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17 LAURENT RD - BUILDING INSPECTION (3) The Commonwealth of Massachusetts RECEI Board of Building Regulations and Standards INSPECTIONAL SEB+VLtCbr� i Massachusetts State Building Code, 780 CMR ReXis�ll�l�ry071 Building Permit Application To Construct, Repair, Renovate Or LlwoaEM hi -a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: I Date pplied: Building Official(Print Name) Signature Date , SECTION l: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers A-] L-o-urev.-F A-d 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions Zoning District Proposed Use Lot Area(sq R) Frontage(11) 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 OWNERSIIIP' 2. Owner'of Record: + ,A-,V.Q✓�dw La �o;n+e ��.Letrr.,� ot -70 Name(Print) n , City,State,ZIP �7 LGi,GW'—C✓LT�'�d 9 IS DIY[" 33^Io No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ 1 Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ — L Building Permit Fee: $ Indicate how fee is determined: 2.Electrical g ❑ Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier_ x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List:_ _ 5.Mechanical (Fire $ Su ression Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ IcJ ❑ Paid in Full ❑ Outstanding Balance Due: SENT \ \ Flo �A Po,A4e SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) S , CIA K S 4,0y Z License Number Expiration Date Name of CSL Holder List CSL Type(see below) 16n� - , orK-ii- SA— No. and Street • Type Description O l U Unrestricted(Buildings u to 35,000 cu. ft.) w\ Iv t'T _I R Restricted 1&2 Family Dwelling City/Town, State,ZIP M Masonr RC Roofing Covering WS Window and Siding R SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) A-�e✓v�i es rvc. � lets �-86 —1 P�+ l HIC Registration Number Expiration Date HIC Company Name o1r HIC Zeigistrant Name / S (Vo f t v� fi Normand Sltrc t W`fA D l q�O Email address City/Town, State,ZIP O Telephone 1 N 7 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 Cy\ff $ 77,4�,r _ } to act on my behalf, in all matters //relative �to work authorized by this building perplication. 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 contame in t�is applicatt"n is true and accurate to the best of my knowledge and understanding. / Print Owner'o Autho zed 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 www.mass.¢ov/dos 2. When substantial work is planned, provide the information below: Total floor area(sq. ft.) (including garage, finished basement/attics, decks or porch) Gross living area(sq. It.) _ 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" A & A SERVICES, INC. A&A SERY{a ICES 115 NORTH STREET,SALEM,MA 01970 SAW911111aji Telephone:(978)741-0424 Fax:(978)741-2012 Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No. CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET Buyers)Name Date of Contract RICP +4MAIVOq L-APo/Aare Y Buyers)Street Atltlress,City,State and Zip Code 17 LAVQ6Yv T 90 5'4—r ^-i /"Irrf 01970 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address V8-7v1- 337 0 The Sevens)listed above hereby jointly and severally agree to purchase the goods and/or 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 pan. WINDOW REPLACEMENT 0 Remove and dispose of# Z 3 existing windows. © Install # 23 new 5'VNQId(3"�VA7rti§uH/l.✓] windows:©/inyl t Wood /,7 `OL H �acturer) �windows ( Gqt_ y2r ood Options: Style �o k&4e&ref_ Grid pattern Color Interior_W kt, Color Exterior __Ln2i b 7_07- Glass Type ann5lLL )IA/LF Llnw- O Wrap exterior trim with aluminum: Style L-(S D Color_(!Z&7lr Styx'N P14, f t All windows will be installed according to the installation procedures in the portfolio. Caulk all interior and exterior edges. t Insulate where possible around new units. 1 Insulate window weight pockets if exist,and around new window units where possible. t Included in this proposal are set up,clean up, Hope vacuum and cleaning windows inside and out. © Building permit included. BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS I Create new window opening by cutting through existing home and framing in opening. I Remove and dispose of existing units)in its entirety. Note:Electric and plumbing may exist in wall and will require additional costs to customer if need to be dealt with. It 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. I Bay t Bow t Casement t Other window(s)to include new interior style trim and new exterior style trim and head flashing as needed. ONote: Painting and staining not included. STORM PRODUCTS If Remove and dispose of If existing storm window(s). If Install new storm windows# Manufacturer Style Color Option t Remove and dispose of# existing storm door(s). It Install new storm doors# Manufacturer Style Color Type: t Aluminum t Solid Core SPECIAL INSTRUCTIONS: hS T FLtiTn— 6 4-TN- !nW/rt/bay 66-7W SSIRSHEs3 /7L0s 7I3b t, q i //VS7m.i.. ®rzyb'n— vew7— /.