32 LINDEN STREET - BUILDING INSPECTION (2) 2115Rrmyn
1�1-t52
The Commonwealth of Massachusetts INSPEMOMA L SERVICES
Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code,780 CMR SAL
EM
914 SEP I RAbse,2* 611
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 Applied: 9
Building Official(Print Name) Sig for el
SECTION l:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
3� tvldn t 1 _U+
Lla 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 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 caner ofp Record:
� tpdhev S4l�w,, MA O ! 5� v
Name(Print) City,State,ZIP
lS &It-eouu Rd. qJ - 1sg 9Lfy6-
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Ill' Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work': Gt cz 11a #'OcS
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ N %0 I. Building Permit Fee: $ Indicate how fee is determined:
❑Standard.City/Town Application Fee
2.Electrical $ a
❑Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (FIVAC) $ List:
5.Mechanical (Fire $ Total All Fees: $
Suppression) —
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ I L-1 (0-0 ❑Paid in Full ❑Outstanding Balance Due:
srAdz- FIE14 . gll°I �X At L,� Ct 12Z
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) D T-71 3
(,�yi j ZoYZ�,l License Number Expiration Date
Name of CSL Holder
,` �-r- C� List CSL Type(see below)
' / S IVOf ( Y, �I Type Description
No.and Street /In yp P
/`0. e ✓h 'V 1 •/1_ 0( p �O U Unrestricted(Buildings u to 35,000 cu.ft.
`7 �1 I R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Mason
ry
RC Roofing Covering
W S Window and Siding
/��( —�`'�J SF Solid Fuel Burning Appliances
0 ` I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) of b 0
ft4- /'t fJl(R$ (V c. HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
llci nlo� S+
No nd Street
M q_� �ct-1 0 Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,c. 152.g 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 Issua e 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
t
I,as Owner of the subject property,hereby authorize ( ��r i-.S —O rZ�z
to act on my behalf,in all matters relative to work authorized by this building perm, application.
C0 VACCI_C—+_ (o I vF
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
containe t th s applicatio t is true and accurate to the best of my knowledge and understanding.
Print 0<vnWs or Authoriz Agent's Name(Electronic Signature) Date
NOTES:
1. 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..og u/oca Information on the Construction Supervisor License can be found at www.mass. ove /dns
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.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halfibaths
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"
r-� THE COMMONWEALTH OF MASSACHUSETTS
EXECUFIVE OFFICE OF LABOR AND WORKFORCE D@:VELOPMENT
MCI 1
�_ ' DEPARTMENT OF LABOR STANDARDS
19 STANIFORD STREET,BOSFON, MASSACHUSETTS 02114
= I
DELEADER CONTRACTOR LICENSE
A & A SERVICES, INC.
115 NORTH STREET
SALEM NIA 01970 j
I
LICENSE: DC000440 EXPIRES: Sunday,June 07,2015
IN ACCORDANCE WITH M.G.L. CH. I 11, § 197B(b)AND 454 CMR22.03, 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.
I
I
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 CMR22.03.
i
HEATHER E. ROWE, DIRECTOP.
ne� fW$r Massachusetts -Department of Public Saret/
7Orrice of Conanmer ntGu rs& Business Regulation \V—�7 Board of Building Regulations and Standards
,HOME IMPROVEMENT CONTRACTOR
Registration: 101609 Type: Cnnc[ruchon Superci,or
'Expiration: 6/26/2016 PrivateCorporatic ! License: CS-057733 ,
A&A SERVICES, INC CWUSTOPHER: ORZY, 3
I15 NORTH ST S
Christopher Zorzy SalemylA 01970�
115 North Street .�
Salem, MA 01970 �—
UndcrsCcret:vy cJ �/L� E(Plrstion
Commissioner 05/26/2015
I I
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jt
Chnsto e• u20120426oa0840
�1 h r Zorz .
\' Y Ex 4/26/2017
A&A Services Inc P
115 North St
c_t lI -"
..,. Salem. NIA 01970
0 '
Cn DEBRIS
'h the
80ding Pal ft Humber is that th d9 rIs 6 psuItanQ srom, HS Work She
b@ dis-pDamd ®':en pP®pF(y.(d�enae� cili as dag3ndd.br90�
Owned by Nor, bd-O- C&T-'n
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Address, Tito, Staty, �i� Cody
The Commonwealth of Massachusetts
Department gf lndastriol Aceitlents
office oflnuesdgations
600 Washington Street, 7° Floor
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors
Applicant information: / Please PRINT legiblv
name:
address �I J / VO✓ t N 7 l r'-e �'/ pp [y y� !/ �/
city �Ca �-e �7 r1 state M[ -rio� D�'/tl,t70 phone li / D "-7Tt��(AgV
work site location(hill address)' h 0 Lf�� 7�l �-e V+'c YK-t4 G 1 l -7 0
❑ I am a homeowner performing all work myself. Project Type: ❑New Construction ❑Remodel
❑ lain a sole proprietor and have no one working in any capacity. ❑ Building Addition
I am an employer providing workers' compensationg for my employees working on this job.
