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19 LINCOLN RD - BUILDING INSPECTION (3) 3 DATE: Citp D a`�AYETTt, �ffiae5ar uE;Ett5 � 9 PLANS MUST BE FILED AND APPROVED BY THE /b INSPECTOR PRIOR TO A PERMIT BEING GRANTED Location of Building Building Permit Application For: (Circle whichever applies) Roof, Reroof, Install Stt Deck, Shed,Pool Addition, Alteration, epan/Replac 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: �P±P.Y L-Inl+7, Contractor: Chr; stonhar Zor7v __ Street LIVl( r) d Cit)•5glPm Street_11 5 North Straat City% am State,Ma. Phone (qV 2AI-7)AID State MA Phone (978) 741-0424 f Architect: City of Salem Licq 1405 I Street -City State Lic#0 5 7 7 3 3 HIP# 101609 State Phone ( ), Homeowners Exempt Form_yes__.,./no Structure: (please circ Single Family, Multi Family# Other Estimated Cost of job $ aW S'9. 00 Will building confirm to law? ✓ yes no Asbestos? es V/ no Description of work to be done: IrSinII Vint1I nopIrtronnen+ LyIrdo ul7S $RVICE3 Drawings miffed: es no Mail Permit to: lY6 NORTH STREET X Signature of Applicati n,SIGNED UNDER THE PENALTY OF PERJURY CONSTRUCTION TO BE COMPLETED WITHIN SIX (6)MONTHS OF PERMIT ISSUED DATE Department use only: Perrnii# Zoning Map/Lot Permit fee S COMMENTS: 7 t I C_.t_)6d.�__3F_•._?_.... _..._O _.. .- tty�oy ._ rr . -too 'i Z � � -�4�Z QmH c j = f �� . - rn O G') s n ' 7 1 4 + I (1 1• ' • i ' fsx,75.9 wl, F4ib)F'6Yitsi:-)'" r.7 i s"/-` 1)F:at f C. li iUlCC�C .k :.dL 116:". it (, � �6� ti .'15�� 1 . .. . �• i.,. j3'lSly�rl7i tr•!1S",.i r _ �: .r4):.: j Liir� IIi Salrnz, : �1`�� uniit �rngxrtg 5sa�r��2 ��- $uitilinu ?�rnrzni (Saz gal= a=n - iII8-'ri5-7575 rzt. 33D DIS?OSAL OF DEBRIS AFFIDAVIT In accordance with the provisions of MCL c 40 , S54 , I acnovIedge that as a condicion of Building ae nit ; all debris resulting from the construction acriviry governed by this 3uilding ?erir shall be disposed oe a properly licensed solid w2ste disposal facility, as defined by MCL c III, S 150A. Salem Transfer Station owned by: The debris will be disposed of at: Northside Carting loczt,on of :zc:_,ty 02La-Ds r-- _ Date Signatu-_ of Appiicant Fully complete the follo::ing information: (?lease print clearly) Chti&t6phetcZoViyc . Name of ?erm,: ADD:-;Cant A & A Services, Inc. Firm tiame, if any 115 North Street, Salem, MA 01970 Address . City 6 State The above statete re?uir=_s that debris from the demolition. renovation, reha' or other zlterztion of bu°-ding or structure be disposed of in z properly licensed solid -aste disposal faci-ity as defined by MCL cIII. S150A and tha building permits or license's are to indicate the' location of the facility at The Commonwealth of Massachusetts Department of Industrial Accidents O///9081 1SVIRSOOS 600 Washington Street Boston,Mass. 02111 Workers'Compensation Insurance Affidavit name: location: city phone Y ❑ I 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. coin an name: A &, A-Services , Inc. address. 