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221 LORING AVE - BUILDING INSPECTION (2)r DATE: 1,9 7 . e �itp of a�AYEITC, � SAL U Ef PLANS.MUST BE FILED AND APPROVED BY THE INSPECTOR PRIOR TO A PERMIT BEING GRANTED Location of Building Ac2I 401'Ihq A i ll — Building Permit Application For: --� '(Circle whichever applies) Reroo Install Sidin Construct Deck, Shed,Pool ddition, Alteration, epair/Replace,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 pm t.) �ffdQ1-10a6 tzld Contractor: A 9, A 5e-rVIG25/e7n 5—zb —7' Street_aal )ZrInG fhb. City Cerr, Street- 115 � nr4h 5�. City lam,-, State Phone (t% 942- ql 77 State M fl Phone- (a7$) Architect: City of Salem Lic# Street City State Lic a7 HIP# I©I(0 09 State Phone ( ) Homeowners Exempt Form_yes_z—no Structure: (please circle Ingle Fami •, Multi Family# Other Estimated Cost of job S Wi6 building confirm t9 law?—Lies no Asbestos?_des ✓ no Description of work to be done: ShSfa I S e Ve h �'7) 64 (ja f-p 0ef I/in y/ ,s10Iv)9 -o aaraqe (EICL- i-« n&� reouirP�l� Q1�ers 0 5hlrOle3 07-1 c7drage-. rao� - /h etall 3/ arm 3-fib roo-hnq 6L41e s 5b-1,p Qxoh rubber rWrL/ Z2p7-)--, .ear SH-2 n I 3 H Qr2 r)�a�A stA�c s �fDli — 115 NORTH STREET Drawing Submitted:_des no Mail Permit to: _ .SALEM,MA 01970 Si re of Applic 'on,SIGNED UNDER THE PENALTY OF PERJURY CONSTRUCTION TO BE COMPLETED WITHIN SIX(O MONTHS OF PERMIT ISSUED DATE Department use only: Permit# Zoning Map/Lot Permit fee S COME MS: i No. �-G� APPLICATION FOR ' PPpMf TO LOCATION i PEIMIT GRANTED 19 AP ROV p 7 INSPECT01 OF BUILDI GS CERTIFICATE OF OCCUPANCY " YES NO ' The Commonwealth of Massachusetts WDepartment of Industrial Accidents Office of Investigations 600 Washin ton Street Boston MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaus/Plumbers Applicant Information n Please Print Legibly Name(Business,Organization/Individual): r� ? A Se_ryia * T-)a 4 Address: us y 1J o r+h S+r(fe+ City/State/Zip: ( ( y:yy\ Mrs DIc1-7U Phone #: ( 9-7061 TAi -DH2JA Aree an employer?Check the appropriate box: Type of project(required): 1.LVJ I am a employer with 4. t am a general contractor and 1 6. ❑ New construction P employees(full and/or part-time).* have hired the sub-contractors 4 2.0 I am a sole proprietor or partner- listed on the attached sheet. t 2. ❑ Remodeling ship and have no employees These sub-contractors have 8. 0 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 3.0 1 am a homeowner doing all work right of exemption per MGL I I.El Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4), and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t I lomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating su ?contractors that check this box must attached an addit ional sheet showing the name of the sub-contractors and their workers com .policy p po q information. lam an employer that is providing workers'compensation insurance for my employees. .Below is the policy and job site information. —f l r Insurance Company Name:_!he_e_ Treay2l rs Policy#or Self-ins. Lie. #:_W C Q 3g X I 9, 1p Expiration Date: q 113) 0 7 Job Site Address L.OrIz City/State/Zip: 5a- MR- 0/9 70 Attach a copy of the workers'compensaUon policy declaration page(showing the policy number and expiration date). Failure to secu re coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties P p sofa fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of tip to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify de the ain and penalties ofperjury that the information provided above is true and correct. Si•nature: O 7 Date: Phone#: CI1$) r7J4 I Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# _ Issuing Authority(circle one): - 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into-any contracrfor the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es) and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain g g Y q a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pemut/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licens