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HomeMy WebLinkAboutBuilding Permit #100-12 - 150 OLD FARM ROAD 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: y - z Date Received Date Issued: 1 IMPORTANT:Applicant must complete all items on this page LOCATION z D C� /r✓ /�fzs�-r �� Print PROPERTY OWNER ;6 �S'�,�1/� A,4 N..7,o—/A Unit,, Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yeano Machine Shop Village ye100 year-old structure ye TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ZOne family ❑Addition ❑Two or more family ❑ Industrial yA l WAlteration No. of units: ❑ Commercial ii Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other lSept c Well 1�Tloodpla n 0'Wetlands v� Watersfied District D Water/Sewer, f DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Print Clearly) OWNER: Name: �A u� J tt;,kA k a a � n tom,A Phone: (pi:2�S Address: /5"0 /d Jr AK,» c✓ CONTRACTOR Name: A&22 e /J� ea' _ _ Phone: (�3-�2;_3 3 Address: d Y 5S" Pi to r1_,g boa 3 3 4' Supervisor's Construction License: Exp. Date: Home Improvement License: -7S S Exp. Date: /,?3Aeo2 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: $ ,, Ib , -2 FEE: Check No.: �Z Receipt No.: NOTE: Persons contrac 'th nre t re ntractors do not have access to the guaranty fund Signature oftAgent/Own _ ;Signature of contractor ? f 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 T HEALTH Reviewed on Signature i � • COMMENTS 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 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS i 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 2011 June/mi r a 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 I ❑ Copy Of Contract ! ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And p p 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 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 Doc: Doc.Building Permit Revised 2008mi r The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass gov1dia Workers' Compensation Insurance Affidavit: Builders/Cont>ractors/JElectri.cians/Plumbers AUplicant Information Please Print Legibly Name(Business/Organization/Individual): Address: ����j /' ✓(� City/State/Zip:_ �jy/�j�- Phone#: Are you an employer?Check the appropriate box: Type of project(required): [2.El ❑ I am a employer with 4. W I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors I am a sole proprietor or partner- listed m the attached sheet.t 7. F1 Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. workers'comp.insurance. Y9. ❑Building addition [No workers' comp.insurance S. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c.152,§1(4),and we have no 12.0 Roofxepairs insurance required.]t employees.[No workers' comp.insurance required.] 13.0 other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. iContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �j Insurance CompanyName: /r�j Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: /.D D�� &U eKZ City/State/Zip: / / r� 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 can lead to the imposition of criminal 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 WORK 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 IA for insurance coverage verification. I do hereby cert u ns dpenalties of perjury that the information provided above is true and correct. Signature: Date: O Phone#: 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectricaI Inspector 5.Plumbing Inspector 6.Other Contact Persoin: Phone#: ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) A� 08/01/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1-404-995-3000 CONTACT Marsh USA, Inc. NAME:PHONE FAX C AIC No): homede ot.certre est@marsh.com E-MAIL p ADDRESS: Two Alliance Center, 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 INSURERS AFFORDING COVERAGE NAIC# Fax (212) 948-0902 INSURERA: Steadfast Ins Co 26387 INSURED INSURER B: Zurich American Ins Co 16535 The Home Depot, Inc. Home Depot U.S.A., Inc. INSURER C: New Hampshire Ins Co 23841 2455 Paces Ferry Road NW