HomeMy WebLinkAboutBuilding Permit #765 - 14 BUCKLIN ROAD 6/23/2008 BUILDING PERMIT NORTH
;°�o
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATIONH 3� °�'' ,.° o�
A
Lt �
J `
Permit N0:
Date Received
A� :�>
a' 7 p�NATED
Date Issued: ��� 9SSACHus�`�
IMPORTANT:Applicant must complete all items on this
sh ill
page
LOCATION 11 4 L!' ICti
PROPERTY OWNER L. -
Re PPycc r
Pnnti a77
k PARCEL " =Y
MAP NO ZONING DISTRICT Histone District
yes
Ma no
Mach Sho
p Village 'yes no
TYPE OF IMPROVEMENT PROPOSED USE
Resid Non- Residential
New Building One famil
Addition Two or more family Industrial
Alteration No. of units: Commercial
Re air, re lacement Assessory Bldg Others:
Demolition' Other
r eptic `Well # Floodp plain: Wetlands;
— , , 3 Watershed District
wWater/Sewer
w
Dj=SCRIPTCION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Alii �LI'S�. Le PuCC i Phone
Address:
� tk} a 1� x c.: tr'�+,
CONTRACTOR Name �df.[r
t meq `�'�
a F . _ Phone x P �
yAdd ,4.6k ,t x xs,.,yy r s7.ress 1 N sT� x :
Q n ff
' 5a
z .
Supervisor's Construction License CSO .�f <ry , Ex Date '' 0 p 4 x
Home Im
4 7—
ov r _ q
ement License x 100 { r
ARCHITECT/ENGINEER Phone:
Address:
Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST
BASED ON$125.00 PER S.F.
Total Project Cost: $ a'oZ J--v , Edo FEE: $
Check No.: lcZ of Receipt No.: uaran ,
h u egistered contractors do not have access to he g un �
Si nat ru a of�A ent/O nwnw a m d
NOTE: Persons contracting w'
nattarfi
9__�-_�. a of contractor'` �7m,
Irv/
)ego(
1 ^✓(��� ���
No. Date 3
NORTH TOWN OF NORTH ANDOVER _-
O w
� +
Certificate of Occupancy $ =
C. Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ —
j
Check # J _
2 270 Building Inspector
i
I
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales
Private(septic tank,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
,d
f
i
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Os ood Street
FIRE DEPARTM,ENTTem:p Durnp
� steronsite"
x , r�
s^9 x�, r ar aT.,
Located ata 24�MainStreet :���
ISI ��nw. .r• ' -r y7„F
Fire Departmen#'signature/date
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— (For department use
❑ Notified for pickup - Date
Doc.Building Permit Revised 2008
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
u Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
i
New Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
i
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
0ORTH
ToVM o ._. _
A- nd over
C% - - o W �` dover, Mass., ••�3 J000
0 LAKi� COC NIC ME WICK V
{� RATED
S BOARD OF HEALTH
Food/Kitchen
Septic System
PERMIT T D
• BUILDING INSPECTOR
��
AT l ......... � v.�il.�ii►..�.. . ......
THIS CERTIFIES TH .....`j.t...... ..�� •• •• •• ••• •••�•• •••••••�••. ••••• Foundation
has permission to erect................. .............. buildings on .. ... ... ,t/ ...... .................... Rough
t0 be OCCUp18d as........
P ...... .. Chimney
. .... . ............................................................................
provided that the perstingthis permit shall in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERS- EXPMES 16 NTS
TT T c�-p T T A T ELECTRICAL INSPECTOR.
UNLESS V LESS CO V S 1 Lid J . al PT
Rough
....... ..... ..........................................................
Service
....................................
BUILDING INSPECTOR
Final '-
Occupancy Permit Required to OcLupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
i
:y
SPECIAL SERVICES CUSTOMER INVOICE Pagel of 16 NO. 2685-153652
r---------------------------------
Store 2685 METHUEN Phone: (978 ) 989-9025
72 PLEASANT VALLEY ST Salesperson: BD 16AO t I
METHUEN, MA 01844 Reviewer:
a i
LL I I
I I
I I
o Name Horaa Phone ; STORE COPY
REPPUCCI CARL& ELISA (978)2044192
co
Address 14 BUCKLIN RD WorkPhcneco
Compecw Name
F � i t
c"y NORTH ANDOVER JobO"c""" 04-12 KITCHEN r
scala MA �P 01845 ESSEX
I
of
I I
N
" MERCHANDISE AND SERVICE SUMMARY mercl'ianJlse sof��o��Sia t®rs quantities
� "
�V 11 QOR.DIRECT SHIP-#
mCUSTOMER
` SID-MERCBANDISETO BE SHIPPED: SIG AMERICAN W900MARKREF#S02 ESTIMATED ARRIVAL DATE:0611912000
;d.-..... .I...........:..+v.-..,..> .. ..._.....-.-........__.Y..-_......._.....�.„a«, e . 9- n
S0201 . w:M1v:t:�N w-..yw:....-.�.......f.>x..../.........».....:>_.:.-r<a_-�a......o.i...;.:»<..:.v:r'r'..:r>.^._-:./:_...:_.u.-.<a..;.y.4:3�-.31S>'..;M.rk;..Y.Rlt.S>.'Jx;.....aYL.::<.i..--.�.r�:s:x.4:e.:.sv,e...-sa.:....n4^a..a.rnd..'/<(..i.vrAa:a.::.[-..::'-:-.-:..•:.:-.. -.::n:-lyry:y.ry.[�.,.J v..w(..:�y}a9.•t{'._i�:..:;Fy.��.:._'ia'i"•i:b'.'�:�4:.:Y:.'!i.i3d�am'.'$,z,Y.::i^:rriLyt!r.,".-::':F�!.%W.?.:,�'.f:'.'i-.�9.•:..O..:',i:)".vYl:fvi'::.ry.:.;v�r:!.�"Yy,K,:
KK.
- -
212-515 8.00 EA CCO /CCO CUSHIONCLOSE GLIDE OPTION CCO /CCO FSIOES:B Y 819.91 9159.28
S0202 212-515 1.00 EA BTK8WD /BTK8WD BASE TOE KICK{96" L WOOD} BTK8WD/8T Y $13.04 613.04
S0203 212-515 2.00 EA BTK8WD /8TK8WO BASE TOE KICK(96" L WOOD) B Y 413.04 $26.08
S0204 212-516 3.00 EA CCMBVNR /CCM8VNR CLASSIC CROWN MOLDI CCMBVNR Y 467.95 9203.85
S0206 212-515 3.00 EA OVSF696 /OVSF696 UNIVERSAL FILLS 2 961OVSF698 Y 458.00 $174.00
S0206 212-516 3.00 EA RMSWD /RMSWD ROPE MOLDIN /RMBWD Y 448.38 $145.14
S0207 212.516 1.00 EA LR8WD ILRBWD LIGHT LR8WD /LR8WD Y 674.47 $74.47
;m 60208 212-515 1.00 1 EA FP4834WO /FP48 D PANELING{WOOD} FP4834/FP4834WD Y 666.23 866.23
FSIDES:B
Im 60209 212-515 1 1.00 1 EA DMD {L} DECORATOR MATCHING DOOR{BASE}/DMDB(L} Y 580.30 580.30
o S:
x,
DO
M x
N
au
o Check your cwrent order status online at
www homedeoot cornlorderstatus
lA
N
t0
C* -ge 1 of 16 No. 26855-153652 Store Copy
i
SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: REPPUCCI Page 2 of 16 NO. 2685-153652
= VENDOR:DIRECT:SHIP 41
TO:CUSTOME1l
910-MERCHANDISE TO BE SHIPPED: 210 AMERICAN WDODMARKREF/1302 ESTIMATED AARIVAI.DATE 0611012008
�
-Y...,
....."....wrr....:.. ..:.,,.r......t:.,a.«.KYrE.x S.f .Y..JF.. .:4i. �•�-- <:..i X{:Yw;.'<;_;.':'..:..'
� :ro F. cr Y7..t�: CJ.r.d� r .tr.rr. .. r :..-.-..z....:a•a<. .br4 e r :. :::- ':6 ..4u.-:5:::u .-Z,: rx.. (
rt.:>-;::.,:ii(�F'1�14
..AJ►•'.[�. Mxe. .-I...A� .F r..irr........ v[4 a'. !-.�-..-......wa'1....[F...[ >}><n >N ..e'• r�r L -','lf:�� xJv.: ....[4.d vF:::" .Y......... t�..r.w......
wv,..v.. .r •r•r /..... Y r
S0210 212-515 1 1.00 1 EA DMDB (L) /DMDB(L) DECORATOR MATCHING DOOR(BASE)/DMD6(L) Y $80.30 $80.30
N FSIDES:B
o S0211 1 212-515 1 2.00 1 EA DMDB (R) /DMDB (R) DECORATOR MATCHING DOOR(BASE)/DMDB (R) Y 980.30 $160.60
d:
FSIDES:B
m S0212 212-515 1.00 EA DS15 4DWR /DB15 4DWR 4 DRAWER BASE 0815 4DWR IDS 11,4DWR Y $333.90 5333'90
.1-
FSIDES:B
S0213 212-515 1 1.00 1 EA CDK15 /CDK15 CUTLERY DIVIDER KIT CDK15 /ATT:DB15 4DWR Y 518.19 $18.19
CDK16 FSI0ES:8
S0214 212-515 1 1.00 1 EA SB36 STO /SB36 STO SINK/RANGE W/FII SS TO TRAY SBIS836 STO Y $394.65 $394.65
FSIDES:B HINGES:B
m 50215 212-515 1 1.00 1 EA STB /STB SLIDING TOWEL BAR STB /ATT:SB36 STO Y $28.14 $28.14
m
cm STB FSIDES:B
+ 50216 212-516 1 1.00 1 EA UF3 /UF3 UNIVERSAL FILLER(BASE) UF3 /UF3 Y $14.76 $14.76
S0217 212-515 1 1.00 1 EA BSS36L WD IOSS36L WD BASE SUPER SUSAN (WOOD SPIN SHIBSS36L WD Y 1 $531.57 $531.57
FSIDES:B HINGES:B
S0218 212-515 1.00 EA B24 2FWT BUTT /B24 2FWT BUTT BASE CABINET W/2 DEEP ROLLI824 2FWT BUTT Y $332.19 $332.19
FSIDES:B HINGES:B
S0219 212-515 1 1.00 1 EA BEP34 WD(R) /BEP34 WD (R)RIGHT WOOD VENEER BASE END/ATT:824 2FWT Y $29.85 529.85
BUTT BEP34 WD (R) FSIDES:B
S0220 212-515 1 1.00 1 EA DMDB(R) (DMDB (R) DECORATOR MATCHING DOOR(BASE)IDMDB(R) Y $80.30 $80.30
FSIDES:R
.�, S0221 212-515 1 1.00 1 EA 612 ROTD L IB12 ROTD LEASE WI ROLLOUT TRAY DIVIDERIB12 ROTD L Y 1 $260.47 $260.47
m
FSEDES:B HINGES:L
S0222 212-515 1 1.00 1 EA BEP34 WD(L) /BEP34WD(L)LEFT WOOD VENEER BASE END P/ATT.B12 ROTD Y $29.85 $29.85
L BEP34 WD(L)
S0223 212-515 1 1.00 1 EA 610 2FWT KSCC R/Bl8 2FWT KSCC R 2FWT BASE W/FA KSCCK B/B18 2FWT KSCC Y $405.97 $405.97
dw0
R FSIDES:B HINGES:R
S0224 212-515 1 1.00 1 EA BWBTIS-2 /BWBT18-2 WASTEBASKET CABINET BWBTIS-2 BWBTIS-2 Y $369.94 5369.94
�. FSIDES:B HINGES:R
S0225 212-515 1 1.00 1 EA BEP34 WD(R) /BEP34 WD (R) RIGHT WOOD VENEER BASE ENO/ATT:BWBTIS-2 Y $29.85 $29.85
BEP34 WD(R) FSIDES:B
o • >;:.•..... ,.'Cff(I` (AIU�.�Na�E�LTpASE`'>`>;.:,�` ':
0
1
N
t0
go 2 of 16 No. 26$5-153652 Store Copy
SPECIAL SERVICES CUSTOMER INVOICE -Continued Last Name: REPPUCCI Page 3 of 16 No. Lf1tiJ'1 `J.idJ/_
-: VEND0A :DIRECTSHIP#.1 :...