es. Anew affidavit P da rt must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia DISPOSAL OF DEBRIS AFFIDAVIT ill In accordance with the provisions of M. G. L. c. 40, Sec. 54, a condition of Building Permit Number is that the debris_:resulting from this work shall be disposed of in a properly licensed facility as defined.by M. G. L. c. 111, Sec. it 150a. I ! The debris will be disposed at: Salem Transfer Station j owned by Northside Carting - !hl Signature of Permit Applicant IM R �fo /0 7 Date Christopher Zorzy F Name of Permit Applicant A &A Services, Inc. I Firm Name. 115 North Street, Salem, MA 01970 Address, City, State, Zip Code Board of Building Regulations and Standards Construction Supervisor License Uv 1, 'N CS 57733 Birtfiaate,_5/26/1958 :E eration ?6/2009 Tr# 13739 UNS - TitesZfF'�tiG� 00; � � (z CHRISTOPHER ZQR�. —'1.7 - - - 115 NORTH ST SALEM, MA 01970 {—``� Commissioner Commonwealth of Massachusetts Division of Occupational Safety Robert J.Prezioso,Commissioner Deleader-Contractor CHRISTOPHER ZORZY Eff. Date 04/02/07 - Exp.Date 04/01/08 OOD440 Member of C.O.N.E.S.T. 08 Y-: BO IIIIII IIIII IIIII I�III IIIII IIIII IIIII IIIII'IIII IIII IIII I BOSTON-RENEW' �.. ork -�mrvneoosu�ea c o�. aaoac�ZuveLfa Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration 101609 11 Expiration: 6/26/2008 1 - Type. Private Corporation - A&A SERVICES, ING. I- Christopher Zorzy. jJ 115 North Street - i Salem MA 01970 Deputy Admrmat� for I ' �1 � A & A SERVICES, INC. A� ICES 115 NORTH STREET,SALEM,MA 01970 a Telephone:(978)741-0424 Fax:(978)741-2012 Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 VINYL SH)ING SPECIFICATION SHEET - Buyer(s)Name Date of Contract `Conn+L.IN VVIi_D a 67 Buyer(s)Street Address,City,State and➢p Code ZZ1 1oTS Ve S levtAx4 cat,17G Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address The Buyer(s)listed above hereby jointly and severalty some to purchase the goods and/or services listed below,in aarordance with Me prices and terms described on this Spedtication sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification Sheet is a part. I VINYL SIDING C AWF152 ONLY, I siding, kr��& oF6+45A 4� Iq Remove and dispose of existing�I i tit L cIA l� Afd sitling *^J Note: ROA10W— IA)Wl astf>21, l'dt'= udcd 6Af_ ❑ Remove and dispose of old wooden gutters. _ ❑ Remove and dispose of aluminum gutters. ❑ Install new.032 gauge aluminum seamless gutters and down spouts as follows: ❑ Open Gutter ❑The Gutter Shutter Color: Inver body of home with i.Q -+gveh houst°u)refp �i @ Cover all trim with aluminum coil stock including.the following: Color: W H(tR— ❑ window trim ❑ deluxe window trim ❑ upper porch trim Wlascia boards door trim ❑ Other: ❑ frieze boards rake boards ❑ Install Soffit Panels: Style: Color: stall vinyl siding to body of home as follows: Manufacturer: ($'�Aiylt+iKA Style: MOV162571M Color: ❑ Replace existing wooden attic louver vents with vinyl vents. ❑ Cover porch ceilings with CertainTeed beaded porch panels. ❑ Remove and re-install existing shutters. ❑ Install# pair of Girardin new vinyl shutters. p�mer Post style: f.M14,a VIA I Color: AMi-:~( yP IIOr.✓ ®/Clean debris from grounds on a daily basis;clean grounds thoroughly at completion. ❑ met d in this proposal are the following items: ullding aril GI WW Permits ❑ Basic Electrical work including removal and remounting of fixtures electric service,and wires. ❑ Basic siding accessories including light,outlet,spigot blocks,dryer vents,and exhaust vents., SPECIAL INSTRUCTIONS: - ReshP4ifne re.