115.. North Street city: Salem 'MA 01970 Phone q• 978-741-'Q424, tr.1•il�u•�4. insurance co. The Travelers oolicvk WC939 have X1256 I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who - the following workers'compensation polices: company name•. J?4i"t# "(•. . a. if address:city: . Mine q• . . insurance co: company name address'-:' .:a city: - t >' hone t#: .3 tpAa1'+na'tr s. insurance co. ' 1 i A oli` p r St�3k^ Failure Insecure coverage as required under Section Mot MCL 152 can lead to the imposition of criminal penalties of a im Dne up to$1,500.00 antUu one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 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 cerfljy tunre p ns art penalties ojperjury that the information provided above is true and correct. Signature Date /0 - (p .�•j Print name Christopher Zorzv 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: permitAlcense N flBuilding Department ❑check if immediate response is required . . []Ueeadog Board []Selectmen's O1Bee contact person: []Healtb Department phone N; nother .. :4 a r . , . .. . In ,.... w"""'.""_.'�J_•,et ~ C ✓AB 'f000)t)ItOrrtl.'8¢�IR n�.�gd.'MA�te(de�d BOA GCC RD OF BUILDIN REGULATIONS l .i {{ License: a CONSTRUCTION SUPERVISOR} t Numbs 057733 BI 958 }k Tr.no: 12633 Re k} ' CHRISTOPHER u r ;. 115 NORTH ST - c ' $ALEM, MA 01970 �- ': S' Commissioner , E � �� (� ^✓� 77M/r9H2O�W/C6CUE 0��2��Cfl•�2IlQE�d _ Board of Building g Regulations and Standards tan darcls HOME IMPROVEMENT CONTRACTOR i Registrabon.� 101609 - I „Expiration:6/26/2006 r . Type: Private Corporation. 1 a A&q ER VI Christopher Zorzyl� F 115 North Street Salem,Jv1A 01970 Administrator - Commonwealth of Massachusetts Division of Occupational Safety "- Robert J.Prezioso,Commissioner 1 . Oelead er-Contractor I CHRISTOPHEWZORZY Eff.Date 01/14/05 .. . . Exp.Date 01/13/06 DCODD440 06 . Wamberof C.O.N.E.S.T. W�N�N�nn�l IgryB� ilnnpI�''II �Ilmp� ��IIII a11��Ill��l��II IHIW�W�I��IIIII aOSTON-RENEW .: 1 n Seabrooke GREAT LAKE . .._ WINDOW NFRC Certified Solar Heat Energy Product Directory Gain Visible Light Condesation Star Product Type/Popular Glazing Options Number U-value Coefricent Transmission Resistance Approved Re ort# Expiration Date Double Hung GLW-DH-135 ETC-04-552-15675.0 12/18/2008 Clear IGU 0.47 0.57 0.60 42.00 No All Grids <11 0.47 0.51 0.53 42.00 No All Grids >I" 0.47 0.45 0.47 42.00 No Hi-R Plus Low E Argon IGU 0.32 0.29 0.53 52.00 Yes All Grids <I" 0.32 0.26 0.47 52.00 Yes All Grids >1" 0.32 0.23 0.42 52.00 Yes Maxuus Double Low E Argon IGU 0.31 0.27 0.47 53.00 Yes All Grids <l" 0.31 0.24 0.42 53.00 Yes All Grids >I" 0.31 0.22 0.37 53.00 Yes Maxuus 7.6 (Triple Pane Double Low E Argon IGU) 0.26 0.25 0.43 60.00 Yes .. All Grids <t' 0.27 0.22 0.38 60.00 Yes All Grids(>t") WA N/A WA WA N/A Slider GLWSL-135 ETC-04-552-15793.0 1/4/2009 Clear IGU 0.46 0.56 0.59 42.00 No All Grids <1" 0.46 0.50 0.52 42.00 No All Grids >i" 0.46 0.45 0.46 42.00 No Hi-R Plus Low E Argon IGU 0.30 0.28 0.52 55.00 Yes All Gdds <1" 0.30 0.25 0.46 55.00 Yes All Grids >I" 0.30 0.23 0.41 55.00 Yes Maxuus Double Low E Argon IGU 0.30 0.26 0.46 55.00 Yes All Grids <I" 0.30 0.24 0.41 55.00 Yes All Grids >1" 0.30 0.21 0.36 55.00 Yes Maxuus 7.6(Triple Pane Double Low E Argon IGU 0.25 0.24 0.42 60.00 Yes All Grids <7" 0.26 0.22 0.37 60.00 Yes All Grids >I" N/A