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HomeMy WebLinkAboutBuilding Permit #448 - 64 NORTH CROSS ROAD 12/1/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must com lete all items on this page LOCATION �a`�, Print PROPERTY OWNER = ) (a ' - I L tom, 0,eL,,_r Unit# Print MAP NO: PARCEL:/k-5—ZONING DISTRICT: Historic District yes Machine Shop Village yes no 100 year-old structure yes o TYPE OF IMPROVEMENT PROPOSED USE Resid ial Non- Residential ❑ New Building etne family ❑A clition ❑Two or more family ❑Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Se ®Flood a ®Wetlands _ p Watershed Dig stnct� . P P - � a� Y ��1�Wa�er`/Sewers DESC TION OF WORK TO BE PERFORMED: f (Identification Please Type or Print Clearly) W ONER: Name:�V �,,2/P �,�,,,J Phone• Address: CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ '7�U -**6v ? FEE: $ Check No.: `D VReceipt No.: y s Z_ NOTE: Persons contracting with unregistered con tr c rs do not h ve c uaranty f unci ..- T J- 4 :+i tlM ate. .` `$�. - _ -. mature of?'Age–t/Owrier Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer El' Tanning/Massage/Body Art Elswimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS d HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decisionlreceipt submitted yes Planning Board Decision: Comments I Conservation Decision: Comments I 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 l 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 m1n.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 20117une/mi 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 o 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 i ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ 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 New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o 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 Location fi(,�✓OZA �o�s No. e ON.4 Date �oRTh TOWN OF NORTH ANDOVER 3?0�,,..o ,•�tio ' . Certificate of Occupancy $ 3 � ; . Building/Frame Permit Fee $ swcMus Foundation Permit Fee $ c Other Permit Fee $ TOTAL $ Check # 2`t b 5 L wlding Inspector NORTH 1; TONM of Andover , - - o Mass - dover, 1r Q LAKE I� COCMICHEWICK 1,p�oRATED � �� -PERMIT 1 Sl BOARD OF HEALTH DFood/Kitchen Septic System . BUILDING INSPECTOR THIS CERTIFIES THAT .............��✓....��!.� L&JV �............................... .. .. ................................................................................ Foundation has permission to erect.............. ..... buildings on ......... .. ....... .�...4�. 5 .•••�•••••••••••••••••••••• Rough ........... _ • to be occupied as �.. �.. ............................................................................................. Chimney ....r.. provided that the person accep ing 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 0 PERMIT EXPIRES IN 6 MONS ELECTRICAL INSPECTOR UNLESS CONSTRUC TS 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. Burner Street No. SEE REVERSE SIDE Smoke Det. C> TOY INS'.TAL, -WORKSHEET FOR 0RD #:-422913 0 DOUG & KRISTINE , ALEXANDER Order#422913 w 64 NORTH CROSS RD. Design Description : HD MEAS TV W 10127!11 o NORTH ANDOVER, MA , 01845 Design File Name : A270893B.KIT x FK000047.KIT 62709B03.KIT o 707079F5.KIT o Home Phone : (978) 382-2951 0 Work Phone : (978) 683-9330 extra. SKU-282627 KITCHEN POINT NATIONAL 1st Product Vendor 2nd Product Vendor .F Haul away debris removed from kitchen, cardboard and install debris w 18.0 Job Site Quote Removal of existing cabinet and countertops. _ 20.5 _ Job Site Quote o Removal of existing back lash, patch and finish to smooth surface. 25.0 Job Site Quote o* 4- Pre-Construction,Demolition,Removal,and Raul Away SubTatal ; $1778.00 4- O •'t'+1•!y T_ }... .. •:�.. �.^•.:f...:,.