*r OC CA$RAe -Y-2(Ta(' w;-Ml pgwccd WkrQ NOSAO.'W ncl 2xtt " • CLt+QK Frot)+s;i4e 4-42 wAll so JgVoyi•l- SiclQ tut{1 CDy7com,+,D r,=P1tfnSL hylrl_ Add RAk� T�A-ds J23 Fr 1` lorti rer, 1 rL%2- Z-aAOye All S Elf tA�s1eJ T�r\bed 4's at "r Cz2L41Q'S 994pA49- -'ZAMA 4'a"6s DIP -K o G&M5: Tors t ova 81� QcofS A&A Services, Inc. provides a five-year labor warranty on vinyl siding Installation to Include any re4nstallatlon 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 parties that this Speelfkation Street along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,commodes the Wim understanding to mean the parties,and there are no verbal understandings changing or modifying any of Me forme.This contract may not be changed or Me harms medthed orvaded in entreaty unless such changes am In tenting and signed by both Me Bu rar(s)and the contras or,euyags)hereby acknowledge Met euyar(s) free read this Specification Short) Contractor Initials: s L Date: al d7 Buyer's Initials: Date: �Li w� �J AN A & A SERVICES, INC. A&ASBMCES 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.OS057733 ROOFING SPECIFICATION SHEET - Buyers)Name Date of Contract row AykL Lin V : of L07 Buyers)Street Address,City,State and Zip Code , �21 Lo�NG Daytime Telephone Number �./Evening Telephone Number Mobile Telephone Number E-Mail Address r•/ The Buyers)listed above hereby jointly and severalty agree to purchase the goods andlor services listed below,in accordance with he prices and terms described on this SpeciAratlon sheet and Me front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification Sheet is a pan. ROOFING SPECIFICATION 64r49e pNZY Strip R f of# layers of shingles cF• nstall 6'of ice and water shield at base of roof where Install 15.b felt paper to roof. -' possible. Install 18-24"of ice and water shield in valleys.❑ Flash chimney as needed(no repointing included). 'Instaliperimeter drip edge to rakes and fascia areas. Q Install vent pipe boots and seal as needed. ❑ Flash valleys as needed ❑ Install rollout type ridge vent. lanks/plywood replacement under 32 SO FT included, 'If more is needed there will be an extra charge of$ per hour for labor plus the cost of materials. - Dumpste isposal cluded: A/o 1>M,uoi ❑Other: Location: cz Lf r"' Install new roof: Manufacturer C2f1-.4 i wf�ed yr - Style/type Included in this proposal are thorough cleanup,building permit,and company/manufaclturer warranties. RUBBER ROOFING SPECIFICATION CW4T- 1Ft :5;WA trip Roof O Not$trip Roof - Install 1/2"High Density Fiberboard to existing roof using O Flash obstacles as needed. f screws and plates. I nstall.060 membrane EPDM(Black)rubber roofing to Install 3x3 aluminum drip edge to perimeter of roof with fiberboard.s seam tape. Flash up sidewall as needed. Included in this proposal are thorough cleanup,buildinq permit,and company/manufacturer warranties. - SPECIAL INSTRUCTIONS: t�.slanoai�te a wide � st��d�lion Il� wi'�I p�sJ�_ >tsnrer�d• It Is agreed and understood by and between Me paN.e that his SpacMradon Sheet along with CUSTOM REMODELING AND IMPROVEMENT AGREEMEM,conethuM Me entire understanding between Me pelves,and share ere on verbal understandings changing or maJgying any of Me terms.This contract may not b r changed or net ' forme modified or varied In any way unless such changes are In wrBing and signed by both Me Buyer.)and Me Contractor.Bayer.)hereby acknowlodge MM Buyer(s) has reed chi.sexiness.Sheet L Contractor Initials: Date: T1 ®7 Buyer's Initials:_ �_ Date: A & A SERVICES, INC. •A ' CES 115 NORTH STREET,SALEM,MA 01970 RTG a 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 , Buyer(s)Name Date of Qontract OLi N'D �— ?-�1 y1Rt— - M t h i> Q Buyer(s)Street Address City,State and Zip Code N. P 2z1 e S i-Utih fill 9n AA.q 019 Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address. 