To:CUSTOMER
..
3...1f30.x:..•N�:.EA.i Cs.Hcto..Ai•v,.�N..r.b�t.I:tS:.."E.TH.O...<.....C 8.....ms.-..Ew,-_S...=.R_.."..�I-..P.Pv.rGt
D:.,..vY:.. Sig
SY.x..1r.vy0
.r....An..,:....PL.S..AEE.l..R.34I Aq-[..�N:W...D..<..�k
O...:.•Y"D:-Lr-•MA". RK-5x.iR.xvx..eE;w iF•.xr..-x....-+..S.x....-..".-.-
2...p.t.r •. (1(!, ■/EST(M.:RA�:r?Tn.,1},..•.Eft.aDn°�..r:♦A:r.•._�.::Rr!''IRr.-Y IVAL.ADryA4�T
iEb:0011912008- 1,•[,
rws
�.�'r�::
z:
%"
4 ry1: x .. w
.
...
-:':. .':�f%:.i�% '•.�..1k'! :::.Tpp_
S0226 212-515 1.00 EA UF3 /UF3 UNIVERSAL FILLER{WALL-30 1/8-- H}/UF3 Y $14.76 $14.76
5 S0227 212-515 1.00 EA W3612 AN3612 WALL CABINET W3612 /W3612 Y $164.36 $164-38
o FSIDES:B HINGES:B
a S0228 212-515 1 1.00 EA W3930 M3930 WALL CABINET W3930 AN3930 Y $259.43 $259.43
co
FSIDES:B HINGES:B
S0229 212-516 1 1.00 EA WEP30 WD (R) /WEP30 WO(R)RIGHT WOOD VENEER WALL END/ATT:W3930 Y $15.44 $15.44
WEP30 WD (R) FSIDES:B
50230 212-515 2.00 EA DMDW30 (R) /DMDW30(R) DECORATOR MATCHING DOOR{WALUDMDW30 (R} Y $51.82 8103.64
FSIDES:R
50231 212-515 1.00 EA OMDW30 (L) /DMDW30(L) DECORATOR MATCHING DOOR(WALL/DMOW30(L) Y 951.82 $51.82
FSI DES:L
S0232 212-615 1.00 EA W1230R 1W1230R WALL CABINET WI 230R /W1230R Y 5142.07 $142.07
+ FSIDES:B HINGES:R
S0233 212-515 1,00 EA WEP30 WD (L) /WEP30 WO(L)LEFT WOOD VENEER WALL END PlATT:W123OR Y 815.44 $15.44
WEP30 WD(L}FSIDES:B
S0234 212-515 1.00 EA CW2430L fCW2430L CORNER WALL CW2430L ICW2430L Y $268.07 $256.07
FSIDES:B HINGES:L
S0235 1 212-515 1.00 EA WI 230L 1W1230L WALL CABINET W1230L /W1230L Y 0142.07 $142.07
FSIOES:B HINGES:L
S0236 212-515 1 EA W3012 IW3012 WALL CABINET W3012 //3012 Y $157.18 $157.18
FSIDES:B HINGES:B
m 50237 212-515 1.00 EA W2430 BUTT /W2430 BUTT WALL CABINET W2430 BUTT /W2430 BUTT Y $195.61 $195.61
r FSIDES:B HINGES:B
50238 212-515 1.00 EA WEP30 WD(R) /WEP30 WD(R) FIGHT WOOD VENEER WALL END/ATT:W2430 Y $16.44 $15.44
o BUTT WEP30 WD{R} FSIDES:B
J S0239 212-515 1.00 EA OCMS /OCMB OUTSIDE CORNER MOLDING OCM8 /OCM8 FSO)ES:B Y $18.87 $18.87
.� 00
S02FR 506-658 1.00 KITCHEN CABINET FREIGHT N 8150.00 $150.
4M .VENDOR-SPECIAL INSTRUCTIONS: UNEAAWCHOIC E DSTYLEA[EXANDRIA MAPLE SIB USTYLE32MRS OWRSTYLE:000 FINISH:COGNAC MAPLE FINISH:COGNAC MAPLE DSGNIL--811SAO
... 310.IVERCRANDISETCOESNMPED: S10AMERICAN WOODMARKREF4SO4 ESTIMATED ARRIVAL DATE 0611912008
SO401 827-523 10.00 1 EAJ CCO ICCO CUSHIONCLOSE GLIDE OPTION CCO /CCO FSIDES:B Y 619.91 $199.10
m
SO402 827-523 2.00 1 EAJ BTK8PRT /BTKOPFIT BASE TOE KICK 96" L PRINT) BTK818TKOPRT Y" $13.04 $26.08
o .>;k�,•':l�th�'ll8- :tf�.NES(T•p4lQ�E.:�.�:,.::�.:;::::.
0
1
A/
N
.D
o ige 3 of 16 No. 2685-153652 Store Copy
SPECIAL SERVICES CUSTOMER INVOICE-Continued Lest Name: RE:PPUCCI Page 4 of 16 NO. Zbldb--1 DJDDZ-
:VENlP0. lRE' SHIP 1 Gift" .'t :. TO:CUSTOMER
.�
oae g
.o SJO-MERCRANDFSETOBESHIPPED: SIOAlV1ERICANWOODMARKlIEFi4rSO4 ESTIMATED AL DATE-0611 1 12
... .. ... ..... .... .. .. ... .. .. .........>-.i h..ww.v v .-.. ... ...9nn.:....Y.r.., <ki %�.::..v. - 4~I,YpY... Pv
:... ., a .............n,.r T... ..:: ,✓ .....i Yr.TY.. :..:. Y ... .....r. /• n"V✓.....•Y�}.
.. 4.w f.-:. :o .,....:¢:. ..:_v.rc�n: ... ......etx.•.3.. �.
FIT
4^'eStiS.;" ._t Y
.E. Y :�. .C :.2 b..yy n-`:'.v. Y: I_ { S ! ..F. 9'.f>r..:.vvx .1
4_ •n. . in YL-:x, .....:"'J " ti-.. yY:.. 'Y/r' -'�Y:: 6`F17.4R 0. } A •<P�.�. .r.... t• ?� -
?-i },. :...tj!. ...l n. i.9x+r.:. i vv,.., w.t'iSa-:. q�i i'�:'%Y+.vY�b.A t:a:9>.•:�•y: .IS.:.....���:%.;+i.•lr i.'$'�:':N.N•
.,..,� .c8... .r. .:.:: ...:.:.:.... t"r :�"�'i:c._.,.a^x:,.�ol1�`'. ..<.:.:..r..,v.w:. .. .bi.�: �.::,.,.,:: ....:�a<,'::":=3i::...
v SO403 827-523 2.00 EA CCM8VNR ICCM8VNR CLASSIC CROWN MOLDING CCMBVNR /CCM8VNR Y $67.95 $135.90
v SO404 827-523 2.00 EA RM8WD IRM8WD ROPE MOLDING RM8WD /RM8WD Y $48.38 896.76
o SO405 827-523 1.00 EA TLRB ITLR8 TRADITIONAL LIGHT RAIL MOLDING TLR8/TLR8 Y $73.10 $73.10
dS6406 827-523 3.00 EA TLR8 ITLRB TRADITIONAL LIGHT RAIL MOLDING TLRB/TLRB Y 573.10 $219.30
CD SO407 827-523 1.00 EA UF3 /UF3 UNIVERSAL FILLER(BASE)UF3 /UF3 Y $14.78 $14,76
CD
$0408 827-523 2.00 EA D630 /D830 3 DRAWER BASE DB30 ID830 FSIDES:B Y $376.17 $756.34
SO409 827-523 2.00 EA FBF3 /FBF3 FLUTED BEADED FILLER FBF3 IFBF3 Y $33.97 $67.94
SO410 827-523 1.00 1 EA B36 2FWT 1536 2FWT BASE CABINET W12 DEEP ROLL-OUT M36 2FWT Y $392.25 $392.25
FSIDES:B HINGES:B
SO411 827-523 1.00 FA B36 2FWT 1636 2FWT BASE CABINET W12 DEEP ROLL-OUT /838 2FWT Y 5392.25 $392.25
CD FSIDES:B HINGES:B
m 50412 1 827-523 1 1.00 1 EA CDK18 /CDK18 CUTLERY DIVIDER KIT CDK18 /ATT:B36 2F1NT Y $18.19 $16.19
+ CDK18 FSIDES:B
SO413 827-523 1 1.00 EA UF3 IUF3 UNIVERSAL FILLER(SASE) UF3 /UF3 Y 514.76 $14.76
SO414 827-523 1 2.00 1 EA WFC31560 FLUTED/WFC31560 FLUTED WALL COLUMN FILLER(FLUT/WFC31560 Y $177.07 $354.14
FLUTED FSIDES:B HINGES:L MODS:W=3"W2-3" H=48" D=12"
SO415 827-623 1.00 EA W1830L /W1830L WALL CABINET W1830L JW18301- Y $117.02 $117.02
FSIDES:B HINGES:L
50418 827-523 1 1.00 1 EA IOFDAFTON30 /1 OFDAFTON30 ONE OFD AFTON 30" I0FDAFT0N3/ATT:W1830L Y S2fi?.67 $287.87
I0FDAFTON30 FSIDES:B
SO417 827-523 1 1.00 1 EA WRC3615 /WRC3815 WINE RACK CABINET WRC3615 /WRC3615 Y $228.20 $228.20
FSIDES:R
50418 827-523 1.00 EA SGH36U /SG436U STEM GLASS HOLDER SGH3eU IATT:WRC3615 Y $97.80 597.80
SGH36U FSIDES:B
o SO419 827-523 i.00 EA W3615 /W3616 WALL CABINET W3015 IW3015 Y 124,67T $124.57
FSIDES:B HINGES:B
0
SO420 627-523 2.00 EA 20FDAFTONI6 I20FDAFTDN15 TWO OFD AFTON 15" 20FDAFTONVATT.W3615 Y $267.67 $535.34
20FDAFTON 15 FSLDES:B
SO421 1 827-523 1 1.00 1 EAJ W1830R IW183OR WALL CABINET W1830R JW183011 Y 5117.02 $117.02
FSIDES:B HINGESA
m
0
0
N
lA
N
4'f
o ge 4 of 16 No. 2685-153652 Stere Cop„
3PECIAL SERVICES CUSTOMER INVOICE -Continued Last Name: REPPUCCI Page 5 of 16 NO.