-i: ,%r' .F,^Y, %(s mss:f' .'t.. Ke the number of Cabinets to be Installed In the Quantity Section. '19.0 Each Y * Per Cabinet Installation (includes Wall, Base, Includes Shelves,Fillers, Scribe, Toe Kick, Handles, & Knobs.) + Per Box Basic Cabinet Installation SubTotal ; $1311.00 oa 00 3. ,i;... �. .�G•8y .Sr .a.i�'•'' iA•. A'...:, •.a 7S .. ..'::.•v7:' - 1'7.•+ •.i ;f'', •... »i•;'.'..'1 00 ^T`• i .4u' :"•::=: � r'14;' bb 'j r:.. i. _E�:'f.� .ij^' '' y� � •r-',�-v,.:.::q .' :..r:,,'A•FS . Valance 1.0 Each 3116"skins, decorativeJbaset�rvall and panels, back of cabinetsper panel) 1.0 Each _ Build up base cabinet to offset floor thickness (up to 314°in height, materials provided by 3.0 Job Site Quote installer) ^' v 4*1 a na N O Installation l allation of four deco doors. 5.5 Job Site Quote ^� o Installation of one wood cutlery divider. W Secure peninsula to floor. _ _ �_ _ _—� W r 00 Custom Assembly or Installation SubTotal: $462.40 m , ' (� ) Molding for top or bottom of wall cabinets. Each layer88.0 Linear Foot Uj cc priced separately(includes blocking at no charge) _ — � Molding installation SubTotal : $476.00 •.'y..`' d' ..ra..9' q.2x `'�°.'''�S•`t^ '.i• :i• ,;s: _z .. :_yid '� .' ,W: 1. Remove existing ceiling fan. 55.75 Job Site Quote 2. Supply and install two recessed lights on one switch. 4.Add outlet and pigtail on dishwasher. 5. Add outlet on peninsula. 6. Update existing_kitchen outlets to code. ISu DDly and install (2}two white xenon under cabinet lights. 18.5 ,Job Site Quote w NOTE: When we remove ceiling fan we may not be able to remove the wires, We will 0.0 Job Site Quote cc either put on a blank plate or we can make it a recessed light for an additional charge._ _ o Electrical requirements/pricing may vary due to local codes Electrical SubTotal : $1536.97 V f :J •'15 .,'�,r.y;kF�: '.rti:� .,�. y y:;Y,. "39•:;-'^=, f .:ti+ a.S::•.'- h::.': .K`!a .�s.X'V i w n 5 Y {t•'""^.... .'Snl iiL°. ".1.. ..[: .A '•.R nV ']' \. : ... > 'A`'i .:. .• 1. Disconnect gas stove. 48.5 Job Site Quote 2. Hook-up sink, faucet and garbage disposal. Drain baskets supplied by owner. 3. Hook-up dishwasher. oa NOTE: If Kitchenaide is purchased there could be installation issues. 4. Hook-up gas stove. NOTE: If LG additional changes will apply. _ — 3 Supply and connect temporary sink. We will disconnect for countertop template and re- 25.5 jJob Site Quote install. We will disconnect for countertop installation. * Plumbing requirements/pricing may vary due to local codes N N 0 Plumbing SubTotal; 51531.80 0 ON Install Built-In A lip ance 2.4 Jab Site Quote Install Free StandingAppliance 2.0 Jab Site Quote opo install micro/hood. 5.6 Job Site Quote o M NOTE: No ductwork included. Put refrigerator and ran-e in lace and level as best we can. 7.0 LLJqb Site Quote CY% 0 UJ Appliance Installadon SubTotal : $462.40 %0 �o a• - •-;rat' =:` "'•..:: ..;•. - ,-y,, _ ,4; f� 4S Flooring and Backsplash Installation SubTotal : $0.00 Drywall Work&Painting SubTotal O Additional Charges(if applicable)SubTotal; $0.04 00 .•" ':i"..� vj. '•�4i' aur ..'? ':.'''•r:.':t-_ •z .{�`::,�.:.: :il A v,?},: f <.S�'. Y ..a, :.Y, ':1 r �'`�%.':4!••.:: :<Y.., .,t:.:.' _ •.`: .:.i'" T— Electrical Permit(cost)_. 115.4 Each _ 4*1 Plumbing (cost) 115.0 Each v Buildin Permit(cost) 1 fivA Each This section is for adding Cost of required Permits for the Job. Permits SubTotal : $395.04 O0 00 „�.• ,, ..�;;.. •,.,.�,`•, : - .,. ',;,rte. �;•,.• cc 41 - i.�.: -., .;y .,_ .. :i.. _ ,f,, `;�. .:9;^.8 } i�'-•'�i' `i..•• Jc ,..y,5::�y.,.:{.�:r :s=:�y'r: •.� ^6. « `:i.. :•� .K<:...:. ..'ij M1_ .✓�1:�::Y•.' ,.1X!'•''k'. .:^t s'�'�:y':-..� :^1 ..:�i "�.' 1 vt'^^.M': V� s.• <,,.. ..,��. .q..•'�":i ',5�•'n•., b <r.%''•: s+`• `7:'.,'. pr 5j;:,:.^n9s'.:: .�5• O: j x }J.9rkJ w .r.•.. FS^,'..�C:�';= .