1+ 9?s-744 4 t-7 The Buyegs)listed above hereby jointly and severally agree to purchase me goods and/or services listed on the accompanying specification sheets,in accordance with the prices and terns described on the front and the reverse of this agreement and any spacitiation sheets(the'Agmemenn,and Buyegs)have requested mat such goods or serves be installed or pmvidetl at Buyer's address listed above.ASIA Services,Inc.CContrapWrl.hereby agrees to install or rouse to be instilled the producer or services listed in this Agreement at me Buyers)address written above. This Agreement represents a ash sale of goods and services. The Buyer(s)agree to pay in asM1 the cost of the goods and services purchased as tlaudbetl herein,re di as of Oming or approval of any financing Busets)ma seek for their purchase. fl9 ,m — si N a to 9. -4,41s ,-rAO Purchase Price: ¢ Est.Starting Data: to` Down Paymenr- Est.Completion Date:. - ❑Ca Amount Due on Start of Job eck O Credit Cad Amount due an of Completion: No. Amount Due on of Completion: Expiration Date: Balance Due on Upon Completion 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 acknowietlge that Buyers)has mad 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 farms,an the date first written above. Buyer(s)also (1)acknowledge that they were orally informed of their right to cancel this transaction;and(11)request that they be contacted via their telephone numbers or a-mail,as listed above, in the event Contractor believes Buyers)would be interested In any additional quality products or services of Contractor. DO NOT SIGN THIS CONTRACT Or IT CONTAMS ANY BLANK SPACES. A&A Services,Inc. .y�J�_, Buyers) Signalur�aa Sign atur§g Print Name IFPrint Name Signature Print Name 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. Sae the following Notice of Cancellation form for an explanatton of this right AabormarloN:Th.esueoo,meal mm.oma hereby mumm,spreem foam-box lithe Brent eher,me has a dlapW eeremeoNb coned.elver pen,may summu sum dispute to - - a ahem anlNvlan sense whim has been abandoned by the Secondary d the Exessuwe cone of Cvsumer Axelm and Bromides provided-end me most per,Mml be Wh and to summit b cam .on as pndom erMGL cfay.. Conuazmwde/ / BUYVSS Irvtie1. Oem a1 TmnmNnn 7 .YW may cyWBl mb banaBCtlun,wMON enY—my or oam of Tmneetlbn NOT.You may edneel she formation.wIasm any anal,or omllgatlSn,wMin m,00 SInB9 dayB M1OTtlle elpvedW.Ilyvu mnml,uy pmaM redid lit, omllg84on',opnNM buelnmadaye lmm the abovx dYe.ll pu„arcN,emJ pmaM mBded in. urypay smadowyouuMer Nefan oreele,wdmyne�tlmbi..,...—,as a Mymemema byyauunderthe CanO oruomd"nepwinabummlwe the by ywwin be remmod..In to den lolbxlna,eaI,by Me a.,,.,a your a,ce1.mtlm, dy you win be Mounted within to dare fmWwing,eoeipl by to Seder of your ere on undid, one any mourn lmema anv,e dmm Ne pawnor cam MSa,xlellM. uyou do a,You mud em err eewd,Nl.,M arising nmdep daneembn asuaaldeu.e.ure enre,mu mom maMoarelMbmmWoyou undrteWanwen ouSioryou My.Mnmmsaa cane xho the masaasaamemNe ssuermYm,esberca,m or Sm.or wumy.if We ahm,co m,cei has amygmb dotiveMmr express,weer Tie he anon ew5919:ayerboxe Ido thf you wbM1.mmp,wM rd a,rypN..11Ne from f under ldlaCmtraC1o,561e:myaumeyat mrwlM,¢mIM'wM me dubee If yd m me Seller9001 munWm Mip,n0n1 W nd boxed s e W ad not expense eM irtsWNMu di mem.I th r.gB,dmq me temm ove Sol of Ne thee¢a1 the ad net expenserand Who If you do mint s.9Mda eve of m of seller vtl nary Seim,Bea ipl trtk.se up ,Idle It you do the Me , mr avalhde m the Belle vN me saMr goes net of Nam up - 'MNIn wyNBl Medabalyour NdW dGevelMtle,You mey,Bbin wdlaaelmme 9e]s within MaeYS of de mm of your Np,ieB pl Canollebn,you may,etBin otd'upoae of Me thcW wmmm�dr, pboodmgeeS era reelm Wfor.then form hour for coruYw-three wimom e„ xxxxt d11dor sururoul.ilm doss,sea you remee mm.s.11.c - agree m,BWm Neer Me d he Soler am .Ihen yon. u form ored.diiKB dell mremmNethone Cos.reMmil trope,ub..r nnulnduffers Marlmmmvp oud, ra .11 meYwu ll Me Contra tTdranel Nadwue,orshore o,dame e"A e So mpy 0 cor n5undutlw CehecmyomnSBrprons,are nn.hre,or rotor maia9egnedaMdemdmpy M M U,celU . p any ONe wnee OTi m Bap a MICNIG,T A $�ety�o�ry� d the S—I ttlon Mlle on u other canton,pll„a,or sent a IBIe9run,to r Services. WM SdM.SaIBm.MBafecM,s.Da d18]O.NOT IATEN TXAN MIDNIGHT OF�fJJ! NMh$bw4 SWm,MaavGusetts 019]a.NOT UTEe TXAN MIpNIGM of (OW) proba I HEREBY CANCEL THIS TiLNSACTON, cinaumon,a,nma nab I XEPE9YCANCIITHIS TMNSACMI Cdsumx'e Shamir. ram