IMCUSTOMER
310-MERCHANDISE TO SE SHIPPED: SJO AMERICAN WGODMARXREF#SO4 ESTIMATED ABRIYAL DATE 0611912008
tt ,,..v.::...k•i.4::,r:-�s .r„'<k'=':oft.;r�::
.•,:+r.:r. ......;..r.,,.,y... [<sa..a t- .r I 1 .:..:- a. ,.�a:..z....•,a:a........ r, .xy_r.....,a..:. ..............F. t,., ._1 �s•„ .:{3�'f.'>K. ..fir; "1`� .
- ,'
,r,::,-•.:s�• :.t-.,:��, bra '4: -
3 '- �,v"v',;. .a.,.._ .:r ,<: .. : iv;, -fib.$St:or"•• v— ';7a_ t�
v SO422 827-523 1.00 EA 10FDAFTON30 ItOFDAFTON30 ONE OFD AFTON 30" 10FDAFTON3IATT:W1830R Y $267.87 5267.67
cz
1 OFDAFTON30 FSIDES:8
I
o VENDOR-SPECIAL INSTRUCTIONS: LINE:AWCHOIC211%'M E*EWPORT WHITE SO USTYLE:05W OWRSTYLE:000 FINISH:WHITE OSGHS9016A0
REPPUCCI CARL & ELISA
m ADDRESS:14 BUCKLIN RD CITY:NORTH ANDOVER
~ STATE MA ZIP: 01845 COUNTY:ESSEX SALES TAX RATE: 5.000 r r 610,283.30
PHONE: (978) 204-4192
::•�':•::�.:::` Elgtt.OE YENDDR DIRECT SNIP;:�i''�;:=�.
"' .INSTALLA .O��N:.:
.�
::.
m
0
BASIC INSTALLATION
:.•_�::•-:if�.....2.:v.a..a:..,.t::,,,,. .IXo"Y,•�v.,..'w.,-_..,_.,`....-„.r_-.............-,,•v.-4.>....n...l...t.L.r{AL,.-:a.B7...>;,O. R,..,.:
•tn...:-r.z,,..>....,.r.-...~,.<,.t,;.-.,::: 3 _.�.. 4v ,g�.p-.i:...n.. ..•,sl.:.:✓.,i...i':.)r:"'xs-'<:�,:'+�f=-:.X-,.�..:�'•.��... is-.: x' :i'4�,.A..,,..'
.�.•s.<'-ici"'3°s'.^:.^d:.-.a-�-0.J,
ci: :;:,'Y.;j_>•"' •:
-'4[yny yt �s�tk•. -�:.,.�:r,
1p:�7�(1�A►�i
-
572-0201 KITCHEN POINT(NATIONAL)EXCEPTION 0.00 EA N $0.01 #0.00
OPTIONAL LABOR SELECTED INCLUDES:
- :-xc•-xss:;,..-s::s: i•i-"-.;i, •'ci #'.'. ::�:��' 's�x� _s.,:a,-af.%:- '.3%.. :t�•�s �$,�:::. .avx:,ca;z
%:i:fl.. ]S�Y:-':�:•-„r- : !. '!,.V.:.:e..,. ..7.J vr`.Qvr. ** v$- /!'
!<{b '3•�4•ii L..6et A'♦Y.iF-FF•:iG I{..• }:..yn/'-<:%' -..;;:L.JY..K Y�F�
.. 5)IX: a.z:-�'�..,.,..:..a-.. fifv<..:. - -::•.r::9.: :a+:ii:•".v�pe-,'?:i::::u'a%.: _:,'.,,'FJr .5. 'e'Sw.'Y;';';moi">-->&.`? :<u..a.>..:,
,.r: -. .QCs; :. .
01 ...Utilize the kitchen point worksheet to obtain total number of 210.10 EA N $29.00 58,092.90
points required to complete installation. Scope of services available
varies by market!
i 02 ...Permits! 350.00 Elk 5350.00
N 51.00
REPPUCCI, CARL& ELISA INSTALL LABOR CHARGE: 46,442.90 .
ADDRESS: 14 BUCKLIN RD THIP CHARGE: $0.00
g CITY: NORTH ANDOVER STATE: MA ZIP: 01845 CREDIT FOR DEPOSITJNIEASURE: 4100.00
COUNTY:ESSEX SALESTAXBATE: 6.000 TAX:Merchandise- Y LABOR- N 46,342.90
0
�
PHONE: (978) 2044192 ALTERNATE PHONE:(978) 204-4176
c
N
m
O
O
N
1
A
N
t�
o Igo 5 of 16 NO. 2685-153$52 Stove Copy
SPECIAL SERVICES CUSTOMER INVOICE-Continued Last Name:REPPUCCI Page 6 of 15 PAD. LC)t%*— 10,3004 '
:`.INSTAnAT�IQN:.#1 REF#101
:.
1 BASIC INSTALLATION LABOR INCLUDES:
v ...An in-home measure and consultation is required to verity "•Measurement/Consuitation fee is NON-REFUNDABLE
proper fit of kitchen cabinetry and other products to be •'*If customer purchases labor from the Rome Depot the
o installed.During this consultation the installer will measurelconsultation fee is applied to the purchase.
a check for unusual situations which may require additional THE FINAL KITCHEN ESTIMATE WORKSHEET MUST BE SIGNED BY BOTH
to labor. THE CUSTOMER AND ASSOCIATE AND THEM IT MUST BE MANUALLY
CD
...Dally clean-vp at jab site.
FAXED TO TE INSTALLER.A COPY OF THE FINAL KITCHEN ESTIMATE
NOTE: WORKSHEET MUST ALSO BE GIVEN TO THE CUSTOMER.
UNLESS STATED ABOVE THIS INSTALLATION DOES NOTINCLUOE:
...Major Structural Work Including: ...Patch and repair wall behing existing cabinetry
Moving Walls l Altering Wails ...Haul away cabinets and/or installation related debris
mAdjusting Openings or any work involving oad Bearing ...Haul away cardboard only
m Walls ...Complex appliance installations(down-drafts.
+ ...Installing Skylights professional appliances,etc.)
...Cutting of Sawing Concrete Floors ...Construction Labor{Minor wall construction or removal
...Relocating or Installing new Plumbing or Gas lines soffitt constuction or removal,etc)
...Relocating or Installing new Vent Stack _Electrical work
..Relocating or Installing new Ductwork for Appliance or ...Drywall Work
HVAC ...Plumbing Work
...Patch and repair wail(from rise backslash demo}
SPECIAL NOTES:
...Customer must be present during installation(must be an installation phases to be completed.The installer will
Up adult over the age of IS present.No work will be done notify the customer when these Items will be unusuable
to
with unsupervised underaged minors present). &for what length of time.
...Customer is responsible for dismwming any security alarms ...Customer Is asked to designate parking,entrance and exit
...No work will be done on Sundays or Legal Holidays. access preferences for the installer(including restroom
!� ...All work will be done with proper permits and up to local access).
•�+ codes and ordinances. ...Customer is responsible for securing pets away from the
...All water&gas supply lines must have independent work area throughout the Wntalation process.
z Shutt-of valves. ...No work will be done If existing jobsite conditions do
N ...The jobsite must be secure and completed,including all not meet local codes&ordinances.
ell.e
0
e
I
1
en
CM
N
.L
go 6 of 16 No. 2685-153652 Store copy
SPECIAL SERVICES CUSTOMER INVOICE -Continued Last Name:REPPUCCI Page 7 of 16 IVO. Lbt$O' 10,300-4
•
INS-TaLLATI01t:#.1 := aEFalol
:. :.ICaetlaaefi
•� exterior doors and windows in place. ...Customer is responsible for any unforeseen conditions
v ...Customer must remove all items from cabinets,countertops which may arise during installation.
and breakables from jobsite area,walkways and access
o points '••THE FINAL KITCHEN ESTIMATE WORKSHEET MUST BE SIGNED BY
d
...Customer must understand there will be a period during BOTH THE CUSTOMER AND ASSOCIATE AND THEN IT MUST BE MANUALI
the installation when the jobsite area will be completely FAXED TO THE INSTALLER.A COPY OF THE FINAL KITCHEN ESTIMAT
unusable.Associate will specify an estimated time frame WORKSHEET MUST ALSO BE GIVEN TO THE CUSTOMER*'•
at the start of job.Other arrangements must be made by I
customer during this time for activities usually held In '"Note:The Home Depot does not provide the following
the jobske area. services las part of kitchen installation program)"•
...The work area will be cleaned up daily,but dust and ...Remove,after or build toad bearing wells(other than
CD construction related debris&noise will be inevitable stud wall framing).
go
a throughout the installation.All possible steps be taken ...Structural alteratlons or repairs.
+ to minimize spread of work area dust to other parts of ...Additional electrical or plumbing work to meet codes.
the home.Customer should change furnace filter before, ...HVAC work.
during and after installation. ...Alterations to exterior of home.
...Water,Gas&Sewer may be temporarily turned off to slow ...Removal of vinyl flooring.