�:;':4i' :>.:1 `' Lead Safe Work Practices SubTotal : $0.04 �. INC General Notes on the Project(Documentation Only--No Cost)SubTotal : $0.00 co N .4- C> . i '�otai tch n'Iei t&Dation Pr© ct :$70.5.?S a 7- THE FINAL KITCHEN ESTIMATE WORKSHEET MUST BE SIGNED BY BOTH T14E CUSTOMER AND ASSOCIATE AND V. THEN IT MUST BE NIANUALLY FAXED TO THE INSTALLER. A.COPY OF THE FINAL KITCHEN ESTIMATE 1-4 00 WORKSHEET MUST ALSO BE GIVEN TO THE CUSTOMER m x 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 latchen installation program). coo Remove,alter or build load bearing walls(other than stud wall framing) o 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 7m(;;7 t Hagar ous Materials SOP Customer Signature: Associate Signature. ' Date Date IL '�7—I v. 0 W 00 a V V 00 00 0o w 4 N b N DETAIL STARTS HERE FAX PURCHASE ORDERS Date: 10/28/2011 Page . 2 FROM: THK HOME DEPOT FAX: (603) 894-04.14 STORE 34SO: SALEM, NH PHONE: (603) 894-1900 xt.. 311 289 SOUTIi BROADWAY SALEM, NH 03079 this number to invoice The Home Depot.) P.O. Nbr 80493184======= For customer: ALEXANDER. DOUG & KRISTINE====_== 282-627 KITCHEN POINT-NAT FROM MEASURE: 422914M01 MEASURE PO#: 80431742 INSTALLATION .LTTE: ALEXANDER, DOUG & KRISTINE PHONE: (978) 683-9330 Ext . 64 NORTH CROSS RD . NORTH ANDOVER, MA 018452 f TRIP CHARGE: $0.00 CUSTOMKR NAME: DOUG & KRISTINE ALEXANDER PHONE : (978) 382-2951 WORK (90) 683-9330• Ext ORDER: 422913 REF # : 01 MERCHANDISE TO BE INSTALLED: iih;r # SICU QUANTITY UM ITKM DESCRIPTION EXPECTED ARRIVAL `02.01 502-321 1 . 00 EA APC: ALL-PLYWOOD BOX 1+201 50202 502-321 1 . 00 EA WHITE WHITE {+a} 11/24/2011 5020:3 502-321 4 . 00 EA VFR8 VALLEY FORGE MLDG 8 FT 80204 502-321 3 . 00 FA TB8-WD14 TOE BOARD .25 WOOD 50205 502-321 4 . 00 EA SHKRCRMB SHAKER CROWN MLDG S0206 502-:321 1 . 00 EA BP9634 . SCRSC R BACK PNL 96W 34 . 50207 502-321 4 . 00 EA .W213OR DOOR S0208 502-321 1 . 00 EA 3DB24 .3 DRW BASE 24 50209 502-321 1 . 00 EA WTCD24 WOOD TIERED CUTLERY ORW 50210 502 . 322 1 .00 EA SLS3336L SUPER SUS ASYMETRIC L `30211 502-321 1 . 00 EA 3DB15 3 DRW BASE 15 50212 b02- 321 1 . 40 EA AF-B-R AUTHENTIC END BASE R 50213 502-321 1 . 00 EA BER36L BASE EASY REACH 36 LH 50214 502-:321 2 . 00 EA 3DB27 3 DRW BASE 27 50215 502-321 1 . 00 FA F'330 FLR 3W 30H 50216 502-321 2 . 00 EA TF396FH TALL F'LR FULL HEIGHT 3 50217 502-321 1 . 00 EA. U218412L UTILITY 21W 84H 12D L 50218 502-:321 1 . 00 EA STK FLUSH TOE S0219 .502-321 1 . 00 FA SB39ST SINK BASE 39 TILT OUT 50220 502-321 1 . 00 EA U218412R UTILITY 21W 84H 1.2D R S0221 502-32'1- 1 . 00 EP_ FTK FLUSH TOE 50222 502-321 1 . 00 EA BWB18 BASE WASTEBASKET 18W 50223 502-321 1 . 00 EA AE-B-L AUTHENTIC END BASE L AM d 2 L L9' LL£'sur L+ << 90068£09 W06809 MME ti :90 L L-L L-L LOE FAX PURCHASE ORDERS Date : 10/28/2011 Page: 3 ==========-- (U5e this niiml)er t..(,) invc>ice The He>me D(a_pot) P .O. Nbr 80493l84======= For customer: ALEXANDER DOUG & KRISTINE-----__ 50224 502-321 1 . 00 EA TCD18 TIERED CUTLERY DIVIDER 1 50225 502-321 1 . 00 EA B30 BASE 30 DRW 30226 .502-321 1 . 00 EA W1836R WALL 18W 36H RH 50227 502-321 1 . 00 EA AE-W-L AUTHENTIC: END WALL L 50228 502-321 1 . 00 EA W3636 WALL 36W 36H 50229 502-321 1 . 00 EA W1836L WALL 18W 36H LH S0230 502-321 1 . 00 EA AE-W-R AUTHENTIC END WALL R 50231 502-321 1 . 00 EA F336 FLR 3W 3611 x()2:32 502•••:321 1 . ()0 EA W'53'3() WALL 33W =3(;H 50233 502-321 1 . 00 EA FV60 FURNITURE VALANCE 6OW 50234 502-321 1 . 00 EA F330 FLR 3W 3011 S0235 502 321 2 . 00 EA W27-3() WALL, 27W :30H 50236 502-321 2 . 00 EA ID15-W INCREASE DEPTH TO 15" {+ 50237 502-321 4 . 00 EA CLEAR--30 CLEAR GLASS 30"H 50238 502-321 2 . 00 FIA MTP MATCHTNG INTERIOR +% S0239 502-311 4 . 00 EP_ CG PREP FOR GLASS 12-3011H `10240 502 321 1. . 00 EA W3018 WALL 30W 18H 50241 502-321 1 . 00 EA W1536R WALL 15W 36I1 R11 F)0242 ti502-321 1 . 00 EA AE-W-R AUTHENTIC END WALL R .:;0213 502-321 2 . 00 EA BBM8 BASEBOARD MLDG 50244 502-321 1 .00 EA OCM8 OUTSTDF CNR MI,DG 50245 502-321 1 . 