INSURER D: Illinois Nati Ins CO 23817 Building C-20 NATIONAL UNION FIRE INS CO OF PITTS 19445 Atlanta, GA 30339 INSURER E: INSURER F: Illinois Union Ins CO 127960 COVERAGES CERTIFICATE NUMBER: 22552223 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICPOLICY NUMBER MM/DDY EFF MNOIIUDCDI EXP LIMITS LTR A GENERAL LIABILITY GL04887714-01 03/01/1 03/01/12 EACH OCCURRENCE $ 9,000,000 X COMMERCIAL GENERAL LIABILITY PREM SES DA AGE ToEaRENTED occurrence $ 1,000,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $EXCLUDED X LIMITS OF POLICY XS PERSONAL 8ADV INJURY $ 9,000,000 X OF SIR: $1M PER OCC GENERAL AGGREGATE $ 9,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 9,000,000 X POLICY PRO- LOC $ B AUTOMOBILE LIABILITY BAP 2938863-08 01 3 COMBINED SINGLE LIMIT Ea _ 1,000,000 accident X ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X SIR AUTO P $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ C WORKERS COMPENSATION WC061967352 (AOS) 03/01/1 03/01/12 X FWCCSTATU- OTH- AND EMPLOYERS'LIABILITYTORY ER D ANY PROPRIETOR/PARTNERIEXECUTIVE YIN NIA WC061967354 (FL) 03/01/1 03/01/12 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? E (Mandatory In NH) WC061967353 (CA) 03/01/1 03/01/12 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Workers Compensation WC061967355(KY,M0,NY,WI, )03/01/1 03/01/12 F TX Employers XS Indemnity TNSC46244151 (TX) 03/01/1 03/01/12 Occurrence/SIR 30M/lM E lWorkers Compensation WC1192378 (QSI) 03/01/1 03/01/12 SIR 1M DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF NORTH ANDOVER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PLANNING DEPT 1600 OSGOOD ST. AUTHORIZED REPRESENTATIVE NORTH ANDOVER, MA 01845 {__ USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Jthornton_hd 22552223 DATE ADDITIONAL INFORMATION 08/`1/2011 08/01/2011 PRODUCER COMPANIES AFFORDING COVERAGE Marsh USA, Inc. COMPANY Illinois Union Ins Co homedepot.certrequest@marsh.com COMPANY Two Alliance Center, 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 INSURED COMPANY H The Home Depot, Inc. Home Depot U.S.A., Inc. 2455 Paces Ferry Road NW Building C-20 Atlanta, GA 30339 TEXT Workers Compensation Continued: Carrier: National Union Fire Insurance Company Policy No.: WC1192379 (MA) Policy Dates: 03/01/2011 ? 03/01/2012 Limit: $1,000,000 SIR: $500,000 *** HOME DEPOT INSUREDS*** Home Depot U.S.A., The Home Depot, Inc. Entity List Chem-Dry Limited Harris Research, Inc. HD Direct LLC Home Depot Installation Services, Inc. Home Depot USA, Inc. dba The Home Depot THD At Home Services, Inc. dba The Home Depot At-Home Services THD At-Home Services, Inc. The Home Depot, Inc. The Home Depot, Inc. Home Depot USA, Inc. Your Other Warehouse, LLC CERTIFICATE HOLDER TOWN OF NORTH ANDOVER PLANNING DEPT 1600 OSGOOD ST. NORTH ANDOVER, MA 01845 USA MARSH USA INC.BY r--- Page 12 NORTH Town 0 Andover .. ti M. No. - �,o = A K E O dover, Mass., .� COCHICHE WICK �,1. AD"�ATED ?a�,�C7 S U BOARD OF HEALTH Food/Kitchen Septic System .. PERMIT T D • tt BUILDING INSPECTOR THIS CERTIFIES THAT.............. . .Q..4�................. �.� ,.................. Foundation has permission to erect.......... ................. ....... buildings on ....� .......... �rC.. V....... .. �......... Rough 111:1 ILIXIII00i __ Chimney to be occupied as...... .. . .. ...... ................... ..ow.................................................................................... ch ' e provided that the person accepting this 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 t PERMIT EXPIRES IN 6 MQNT1,HS ELECTRICAL INSPECTOR L`1�LESS CONS UC 1 A0 Rough ...................... ...................................................................... .......