S aIL•AYIz1.'"e :- REF#105
BASIC INSTALLATION LABOR:
.i<v..,. .... ..... s.:.c t
i, .... ...... ..... ........ .mss<............ .. ::!:... ...s. ,x%�:..: �,.r..g•....r..n:..:i-•` �3':�'
r.-. a:e., < ..,. v. .. ..,. ..aw;. .rr.::va- .,.•.sv' r.,..t.raey,.,..:-::.%ti... (
m es: . ... : xa .�. .:�. .+•w,+,,.w... i...<.. .. .r< :s:.,':..• .'`ce'$>, .> Kin A U _
•p �.�. ...,., �:�b,"'.^:sst^...•,3'�,=;;r?�t3....+�::�.,,•x,. .-r_ >.F� �?a ::�xi..,>- -wy:',>x:.,. "<'r:
282-627 KITCHEN POINT NATIONAL 0.001 EA I N 50.01 50.00
OPTIONAL LABOR SELECTED INCLUDES:
st ..<::�^' .<. :r•..•N::i' x::=z:`:A- rsra;:.%:P "%:ry .vu<:_ :.::.�.".. <.S.d-.t ':=.'-,.......'.a.`E':i:..,....<,qf:»::•£'-: ..r<
Y. tiw',i:t.4+...� e .;�.s . . aY;,.. .•�.rh:c ..,. -
'•rkuo:.sr.}s.^•.�; ,A.:•,":;t..;.>•.= i:4"Y:4:�:._t.<,.s._.c.,y;..:«r�.-,,-,..._:.,, K4�•r.4 .f...w.,:-. ':..s..,:�xsnr...,.
o ^02 PER CABINET INSTALLATION{INCLUDES WALL,BASE,PANTRY,PENINSU LAOVEN,&APPLIANCE 21.001 EA I f11 $69.00 91,449.00
LL CABINETS.INCLUDES SHELVES,FILLERS,SC RISE,TOE KICK,HANDLES,&KNOBS.)KEY THE
NUMBER OF CABINETS TO BE INSTALLED IN THE QUANTITY SECTION)
IA
:;Y• :'�',':-CONTINU�,ON.AIEI(T I�II6E��r;:. .
m
0
0
N
1
N
1
t0
igle 7 Of 16 No. 2685-153652 Store Copy
IPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: REPPLICCI Page S of 16 NO. /_000— 10%3004
'INSTALLATI
REF 11106
•L r ,' . REPPUCCI, CARL & ELISA INSTALL LABOR CNARGE $1,449.00
ABOBESS: 14 SUCKLIN RD TRIP CNAROE: $0.00
CITY: NORTH ANDOVER STATE: MA ZIP: 01845 CREDIT FOR OEPOSITJAIIEASURE: $0.00
co
C:! COUNTY:ESSEX SALES TAX RATE: 5.000 TAX:Marchaadise• N LABOR• N $1,449.00
d
PNONE: (978) 2044192
to
co BASIC INSTALLATION LABOR INCLUDES:
'- ...AN IN-HOME MEASURE CONSULTATION IS REQUIRED FOR PROPER •"IF CVSTOMER PURCHASES LA80R FROM THE HOME DEPOT,THE
FIT OF KITCHEN CASINETRY AND OTHER PRODUCTS TO BE INSTALLED. IN-HOME MEASURE CONSULTATION FEE IS APPLIED TO THE PURCHASE.
DURING THIS CONSULTATION THE INSTALLER WILL CHECK FOR THE FINAL KrrCHEN POINT WORKSHEET MUST BE SIGNED BY BOTH THE
UNUSUAL SITUATIONS WHICH MAY REQUIRE ADDITIONAL LABOR. CUSTOMER AND STORE ASSOCIATE.A COPY OF THE FINAL,SIGNED
...DAILY CLEAN UP OF JOB SITE. KITCHEN POINT WORKSHEET MUST BE GIVEN TO THE CUSTOMER AND
m ...NOTE: "•THE IN-HOME MEASURE CONSULTATION FEE IS INSTALLER.
m
m NON-REFUNDABLE.
co
4. UNLESS STATED ABOVE THIS INSTALLATION DOES NOT INCLUDE:
...ADJUSTING OPENINGS OR ANY WORK INVOLVING LOAD BEARING ...INSTALLING SKYLIGHTS
WALLS ...STRUCTURAL ALTERATIONS OR REPAIRS
...REMOVE,ALTER,OR BUILD LOAD BEARING WALLS(OTHER THAN ...ALTERATIONS TO EXTERIOR OF HOME
STUD WALL FRAMING] ...REMOVAL OF VINYL FLOORING
SPECIAL NOTES:
...CUSTOMER MUST BE PRESENT DURING THE INSTALLATION(MUST BE WILL NOTIFY THE CUSTOMER WHEN THESE ITEMS WILL BE UNUSABLE&
AN ADULT OVER THE AGE OF 18 PRESENT.NO WORK WILL BE DONE FOR WHAT LENGTH OF TIME.
WITH UNSUPERVISED UNDER AGED MINORS PRESENT). _CUSTOMER IS ASKED TO DESIGNATE PARKING,ENTRANCE AND EXIT
m ...CUSTOMER IS RESPONSIBLE FOR DISARMING ANY SECURITY ALARMS ACCESS PREFERENCES FOR THE INSTALLER{INCLUDING RESTROOM
...NO WORK WILL BE DONE ON SUNDAYS OR LEGAL HOLIDAYS. ACCESS).
IN
WORK WILL BE DONE WITH PROPER PERMITS AND UP TO LOCAL ...CUSTOMER IS RESPONSIBLE FOR SECURING PETS AWAY FROM THE
o CODES AND ORDINANCES. WORK AREA THROUGHOUT THE INSTALLATION PROCESS.
4E ...ALL WATER AND GAS SUPPLY LINES MUST HAVE INDEPENDENT ...NO WORK WILL BE DONE IF EXISTING JOBSITE CONDITIONS DO
SHUT-OFF VALVES. NOT MEET LOCAL CODES&ORDINANCES.
...THE JOBSITE MUST BE SECURE AND COMPLETED,INCLUDING ALL ...CUSTOMER IS RESPONSIBLE FOR ANY UNFORESEEN CONDITIONS
EXTERIOR DOORS AND WINDOWS IN PLACE. WHICH MAY ARISE DURING INSTALLATION.
N ...CUSTOMER MUST REMOVE ALL ITEMS FROM CABINETS,COUNTERTOPS I
m
0
N
1
[.f
N
(0
o ge s of 18 No. 2685-153652 Store Copy
SPECIAL SERVICES CUSTOMER INVOICE-Continued Last Name: REPPUCCI Page 9 of 16 NO. 2-005- 1 0.300L
ATION:-#2=. RIF�rlaS
.:.:. :.: ..: ... ......
AND BREAKABLES FROM JOBSITE AREA,WALKWAYS AND ACCESS POINTS '•'THE FINAL KITCHEN POINT WORKSHEET MUST BE SIGNED BY 80TH
v ...CUSTOMER MUST UNDERSTAND THERE WILL BE A PERIOD DURING THE CUSTOMER AND STORE ASSOCIATE.A COPY OF THE FINAL,
1 m THE INSTALLATION WHEN THE JOBSITE AREA WILL BE COMPLETELY SIGNED KITCHEN POINT WORKSHEET MUST BE GIVEN TO THE CUSTOMER
UNUSABLE.ASSOCIATE WILL SPECIFY AN ESTIMATED TIME FRAME AT AND INSTALLER.
d THE START OF THE JOB.OTHER ARRANGEMENTS MUST BE MADE BY
m CUSTOMER DURING THIS TIME FOR ACTIVITIES USUALLY HELD IN THE •.•NOTE:THE HOME DEPOT DOES NOT PROVIDE THE FOLLOWING
JOBSITE AREA. SERVICES IAS PART OF KITCHEN INSTALLATION PROGRAM)"
...THE WORK AREA WILL BE CLEANED UP DAILY,BUT DUST AND ...ADJUSTING OPENINGS OR ANY WORK INVOLVING LOAD BEARING
CONSTRUCTION RELATED DEBRIS&NOISE WILL BE INEVITABLE WALLS
_ THROUGHOUT THE INSTALLATION.ALL POSSIBLE STEPS WILL BE ...REMOVE,ALTER OR BUILD LOAD BEARING WALLS(OTHER THAN
N TAKEN TO MINIMIZE SPREAD OF WORK AREA DUST TO OTHER PARTS STUD WALL FRAMING)
o OF THE HOME CUSTOMER SHOULD CHANGE FURNANCE FILTER BEFORE, ...INSTALLING SKYLIGHTS
o DURING AND AFTER INSTALLATION. ...STRUCTURAL ALTERATIONS OR REPAIRS
...WATER,GAS AND SEWER MAY BE TEMPORARILY TURNED OFF TO ._ALTERATIONS TO EXTERIOR OF HOME
ALLOW INSTALLATION PHASES TO BE COMPLETED.THE INSTALLER ...REMOVAL OF VINYL FLOORING
.....:..... :.......
BASIC INSTAttATION LABOR:
...... .._. .. ,_.......•........_... ....r...<: vim..::..-..,s ..r.• :.its-• -
L43-61;61
�up
, ..r_o-.`• vF.,��a>f./- .... -- -:.:P...i..p. .:.Fad SILESTONI=COUNTERTOPS 0.00 SF N 40.01 $0.00
L LABOR SELECTED INCLUOfS-.
Xai{- .•�'`..�w%::�'f ^..•;�•R�u":i''.siF:' :.,a`,..,+ic•°ciq.j.`rti;£t- •ii':-�,r ..mac..-<..
_4N
07
f.� gqj - - ,.�:i:��>..::.:o-•+•r - .i.:n'6�y. x,z-
r�� -*`--;:.�::,r^�-<�:%r_:%i':'t .�� Si�.- ^"s:";'^r, ..?cdf./,• ""a"
07 Silestane Countertops!Backsplash 1 118" (3cm)Group C/ 24.97 SF I N 1 $76.00 $1,872.75
$ 19 Undermount stainless sink(sink supplied by customer) includes polished 1.00 EA N 5249.00 5249:00
oedge and mounting/
43 `PROM00412"128/08 SILESTONE 10%OFF SELECT COLORS W/MIN PRCH OF 25 SF ORDR 35.951 SF I N 585.50 53,073.72
MST B PD N FLL BY 5/28.)NSTLD W/80 DYS OF5/26. ORDR ADJSTMTS COMPLTD BY 6118.
NO CRDT APPLD IF OFFR RFSD. LMT 11H-FOLD.STD FAB&NSTALTN CHARGES APPLY.13CM
-N
SIENNA RIDGE ntl
.>..',r.:;+::�f!'�GNTINU�•MP.II<,EIf;T:P�E.��*:r:y»;`!:'..,.
m
0
0
N
t
A
N
i0
o Ige 9 of 16 No. 2685-153652 Stare Copy
SPECIAL SERVICES CUSTOMER INVOICE-Continued Last Name: REPPUCCI Page 10 of 1 emo. Z-000- 10%2004
.....:....