00 EA SHKRCRM8 SHAKER CROWN MLDG 50246 502-321 3 . 70 EA SSM SMALL SCRIBE MLDG 8 50247 502-321 1 .00 EA WHITE WHITE {+a} MERCHANDISE WILL ARRIVE AT SITE VIA THE FOLLOWING: Supplier i4 responsible for shipping to the Customer the fallowing merchandise : REF # SKU QUANTITY UM ITEM DESCRIPTION EXPECTED ARRIVAL 50201 502-321 1 . 00 EA APC ALL-PLYWOOD BOX (+20%) 50202 502-321 1 .00 EA WHITE WH1'TE {+Q} 11/24/2011 5020.3 502-321 4 . 00 EA VFRS VALLEY FORGE MLDG 8 FT :0204 502-321 3 . 00 EA TB8-WD14 TOE BOARD . 25 WOOD 50205 502-321 4 . 00 EA SHKRCRM8 SHAKER CROWN MLDG ;,0200 502-321 1 . 00 EA BP9534 . SCRSGR BACK PNL 96W 34 . 50207 502-321 4 .00 EA .W2130R DOOR ! / 50208 502-321 1 .00 EA 3DB24 3 DRW BASE 24 50209 502-321 1 .00 FA WTCD24 WOOD TIERED CUTLERY DRW WLZ d 2LL9' LL£'888' L+ « t Mt68£09 t006809 X308t£ W90 LL-LL-LL02 FAX PURCHASE ORDERS Date: 10/28/2011 Page: 4 -----•= = (i75e t-his number to invoice The. Home Depot) Y.U. Nbr 80493184=--_-__ For customer: ALEXANDER DOUG & KRISTINE======= 50210 502-321 1 . 00 EA SLS3336L SUPER SUS ASYMETRIC L 50211 b02-321 1 . 00 EA 3DB15 3 DRW BASE 15 50212 502-321 1 . 00 EA AE--BR AUTHENTIC END BASE R 50213 502-321 1 . 00 FA BER36L BASE EASY REACH 36 LH ,`x0214 502 -321 2 . 00 EA 3DB27 3 DRW BASE 27 ::;021.5 .502-321. 1 . 00 EA F330 FLR 3W 30H 50216 502-321 2 . 00 FA TF396FH TALL FLR FULL HEIGHT 3 f / :3021'/ ti02-321 1 . 00 EA U2184121, U'I'1 T.TTY 21W 84H 12D L 1 1 S0218 502-32.1 1 . 00 EA FTK FLUSH TOE 50219 502-321 1 . 00 EA SB39ST SINK BASE 39 TILT OUT 50220 502 321 1 . 00 EA U218412R UTILITY 21W 84H 12D R 50221 502-321 1 . 00 EA ):"1.'Y �'l,USH TOE S0222 502-321 1 . 00 EA BWB18 BASE WASTEBASKET 18W SQ22:3 502-:321 1 . 00 EA AE-B-L AUTHENTIC END .BASE L 50224 502-321 1 . 00 EA TCD18 'l' I P.RED CUTLERY DIVIDER 1 { / 50225 502-321 1 . 00 EA B30 BASE 30 DRW `10226 502-321 1 . 00 EA W1836R WALL 18W 36H RH 6;()227 502-321 1 . 00 EA AE-W-L AUTHENTIC END WALL L 1 / 50228 502-321 1 . 00 FA W3636 WALL 36W 36H ;022.9 502-321 1 . 00 EA W1836L WALL 18W 36H LF S0230 502-321 1 . 00 FA AE-W-R AUTHENTIC END WALL R 5023.1 502 :321 1 . 00 EA F336 FLR 3W 36H 502:32 502-321 1 . 00 EA W3336 WALL 33W 36H ()2;3:3 .502-321 1 . 00 EA FV60 FURNITURE VALANCE 60W E0234 502-321 1 . 00 EA F330 FLR 3W 30H WEE d Z L L9' LL£'8$8' L+ « t006809 68£09 t 0069£09 X308h£ 5 :90 L L-L L-L L OZ FAX PURCHASE ORDERS Date: 10/28/201.1 Page: 5 =======-=-== (Use this number to invoice The Home Depot) P .O. Nbr 80493181======= For customer: ALEXANDER DOUG & KRISTTNE======= 50235 502-321 2 .00 EA W2130 WALL 27W 3011 j f 50236 502-321 2 .00 EA I,D15-W INCREASE DEPTH TO 15" {+ f / 30237 502-:321 4.00 EA CLEAR--30 CLEAR GLASS 30^H / I 50238 502-321 2.00 EA MIP MATCHING INTERIOR +% 50239 502-321 4. 00 EEA CG PREP FOR GLASS 12-30"H / f 50240 502-321 1.00 EA W3018 WALL 30W 18H 50241 502-321 1 .00 EA W1536R WALL 15W 36H RH S0242 502-321 1 . 00 EA AE-W-R AUTHENTIC END WALL R 50243 502-321 2.00 EA BBM8 BASEBOARD MLDG 50244 502-321 1 .00 EA OCM8 OUTSIDE CNR MLDG S0245 502-321 1 .00 EA SHKRCRM8 SHAKER CROWN MLDG f f 50246 502-321 3 .00 EA SSM SMALL SCRIBE MLDG 8 3024/ 502-321 1 . 00 EA WHITE WHITE KITCHEN POINT-NAT OPTIONAL LABOR PURCHASED: 01 KITCHEN CABINETS WORKSHEET POINTS FOR DEMOLITION, DEBRIS REMOVAL, ELECTRICAL, PLUMBING AND APPLIANCES (UTILIZE THE KTTCHEN POINT WORKSHEET TO OBTAIN TOTAL NUMBER OF POINTS) Quantity: 113 . 50 UM: EA Price Ea_ : $28 . 00 Extension: $3, 178 . 00 02 PER CABINET INS'T'ALLATION (INCLUDES WALL, BASE, PANTRY, PENINSULA OVEN & APPLIANCE CABINETS . INCLUDES SHELVES, FIL LNRS, SCRIBE, TOE KICK, HANDLES & KNOBS . ) KEY THE NUMBER OF CABINETS TO BE INSTALLED IN THE QUANTITY SECTION. Ouantity: 19 . 00 UM: EA Price Ea. : $69. 00 Extension: $1, 311 . 00 03 PERMIT AND ADMINISTRATIVE FEE (QTY X $1 .00) Quantity: 395 .00 UM: EA Price Ea . : $1 .00 Extension: $395 . 