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy 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. TBurner Street No. SEE REVERSE SIDE Smoke Det. - 91te - -__ O face of Consumer Affai and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 112785 r" Type: Supplement Card HOME DEPOT USA INC Expiration: 4/23/2013 MICHAEL MOSS 2455 PACES FERRY RD. ATLANTIC, GA 30339 Update Address and return card.Mark reason for change. DPS-CAI is 50M•04/04-G101216 Address 0 Renewal [:] Employment E] Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 112785 Type: 10 Park Plaza-Suite 5170 Expiration: 4/23/2013 Supplement Card Boston,MA 02116 HOME DEPOT USA INC MICHAEL MOSS 2455 PACES FERRY RD. 4 ATLANTIC, GA 30339 Undersecretary Not valid without signature RAVI & SARITA , KANJOLIA Order# 421662 150 OLD FARM RD Design Description : KIT 6/26/11 NORTH ANDOVER , MA , 018451130 Design File Name : FK000040.KIT 52201 C85.KIT 62606DF LKIT Home Phone : (617) 755-0189 Work Phone : (978) 975-7183 extn. SKU-282627 KITCHEN POINT NATIONAL Ist Product Vendor 2nd Product Vendor i. Haul away debris removed from kitchen cardboard and install debris 16.0 Job Site Quote Remove existing cabinets countertop and soffit. 36.0 Job Site Quote Pre-Construction,Demolition,Removal,and Haul Away SubTotal : $1456.00 :Per B6x 13a�ic Cabnxi=f Installation. '- � - Key the number of Cabinets to be Installed in the Quantity Section. JEach * Per Cabinet Installation (includes Wall, Base. Includes Shelves, Fillers, Scribe, Toe Kick, Handles, & Knobs.) Per Box Basic Cabinet Installation SubTotal : $1311.00 Custom• ss�`ritbl •or Installatiori - .°•- �° " ��.' ' ' _� �•, i . - (fit � ,�, UC)M ,; , 3/16" skins decorative/base/wall end panels, back of cabinets (perpanel) 4.0 Each Build up base cabinet to offset floor thickness (up to 3/4" in height, materials provided by 7.0 Job Site Quote installer Create Stem Glass Holder as per detail sheet 7.5 Job Site Quote Install two deco doors. 12.0 JJob Site Quote Build out toe kick on both wine cabinets and B21 4.0 JJob Site Quote Custom Assembly or Installation SubTotal : $742.00 UQM Moldtn 11i tally ivn ; ,/�}( A .. ♦t. Molding for top or bottom of wall cabinets. Each layer 61.0 Linear Foot priced separately includes blocking at no charge) Molding Installation SubTotal : $427.00 ElectricalQt 1.1C31V1. } - - 1. Update existing kitchen outlets. 38.0 Job Site Quote 2. Add outlet and pigtail for dishwasher. 3. Add outlet and pigtail for garbage disposal 4. Move refrigerator line. 5. Kill existing light over sink. Supply and install six xenon under cabinet lights on one switch. 41.0 Job Site Quote Supply and install six recessed lights on one dimmer switch and remove or put junction 45.0 Job Site Quote box for existing light. * Electrical requirements/pricing may vary due to local codes Electrical SubTotal : $2566.80 t"�Ilurnbi'n _� • ,=t a ss Supply and install temporary sink. We will remove sink for countertop template and re- 25.5 Job Site Quote install after. We will remove sink for countertop installation. 1. Hook-up sink, faucet and garbage disposal. Drain baskets supplied by owner. 34.0 Job Site Quote 2. Hook-up dishwasher. 3. Run new line and hook-up icemaker. * Plumbing requirements/pricing may vary due to local codes Plumbing SubTotal : $1231.65 A. Dance Installattdn Cit WO#1>f: Install micro/hood and duct outside. 17.0 Job Site Quote Put refrigerator and range in place and level as best we can. 4.5 Job Site Quote Appliance Installation SubTotal : $602.00 Floor n .and Backs lash Installation Qt. Ubm Flooring and Backsplash Installation SubTotal : $0.00 is a11,Work &.Pantm 1 Patch ceifinq where soffit was removed and match existing as close as possible. 23.0 lJob Site Quote Drywall Work &Painting SubTotal : $644.00 Additionai°Char Additional Charges (if applicable)SubTotal : $0.00 I?ermits _ Q 1J( M . Electrical Permit cost 115.0 Each Plumbinq Permit cost 115.0 Each Building Permit cost 165.0 Each This section is for adding Cost of required. Permits for the Job. Permits SubTotal : $395.00 Lead Safe Work Practices . Qf`,, USM Lead Safe Work Practices SubTotal : $0.00 General Notes vr� the'PrQ`ect f7ocurr n,#tion t rtl : . IVo'Gosh `� oty- . j NOTE: It is unknown what is in the soffit-- if wires or piping additional char es will apply. 