7: REFRI86
co
tab
<
INSTALL LABOR CRARGE: $5,196.48•
REPPUCCI, CARL& ELISA
ADDRESS: 14 EIUCKLIN RD TRIP CBARGE: $0.00
CITY: NORTH ANDOVER STATE: MA ZIP: 01845 COEDIT FOR DEPOSITIMEASURE: $0.00
o.
COUNTY:ESSEX SALES TAX RATE: 5.000 TAX:Merchandise- N LABOR• N t 1 $4,&75.93
PHONE: (978) 204-4192
to
INSTALLER SPECIAL INSTRUCTIONS:THIS PO HAS 2 DIFFERENT COLORS AND 2 DIFFERENT DRAWINGS.PLEASE CHECK FAX.TOTAL OF 8 PAGES.
BASIC INSTALLATION LABOR INCLUDES:
1. In home inspection to verify the layout,measurements, 7. Finished exposed ends Iflat finish no edge detaill.
special installation requirements and lemptating. example:next to range or refrigerator
2. Delivery and normal installation of countertop. S. Eased polished edge on backsplash{ell exposed edges).
3. Includes faucet hole drilling(up to 4 holes). 9. Subtop or support strips.
CC 4. Includes 1 sink or 1 coaktop cutout{unpolished top 10.Standard eased edge included(Edge#10-2cm or
fm
It— mount)per project. Edge#24-3eml from group A Edges.
+ 5. Wall support cleats as needed at corner cabinets. 11.Final clean up of installation related debris and
6. Eased or radius corners up to 314"max. jobsite.
UNLESS STATED ABOVE TNIS INSTALLATION DOES NOT INCLUDE:
THE FOLLOWING OPTIONS ARE AVAILABLE BY ESTIMATE ONLY Cut around posts or odd shapes
Support material for overhang(required for overhangs of Custom edges on backsplash
V or more) Disconnect or reconnect of plumbing or electrical
Window sills/garden windows&pass throughs Repair or alterations to existing cabinetry
Cabinet bump out
SPECIAL NOTES:
m ' No work will be done on the weekends or holidays. cancellation lees and far any missed scheduled appointments
'An adult must be present at the time of install. with the installer.
a • The installer will contact the customer within XX business ' Customer should be prepared to be without full use of sink
o days after receiving the paid purchase order to schedule the and appliances during installation.
x
template/measure appointment.
Existing countertops must be removed prior to templating.
Customer Is responsible for payment of the appointment
N
allm
O
O
ti
r
N
o )ge 10 of 16 NO. 2686-153652 " Indicates Item markdown
Store Copy
SPECIAL SERVICES CUSTOMER INVOICE -Continued last Name: REPPUCCI Page 19 of lNo. 2685-1536!
co
:.
T::ALfiA 63::i # lNIEI �CWAIDISEV1 N
a 522,731. N
...... ...................... . .. . ..: .. ..: . .
SALESTAX $505.( m
TOTAL 523,236.E
BALAN�EGUE 523,236.E
rJ3�.r}7y''
:<
END:f7
is
rh
N
Dl
m
VI
O
O
ro
m
m
ss
v►
o.
A
N
1
1
m
m
os
0
a
0
0
m
Page t i of 16 No. 2685-153652 Store Copy
The Home Depot Special Services/Home Improvement Agreement Pegg 12 of 1A11tU a Lvov- t uJv:i�
P P
PLEASE READ THIS
Important additional information regarding your rights may be contained in an attached State Supplement which is an integral part of this Agreement.
REPPVCCI CARL& ELISA 153652 2685
.;L Customer's Full Name(Last Name,First Namel Order No. Store No.
14 BUCKLIN RD MORTiH ANDOVER
Billing/Mal ling Address EFor Delivery/Service Address(es)See Attached Invoice.) City
a.
MIA !j 01845 -�
BillingfMailing Address(For Delivery/Service Addresslesl See Attached Invoice.) State Zip
p - (978) 204-4192
IL Customer's Daytime Tel.No. Customer's Evening Tel.No.
FirmrentSdodufe:You agree Your paymerdswin became due onthe dates im& led below and,a You are paying olharlhan by chock or money cider.maybe aulornalicarri chrooW at debiled(as a*cW@)to Your designated occounIs)when due
payment: f 22,731.13 Due In ful Immediately.
Sales Tan: f 505.67 If applicable.
Total Amoardof Sate: f 23,236.80 Includes all applicable dtseounls,rebates,and tares.Fzdades finance charges.•
o Please irWial here f You wish in pay the Iofalamount of the sale now.You have the option of paying kes as further specified in the Stda Sull0emenl to thisAgremaenL
b Any interest payments a other finance charges will be determined by your separate cardholder or loan agreement,to which Home Depot is NOT a party.Please see Ilia Agreemenfs General terms and Conditiorus for more details as to other
mchatoes that mav e
m Please note:Neither The HomeOepof car Installation PYetessional are responsible for slartfinishdelays resufbng from wentr beyond their control incltxlieg,but not
Anticipated Delivery l Inst�fation Schedule
as P limited to,Change Orders,eels of nalmue,governmental actlaxe,manutaclurirrgJdeliverydefays or damage to merchandise caused by third Forties.labor stdkesAmresl
4. Delivery Data: NIA Your aedtl6rvrrucing,anyexcorrecl information You provide,legal encumbrances on Your prcpergr,Your prapaty's nanoonfonnarrzwilh zoning requinements or
Start Date: 0512212008 budding code requirements,hidderrfurtfareseen physiaellhazardow conditions(including,but not limited to,envfrorvxeetal hazards such as mold,asbestos and food
paixt)at Yoor service address,or Your noncompliance with this Agreement.The Home Depot reserves gra right to terminate this Agreement and'or require Inslalla5m
Finrsh Date: 06/21/2000 Refesaional to 69conGmre Inslaltalion giaen any of fee foregoing condlions.
Definition : ou bb means the customer Iderriffled above.'Installation"means the Instdiailildn se nes spec n s ftmement.olnsblWCR riorlossionar or Trolwaroull means an Independent contractor aulhorim
by Home Depot{Neensed and Insured as required by Homo Depot and applicable lav4 acrd the contractoes employees,agents and subcontractors"Agreemnere means this Special SarvicedHome lmptoyament Agreenentbetween
You and Home Depot U.SA,Inc.Interchangeably referred to as'rhe Herne Depot', 'Home Depot,or"EXPO Design Center"),whkh Includes this page.the General Terms and CandEans fogowing this page,the State
Supplement,the hrvolce or SpeclOcxMeno and any other documents expressly made a part of Ibis Agreement Please see this Agreemorl s General Terms and Conditions for additional de fallons.
Acceptance and Authabrailon:By signing below,You audtodre Home Depot to(a)arrange for Installation Professional to perrorm Installation andfor(b)order and arrange for the delhrery of special order rembandiss,Including
special order merchandise that may be custom made.as specified In this Agreement You understand this Agreement const(ides the entire rmderstandIng between You and Home Depot and may only be amended by a Change
Order signed by Home Depot for by tnstallallon Professional or Its authorked representative on Home Depot's behall)and You.This Agreement expressly supersedes all prior written orverbel agreements or representadons made
by Home Depot lnstafladon Professional.You.cur anyone else.Except as set forth In this Agreement,You agree there are no out or written representations of Inducemeift.express or Implied,In any way conditioning this
Agreement and You expressly drscla(mtheir exfsienee.Do riotolgn If Wank or Incomplete.Installation Professional'sfpermitting Intonation may need to he pmv)ded to You later.)By sigofng,You acknowledge that You have read.
e understand and accept Ibis Agreement In Its en&aty.You further acknowlsdga receiving a complete copy.Keep itto PROW Your legal rights.
CANCELLATIOYOU MAY CANCEL THIS AGREEMENT WINOUT PENALTY OR OBLIGATION BY DE JYERfNG WRITTEN NOTICE TO HOME DEPOT BY MIDNIGHT ON THE THRD BUSINESS DAY AFTER
SIGNING.THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRFSCRIBEID BY LAW IN YOUR STATE Ynlr payments)will be rehlmmai wSfmin ten(td)tw5iness days stet Home
Wr Depots receipt of Your notice.You must make aiiWabler for pdwp by Home Depot or Professional at Your service addreK in subsbintlaly the sortie condtion as whets delivered.any inerchandise or ntatefials defiwxed 11
to You.Or Yopm contact Hone D fox irts4uctions in return shipment at Home Depot's wpame.
opted Professional's Full Busfness/Trade Name,Address and License No.or Nos.as Applicable:
.� Z t.
Customer's date
Customer Inittals : 411— BY INITIALING,YOU AUTHORIZE DELIVERY OF MERCHANDISE TO
SERVICE ADDRESS PROVIDED ABOVE VWTHOUT OBTAINING DELIVERY AGENT'S SIGNATURE
AND AGREE TO IDEMNIFY AND HOLD HOME DEPOT HARMLESS FROM ANY RESULTING CLAIMS.
Submitted By: Horne Depot Associate Professional's Tel.No
o J Profs UAuahorized Representative on Home Depot's Behalf Z2 "meq
e*.. -�il� )�+`�� X yr
Associate's/Prof essfonal's/Aulthorlzed Representative F01 Signature Date
CIA
AssociatelRepresentative:Prfnt Your FulI Name and Check Applicable Box Above Associate/Representative: Please Print Your Salesperson's UCense No.if Applicable
o HOME DEPOT'S LICENSURE INFO:SEE GENERAL TERMSICONDRIONS
rge 12 of 16 NO. 2685-153652
Stare Copy BUYER'S RIGHT TO CANCEL:SEE GENERAL TERMSICONDMONS
•■M 4/V8■/V �IV'IV• V1/vv,N� vv,�•vv�.I���•..- •...r.r.�...•... _y._�..._...
. Page 13 of 1AV0. L000- 1 73VJL
Scope:This Agreement is between You and Home Depot Under this Agreement,Home Depot does not perform Installation,but arranges for Professional to do an directly or through Professional's
specialty subeontraclars.Home Depot does not pnMde.or ,arrange for,architecturallengi neering services or structural changes to dwelli ngs.You will not pay anything to Professional,although
Professional may present this Agreement to You for Your review and signature andlor collect Your payment(s)to Home Depot on Horne Depors behalf.Installation vial,subject to any Change Order,
" be completed in substantial conformance with the attached Invoice or Specifications.The State Supplement.H any,contains brportant additional terms,conditions,and Information specific to Your
g state.
N Special Order and Custom Made Merchandise:A description of any special order or custom made merchandise You have purchased appears in the Invoice or Specifications.The anticipated
s delivery date appears on the preceding page.This Agreement's pro Asions relating to Installation or Professional shall NOT apply to Your purchase of special order or custom made merchandise
unless Home Depot will be arranging for its installation.