00 05 PER POINT - PLUMBING AND ELECTRICAL ONLY Quantity: 148 .25 UM: EA Price Ea. : $20 . 70 Extension: $3, 068 . 78 AM d W91W 89911- « 90068£09 W068£09 X308t£ W90 L L-L 4-6 40Z FAX PURCHASE ORDERS Date: 10/28/2011 Page: 6 thi_;; number to invoir.-e The Home Oopot) P.O. Nbr 80493184===-=___ For c1.2sl.omer: ALEXANDER DOUG & KRISTINE====__ INSTALLATION TABOR SI7B-TOTAL: $7, 952 . 77 CREDIT FOlt MEASUREMENT: -$99. 00 ----------- INSTALLATION LABOR TOTAL: $7, 853. '/-7 00656520 P .O. Nbr 80493134=====-=- W/W d 2LL9' LL£'888' L+ << t006809 68£09 t 00b8£09 X308h£ 5t:90 LL-LL-LL02 O face of Consumer Affai and Business Regulation 10 Park Plaza - Suite 5170 "h Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 112785 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-CAt 0 50M-04!04-G101216 Address E] Renewal [:] Employment 7 Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only expiration date. If found return to: before the ex = � HOME IMPROVEMENT CONTRACTOR p 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. ATLANTIC,GA 30339 Undersecretary Not valid without signature ------------ ------------•------------ IV CD i i i i 1 i 3"Wall Filler - This window and the measurements 836R W3636 4`' T C� from the right casing of the window over _ to the left are NOT correct-Measurements from the right over are correct _ W -- D 24.DI81 IV1r SL533 ........ ...... .. .... ..... °° — .�. .�. �-- r -- I m Trim and Install panel on backom,� X Cell Inhei ht 145 112" Install Baseboard molding of pen lnsul9.Install(4)21" t ,' cu 9 g ©eco Doors over panel. - ;a. "' M, VJ r 0c The clearance on back and return on o 110 under the beam side of end cab. ,s p ,' ` o CD Is 96 314 End cab has Factory 1: Installed Deco Door on left side m h CUSTOMER WOULD LIKE I PENINSULA OUTLET ON - J �.% BACKSIDE OF PENINSULA Y; I HUTCH AREA:Wall Cabs are 30"High and will be Installed at 81 112"AFF- ; w so the II come down lower then standard Xhis Is Hutch Look is acceptable to g^x gg•'Tall 0, custorner. 3"base and wall fillers trimmed to 518"and installed on 1 side or trimmed Fillers00 to 5116"and Installed on each aideValance trimmed and Installed over to co toekick. Walt Cabs have Glass Doors ID to 16' trimmed to approx 2511$"x84 II C3 .: do each side I 41- _ Rlush TK i ----- — do tall Dabs Doug and Kristine Alexander V i� _- ti and install S® a V 64 North Cross Road '•�; y�'' t: _ G� North Andover,MA 41845 _ -----. <," l—,�. 976-382-2951 a front door--It's V b —�- � ,. + a swinging door W2730 >^e Manuf:Thomasville 4 'k ----- - -- •N. �' Doorstyle:Cottage Maple The ceiling In this space ; T; 5:,98FHI U2164 H Finish;White Paint Is only 83 314"high :.i Full Overlay --�•-- ---- - - ,.. :<;: ;'•�- �~ tai All Plywood Construction i ,A.li dimensions -size designations This is an original design and must TPrint d: 1 /27/2 11 � given are subject to verification on not be released or copied unless Printed: 1012 712011 job site an stimellIftAffit job applicable fee has been paid or job conditio order placed. 'D N All revving#_ �R ® CERTIFICATE OF LIABILITY INSURANCE D /DDn A � 08/01 oa/o1/zo11 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(ies)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 NAME: Marsh USA, Inc. PHONE FAX A1C o Ext): AIC No homedepot.certrequest@marsh.com E-MAILA Two Alliance Center, 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 INSURERS AFFORDING COVERAGE NAICB Fax (212) 948-0902 INSURER A: Steadfast Ins Cc 26387 INSURED INSURER B: Zurich American Ins Co 16535 The Home Depot, Inc. Home Depot U.S.A., Inc. iNSURERC: New Hampshire Ins Co 23841 2455 Paces Ferry Road NW INSURER D: Illinois Natl Ins CO 23817 Building C-20 Atlanta, GA 30339 INSURER ENATIONAL UNION FIRE INS CO OF PITTS 19445 : INSURER F: Illinois