA 01970 LICENSE: DC000440 EXPIRES: Friday,May 10,2013 IN ACCORDANCE WITH M.G.L. CH. 111, § 197B(b)AND 454 CMR 22.03,THIS LICENSE IS ISSUED BY THE DEPARTMENT OF LABOR STANDARDS TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF ENTERING INTO OR ENGAGING IN DELEADING WORK. THIS LICENSE IS VALID FOR A PERIOD OF ONE YEAR. THIS LICENSE MUST BE MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN DELEADING WORK IN ACCORDANCE WITH M.G.L. CH. I I I § 197B(b)(2)AND 454 CMR 22.03. t HEATHER E.ROWE,DIRECTOR f� Massachusetts -Department of Public Safety alec p i �powemso�aaea�o{�CaJaac�irnte(1d Office of Consumer Affairs&Busihess Regulation Board of Building Regulations and Standards OME IMPROVEMENT CONTRACTOR Construction Supc nisnr egistration 101609 Type: License: CS-057733 xpvation: 6/26l2014 Private Corporatie CHRISTOPHER ZORZY A&A SERVICES. NC 1 :-t € 15 NORTH ST , ,F Salem XIA 019707 Christopher Zorzy 115 North Street - - �'� - _ g `'ram i� ` >i rl" Expiration Salem,MA 01970 - Undersecretary I ��'�'^" �` 05/26/2015 commissioner I �'SUILDING PcRiORf1ANt=E tNSTITU lE.-iYC: ,e ,t ' L0? Hermes Road SUi'a l7.J 'till r lalta NY I2020 - Program (87/) 2ig ar j Ntv er.bpi erg fChristopher Zorzy n 2012 426000840 OB A&A Services Incp 4/26l2017 115 North St CHRIS ZORZY Salem, MA 01970 ' 4:� -Matthew JGibson r _ p.imin'elnrcA M.Il+.+1rtr..�Lf .. n+l Inn