Professional's Responsibilities:Professional will complete Installation in a workmanlike manner.Professional wid not start,perform,alter,or finish Inslanadon except in acoordance with applicable
law.Professional will either not start or will immedately discontinue,Installation upon discovery of unforeseen hazardous condidons at Your service address.Neither Home Depot nor Professional
w1l attempt to remediate such condlUons. Neither Home Depot nor Professional are responsible for identifying property lines,easements, covenants,or other legal enow*rances Your service
address is subject to and shall be entitled to rely on Your representations.Neither Home Depot nor Professional will modify security systems to accommodate Installation.Professional will obtain
required permits and provide permit numbers if required.
Your Responsibilities:You agree to pay Home Depot according to the terms and conditions of this Agreemend.If Your service address is subject to any easements.covenants,or other legal
encumbrances that could affect Installation,You agree to let Home Depot or Professional harrow about them before Instal€ation.You apron to facilitate the location of utility lines.You are responsible
for identifying properly lines.You agree to ensure teat work areas are free of preexisting physical or environmental hazards,and bteldingfzoning code violations.You agree to provide Professional
2 access to work areas during wanking hours and provide access to sanitary facfilies or pay the facilities' rental costs.You agree b ensure any security system You have will not interfere with
to Installation.You agree to provide power to,and,as appticable,climate control In,wait areas.You agree riot to allow unattended minors at Your service address while Professional is present You
co
agree to control and keep pets away from work areas.You agree to keep pasted permits on display at all times You agree that J You or anyone You control interferes with or delays Installation,You
may be sAect to transportatiordstorage charges or other resulting charges.You agree not to assign or transfer this Agreement You agree any claims against Home Depot or Professional under this
Agreement should be made to Home Depot within thirty(30)calendar days of the date You fust become aware of a problem.(Home Depot will attempt resohdon of any claim(s)within sixty(61))
calendar days of receiving Your nodoe.)YOU ASS UME THE RISK AND THE RILL LIABILITY OF PHYSICALLY ASSISTING WITH DELIVERY OF MATERIALS OR WI TH INSTALLATION.
Chances and Chance Orders:Home Depot,at Your request,may arrange for Professional to perform additional work,subject to a Change Order and additional charges payable by You b Home
Depol.Any changes to Inslallation,i.e.,a substitution of materials or an expansion of the scope of the work,will require You and Professional(on Home Depots behhal)to sign a Change Order that
will become part of this Agreement.Change Orders must be dear in scope and spa*any additional payments)andfor changes in anticipated starilfinish dates.Following discovery of previously
undisdosedb0dentifred legal encumbrances on Your premises,buildingfmning cads violations,or hhdderAddreseen physical or environmental hazards such as the presence of underground or
overhead utility lines, rocks, roots. buried debris, mold asbestos, lead paint, or any conditions drttering from what You represented, Home Depot may immedately ask for a Change Order,
discontinue Installation,or terminate Iles Agreement without further obligation to You.
Credit CardlFlnanced Transactions:Your separate cardholder agreement(to tMnich Home Depot is NOT a party)will determine the total cost of Yourpurchase if by credit card including any hnkial
payment/deposit You may make and ail interest charges and fees.You wrli be farther subjectb Your cardholder agreement's terms and conditions.If You are financing this transaction in whole or in
F part,Your separate loan agreement(to which Home Depot is NOT a party)wil I datemrine:(Ij the amount financed(Ire amount of credit provided to You);(i)the associatedfinance charges(Ire dollar
amount the loan vati cost You);and[a)the btal payment(the amount You will have paid when You have made all scheduled payments).You will be further subject to Your loan agreemenrs terms
and conditions.
Liens: Saco div Interests:If You make all payments as required under(his Agreement, no security interest%#all be placed against Your property by Home Depot If a security interest is placed
oagainst Your property,it creates a lien.mortgaga.or other Bairn against Your property to secure payment and may cause a loss of Your properly if You fail to pay as requested.Atter paying on any
u completed phase of Installation and before making anyfurther payments,You should request from Professional a signed,unoondtlond release from,or welver at any right to place any dorm against
Your property applicable b the work then completed.You may ask an attorney about Your rights to discharge security interests.
UMITED WARRANTY HOME DEPOT WARRANTS THE WORKMANSHIP OF THE INSTALLATION FOR A PERIOD OF ONE(l)YEAR FROM ITS COMPLETION DATE PROVIDEDYOU MAKE
N A CLAIM OF DEFECT TO HOME DEPOT DURING THE WARRANTY PERIOD,HOME DEPOT WILL ARRANGE FOR REPAIR AT NO CHARGE TO YOU OF ANY DEFECTS DUE TO FAULTY
WORKMANSHIP. HOME DEPOT'S WARRANTY DOES NOT COVER DAMAGE CAUSED BY ABUSE,MISUSE,NEGLECT,OR IMPROPER CAREICLEANING. MERCHANDISEAND
MATERIALS ARE COVERED EXCLUSIVELY BY THE MANUFACTURE'S WARRANTY,IF ANY.(HOME DEPOT WILL ASSIST YOU WITH WARRANTY CLAIMS AGAINST MANUFACTURERS).
N SOME STATES OO NOT ALLOW LIMITATIONS ON HOW LONG AN IMPUE4WARRANTY LASTS,SO THE ABOVE LIMITATION MAY NOT APPLY TO YOU. THIS WARRANTY GIVES YOU
•t• SPECIFIC LEGAL FIGHTS,AND YOU MAYALSO HAVE OTHER RIGHTS WHICH VARY FROM STATE TO STATE
`i HOME DEPOT U.S.A.INC.,2455 Paws ferry Road,NW,BLDG B.5,Atlanta.Georgia.30339
o rge 13 of 16 NO. 26$5-153652 Store Copy
--��- ""ad 'atu"GeBIMOme Improvement Agreement - General Terms and Conditions
Page 14 of 76NO. 2685-1535 N
N
WAIVER OF CERTAIN DAMMM: YOU AND HOME DEPOT HEREBY WAIVE ANY CLAIM AGAINST EACH OTHER FOR LOST USE,LOST PROFIT;LOST REVENUE,INDIRECT
INCIDENTAL OR CONSEQUENTIAL DAMAGES RELATING TO THE INSTALLATION,THE MATERIALS OR SERVICES OFNOME DEPOT OR OF PROFESSIONAL,OR THIS AGREEMENT
(BUT EXCLUDING WAIVER OF CLAIMS FOR INJURY TO PERSONS). SOME STATES DO NOT ALLOW THE EXCLUSION OR LIMITATION OF INCIDENTAL O
DAMAGES,SO THE ABOVE LIMITATION OR EXCLUSION MAY NOT APPLY TO YOU. R CONSEQUENTIAL
Mediation (EXPO 0 Cerrtsrc only);If(he total amount of the sale equals or exceeds$7,500.00,You agree before taking regal action to participatece, ,I(rerequested,i
(typically taking shalt half a business day)using a professional mediation service aomptable to You and EXPO.EXPO Will q n non-binding mediation
Termination;You may terminate this Agreement at any time ager providing Home Depot with ben (10)or more business ays,advancewrittennotice, If You breach this reement or
reasonable Change Order request,Home Depot may Immediately terminate the Agreement without further obligation to You.In either event,You agree to
materials,labor,and other services provided by Home Depot andlor Professionel th A9 decline a
rough the datergime of termination,plus any other amounts allowed undeaaypplicable levet the costs of merchandise,
Returns A 1596 restocfdng fee applies to the return of regular special orders,i.e..
color malched,shaped,sized.or otherwise uniquely designed or fitted to accommodate the requirements is a particular at Is not custom
oed made,Special(some ehamare
escust c made I coon
uniquely altered,
wall coverings„and window treatments)are non-r®tumable.Exceptions:Cancellations made by midnight on the third business day after the date of Your purchase;merchandise incorrect Ordered Home Depot or by Professional;or merchandise damaged beyond repair in delivery or Professiona< Unless otihenvJse � torrectl floor and
posted time frame. g y p ry y specified fn this Agreement,all returns must be made within Home DepOrs y
Questions or Conceals? You should be wrhmurticating with Professional and/or Your store regarding routine netters Such as scheduling, changes to Your order or Installation or
owerns about Your order or the service You are receiving.if this Agreement COWS an Installation,first call Professional at the to
to assist if You have Ju sill h number rn the preceding any initial
any difficulty oodtacfing Professional.If Professional and Your store are unable to answer Your questions or You still have concerns,Home Depot CustomerrCar stands nee able
assist You at 1-000.553-3199 and may also be 0ontacted al the address below.
�1'to
License Number(s)held by or on behalf of Home Depot U.S.A.,Inc.ardlor EXPO Design Center' _
��Provided by The Hone
#23728Depot authorized independent ins 0925on professionals AK#25084,ANCHORAGE#1745;AL 011253(HB),#3010(HVAC),BALDWIN
SWCe EAST BREWThe one Depo a #orized G/C}independent
R00092561( rotes ibn ls0233f
CA
DE g1997115489(331),BETHANY BEACH#0630! (8L),REHOBOTH BEACH#15514(BL);FL CGCf 06093,ME )GC1 05 8916 (HOME CT DEPOT),G2C0356460E02
xPp�
CGO1509909 (EXPO), EC0000109. CAC042609, CACIS13767 CFC142S636, CFC1426D21, #6083, ( , a�
#160001242.LAFAy1243,#IBth001250,#Q80008009,#QB29610,AELPG#22640;Hr#G-22120(C68LA)623378;IA#91,302.04;ID#RCE 19683(CR);IL!1058.169244
#0408240 GdC,#04-Oggs1, �OOt-0076396, #180-0005573,.
LEXINGTONlLAFAYETTE, KY#11517; LA#LMP-2977(MSTR) CCL#43960 ; MA#112765; MO 042144(8), OCEAN CITY#3,2682; mer#2102-119069, aETROIT
#LIC200t-07767,,MN#BC-20147283;MS SYR-00304;MT 037730;NE i92S085;NO 428073(A);NM
03993-K 106743; NY-NASSAU #H777105ODDO, NYC #900457, #900458 #900456, # 152032, #1003522.808 0734 911o621M,0#9108 2#1152040, #922474,
41028224,01003830,#1003828,#1152039,#968605,#1003833,#1003828 #1133444,#1003825,#1152036,111152036,#1133445,#1152035,#1129817,#1129557,
#1129556,01129562,#1154293,#1129555,#1129554,#1129559,#1129552,81178447,#118@042, PUTNAM#P6689=A,SUFFOLK
6464,EAST HAMPTON#4498,LONG BEACH#4917,YONKERS#1987,NIAGARA FALLS#571,BUFF
#10258, NORTH TONAWADA 9368-04, TONAWANDA TOWN CN2324, WESTCHESTER #WC-1848414 H06; OH-CLEVELAND HEIGHTS•#38.97, SHAKERHm
ALO#524355,SOUTri HAMPTON#002058-0,TONAWArypq a
HEIGHTS#7223;OK 091910;OR 085843,OR#8558(LC);PA-PHILA NOV.LANCASTER#2779,PLUMSTEAD 03399;RI#9460;SC#C6000019(COA),4008151,
#019654, 110172$5, #20035, #M-104779iPBSY01 TN i100047781(BC 214!6), 4148; TX-- AIM-36192, #M-16451, NTACLA001574C.# EC24447, #ME 137170, �_
#TACLB00014960C, #TACLB00016712C, 1481 (RB) DAL[AS #20951,#20950,#21389, #23818,#22088,#22090,A12209i; UT 0286936-5501j9_100 LRF); VA o
#2710019977(HIC,HVA);WA#HOMED"OSBRH(2719);WI#1046796;WV#YV11036104.#63802;WY--CHEYENNE#0409550,1104-13313. _o
0
a
'An enterprise of dome Depot U.S.A.,Inc.