�o x /n. C- s/o r /�urs�.A-YvT 41//MDOM/ /-I-ND /Nely tyl"-OCA. 15ut -zJ. /&-o SGLL. It is agreed and understood by and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms. This contrast may not be changed or Its terms modified or varied in any way unless such changes am In writing and signed by both the Buyerts)and the Contractor by acknowledge that Buyers) has read this Specification SShe�e,tr fJ `('1�(ggq✓y'"i9) Contractor Initials: y 43 Date: �V-zZ-1 / Buyer's Initials: Date: ,, /� �+ �/�p12" A & A SERVICES, INC. - A&A SE Iy J 115 NORTH STREET, SALEM, MA 01970 • - • MANE Telephone:(978) 741-0424 Fax: (978) 741-2012 Contractor Registration No. 101609 Construction Supervisor No.CS057733 Federal EIN: 04-3090162 - CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Bu er s Name Data of Contract 1cN + /�wtnNo✓+ La ofU—r- 1 i0_ 2-2 Bu er s Street Address, City,State and ZipCode / Lg V P,eW T 20 S4-t-awr r4,04 0i970 Daldirry,Telephone Number Evenin Tale hone Number Mobile Telephone Number E-Mail Address 9787Y1- 3370 2Nt-s3/(p@J-jcT,.agl�, et-� 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 the front and the reverse of this agreement and any specification sheets(this'Agreement"),and Buyerls)have requested that such goods or services be installed or provided at Buyer's address listed above,A8A Services,Inc,('Contractor'),hereby agrees to install or cause to be installed the products or services listed in this Agreement at the Buyerls)address written above.This Agreement represents a Cash sale of goods and services.The Buyer(&) agree to pay in Cash the Cast of the goods and services purchased as described-herein,regardless of timing or approval of any financing Buyerls)may seek for their purchase. {�-T Purchase Price: //Z, Est.Starling Datef�- Down Payment: e 6SS Est,Completion Date: /2-5_-/ '1Cash Amount Due on Slum of Job: "Check Credit Card Amount Due on of Completion: No. Amount Due on_of Completion: Expiration Date' Balance Due on Upon Completion. /3 3/7, CVC Cotle: 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.Buyerls) hereby acknowledge Nat Buyerls)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.Buyerls)also(i)acknowledge that they were orally informed of their right to cancel this transaction;and(if)request that they be contacted via their telephone numbers or email,as listed above,in the event Contractor believes Buyerls)would be interested in any additional quality products or services of Contractor. 00 NOT SIGN THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES. - A&A Servic ne✓ Buyer(s) By: N(===a Signature Signatugqre Print Name �C IC� Z/ O/�o9of 117, Print ame Signet e �� k}�irt�cuA�u � Lal'o/n Print Name You,the Buyerls), 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 The contractor and the tromeowner hereby suesally agree In oryanre that in...-at aNm par,has a dispute mnmming try contract,(tither parry may meant such diamond to a privets aid after access whisk has been approved by lie Secretary state Emcudve CMce01 Con.at All6r§9p mess Regulations and has other pan shall be required m subnit to such aNllratim as pureed inMG.L c.tCPA. C�,y., ter. Cam nor im'tinls <-/ BurmslnLinlr: XQ ma,.,.a/0�2—/t/ rise: v NOTICE OF CANCELLATION NOTICE OF CANCEI LATICHIN Date or Toy naa distill 22—/ You may cancel mia transaction,anthem any Em auy or Dmv of Tmmsatlinn O—ZZ—/ you may cancel this tranmcaon nilnoul any penalty or obleauon.within three beans&&days from the amve date.lfyouddnceranydroprvlytmded in. obligation,withinilreebu9ressdaysnomeaabovedam vypucancel any pmpa tmded in, any Payments made by you under me Contract or Sale,and any negotiable Instrument sweated any payments made by you under the real or Sale,and any negotiable restmnent eaewle0 by you W II de returned Men 10 days following receipt by me Seller of your cancellaaan rouse, by you will you returned victim 10 days ordered receipt by the Seller of ywr cancellation notice, and any security irearesc arising our of the transaction will be canmlled.II you cancel,you rcon and any security interest ansing out of the normal will be cancelled.II you wncH,you—of make available he Ins Seller al your residence,and w craireally in as good wndibon as when make available he tat seller at your radiation,and subseducally in as goes COnducan as when resserver.any mdis delivered to,-under this Contract or Sale:or you may,it yen yeah,marbly usesse ,anygmds delivered by creature Convect or Sale:orymu obi lyou Cars,cwnply silt the assurance ce M the Seller regaMing the Haum chimer of by.golds el are Sellers with the instructions 0l be Sells,regard'er the return cons of the goads at the Sale— expense and risk.If you do make the goods available b the Seller and the Seller does not pick examse and risk.If you do make the goods available W the Scher and fie seller tices not pick Main up Whin 20 data of the date of your Notice of Carvell mar.you may retain Or disease W the Ines up within 20 days OI the data Ol lot Noua of Gencelladon,you mwy retain Or cllass-01 goods vathout any lumber odigaaon,If you fah to make the goods evailade to the Seller,or 9yw milroWav,NONanytunherracration llyou fail b make the goods evailade to the sells,.ottl agree toreturn me goods to the SHkr and hail to do so,then yen relrein liable for performance of you agree to rmum the goods to me Seller and fail b do so,then you remain liable for performance all caligali cos under the Contract TO WncH has transaction.mail or dellvsr a signed and dated of all obligations underlie Cancel To dencel this transaction,mail m deliver a signed and dated Copy of the foread rsom house or any Other widlen notice,or send a telegram b A&A Sorroces, ca e,duty of the ncellation notice or any she"I tun sears.or mend a 191ea�g/�n he AAA Services. 