10.0 Each General Notes on the Project(Documentation Only-No Cost)SubTotal : $0.00 T"0taI_ frtche Inst allat�0n Project . X93 75 45 T I I E Va'NA.1, KITCIIE,N IvS7'1;!'1:4"IT ti ORKSflEl:'T MUST 13E S1 'NED BV BOTII TIM a USTCI MER AND ASSc�CIAI' -*tND *l'CrE S I I ^�(-,1i�.:'3 T BE �1,�NUA1.1,1 1'{ _I:ty3{�I 0 "1y'IIF ;N'Sq /I''.Uy'Ll"IR, k COP OU `f1-I l;`NA1 N1'1 ( IIEN FSTI)l.t�l'E V� 4 J 14 I4 SIf I4 E,19 11 t,'S I, .k I �-t.39 V, €,I r.'V I() i11&, f_ t.'SI \�NILR Job will be scheduled once all materials are at the job site Note: The Home Depot does not provide the following services (as part of kitchen installation program)., � - -- 211- ° --- Ravi and Santa Kanjofia V� 150 Old Farm Road I` North Andover,MA 01845 978-975-7183 721" '--30-V'--1Manuf:Thomasville I +" Doorstyle:Villa Cherry Square 1/8"CT-&-irance2a Finish:Brierwood II on each side of All Plywood Construction window 1/2"Partial Overlay r � �' . 18 6Rl W3636 9 3 R36 121 ,Customer will use W1836 with No Doors as. is a place for Temple. Do not install shelves - E- I in this cab.Temple is � _ 77 K -' 31 1/2"Hx10 1/2"Wx10 1/2"D s = F330->4 DiSHW T SLS36 i W i WEPS36/Skin - ro Ceiling height m trimmed and w ! 90 1/4"to 90 3/8" D installed in comer to hide A back of 821 Z M Install remaining w m WEPS36 skin A - ) and 6"overlay p w ---f-- (actually 9 �o w n? v lul n drawer front) 30" [' i II � on back of Wine re Cab (� rr' Outside Comer molding on vertical I 3"tail filler trimmed to approx 1" I I� I. N French door 31 at 90 degree TI=P2 _ - - -- Customer W331824 f will g t th C18181 a q a_ ^n Base Wine Cabs Installed on each end of11�. Ctop p Fridge peninsula facing Wall 5,No filler on far left, 621 w/full ht doer has toekick on back,installer will need to flush toekick in field on B21 - I and both Wine Cabs(See Detail) Trim and install 48"finished -` 3 18"—i Tali Cabinet is created with panel,install(2)21"Deco Doors over 30"depth tall fridge To front 3 stacked cabinets.Base is panel,evenly spaced.Install Baseboard panels trimmed to matct40 1/2"H,Wall cab is 30"H molding at base,on return and around fridge box depth.Pull --611 3 ;"— with 24"depth,Top Wine back of base wine cab on end of wall cab out from wall Cubby is 18"H with 18"depth. peninsula.Bury molding into to match panel depth 54 i"- TBPB(3/4")installed between 824's Toekick each cab.Pull Wine Cubby 18" out to match 24"depth All dimensions .size designations rY This is an original design and must Designed: 6/26/20171 given are subject to verification on L, not be released or copied unless Printed.: 6/26/201.1 job site and adjustment to fitjob p j j j �., applicable fee has been paid or job conditions. order placed. (4w 52201C85XIT _ _ __ A.II — Drawing#_I Remove, alter or build load bearing walls (other than stud wall framing) Structural alterations or repairs Alterations to exterior of home Removal of vinyl flooring unless in installers professional opinion that the job meets industry standards and norms and is manageable under The Home Depot Hazardous Materials SOP Customer Signature: R- /I Associate Signature: Date 6- U — 1 t Date —2- �p-- ,, SPECIAL SERVICES CUSTOMER INVOICE Page 1 of 9 NO. 3480-421662 Store 3480 SALEM, NH Phone: (603) 894-1900 289 SOUTH BROADWAY Salesperson: HH 1174 t " SALEM, NH 03079 Reviewer. Name Home Phone REPRINT • KANJOLIA RAVI & SARITA (617)755-0189 Address 150 OLD FARM RD work Phone (978) 975-7183 Company Name \ - • oih NORTH ANDOVER JobDescrption HD MEAS TV THIS IS THE ONE '2011-08-03 10:59 State MA Zip 01845-1130 County ESSEX VENDOR DIRECT SHIP 01 TCUSTOMER RCHANDISE AND SERVICE SUMMARY We reserve stomershttolimitthequantitiesofinerchandise S/O-MERCHANDISE TO BE SHIPPED: S/O THOMASVILLE REF# S02 ESTIMATED ARRIVAL DATE: 07/24/201 553631 REF# SKU QTY UM DESCRIPTION TAX PRICE EXTENSION S0201 502-755 1.00 EA APC/APC ALL-PLYWOOD BOX f20%)/APC N 047.60 $1,047.60* S0202 502-755 1.00 EA TBEM/TBEM TRIPLE BEAD MLDG/TBEM MODS: W=96"W2=96" H=0 3/4" D=0 $30.30 $30.30* 1/2" S0203 502-755 3.00 EA VFR8/VFR8 VALLEY FORGE MLDG 8 FT/VFR8 MODS: W=96" W2=96" = N $27.48 $82.44* D=1 1/4" S0204 