union Ias 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. ILTR TYPE OF INSURANCE INSR SUER POLICY NUMBER MMM/uDD CY EFF M/DD OLICY EXP RLIMITS A GENERAL LIABILITY GL04887714-01 03/01/1 03/01/12 EACH OCCURRENCE $ 9,000,000 xi COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDm1,000,000 PREMISES(Ea occurrence) $ XCLAIMS-MADE �OCCUR MED ERCP(Any one person) $EXCLUDED LIMITS OF POLICY RS PERSONAL BADV INJURY $9,000,000 % OF SIR: $1M PER OCC GENERAL AGGREGATE $9,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 9,000,000 X POLICY PRO- LOC $ B AUTOMOBILE LIABILITY BAP 2938863-08 COMBINED SINGLE LIMIT 1,000,000 Ea acadent X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 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 g I WCSTATU- I JOTH- AND EMPLOYERS'LIABILITY TORY LIMITS D ANY PROPRIEfOWPARTNER/EXECUTIVE YIN WC061967354 (FL) 03/01/1 03/01/12 EL.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? aN/A E (Mandatory in NH) WC061967353 (CA) 03/01/1 03/01/12 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ C Workers Compensation WC061967355(KY,MO,NY,WI, )D3/01/1 03/01/12 F TX Employers XS Indemnity TNSC46244151 (TX) 03/01/1 03/01/12 Occurrence/SIR 30M/1M E Workers Compensation WC1192378 (QSI) 03/01/1 03/01/12 SIR 1M DESCRIPTION OF OPERATIONS/LOCATIONS I 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 � " 71_ USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Jthornton_hd 22552223 ADDITIONAL INFORMATION D08/011D 08/01/20011 1 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 INCAY �--- Page 2 ITVY VYV" �0 'SAl1F 0 Am�AdIb— �� TynD wn4ytod M".VWA I\U arru ,&1011� *jvr 90 wTM'^� tied NYLL90 Tpwr 4w cq Trf Q ��' ��,°-pro � Kitchen Installer Job Packet FaxCover The Home Depot Store Name&Number: Sct\e:m, THD Store Phone Number: THD Store Fax Number- THD Sales Associate Name: To Installation Company: A e e Installer Fax Number.�r r_ _ #of Pages Including Cover: (�tJ y ti0 Customer Name- Customer PO Number: uc;s Q ❑ 7 20120 Design Drawings w/customer signature ❑ ❑ 3 Itemized 20/20 Product List ❑ ❑ ( Install Point Worksheet w/customer signature ❑ ❑ Install PO that matches Point Worksheet ❑ ❑ Install Notes/Details ❑ ❑ Molding Details Forms ❑ ❑ ° S C las ❑ Comments: An C nett t am Oo Installers—FaK FOM back to Stora and CoOMM Receipt of all Forma Faxed To Store Name/Number: Fax Number: Faxed By: Faxed Date: HDS-913(07-16-07) Yhie tam is part of Kff-466 only_Not omereble aewaWy. (Fax.to installer) W/Z d ZLL9' LL£'888' L+ <t t0068£09 t0068£09 X308*!£ W90 LL-LL- LLOZ Kitchen Project Closing Checklist Customer Name: �S 4 DL,►Ale-yander Measure P0#: Designer Name: ��T Store# � Know What to Expect Farm-Customer has revreared&signed. Q�Customer signature on final design_ Customer signature on final labor bid. Review Process for Countertop template.fabrication,'Installation VV,_,/Review tentative Project Schedule(based on product derivery dates) Material storage location during Inatallation: i"an/MRn(n1-t�T �t]iscuss customer Surrey and Warranty Site Detalls: Pets(Type/Location 0g,S Installers should access work arra from Parking location or instructions for installer vehicle(,) Jr Restrooms available for insCatiers EfYIES ❑NO Restroorn Location over,e-IF r- --' Telephone available for installers YES ❑NO Telephone Location 56M '�:1�_r Witt other omrtractom be at the job site at the same time7� Company Mame,Contact Person,S Type of +workk completing YES'ffW Alarm It is the customer's respons&ft to deac*ate the alarm on days work wiry iQ perior ?ed N 0 Debris Location(Pals or Receptacle) i t)S-61Ie-C,S � Cutting Location(e.g.,wet saw.miter box.etc.) —D(-i V t U-)Cx of- 6raua e- 1c Water shut-off location Riemcai Panel Location Gas shut-off location t^ Product Delivery Informetiarr: How will Product Arrive at Jobsite? Item erode/# ---—Cu—swmar Home Depot ShpResponsibility Installer NIA kitchen Cabinets ❑ ❑ ❑ Countertop /' ❑ ❑ ❑ Sink G7 ❑ ❑ ❑ Faucet ❑ �/ ❑ ❑ s@'� ❑ 0 C1 ❑ C1 ❑ ❑ 0 ❑ O ❑ 0 ❑ ❑ ❑ ❑ 11 Customer S , r Date: Designer bate= �Wlore y Canary-Cuatamer copy (rax to rr&talrer) KP-OM r07--98-07) W/£ d Z L L9' LL£'M' L+ << %tM8£09 %t06909 MOM 6£=90 L L-L L-6 602 -------------------------------------------------------—q.