cartoon v name: /',C,- f' �/�Q('s-V! S f Al C
address: ( 15 I N O ✓ l��V21 J (] �j [ ' / �7
city: S CT, 'e ("� . M rl phone#: —I�2t O - 7 7 �/ -/6`f o'-�
insurance co 1 ,z 7✓-a y✓e I-e Y 1S nolicv# C)jq pvq V 1 _
❑ 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:
address:
city: phone At:
insurance co. nolicv#
company name:
address:
city: phone#•
insurance co. nolicv#
Attach additional sheet if necessary
Failure to secure coverage as required under Section 25A of�y1G1. 152 can lead to the imposition of crimimd penalties of it fine up to S1,500.00 and/or
one years'imprisonment as well as civil penaltics in the form of it STOP woRK ORDER and a fine of S100.00 a day ago ins)me. I understand that a
copy of this statement may be forwarded to the ffice of Investigations of the DIA for coverage verification.
I tlo hereby/certify unr a th pains nntl p nalties of perjury that the information provided above is trite and correct.
Signatuo! V 0 Date .7-110 -1q
Print name Llq✓i�(�0 e' —2OY'Z ,/� Phone#_917 D p-7 7 I-OY l
official use only do not write in this area to be completed by city or town official
city or town: permiWicense# ❑Building Department
❑Licensing Board
' ❑check if immediate response is required ❑Selectmen's office
[:]Health Department
contact person: phone H; ❑Other
tmviseJ Scnr 2001)
30
/� �, /� �+�p�/Air A & A SERVICES, INC.
AAA� ERVICES 115 NORTH STREET, SALEM, MA 01970
• '•• 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 Date of Contract
J B ire -//-/
8u s Street Address,City, by and Zip Code
l
i
Da ire Tele hone Number Evenin Tele hone Number Mobile Tele hone Nvmber E-Mail Atldress
The Buyers)listed above hereby jointly and severally agree to purchase the goods and/or services listed on the accompanying specification sheets,in accordance
vath the prices and teas described on the front and the reverse of this agreement and any specification sheets(this'Agreemem'),and Buyers)have requested
that such goods or services be installed or provil at Buyer's address listed above.ASA Services,Inc.('Contractor"),hereby agrees to install or cause to be install
the products or services listed in this Agreement at the Buyers)address wriflen above.This Agreement represents a Cash sale of goods and services.The Buyers)
agree to pay in on the cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyer(s)may seek for their
purchase. /
Purchase Pricer 66r �S 36o•aUDate.
Est.Staling t'
�' r� i '1
Down Paym It J 3r S•O/Orf'°'r d r� Est.Completion Date:
El Cash
Amount Due on Stan of Job: �^D•P O Check
:"Credit Caad
Amount Due orl Completion' No.
Amount Due on of Completion, Expiration Date:
Balance Due On Upon Completion'. R�
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.Sayable)
hereby acknowledge that Sayable)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.Sayable)also(I)acknowledge that they were orally
informed of their right to cancel this transaction;and(III request that they be contacted via their telephone numbers or email,as listed above,in the event
Contractor believes Buyers)would be interested in any additional quality products are services of Contractor.DO NOT SIGN THIS CONTRACT IF IT
CONTAINS ANY BLANK SPACES.
A&A Se ices Inc. Buyer(s)
Signalu
ZO f Z Sygnature (J
Pont Name
j 6-
Print Name
Signature
Print Name
You,the Buyers. 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.
ARBRRATION;TI¢wnlratlorantl Pe homeowner hereby mutuallyagree in adv nm that in Ne ewnl attar party aces a diswW mnmming this mntr d,eithermry may submit such Oispule b a
private artiVered mrmon unien has been doormat by tree Secretary of the Freddie,Oltice of Consutrer N; en0 Business Regulations and tire routinely shall M required W submt to ton,
arGtraticn as pmvN in M.GL c.1<2A �/jp/'t
Cnmeservaials�.� auyc/�ynil lr�
tote: tote:?