502-755 4.00 EA SWCRM8/SWCRM8 SOLID WOOD CROWN MLDG/SWCR =96" N $36.29 $145.16* W2=96" H=1 1/2" D=1 1/2" S0205 502-755 3.00 EA TB8-WD14/TB8-WD14 TOE BOARD .25 WOOD/T - ODS: W=96" N $28.18 $84.54* W2=96" H=4 1/2" D=0 3/8" S0206 502-755 1.00 EA .B30/.B30 TOP.DF/.B30 N $31.36 $31.36* S0207 502-755 1.00 EA 3DB18/3DB18 3 DRW BASE 18 IDES:B HINGES:B N $379.40 $379.40* S0208 502-755 1.00 EA B21 FHL/B21 FHL BASE 2 jt&RWB21 FHL FSIDES:B HINGES:L N $231.44 $231.44* S0209 502-755 1.00 EA BTK/BTK RECES KI - ACK/ATT:1321 FHL BTK FSIDES:B N $35.23 $35.23* S0210 502-755 2.001 EA BWC6/BWCA55, E CUBBIE 6W/BWC6 FSIDES:B N $231.09 $462.18* S0211 502-755 1.00 EAI F330/-F-3.3 W 30H/F330 FSIDES:B MODS: W=1" H=34 1/2" D=24" N 1 $13.741 $13.74* ***CONTINUED ON NEXT PAGE*** D O� Check your current order status online at www.homedepot.com/orderstatus Indicates Page 1 of 9 NO. 3480-421662 * Customer markdown SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 2 of 9 NO. 3480-421662 VENDOR DIRECT SHIP #1 (Continued) TO: CUSTOMER S0212 502-755 2.00 EA TEP2490-WD/TEP2490-WD TALL END PNL WD 24W 90H/TEP2490-WD N $149.01 $298.02* FSIDES:B MODS:W=0 3/4" H=90" D=30" S0213 502-755 2.00 EAJ ID30-EP/ID30-EP INCREASE DEPTH END PNLS TO 30"{/ATT:TEP2490-WD N $74.50 $149.00* ID30-EP FSIDES:B S0214 502-755 1.00 EA B24SS/B24SS SLIDING SHF BASE 24 2DR/B24SS FSIDES:B HINGES:B N $522.78 $522.78- S0215 502-755 1.00 EA CIW24/CIW24 CUTLERY INSERT WOOD 24/ATT:B24SS CIW24 FSIDES:B N $69.40 $69.40* S0216 502-755 1.00 EA TF390/TF390 TALL FLR 3W 85.51-1/TF390 FSIDES:B MODS: W=1" H=90" D=24" N $35.93 $35.93* S0217 502-755 1.00 EA B1840FHSSL/B1840FHSSL SLIDING SHF BASE 18 FHD 40H L/B1840FHSSL N $527.35 $527.35* FSIDES:B HINGES:L S0218 502-755 2.00 EA JCORBELSHKR7/JCORBELSHKR7 SHAKER CORBEL 7H/JCORBELSHKR7 N $176.14 $352.28* FSIDES:B S0219 502-755 1.00 EA SB33ST/SB33ST SINK BASE 33 TILT OUT/SB33ST FSIDES:B HINGES:B N $0.00 $0.00 S0220 502-755 1.00 EA SLS3633L/SLS3633L SUPER SUS ASYMETRIC L36 R33 LH/SLS3633L N $757.75 $757.75* HINGES:L S0221 502-755 1.00 EAJ F330/F330 FLR 3W 30H/F330 FSIDES:B N $13.74 $13.74* S0222 502-755 1.00 EA 4DB12/4DB12 4 DRW BASE 12/4DB12 FSIDES:B HINGES:B N $407.58 $407.58* S0223 502-755 1.00 EAJ BP4834.5-WD/BP4834.5-WD BACK PNL 48W 34.5H WOOD/BP4834.5-WD N $60.59 $60.59* FSIDES:B MODS:W=42" H=341/2" D=0 1/4" S0224 502-755 2.00 EA .W2130R/.W2130R NHR.DOOR/.W2130R FSIDES:B N $109.55 $219.10* S0225 502-755 1.00 EA I W1836R/W1836R WALL 18W 36H RH/W1836R FSIDES:B HINGES:R N $191.94 $191.94* S0226 502-755 1.00 EA CBO-W/CBO-W CABINET BOX ONLY -15% /ATT:W1836R CBO-W FSIDES:B N $0.00 $0.00 S0227 502-755 1.00 EA MIPPS/MIPPS MATCHING INTERIOR W/PLYWOOD SHELF/ATT:W1836R N $67.74 $67.74* MIPPS FSIDES:B S0228 502-755 1.00 EA W3636/W3636 WALL 36W 36H/W3636 FSIDES:B HINGES:B N $369.89 $369.89* S0229 502-755 2.00 EAl MULDR36/MULDR36 MUL DOOR 36"H /EA /ATT:W3636 MULDR36 FSIDES:B N $162.05 $324.10* S0230 1 502-755 1.00 EA MIP/MIP MATCHING INTERIOR %/ATT:W3636 MIP FSIDES:B N $92.47 $92.47* S0231 502-755 1.00 EA VV48/VV48 STRAIGHT VALANCE 48W/VV48 FSIDES:B MODS: W=44 1/4" H=4 N $28.89 $28.89* 1/2" D=0 3/4" S0232 502-755 1.00 EA ES1248/ES1248 EXTERIOR SHF{/EAI/ES1248 FSIDES:B MODS:W=44 1/4" N $60.24 $60.24* H=0 3/4" D=11 1/4" S0233 502-755 1.00 EA WGH36/WGH36 WINE GLASS HOLDER 36W/ATT:ES1248 WGH36 FSIDES:B N $91.59 $91.59* S0234 502-755 1.00 EA W936R/W936R WALL 9W 36H RH/W936R FSIDES:B HINGES:R N $181.07 $181.07* S0235 502-755 1.00 EA ER362121 L/ER362121 L WALL EASY REACH 36H 21 W 12D LH/ER362121 L N $383.63 $383.63* FSIDES:B HINGES:L S0236 502-755 1.00 EA WSP1236/WSP1236 WALL SPICE PULLOUT 12W 36H/WSP1236 FSIDES:B N $330.44 $330.44* HINGES:L S0237 502-755 1.001 EA W3018/W3018 WALL 30W 18H/W3018 FSIDES:B HINGES:B N $207.841 $207.84* ***CONTINUED ON NEXT PAGE*** * Indicates item markdown Page 2 of 9 NO. 3480-421662 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 3 of 9 NO. 3480-421662 VENDOR DIRECT SHIP #1 (Continued) TO: CUSTOMER S0238 502-755 1.00 EA W1236R/W1236R WALL 12W 36H RH/W1236R FSIDES:B HINGES:R