0
HOME DMT U.S.A.INC.,2455 Peen Ferry Road,NW,BLDG 8.5,Atlanta,Georgia,30339
Page 14 of 16 No. 2685-153652
Store Cnnv
Page 15 of IdYo. 2685-153652
The Home Depot Special Services/Home Improvement Agreement: MASSACHUSETTS SUPPLEMENT
REPPUCCI. CARL& EUSA 153552 Fissr,
Customer's Full Name(Lest Name,First Nome) Order No. Store No.
v
0
The terms and conditions of this Massachusetts Supplement apply to, and are expressly made a part of, the attached Agreement between You
and Home Depot U.S.A., Inc..(Interchangeably referred to as "The Home Depot", "Horne Depot", or "Expo Design Center").
co NOTICE TO BUYER
TAX IDENTIFICATION NUMBER FOR HOME DEPOT U.S.A., INC.: 58-1853319
N NO WAIVER OF RIGHTS:Your rights under the Home Improvement Contractor Law (MGL chapter 142A) and other consumer protection laws
(i.e., MGL chapter 93A) may not be waived in any way, even by this Agreement. However, You may be excluded from certain rights if the
service provider You choose is not properly registered as prescribed by law.
m
REQUIRED PERMITS: Home Depot U.S.A., Inc. and/or Installation Professional is/are obligated to inform You of any and all permits necessary
to complete the work contemplated by this Agreement, and it is the obligation of Horne Depot U.S.A., Inc. and/or Installation Professional to
obtain said permits. If You secure their building permits, You are automatically excluded from any Guaranty Fund provisions of the Nome
Improvement Contractor Law.
WARRANTIES: Home Depot U.S.A., Inc. may guarantee or provide an express warranty for workmanship or materials. Apart from any
guarantees or warranties that may be provided by Home Depot U.S.A., Inc., all goods sold in Massachusetts carry no implied warranty of
merchantability and fitness for a particular purpose. Any enumeration of these matters on which You and Home Depot U.S.A., Inc. lawfully
agree may be added to the terms of this Agreement as long as they do not restrict Your basic consumers rights.
REGISTRATION: All contractors or subcontractors that will perform the work under this Agreement must be registered. If You want to verify the
registration of Home Depot U.S.A., Inc. and/or Installation Professional or if You.have additional questions or need additional information
specifically about the registration component of the Home Improvement Contractor Law, contact the Director of Home Improvement Contractor
Registration at: Bureau of Building Regulations and Standards, One Ashburton Place, Room 1301, Boston, MA 02108, (617) 727-3200.
0
it
PAYMENTS: Any deposit made prior to the commencement of the work must not exceed the greater of: (i) one-third of the-total contract price
or(€i) the purchase price of any materials or equipment of a special order or custom-made nature that must be ordered in advance. Though You
may choose to pay the total contract price prior to the completion of the work to be performed under this Agreement, Home Depot U.S.A., Inc.
may not require that You do so.
N
m
ACCELERATED PAYMENTS: Home Depot U.S.A., Inc. may not demand payments in advance of the dates specified on the payment
0
a
N
fD
go 15 of 16 No. 2685-153652 Store Copy
o
Page 16 of 1 M. 2685-153652
The Home Depot Special Services/Home Improvement Agreement: MASSACHUSETTS SUPPLEMENT
REPPUCCI, CARL& ELISA 153652 F2685
'T Customer's Full Name ILest Name,First Nome) Order No. Store No.
v
47 schedule in cases where You deem Yourself to be financially insecure. However, in instances where Home Depot U.S.A., Inc.deems itself to be
d financially insecure, Home Depot U.S.A., Inc. may require the balance of funds not yet due be placed in a joint escrow account as a prerequisite
CD m
to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties.
ARBITRATION: The Home Improvement Contractor Law provides You with the right to initiate an arbitration action (as an alternative to court
action) if You have a dispute with Horne Depot U.S.A., Inc. andfor Installation Professional.
ADDITIONAL INFORMATION: If You have general questions or need additional information about the Home Improvement Contractor Law or
other consumer rights, or if You wish to obtain a free copy of A Consumer Guide to Home Improvement Contractor Law, contact the Office of
Consumer Affairs and-Business Regulation, 10 Park Plaza, Suite 5170, Boston, MA 02116 (617) 973-8787. For assistance with informal
mediation of disputes or to register formal complaints against a business, cap: Consumer Complaint Division, Office of the Attorney General,
(fi -7)727-8400.
z=
m
N
of
W6
G
O
S
.i
O
N
m
O
O
N
1
M
N
ca
ige 16 of 16 No. 2685-153652 Store Copy
06/23/08 13:27 FAX 978 762 0581 14ALKIN & SONS 0001/001
BoardmoIt gIegulaons/a�ndlanr s
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Horne Improvement Contractor Registration
Registration: 100654
Type: Individual
Expiration: 6/22/2010 Tr# 267871
IRA G. MALKIN
Ira Malkin
180 Dayton St -- �-
Danvers, MA 01923
Update Address and return card Mark reason for change
GIStAl O sOM-07107-MUDO
E3 Address E] Renewal El Employment F" Lost Card
r
DATE(MMIDDlYYm
ACORDM FERTIFICATE OF LIABILITY INSURp►N'C'E g KOATB
06 19' as
PRODUCER THIS CERTIFICATE IS.ISSUEQ AS AMA'TTER OF INFORMATION
ONLY AND CON >"R$,N0,RIGHTS,UP ON 7H�CERTIFICATE
John! Walsh' Ins8 -AJexloyr .Inc HOLDER,THIS CERTIFICATE�DOES.N TAM1=Nb,EXTEND'OR
4 0'7 >...
.;.
ALTER ERAC ES BELOW.
' 0 AF
t-
.S.a D:1 .6�?�:07.,• I -7.: �y.,.�- .�,��. $i�' �. •;..4::. B.
� �4A .17
,
Phone.-978-7.45-.33.00... Fax•978-745-9640'.V' '
5 5 7 � INS.LIRERS AFFORD)�Id,CO.V . GE
,
INSURED - —
• .•a ' ,' ., SURERA,,,•,,,,N311t11 ��A�tx,'rance �oEl lai3r
I
N.
INsuRERB: •,,,,'xravel,e,�s
N ER
I:
INSURER A' "�
�ST BET
Ql 3... . ..
..,.:.. .::. .,r 1 $,. ,.;, .;� ,.R:•,:,y: :.i i a:. l .,�ti� .. {': u.xflr::'. .,d:V,.i..':fl!w��:A1MVa,y..Fia' Ri,L�:•,;Rlnii�I�J;,,�.:u1[!
INSURER E;
COVERAGES
THE PbLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTY�ITHSTANDSNG
ANY REQUIREMENT,TERM OR.CONDITION.OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE IS§UED OR
MAY PERTAIN;THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AG6RVGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MIW��IYY E PDA MMID TION LIMITS
, .,. : ,;,. C•, uAeluri,,: "�Nc�;.`:'.;,'I;' S 100`0000. .
:A X ;COMM RCIALGENERALLIA61LITY 14C76348'8PREMISES raoccurence> 5 50 00
'C1;I11MSItiE, 7E' �04CUR
10/03/07 10,/03/08 P «,I
DVINJUFt5 x.000000
,.. ER50 �L'&A`.C1ENE GATE,. 20'.0000
GEn&�. AGGREGATE iIMIFAPPuES'PER S, U T MP�PP';AG $a0'AOODO
PRbD
" �`
i0oudIr:. J£CT EAC I
A MOBILE.LIABIWTY
- if
1 r
9.
I '
qqq '
;'GOMBID�NGLE LIMIT
'(Fa.aca eh
ANY AlfTO ?�� I
ALL.jOY iNED A 98
,:.
s�ODIF N4,
Per'a3orf Li
SCHEDIJLEDAUTOS �:,
,f rr
ti F
1R :AUT03'."
R
EQ
DILA NJ�Y�': �I
O
-B i
,
-0wkil b AUYos .. .
;.
� �
PROP LTi:i AMAGL! $
GELIAOILITY.:,. AUT LY�P.IIACPIDEK,': S
Y AUTO - �bTH
i' 1
a � ACda' S
¢NIBRELIA;LWBILITY;i•' PACH'C C €NC@. i
T
UBLEiidENTION �$ Al U-
' r:
WQRrh COMPEAL4ATIONAND a MIT ER
wd
ANY,PRO�ENI�BEKE(CLUDFDI trriVIE 3-?7 08/31/07 8 31'/68' 1" _L,EACHAccuiE(vT 510°0000
EMPLOYERS'LIABILITY
B R 7PJVB-2,0370968- 0 /
OFF CF�/&t E-L DI E 8P+ P(O $1,Q10 O 0.0.
If eg:flasrjlbe:under :. r' I
•SPECIAL PROV(S&S bal" Itl•'YJLI. $5:010:11.00:' !,
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCCLLATION ..
0001003 SHOULD ANY OF THE ABOVE DESCRIBED POLICIRS BE�IpNCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE.ISSUINO INSURER WILL ENbEAVORTO MAIL 3-0 DAYS WRITTBN
NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE LEFT,BUT FAILURE TO DO SO SHALL
Carl & Elisa Reppucci
14 Su�k1 in Rd IMPOSE NO OBLIGATION OR LIABILITY OF ANY,10ND UPD'N THE INSUIRM ITS AGENTS OR
-Xor' h Andover MA 01845 REPRESENTATIVES, II
AUTHORIZED REPRESENTATIVE
i.