WA WA WA N/A Picture GLW-PI-135 ETC-04-552-15755.0 12/11/2008 Clear IGU 0.46 0.66 0.69 43.00 No All Grids <I" 0.46 0.59 0.62 43.00 No All Grids >7' 0.46 0.53 0.55 43.00 No Hi-R Plus(Low E Argon IGU) 0.28 0.33 0.61 55.00 Yes All Grids <l" 0.28 0.30 0.55 55.00 Yes All Grids >1" 0.28 0.27 0.49 55.00 Yes Maxuus Double Low E Argon IGU) 0.27 0.31 0.54 56.00 Yes All Grids-(<7") 0.27 0.28 0.49 56.00 Yes All Grids >7" 0.27 0.25 0.43 56.00 Yes Maxuus 7.6(Triple Pane Double Low E Argon IGU 0.19 0.28 0.49 65.00 Ves Seabrooke Seabrooke 'TREAT IAKF I DOW NFRC Certified Solar Heat Energy Product Directory Gain Visible Light Condesation Star Product Type/PopularGlazing Options Number U-value Coeficent Transmission Resistence Approved Report# Expiration Date All Grids <1" 0.21 0.25 0.44 65.00 Yes All Grids >1" WA N/A N/A WA N/A Casement GLW-N-033 ETC-02-552-12497 11/7/2006 Clear IGU GLW N 033 001 0.45 0.51 0.54 No All Grids <1" 0.45 0.47 0.49 No All Grids >i' 0.45 0.43 0.44 No Hi-R Plus Low E Argon IGU GLW N 033 083 0.30 0.27 0.47 Yes All Gros <7' 0.30 0.25 0.43 Yes All Grids >1" 0.30 0.23 0.39 Yes Fixed Casement GLW-N-001 ETC-02-552-12499.0 111WO06 Clear IGU GLW N 001 001 0.50 0.63 0.67 No All Grids <7' GLW-N 001 002 0.50 0.57 0.60 No All Grids >7' 0.50 0.52 0.54 No Hi-R Plus Low E Argon IGU GLW N 001 005 0.31 0.33 0.59 Yes All Grids 0" GLW N 001 006 0.32 0.30 0.53 Yes - All Grids >1" 0.32 0.26 0.41 Yes Awnin GLW-N-034 ETC-02-552-12497 11/7/2006 Clear IGU GLW N 034 001 0.46 0.52 0.54 No All Grids <I" 0.45 0.47 0.49 No All Grids >1" 0.45 0.43 0.44 No Hi-R Plus Low E Argon IGU GLW N 034 083 0.30 0.27 0.47 Yes All Grids <1" 0.31 0.25 0.43 Yes All Grids >7' 0.31 0.23 0.39 Yes Slidino Patio Door Premier(crD) GLW IN 062 ETC-04-552-15098 5/27/2008 Clear IGU GLW N 062 0001 0.43 0.52 0.56 43.00 No Al Grids GLW N 062 00001 00001 0.43 0.46 0.48 43.00 No Hi-R Plus Low E Argon IGU GLW N 062 00003 0.29 0.27 0.48 56.00 Yes All Grids GLW N 062 00003 00001 0.29 0.24 0.42 56.00 Yes Maxuus 7.6(Triple Pane Double Low E Agon IGU GLW N 062 00006 0.23 0.23 0.38 63.00 Yes All Grids GLW N 062 000016 0.24 0.21 0.33 63.00 Yes Premier with Euroglide(CPPD) GLW N 063 ETC-04-552-15100 5/27/2008 Clear IGU I GLW N 063 0001 0.43 0.52 0.56 43.00 No Seabrooke t - SeabrookeGREAT LA KF . . .._ WINDOW NFRC Certified Solar Heat Energy Product Directory Gain Visible Light Condesation Star .,. Product Type/Popular Glazing Options Number U-value Coefcent Transmission Resistence Approved Report# Expiration Date All Grids GLW N 063 00001 00001 0.43 0.46 0.48 43.00 No Hi-R Plus Low E Argon IGU GLW N 063 00003 0.29 0.27 0.48 56.00 Yes All Grids GLW N 063 00003 00001 0.29 0.24 0.42 56.00 Yes _ Maxuus 7.6 (Triple Pane Double Low E Argon IGU GLW N 063 00006 0.23 0.23 0.38 63.00 Yes - "^ All Grids GLW N 063 000016 0.24 0.21 0.33 63.00 Yes " Ho Doer GLW-N-005 Old design not Iabelin ,Not Tested new design 01-33259.01 Not Labeling - --- Clear IGU Hi-R Plus Low E Argon IGU special Sha es Clear IGU Hi-R Plus Low E Argon IGU grim Footnotes: Residential values sin le strength glass U-values w/o gdds total unit values DS or TS worst U-value w/grids Seabrooke