N $192.69 $192.69- S0239 502-755 1.00 EA W1830L/W1830L WALL 18W 30H LH/W1830L FSIDES:B HINGES:L MODS: N $178.96 $178.96* W=18" H=30" D=24" S0240 502-755 1.00 EAl ID24-W/ID24-W INCREASE DEPTH TO 24" % /ATT:W1830L ID24-W FSIDES:B N $107.37 $107.37- S0241 502-755 1.00 EA WSC181818/WSC181818 WALL WINE STORAGE 18W 18H 18D/WSC181818 N $199.74 $199.74* FSIDES:B S0242 502-755 1.00 EA W331824/W331824 WALL 33W 18H 24D/W331824 FSIDES:B HINGES:B N $260.69 $260.69* S0243 502-755 3.00 EA BBM8/B13M8 BASEBOARD MLDG/BBM8 N $64.47 $193.41- S0244 502-755 1.00 EA OCM8/OCM8 OUTSIDE CNR MLDG/OCM8 N $17.97 $17.97* S0245 1 502-755 3.00 EA SSM/SSM SMALL SCRIBE MLDG 8/SSM N $15.85 $47.55* S0246 502-755 1.00 EA TBP8/TBP8 TRIPLE BEAD PILASTER MLDG/TBP8 N $72.92 $72.92* S0247 502-755 1.00 EA WEPS36-WD/WEPS36-WD WALL END PNL SKIN WD 36H/WEPS36-WD N $26.42 $26.42* S0248 502-755 2.00 EA WSCRIBE/WSCRIBE WIDE SCRIBE MLDG /WSCRIBE N $58.13 $116.26* S02FR 506-658 1.00 KITCHEN CABINET FREIGHT N $250.001 $250.00 VENDOR-SPECIAL INSTRUCTIONS: LINE:THMASVIL DSTYLE:VILLA CHERRY USTYLE:VILLA-CHY-SQ LSTYLE:VILLA-CHY-SQ WOOD: APC FINISH: BRIERWOOD DSGNR:HH1174 VENDOR WILL SHIP MDSE TO: KANJOLIA RAVI &SARITA ADDRESS: 150 OLD FARM RD CITY: NORTH ANDOVER STATE: MA ZIP: 0184511 COUNTY: ESSEX SALES TAX RATE: 6.250 $9,950.73 30 PHONE: 617 755-0189 ALTERNATE PHONE: 978 975-7183 PAGER: END OF VENDOR DIRECT SHIP INSTALLATION #1 REF# 101 ESTIMATED INSTALL BEGIN DATE: 06/26/2011 ESTIMATED INSTALL END DATE: 07/26/2011 * Indicates item markdown Page 3 of 9 NO. 3480-421662 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 4 of 9 NO. 3480-421662 INSTALLATION #1 (Continued) REF#101 MERCHANDISE TO BE INSTALLED: REF# SKU QTY UM DESCRIPTION S0201 502-755 1.00 EA APC ALL-PLYWOOD BOX f 20% S0202 502-755 1.00 EA TBEM TRIPLE BEAD MLDG S0203 502-755 3.00 EA VFR8 VALLEY FORGE MLDG 8 FT S0204 502-755 4.00 EA SWCRM8 SOLID WOOD CROWN MLDG S0205 502-755 3.00 EA TB8-WD14 TOE BOARD .25 WOOD S0206 502-755 1.00 EA .B30 TOP.DF S0207 502-755 1.00 EA 3D618 3 DRW BASE 18 S0208 502-755 1.00 EA B21 FHL BASE 21 FHD LH S0209 502-755 1.00 EA BTK RECESS TOEKICK-BACK S0210 502-755 2.00 EA BWC6 BASE WINE CUBBIE 6W S0211 502-755 1.00 EA F330 FLR 3W 30H S0212 502-755 2.00 EA TEP2490-WD TALL END PNL WD 24W 90H S0213 502-755 2.00 EA ID30-EP INCREASE DEPTH END PNLS TO 30" S0214 502-755 1.00 EA B24SS SLIDING SHF BASE 24 2DR S0215 502-755 1.00 EA CIW24 CUTLERY INSERT WOOD 24 S0216 502-755 1.00 EA TF390 TALL FLR 3W 85.5H S0217 502-755 1.00 EA B1840FHSSL SLIDING SHF BASE 18 FHD 40H L S0218 502-755 2.00 EA JCORBELSHKR7 SHAKER CORBEL 7H S0219 502-755 1.00 EA SB33ST SINK BASE 33 TILT OUT S0220 502-755 1.00 EA SLS3633L SUPER SUS ASYMETRIC L36 R33 LH S0221 502-755 1.00 EA F330 FLR 3W 30H S0222 502-755 1.00 EA 4DB12 4 DRW BASE 12 S0223 502-755 1.00 EA BP4834.5-WD BACK PNL 48W 34.51-1 WOOD S0224 502-755 2.00 EA .W2130R NHR.DOOR S0225 502-755 l.nnl FAI W1836R WALL 18W 36H RH ***CONTINUED ON NEXT PAGE*** Page 4 of 9 NO. 3480-421662 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 5 of 9 NO. 3480-421662 INSTALLATION #1 (Continued) REF#101 S0226 502-755 1.00 EA CBO-W CABINET BOX ONLY f-15% S0227 502-755 1.00 EA MIPPS MATCHING INTERIOR W/PLYWOOD SHELF S0228 502-755 1.00 EA W3636 WALL 36W 36H S0229 502-755 2.00 EA MULDR36 MUL DOOR 36"H /EA S0230 502-755 1.00 EA MIP MATCHING INTERIOR % S0231 502-755 1.00 EA VV48 STRAIGHT VALANCE 48W S0232 502-755 1.00 EA ES1248 EXTERIOR SHF /EA S0233 502-755 1.00 EA WGH36 WINE GLASS HOLDER 36W S0234 502-755 1.00 EA W936R WALL 9W 36H RH S0235 502-755 1.00 EA ER362121 L WALL EASY REACH 36H 21W 12D LH S0236 502-755 1.00 EA WSP1236 WALL SPICE PULLOUT 12W 36H S0237 502-755 1.00 EA W3018 WALL 30W 18H S0238 502-755 1.00 EA W1236R WALL 12W 36H RH S0239 502-755 1.00 EA W1830L WALL 18W 30H LH S0240 502-755 1.00 EA ID24-W INCREASE DEPTH TO 24" S0241 502-755 1.00 EA WSC181818 WALL WINE STORAGE 18W 18H 18D S0242 502-755 1.00 EA W331824 WALL 33W 18H 24D S0243 502-755 3.00 EA BBM8 BASEBOARD MLDG S0244 502-755 1.00 EA OCM8 OUTSIDE CNR MLDG S0245 