,Tobe LT. Wal
AC0025.(2001/08) CORPORATION.1988
ZO 'd SV:8 9002 61 unf LS96SVL8L6:xeJ 33NvdnSN1 HSIVA NHOP
a,,
Board of Building .Rc ul�ltions and Standards
rt
.. :-� Onc Ashburton Place - Room 1301
Boston, Massachusetts 02108
l lome Improvement Contractor Registration
Redistralion: 100654
'Type: Individual
Expiration: 6122/2006
IRA G. MALKIN
Ira Malkin
180 Dayton St
Danvers, MA 01923
lipdnle Address and return card. 'A.AsOn;to], (1111
Address j Renewal I.ntpinyntcnt L +i
.CAI :, -AW 0.111'..rr.ni0.ui
_..
........... -111_1 r-------- --- -- ---- ------J61le -eo
Board of Building Regulations and Standards
One Ashburton Place - Room 1301
Boston. Massaphusetts 02108
Construction Suvisor License
i { License CS: 20014
Restriction: 00
Birthdate: 7/31/1955
Tr# 15631
Expiration: 7/31/2009 5ii3
IRA G MALKIN
s
I 180 DAYTON ST --
DANVERS, MA 01923
Update Address and return card.Mark reason for change.
- Address --] Renewal (] L',ost Card
OP
S-C 8
Al 5
OM-05/08
PCao90
✓fie >°oumimonuiea`!� o�/�aaacu/tuaelta
Board f Building Regulations and Standards
Construction Supervisor License
Lies i$e: CS 20014
7131/1955
2009 Tr# 15631
_ = ' .
447
4 et�il+i. 00
IRA G MALKIN
180 DAYTON ST 7"
DANVERS,MA 01923 Commissioner
r '
The Commonwealth of Massachusetts
Department of Industrial Accidents
' Office of Investigations
600 K'ashington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Buil ders/Contractors/Electricians/PluBabe rs
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):_ �j PA- D,
Address: O Q/¢_9Y&Y S
City/State/Zip: JAI M5, Phone #: 7I*-,Q F6
Are you an employer? Check the appropriate box: --
,�•,. Type of project(required):
1.L1rJ 1 am demployer with_�� 4. ❑ I am a general contractor and 1
employees (full and/or part-time).* have hired the sub-contractors 6 New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7 Remodeling
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.[:1 Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL 11-El Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12;❑ Roof repairs
insurance required.] t employees. [No workers'
comp. insurance required.] 13.❑ Other
*Any applicant that checks box Al must also rill out the section below showing their workers'compensation policy information:
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such
tContraclors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp,policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: T R�4tx'��PS
Policy#or Self-ins. Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
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 25A of MGL c. 152 cau..lead to the imposition of crinunal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORT{ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pai s and penalties of pe,jut),that the information provided above is true and correct.
Si afar : _ Date:
Phone#: q 771/ ;t-U
Oficial use only. Do not write in this area,to be completed by cite or toren offrcial.
City or Town: Pernlit/Liceuse#
Issuing Authority (circle one):
1.Board of Health 2.Building Department 3.Cityrrown Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
tp['£ogpo9l t,
Rvw.va`Q t d j 1
�I I
poontd�pte qof Jo pied>maq I I mo.�tpuoD qoF tg of lcrnsam4ps I I.
J II pao o qo(uO nonuo;j!2n of loo fq-;
oo:rl/S=p°1QI�d ""q�3�jct�tlddo taotan t»!doo io L»6spl� oan•8 avoRvas9!*oP�!� tLotoaaatrP tT�' i
)t/L lii:pos®�.oQ( -e{4ou:onto pva.9t9op Mnl9uo W 6t>;W.I.
I
i
i
I.
� I
Jul
_)99t
- �
I' I II
- ! ----------------------
_
_ .. -.
,,eroaauos.�ee,� Pl„l I
,I .� X4"444.1 __ v.i a o1 vwoo�•n I 1
.� ontW�P
.�a,�P
u�Wul
tuatr
i s rnolna3.P o w a
I Il�mi' zsn eto ai�aa I °� I i
ti
SV
sloPne xtMdna r II•l9ul o i
o
w.
•
1 '---- a31--J--n• I I
To wtw•N.TH Vol --
0 9 M-rro •,
I ' I I a �ro•k 9t�G� = II�� -'��^ � � i i
- pno t'LRR I uocm _
,t I
I
.4rtt K
I,
—�.V99 �.9L—tf .119► ----�.4Lt I -
L
.}9rt
l@@-d
110/100 d @19-1 1Zb99g6816t6+ 589Z1Od303WOH-MNO 00:Zl
ip['so4P09T V �I
Rvu..oaar— 1
dl
)L/Elis:p1oiAw-Q JI vetddv Ca�tan OaD iI III �o,1lpvDo qoBm TmaasnlDs
pozn(d�pte qoo pPd 7Su =*its q of ao aopcoljuon DS TpoCA-
;1
o0-%;rll � pg aan!$avo IUUOa�QZW caoiawtu!p11 '
q tm 6lMIJ.
I
Jftf
-1 LOL
7' K
_ ----- -----------•---------
ja yoeq v0 s-�P 'I �
-� it I t.u•d poop onpiumoP ,� r�I I I I i I
t= z i� '"motoa 1-100 zaidr6 urwui
w
0,9
V
wOHN)17
•Itl
N„s 031n�,on
N vol -------- - ----------. --------. - -- •1fl) u
, I
I
i
I I vrort
� oreva M6ocM
O °
t i
-- -
.!K
.OE 7"IL' -
7 -
l£8-d HO/200 d 819-1 1Zb99g68L616+ 989LOd303MOH-A08J 00 z -IW07Z
s?-q'so4P09t>'I �
I
•po�n�d z�p:o
»O:O/�Lrl/st/:po1B!e[ve'QaJII t i p ao atpnoooaoqAoafo113gpoof n1Bo7sn�4ps�tfiglUtts
",Z�Iq"!tdda OTan P=op» aant$avnA-P vas'auol¢Clcltp 17V"-q
lev aatttr pav totsOD t"w6iUc.W 6t xtttt-
i
i
I
I.
I
.rz
I _199E I G I
III � I 9n
I , I
----------- ----------
. .. -. _ •------- ar
( f III I
I I � r I I j •' pUfl9: St�-.pt�_.al I I I I _ I
ja M9¢7 uo s.�P I '-
� _ o_ VtNV OIOWDO��R I �61 o`I
� •I I � .I � I I; '� t.uetl Goof onptumoP I I I I -
l n x do nrWul
i I ;
- _--.•'--------- NII
I ' 049 TO .I IIII I'
xoGdd¢tlol Gv,v^otI v^oG¢
I I '. �e � S1011r.e xoprtp!II.lOul �,I � I
I
3 `
G.nn coed
I IJo 6P:9 031n1d___.fin. ,
o
Ii t` VIM mmO oC6vvc pow T
I
-oz--4.at Vat
K
i
.rK
-.fact -
v9 -- .DE
I
I
l£8-d I WIN'd 819-1 1Zb99b681616+ 989Z1OAHAOH-AUO 00 ZI70Z-Zl-90
14 Bucklin Road
;i
9
Dat . . .. . .. .
q
OF+NORTH . 4
or °` TOWN OF NORTH ANDOVER
. :
PERMIT FOR GAS INSTALLATION
a.,�x. 4 93SACMUSE4 _ ,t
, his certifies that . . . . . . . . . . . . . . . . . . . Iq. . . . . . . .
has permission for gas installation-A ". . . . . . s
in the buildings of . . .F. . . . . . . . . . . . . . . . . . . . . . . . . .
at North Andover, Mass.
Fee; ?.. . . Lic. No/4. . .jl . . . . . . . . . .
GAS I �S�PECTOI
Check#
648
MASSACHUSETTS LMORMAPPUCATONFORPERMlT TO
DO GAS FITTING
(Type or print)
Date ,
NORTH ANDOVER, MASSACHUSETTS
Buildin L a'
g 'or'
tions
D
Perm' d
rt#
vr✓G� p c�
Owner's Name Amount$
New❑ . Renovation Replacement P Plans Submitted
� a
r _ C U _ F
c U
Z C =W" FFd y m Z
w w z v w x z F a p a > w
., x
x w a
U F z 'Sa w F F x
F W W
z d w z F W O O > Gs, U v� C
Q F F
a
a w
> v, w
z F
w > W � m o z
z o x
° > c a H o
SUB-BASEMENT
BASEMENT
IST. FLOOR
2ND. FLOGR
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR
6TH . FLOOR
7TH . FLOOR
8TH . FLOOR
(Print or type) Af /
Name Check one: Certificate Installing Company
� dh+.l�/� .� L C � Corp.
Address A-VZ,
Partner.
ei d
Business C
s e ep one
® Firm/Co.
Name of Licensed Plumber'or Gas Fitter , �—a//
INSURANCE COVERAGE Check 2n .
I have a current liability insurance,policy or it's substantial equivalent. Yes
If you have checked Les,please i tate the type coverage by checking the appropriate box. No❑
Liability insurance policy Other type of indemnity 13 Bond
Owner's Insurance Waiver: 1 am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass.General Laws,and that my signature on this permit application waives this requirement.
., I Signature of Owner or Owner's Agent Check one:
Owner � Agent
I hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performeA under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State G
and Cha5er 142 of the a eral Laws.
BY Signature of Licensed Plumber O Gas ittirr
Title Plumber
.. D
lCity/Town,
Gas Fitter =cense INUMDer
Master
_
APPROVED(OFFICE USE ONLY) Journeyman
5
' „oRTM, TOWN OF NORTH ANDOVER
o t,�.o do
o�
PERMIT FOR PLUMBING
, This certifies that . . . . . . . . . . . . . . . . . . .a.r. . . . .,,.. �
has perfission to perform . . . . . . . . . . . . . ...
plumbing in the buildings of .�_.�� •:�. .
F
ft at . . orth Andover, Mass.
Fee7�c?� '' .Lie.
�RLUIV NSPECTOR
Check #
7801
MASSACHUSETTS
UNIFORM
APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
� Date � 0
IV 7
Building Location / ��� �� Owners Name permit#
- � �� /
Amount
TypeofOccupancy , --
New ri Renovation Replacement Plans Submitted Yes No
FIXTURES
w � U a
o
H
a A a co A Q ca
MFLoae
z a FLOC t
3MHf=
4M FLOCR
MR-oat
7MElf M
sMrz"
(Print or type) A
Check one: Certificate
Installing Company Name zz El Corp. L L
Address ® �s� ��� / Partner.
0'2
usmess elephone a E] Firm/Co.
Name of Licensed Plumber:
Insurance Coverage• IndicatLthLqfte of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ Bond ❑
insurance Waiver: I, the undersigned,have been made aware that the licensee of this applicatio
eeinsurance n does not have any one of the above
Signature OwnerE] Agent ❑
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts Sta
�b�g Codeand apter 14 e General Laws.
SignatureBy: o icense um er
Type of Plumbing License
Title
City/Town icense um er
APPROVED(OFFICE USE ONLY Master Journeyman ❑