—__r_�_..------------------------------------------------- -- I 3 1 ho/� Y_ 0 T_- 00 -- Q W3018 x o� 0 F3 W3336 W1536 CO -- - 4;- MW.HOODOCI uC30 (�} 0) CD 0 1) 218412 E o• 0 w 00 ►o — o SLS3336L 30-GAS-RANGE23DS15 V w --- 36'1 3 0� 15";--------79411 +� 211 �G�1 c� V V 1 All dimensions..sire designations This is an original design and must Designed: 10/27/201: given are subject to verification on not be released or copied unless Printed: 10/27/2011 job site said adjustment to fit job applicable fee has been paid or job conditions. order placed. tin N ----------- ---------------- �s270S9iiXIT El 5 Drawing #: -------------------------------- N _ A - - -- 155-i ' - -- - CD CD Q M x 1 336 CD W1836R W3636 W1 836L 3 V L-L - �` _ - _ w NO 0 BER36L 3DB24 24.DISHW SB39ST SLS3336L ' CO w All dimensions size designations This is an original design and must Designed: 10/27/201 given are subject to verification on not be released or copied unless Printed: 10/27/2011 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. A270993B.K1T _ —_ ---— E 4_ J Drawing#_ — — — ------------------------------------------------------------------------------- ---------------------N _---- C� 3 Q W1836R CD 0 4- cc 0 M x 0 CO w 84 7212" CD w CO 0 4- v B B18 B30 BER36L + All dimensions.size designations _ This is an original design and must — Designed 10/271201 given are subject to verification on not be released or copied unless Printed_10/27/2011 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. V A270893B.KIT El 3 _ Drawing#: _--- ___-----__--------_-- ---- 3 1 .i W Co C> M --- ——-------—84C0% W Co %0 __------7 rC> a f N DOOR DOOR DOOR DOOR w 0) 00 w CD CD 4S -G V _2 �0-1117L207 O i lit w 3 A11 dimensions .size designations This is an original design and must Designed: 10/27/201: given are subject to verification on not be released or copied unless Printed: 10/27/2011 job site and adjustment to fit job applicable fee has been paid or job -0 conditions. order placed. Co — ------------- --- - A270893B.KIT EJ 2 brawing if: --------------------- -------------------------------------------- N O 511 o w 4- CO 0 M x 0% 0 w cc No .9- CD Mlet .� C3� TF39 U218412L U2184TF396FH o� 0 w V CO V V + w 05 —_ ---------- ------ - _----_-----_ ....... T............. N All dimensions_.size designations This is an original design and must Designed. 10/271201 given are subject to verification on not be released or copied unless Printed: 10/27/2011 job site and adjustment to fit job applicable fee has been paid ox job conditions, order placed. ------ ----- — — — A270893B.K1T----- F-1 ,6 _ Drawing#; -----------------------.-------------------------------------------------------------------------------- 0 54 5 _ CD -- --------------------- 4- cc M x F3 V112730 V112730 W r-IV t D1. 0 CO f � CO 3DB27 3DB27=F330 41- V V V . 4 ,,---2 7" Of .All dimensions _size designations i This is an original design and must Designed: 10/27/201 . given are subject to verification on not be released or copied unless Printed: 10/27/2011 _ job site and adjustment to fit job applicable fee has been paid or job V conditions, order placed. j 0 — w A270893B.KIT EL ] Drawing#: File name: A270893B,KIT Description: HD MEAS TV 1027111 CATALOG THMASVIL Supplier Thomasville Wall doors: Cottage Maple Drawer fronts: Tall doors: Drawer pulls: Base doors: Cottage Maple Door pulls: Door style: Cottage Maple Item Ref Qty Description User Cade Manuf, Code