502-755 3.00 EA SSM SMALL SCRIBE MLDG 8 S0246 502-755 1.001 EA TBP8 TRIPLE BEAD PILASTER MLDG S0247 502-755 1.001 EA WEPS36-WD WALL END PNL SKIN WD 36H S0248 502-755 2.001 EA WSCRIBE WIDE SCRIBE MLDG BASIC INSTALLATION LABOR: SKU I DESCRIPTION QTY I UM ITAXI PRICE EACH EXTENSION 282-627 IKITCHEN POINT-NAT/ 1 0.001 EAJ N 1 $0.011 $0.00 OPTIONAL LABOR SELECTED INCLUDES: ***CONTINUED ON NEXT PAGE*** Page 5 of 9 NO. 3480-421662 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 6 of 9 NO. 3480-421662 INSTALLATION #1 (Continued) REF#101 OPTION DESCRIPTION QTY UM TAX PRICE EACH EXTENSION 1 KITCHEN CABINETS WORKSHEET POINTS FOR DEMOLITION, DEBRIS REMOVAL, 138.25 EA N $28.00 $3,871.00 ELECTRICAL, PLUMBING AND APPLIANCES(UTILIZE THE KITCHEN POINT WORKSHEET TO OBTAIN TOTAL NUMBER OF POINTS)/ 2 PER CABINET INSTALLATION (INCLUDES WALL, BASE, PANTRY, PENINSULA OVEN & 19.00 EA N $69.00 $1,311.00 APPLIANCE CABINETS. INCLUDES SHELVES, FILLERS, SCRIBE, TOE KICK, HANDLES& KNOBS.) KEY THE NUMBER OF CABINETS TO BE INSTALLED IN THE QUANTITY SECTION./ 3 PERMIT AND ADMINISTRATIVE FEE QTY X$1.00Y 395.00 EA N 1 $1.00 $395.00 5 PER POINT- PLUMBING AND ELECTRICAL ONLY/ 183.501 EAJ N 1 $20.70 $3,798.45 INSTALLATION SITE NAME: I KANJOLIA RAVI &SARITA INSTALL LABOR CHARGE: $9,375.45 ADDRESS: 150 OLD FARM RD TRIP CHARGE: $0.00 CITY: NORTH ANDOVER STATE: MA ZIP: 018451130 CREDIT FOR DEPOSIT/MEASURE: $49.00 COUNTY: Essex SALES TAX RATE: 0.000 TAX: Merchandise- N LABOR- N • $9 326.45 PHONE: 617 755-0189 ALTERNATE PHONE: 978 975-7183 INSTALLER SPECIAL INSTRUCTIONS: RIP OUT&INSTALLATION OF CABINETS, CTOP AS PER KITCHEN WORKSHEET DETAIL BASIC INSTALLATION LABOR INCLUDES: AN INSTALLER SITE ANALYSIS IS REQUIRED FOR PROPER FIT SITE ANALYSIS FEE IS APPLIED TO THE PURCHASE. OF KITCHEN CABINETRY AND OTHER PRODUCTS TO BE INSTALLED. *THE FINAL KITCHEN POINT WORKSHEET MUST BE SIGNED BY BOTH DURING THIS CONSULTATION THE INSTALLER WILL CHECK FOR THE CUSTOMER AND STORE ASSOCIATE.A COPY OF THE FINAL UNUSUAL SITUATIONS WHICH MAY REQUIRE ADDITIONAL LABOR. SIGNED KITCHEN POINT WORKSHEET MUST BE GIVEN TO THE *DAILY CLEAN UP OF JOB SITE CUSTOMER AND INSTALLER. *THE SITE ANALYSIS FEE IS NON-REFUNDABLE *IF CUSTOMER PURCHASES LABOR FROM THE HOME DEPOT,THE UNLESS STATED ABOVE THIS INSTALLATION DOES NOT INCLUDE: ADJUSTING OPENINGS OR ANY WORK INVOLVING LOAD BEARING WALLS ALTERATIONS TO EXTERIOR OF HOME REMOVE,ALTER OR BUILD LOAD BEARING WALLS(OTHER THAN STUD WALL REMOVAL OF VINYL FLOORING FRAMING) INSTALLING SKYLIGHTS STRUCTURAL WORK Page 6 of 9 NO. 3480-421662 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 7 of 9 NO. 3480-421662 INSTALLATION #1 (Continued) REF#101 SPECIAL NOTES: `AN ADULT OVER 18 YEARS OF AGE WITH THE AUTHORITY TO MAKE CHANGE FURNACE FILTER BEFORE,DURING AND AFTER INSTALLATION. DECISIONS ABOUT YOUR INSTALLATION MUST BE PRESENT DURING THE .WATER,GAS AND SEWER SERVICE MAY BE TEMPORARILY TURNED OFF INSPECTION(WHEN APPLICABLE),DELIVERY AND INSTALLATION DURING THE INSTALLATION PROCESS. THE INSTALLER WILL NOTIFY *NO WORK TO BE DONE ON SUNDAYS OR HOLIDAYS THE CUSTOMER OF AN ESTIMATED LENGTH OF TIME FOR THE SERVICE `ALL WORK WILL BE DONE TO LOCAL CODES AND ORDINANCES TO BE UNAVAILABLE. `ALL WATER AND GAS SUPPLY LINES MUST HAVE INDEPENDENT *CUSTOMER IS ASKED TO DESIGNATE PARKING,ENTRANCE AND EXIT SHUT-OFF VALVES. ACCESS PREFERENCES FOR THE INSTALLER(INCLUDING RESTROOM *JOBSITE MUST BE COMPLETELY ENCLOSED WITH ALL WINDOWS, ACCESS). DOORS,INTERIOR WALLS,ROUGH PLUMBING AND ELECTRICAL WORK *CHILDREN AND PETS MUST BE KEPT AWAY FROM THE WORK AREA COMPLETED PRIOR TO THE INSTALLATION *CUSTOMER IS RESPONSIBLE FOR ANY UNFORESEEN CONDITIONS *THE WORK AREA MUST BE CLEAR AND ALL VALUABLES AND WHICH MAY ARISE DURING INSTALLATION. BREAKABLES MUST BE REMOVED FROM THE WORKSITE PRIOR TO WORK *THE FINAL KITCHEN POINT WORKSHEET MUST BE SIGNED BY BOTH BEGINNING THE CUSTOMER AND STORE ASSOCIATE.A COPY OF THE FINAL, `CUSTOMER MUST UNDERSTAND THERE WILL BE A PERIOD DURING SIGNED KITCHEN POINT WORKSHEET MUST BE GIVEN TO THE