115 Nomh Street,call MA 01970.NOT LATER THAN WON I GHT OF/t'/—Z�j y 115 Noan Street,Salem MA 01970,NOT LATERTHAN MIONIGHTOF/;y=2s Y mast I HEREBY CANCEL THIS TRANSACTION 1 HEREBY CANCEL THIS TRANSACTION Comume,S Signature Dec. Consumers Signature .is ��- The Commonwealth of Massachusetts f Ge Department of Industrial Accidents r office of/nuesfigadons p 600 Washington Street, 7/' Floor Boston, Mass. 02111 --- Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors Applicant information: Please PRINT legibly name _l.. `irr 5�py��l�C' �C7lZy. address: /I J Nor- k, -tY-ee4 city 6G 12 D i' state: M A zip, /970 ohootic# work site location(full address): ( 1 La�la Y'4'til� I�C1 ` aCe.Yvl ,'l A- V ( 91 ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction ❑Remodel ❑ I am a sole proprietor and have no one working in any capacity. ❑ Building Addition El I am an employer providing workers' compensation/for my employees working on this job. comanv name: / 1` ,1� •r - r :Q s-V 1 !ems F t C address;C I 15 t W 0 ✓M6 a✓�1 a (] p `[ /5' / �7 (� city' /,0., i -e tM-'t -/r'-L-TI ( phone#: -I 7 - 7 1Q'-6 `l d'" / insurance cc I a,- f ✓aU-e1 -er- '5 italics,# m O d ❑ I am a sole proprietor, general contractor, m homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name address: city: phone#: insurance co. police# company name: address: clh" phone#: insurance co police it Attach additional sheet if necessary Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of it fate up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that copy of this statement may be forwarded In the (lice of Investigations of the DLv for coverage verification. !do hereby certify Zun( thpaitts and p nalties of perjury that the information provider!above is true nor!correct. SignakucvZ Date ` �o� 0 Q' I `� Print name�&,✓1 C 0 , oZ.e / Phone# 7 0 7 T v' official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selechnen's Office ❑ILealth DepurtmeTt coronet person: phone#; ❑Other (mvlsad S,I I003) 9ihit C, L 0. 407 Sao, dAa vuon 6B-LI'ddh9 PS mil It i Nei t 17 d9bris rasultain'� a1�a�1J B� Q o �alj_d ;�oca`ad O pr r er is .17 ' lilt �06_, d d dye„ 111�1 Ciy ,teacsSd 4' " P rlW�ligfy Data Kim 4r A A A SsF cr-2 @nm Fir, State code Control No: 33262 THE COMMONWEALTH OF MASSACHUSETTS .DEPARTMENT OF LABOR DIVISION OF OCCUPATIONAL SAFETY 19 STANIFORD STREET, BOSTON,MASSACHUSETTS 02114 LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER A & A Services, Inc. 115 North Street Salem, NIA 01970 WAIVER: LW 000318 EXPIRES: February 12,2015 IN ACCORDANCE WITH M.G.L. C. 111, § 197(B)(b) AND 454 CMR 22.03(3)(b), THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER IS ISSUED BY THE DIV. OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF PERFORMING LEAD-SAFE RENOVATION WORK. THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER MUST BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 111, § 197B(b) AND 454 CMR 22.04 WHEN PERFORMING LEAD-SAFE RENOVATION WORK. HEATHER E. ROWE,ACTING COMMISSIONER �vlassachusetts - Department of Public Safety , �. ,a, Board of Building Regulations and Standard A Con,tructinn Supers isnr pa License: CS-057733 - LFIrb�rCerhe idin g CHRISTOPHER ZORZY 115 NORTH sT Salem MA 01970 " Christopher Zorzy u 20120426000840 Salem A&A Services Inc Exp 4262017 .>' 115 North St Salem, MA 01970 Expiration Commissioner 05/26/2015 Matthew J Gibson n,s„�canam.a.,ya�c Administered try Data Works International.Ina Office of Consunter Affairs& Business Regulation 3..�.„ HOME IMPROVEMENT CONTRACTOR. Registration: 101609 Type: Z ?Ezpiration: 6/2612016 Private Corporatic A&A SERVICES, INC Christopher Zorzy 115 North Street ., Salem, MA 01970 --- Undersecrenrry 30 Phone: 978-741-0424 /�&A CERV C Fax: 9vices. -2012 fL71 J J www.a-aservices.com . . 115 North Street Salem, MA 01970 October 30, 2014 City of Salem Building Dept. 120 Washington Street Salem, MA 01970 To Whom It May Concern: Enclosed please find the permit•app ical tion for Richard & Amanda LaPointe, 17 Laurent Road, Salem, MA to replace windows. I have enclosed a check for$140.00 based on your fee schedul7 per $1,000.00. The total for the jjoob�was $19,972.00. Please send the completed pAllit to AL A Services, Inc. at 1.1-5 North Street, Salem, MA 01970. If you have any" questions,please contact me at (978) 741-0424. Thank you for your. istande. 1 Sincerely, Barbara dzy V Office Manager