Fin. Side 6 1 Utility 21w 84h 12d Lh U218412L U218412L B 6,1 1 Flush Toe FTK FTK B 7 1 Utility 21w 84h 12d Rh U218412R U218412R B 7.1 1 Flush Toe FTK FTK B 8 1 Back Pnl 96w 34.5h Crsgr BP9634.5CRSGR SP9634.5CRSGR B Modifications: width= 84" width2= 0" height= 34 1/2" depth = 0 114" g 4 DOOR .W2130R B 10 1 3 Drw Base 24 3DB24 3DB24 B 10.1 1 Wood Tiered Cutlery Drw 24 WTCD24 WTCD24 B 11 1 Super Sus Asymetric L33 R36 Lh SLS3336L SLS3336L 12 1 3 Drw Base 15 3DB15 3DB15 B 12.1 1 Authentic End Base R AE-B-R AE-B-R B 13 1 Base Easy Reach 36 Lh BER36L BER36L B 14 2 3 Drw Base 27 3DB27 3DB27 B 15 1 Sink Base 39 Tilt Out 8839ST SB39ST B 16 1 Base Wastebasket 18w BWB18 BWB18 B 16.1 1 Authentic End Base L AE-B-L AE-B-L B 17 1 Base 30 Drw B30 B30 B 18 1 Wall 18w 36h Rh W1836R W1836R B 18.1 1 Authentic End Wall L AE-W-L AE-W-L B 19 1 Wall 36w 36h W3636 W3636 B 20 1 Wall 18w 36h Lh W1836L W1836L B 20.1 1 Authentic End Wall R AE-W-R AE-W-R B 21 1 Wall 33w 36h W3336 W3336 B 22 1 Furniture Valance 60w FV60 FV60 B Modifications: width = 54 5/8" width2= 0" height= 41/2" depth= 0 314" Print date: 10/27/2011 Page 3/5 WAL d 2LL9' LL£'888' L+ << t006809 t006909 09 X308 £ Lt:90 LL-LL-LL02 File name: A270893B.KIT Description: HD MEAS TV 1027111 Item Ref Qty Description User Code Manuf. Code Fin. Side 23 2 Wall 27w 30h W2730 W2730 B Modifications: width = 27 width2= 0" height= 30" depth= 15" 23.1 2 Increase Depth To 15"{+%) ID15-W I015-W B 23.2 4 Clear Glass 30"h CLEAR-30 CLEAR--30 B 23.3 2 Matching Interior +% MIP MIP B 23.4 4 Prep For Glass 12-30"h CG CG B 24 1 Wall 30w 18h W3018 W3018 B 25 1 Wall 15w 36h Rh W1 536R W1536R B 25.1 1 Authentic End Wall R AE-W-R AE-W-R B 26 4 Valley Forge Midg 8 Ft VFR8 VFR8 Modifications: width = 96" width2 w 96" height= 0 314" depth= 1 114" 27 3 Toe Board .25 Wood TB8-WD14 TB8-WD14 Modifications: width = 96" width2 = 96" height= 41/2" depth= 0 318" 28 4 Shaker Crown Mldg SHKRCRM8 SHKRCRM8 Modifications: width = 96" width2= 96" height= 2" depth= 1 1/2" 29 1 Fir 3w 30h F330 F330 B Modifications: width = 05/1611 width2 = 0" height= 34112" depth = 24" 30 2 Tall Fir Full Height 3w 96h TF396FH TF396FH B Modifications: width= 2 3/4" width2 = 0" height= 84" depth = 12" 31 1 Fir 3w 36h F336 F336 B 32 1 Fir 3w 30h F330 F330 B Modifications: width T 0 5/8" width2 = 0" height= 30" depth= 15" "33 1 All-Plywood Box {+20%) APC APC `34 1 White {+%) WHITE WHITE "35 8 Cottage Maple COTTAGE-MPL COTTAGE-MPL Print date: 10/27/2011 Page 415 WE d ZLL9' 41£'899' 6+ << t006$£09 tLt069£09 MOM Z�:90 4L-Lb-LLOZ File name: A270893B.KIT Description: HD MEAS TV 10127/11 Item Ref Qty Description User Code Manuf. Code Fin. Side x36 13 Cottage Maple COTTAGE-MPL COTTAGE-MPL *37 2 Baseboard Mldg BBM8 BBM8 *38 1 Outside Cnr Mldg OCMB OCMB *39 3 Small Scribe Mldg 8 SSM SSM "40 1 White {+%) WHITE WHITE Volume: 274.20 Weight: 42.00 *: non-plan item PROJECT SUMMARY Volume: 274.20 Weight: 42.00 Print date: 10127/2011 Page 515 WEL d Z L L9' LL£'888' L+ << tLt069 09 t0l)%8£09 X308t£ Zt:90 L L-L L-L LOZ ' G KITCHEN MOLDING/CUSTOM DRAWINGS T;M4) 6 7 8 Date: CUSTOMER N nvC� ckr,d r �s N .tic xa+ndev -- -- DESIGNER: MEASURE PQ# INSTALL PO#: STORE#: _&o.. . --- 1 �� 3 "hilwt Height L . , &arra t n9nMr._ . _r. -'- Mokling D',mensioes: - a Mowing Podumk : __......._. Attach 20/24 dmvAngs if avadabie. lftxn - { S - 4 -- -- 5-- ......... - , UPON&. , i B w- , ' I ; { —4- -4— ie�� � .... = - .............. _ Cd% i r : { .. .. i i A rew STEP 4,fox VAs form to the ICU!') Thio form is WA OF Kit CP5rW.Not wdw**,mow ste{v. -I Maidinq �f' co'sk : A 5i" or mop • Aret% Are YOO bt& may . OVIWA%, 40 Ckrop shaker *v wn40 Celb ► cfiV, f' ...... .. . �~' .... &/I IA pyt Xr�, �' �', ,••- .:..�� .�:H•ar�t v��i • �s ni 1 solid wood crown SWCRM8 17215 d 2LL9' LL£'M' L+ << t00168£09 %t06909 X308 £ 2t:90 LL-LL-6602