CUSTOMER THE INSTALLATION WHEN THE JOBSITE AREA WILL BE COMPLETELY AND INSTALLER. UNUSABLE. *NOTE:THE HOME DEPOT DOES NOT PROVIDE THE FOLLOWING `CUSTOMER MUST UNDERSTAND THERE WILL BE A PERIOD DURING SERVICES(AS PART OF KITCHEN INSTALLATION PROGRAM) THE START OF THE JOB.OTHER ARRANGEMENTS MUST BE MADE BY *ADJUSTING OPENINGS OR WORK INVOLVING LOAD BEARING WALLS CUSTOMER DURING THIS TIME FOR ACTIVITIES USUALLY HELD IN *REMOVE,ALTER OR BUILD LOAD BEARING WALLS(OTHER THAN THE JOBSITE AREA. STUD WALL FRAMING). *THE WORK AREA WILL BE CLEANED UP DAILY,BUT DUST AND *INSTALLING SKYLIGHTS CONSTRUCTION RELATED DEBRIS AND NOISE WILL BE INEVITABLE *STRUCTURAL ALTERATIONS OR REPAIRS THROUGHOUT THE INSTALLATION. *ALTERATIONS TO EXTERIOR OF HOME *ALL POSSIBLE STEPS WILL BE TAKEN TO MINIMIZE SPREAD OF *REMOVAL OF VINYL FLOORING WORK AREA DUST TO OTHER PARTS OF THE HOME.CUSTOMER SHOULD END OF INSTALL#1 INSTALLATION #2 REF# 103 ***CONTINUED ON NEXT PAGE*** Page 7 of 9 NO. 3480-421662 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 8 of 9 NO. 3480-421662 ESTIMATED INSTALL BEGIN DATE: 06/26/2011 ESTIMATED INSTALL END DATE: 07/26/2011 BASIC INSTALLATION LABOR: SKU I DESCRIPTION I QTY I UM I TAXI PRICE EACH I EXTENSION 772-078 1 GRANITE 3CM-NAT/ 1 0.001 SFJ N 1 $0.011 $0.00 OPTIONAL LABOR SELECTED INCLUDES: OPTION DESCRIPTION QTY UM TAX PRICE EACH EXTENSION 20 REVERE STAINLESS STEEL SINKS-STANDARD MODELS/NCFU2115 SINGLE BOWL 1.00 EA N $269.00 $269.00 23 UNDERMOUNT INSTALLATION -STAINLESS STEEL(LABOR ONLY- FINISHED EDGE, 1.00 EA N $249.00 $249.00 MOUNTING AND CRADLE)/ 67 *PROMO 6/23-7/10/11 NATL* FREE EDGE UPGRADE W/25 SF MIN PURCHASE. ORDER 1.00 LF N $0.00 $0.00 PAID BY 7/10-ADJUSTMENTS BY 10/2. NOT COMBINABLE W/SPECIAL BUY PROMOS.NO CREDIT APPLIED IF OFFER REFUSD. STANDRD FAB& INSTALLATN CHARGES APPLY. LMT 1/H-HLD/GROUP B 68 *PROMO 6/23-7/10/11 NATL* FREE COLOR UPGRADE W/25SF MIN PURCHASE. ORDER 44.65 SF N $70.00 $3,125.50 PAID BY 7/10. ADJUSTMENTS BY 10/2. NOT COMBINABLE W/SPECIAL BUY PROMOS. NO CREDIT APPLIED IF OFFER REFUSD. STANDARD FAB& INSTALLATN CHARGES APPLY. LMT 1/H-HLD/GROUP E INSTALLATION SITE NAME: KANJOLIA, RAVI &SARITA INSTALL LABOR CHARGE: $3,643.50 ADDRESS: 150 OLD FARM RD TRIP CHARGE: $0.00 CITY: NORTH ANDOVER STATE: MA ZIP: 018451130 CREDIT FOR DEPOSIT/MEASURE: $0.00 COUNTY: ESSEX SALES TAX RATE: 6.250 TAX: Merchandise- N LABOR- N • $3 279.15 PHONE: 617 755-0189 ALTERNATE PHONE: 978 975-7183 INSTALLER SPECIAL INSTRUCTIONS: JUPERANA PERSIA WITH BULLNOSE EDGE REVERE SINK 2115, 4" HIGH BACKSPLASH BASIC INSTALLATION LABOR INCLUDES: 'IN HOME INSPECTION TO VERIFY LAYOUT,MEASUREMENTS,SPECIAL 'EASED EDGE ON BACKSPLASH(ALL EXPOSED EDGES) INSTALLATION REQUIREMENTS AND TEMPLATING 'SUBTOP OR SUPPORT STRIPS •BASIC INSTALLATION OF COUNTERTOP 'GROUP A EDGE DETAIL 'ONE SINK OR COOKTOP CUTOUT(TOPMOUNT)PER PROJECT *FINAL CLEAN UP OF ALL DEBRIS RELATED TO INSTALLATION 'FAUCET HOLE DRILLING(UP TO 4 HOLES) 'DELIVERY WITHIN 30 MILE RADIUS OF STORE 'WALL SUPPORT CLEATS AS NEEDED AT CORNER CABINETS 'EASED OR RADIUS CORNERS UP TO 3/4"MAX UNLESS STATED ABOVE THIS INSTALLATION DOES NOT INCLUDE: ***CONTINUED ON NEXT PAGE*** Page 8 of 9 NO. 3480-421662 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: KANJOLIA Page 9 of 9 NO. 3480-421662 INSTALLATION #2 (Continued) REF#103 WINDOW SILLS/GARDEN WINDOWS AND PASS THROUGHS MILEAGE BEYOND 60 MILES FROM STORE ONE WAY CABINET BUMP OUT REPAIR OR ALTERATIONS TO EXISTING CABINETRY CUT AROUND POSTS OR ODD SHAPES WARRANTY ON TRAVERTINE,MARBLE OR HONED GRANITE SUPPORT MATERIALS FOR OVERHANG(REQUIRED FOR OVERHANGS>6") CUSTOM EDGES ON BACKSPLASH END OF INSTALL#2 TOTAL CHARGES OF ALL MERCHANDISE & SERVICES =91:1014: $22,556.33 SALES TAX $0.00 TOTAL $22,556.33 BALANCE DUE $0.00 END OF ORDER No.3480-421662 Page 9 of 9 NO. 3480-421662 Customer Copy Locationd No. A00 1.2, Date NORTp TOWN OF NORTH ANDOVER P Certificate of Occupancy $ — �� Building/Frame Permit Fee $ t Foundation.Permit Fee $ ' Other Permit Fee $ TOTAL $ Check # 24440 __ wilding Inspector