NOTICE OF CANCELLATION NOTICE OF CANCELLATION
Dale o1 Tranaallon -/ -/ Ydh hay mncel Nis Vanssetion,father any IteneM or Card of Ttansid im You trey eanr¢I this treossction,withmt any penalty or
confused,warm three buvmss days from the above ask.N you anal any avopeM t2tled In, obligation.within Mree ouar,ess tlays fromthe aMtre date.llywcarmtanypmpenyonal n,
any payments oxide by you under the Cmtmtl or Sale,and any resource instrument exerted any payments made by you under the Con vent or Sale,and any oagouade ineadmnt executed
by you will be reme.within 10 days btlorng rttelpt by re Seller of your correlation nal by you%hI be rearmed xiNln 10 days falmong remipt by the Seller M your mncelladon notice,
and any sedum interest ad9ng out of me transaction fall be charged.It you cancel you must and any wearily interest ansirg opt of are traneac4r WII as CanWlled if yrmaadal,you men
nnFa aver made goods b re Sollore r et you resunder na,and at or Soup in as Sendmy,rnuiwes as wt,en oreakremo ed any g o Ne teller at your under is and substantially in as gat nu va as Men
mithe members
dof metlller udder this Combat Or Soup or you my,it you esasre.amply rtheenygoour eof rxretltoer regarding
Contrail or shipment
or yw tray.Nyou Hsh,ttny,ly
expense
N¢in9rvNons of me Salle hgoods
regarding re return shipment of are Sat at arees Sellers ex the in d ask If of re aellw regartlinp re alum am Sole of re Sale at the Sellers
expense and risk.N you do make theeour N available r Seller and re Sellerdapo not hid expense and ask you f t e date
a your available r ce Seller and Ne haver does not pick
rodsem wtiout 20 days of redate of yew Notiw he Corrosion.the gyouilacre my aihe Sellpom olthe them
odswini0 days oferoingolymr Nu Mil he e thego,ynumayre 0te tlispme of
goods to reON any fuller to the Seller you fail to do k¢men
egmn drum nlialethe Sellerdemmmdmeof the save wi Ncur any arelusher to
Sellren and tail
bmorehe gwdsav&IaWet for parller,oril
al er houseoldsreturn nepwe Cotrant To and fail totlo so,Nen yrd or Mora
signed
neda and
dated of alldesigners
signerreturn Ne goodssm are Seller fed do ertion you orrrefiversl signed and a^m
all obligations under re Contrail To ancel this Vansallon,mail or deliverasig^ttl and dated of all eDligadonsuMer Ott ConVad.Tocanml Nis VanseNm,nwl ertlelivera signed and dated
may of the mnalla0on nand,or any other ware notice ar send a loan,to W Servitor, cppy of me cancellaYon notice or any other Mtlen notice,or see a del 'ty''kA7;kad
""North SewtSalem MA01W4 NOT LATER THAN MIDNIGHT OF J n/,f•/c'1 115Noah"Vet Salem MA01970,NOT IATER TWIN MIDNIGHT OF /��.T'
der,
I HEREBY CANCEL THIS TRANSACTION / I HEREBY CANCEL THIS TRANSACTION ere
Consurar's Signature Data Consumers Signature Date'.
+ PG a
pp,,,, � q7 z �1 A & A SERVICES, INC.
/16t/1 S�R Y'l��S 115 NORTH STREET,SALEM,MA 01970
• ` • Telephone:(978)741-0424 Fax:(978)741-2012
Contractor Registration No. 101609
Federal EIN:04-3090162 Construction Supervisor No. CS057733
ROOFING SPECIFICATION SHEET
Buyer(s)Name Date of Contract
Buyers)Street Address,City,State and Zip Code
,XoeelsJ
�
Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address
�j7sr-7r��-9y�s'
The Buyerls)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 part.
!!11 ROOFING SPECIFICATION
Strip Roof of# _ 91 layers of shingles
Install 6'of ice and water shield at base of roof where 14 Install 15.1a felt paper to roof.
possible. Install 18-24"of ice and water shield in valleys.
If Flash chimney as needed (no repointing included). Install 6"perimeter drip edge to rakes and fascia areas.
Install vent pipe boots and seal as needed. Flash valleys as needed
t Install rollout type ridge vent. 't Planks/plywood replacement under 32 SO FT includeA
'If more is needed there will be an extra charge of$
per hour for labor plus the cost of materials.
111' Dumpster/Disposal Included: 4 Other: �1
Location: zwc— Go/c/ lolrri� lit7o`
Install new roof: Manufacturer �f er Ard, o yr Style/type G eo vPo
Included in this proposal are thorough cleanup, building permit,and company/manufacturer warranties.
RUBBER ROOFING SPECIFICATION
It Strip Roof it Not Strip Roof 4�j P� s. U duty Is,
Install 1/2"High Density Fiberboard to existing roof using # Flash obstacles as needed.
screws and plates.
Install .060 membrane EPDM(Black)rubber roofing to Nt Install 3x3 aluminum drip edge to perimeter of roof with
fiberboards seam tape.
Flash up sidewall as needed.
Included in this proposal are thorough cleanup, building permit,and company/manufacturer warranties.
SPEC L INSTRUCTIONS:
2 n-rhy� 4rvr.(' Qisiros � l�li' n �- �s ?i-y
4lIZl✓,L3wofL ar�—
It Is all 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 contract may not be changed or its
terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and the Contractor. Buyer(s)hereby acknowledge that Buyerls)
has mad this Specification Sheet.
q
Contractor Initials: {- Z Date: Buyer's Initials:_�� Date: /