32 ORNE ST - BUILDING INSPECTION The Commonwealth of Massachusetts
OR
Board of Building Regulations and Standards 1 IP
al.l'I 1'
Massachusetts State Building Code. 780 CMR. 7i6 edition MUNIIjSF
W Building Permit Application To Construct. Repair, Renovate Or Demolish a Ret i ed Amum
One- or Tiro-Family Dwelling 1. loos
This Section For Official Use Only
Building Permit Num Date Applied:
Signature:
Boil ng Commissioner/ Inspector of Buildings Date
SECTION l: SITE INFORMATION
i
1.1'Zp7 1.2 Assessors Map & Parcel Numbers
1.1a Is this an)accepted street?yes_ no Map Number Parcel Number1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use - Lot Area(sq it) Frontage(ti)
1.5 Building Setbacks(R)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c. 40, §54) 1.7 Flood Zone Information: 1.g Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal ❑ On site disposal a stun ❑
Public❑ Private❑ Check if yes❑ P' Y
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner,'ram �of Record:
Name(Print) Address for Service:
ig aature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building ❑ Owner-Occupied 10Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other Y9 Specify: z+-��-to•..��.
Brief Description of Proposed Work:
n/n ? < s-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ 9� �i/ 1. Building Permit Fee: $ Indicate how fee is deter i ed:
❑Standard City/Town Application Fee =l 6
2. Electrical $ -
❑Total Project Cost (Item 6) x mult'iplier x
�p
3. Plumbing $ -- 2. Other Fees: $ '`i /
4. Mechanical (HVAC) $ - p - List: [J(J
5. Mechanical (Fire $ �� — Total All Fees: $
Suppression)
Check No. Check Amount: Cash Amount-
(3. Total Project Cost: $ j 9s�y' ❑Paid in Full ❑Outstanding Balance Due:
all
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) Z vJ_2 6's
License Number xplrauon Dulc
Namc of CSL- Holder List CSL T (see helow)
Type Description
4ddress o�19 a U UnrestrictLd i up to 35.000 Cu. Ft.)
R Restrict I&_ Family Dwcllin
Signatu M Masonry Only
RC Residential Routing Coverui
Telephone - WS Residential Window and Siding
SF Residential Solid Fuel BU111111gApill1alke IIBI.IIIat1011
D Residential Demolition
5.2 Registered Horne Improvement Contractor(HIC)
HIC CTm y 5=h HaIC,RGegstrant Name Registration Number
Address
Expir tion Date
Si an Telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152. $ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure a) provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .......... Gh No ........... O
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1 11� , as Owner of the subject property hereby
authorize —.323 �� to act on my behalf, in all matters
relative to work authorized by this building permit application.
Signature of Own r Date'
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
1 zd�h , as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and
behalf
Prim
Signature of Owner or Authorized Agent - Date
(Signed under the pains and penalties of perjury)
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC) Program), will Mol have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 1 IO.R6 and I IO.RS, respectively.
2. When substantial work is planned, provide the information below:
Total floors area(Sq. Ft.) (including garage, finished basement/attics.decks or porch)
Gross living area(Sq. Ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/ porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTLIENT
iQ-41 11
NI cl
\l. l_'C W.\9 3EET • SALI\i- \t.\ii.\last ,E 1
rel:'i,'8.745-')595 • F.\x: 979J4C-9946
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance w ith the sixth edition of the State Building Code, 'SO CNIR section i 11.5
Debris, and the provisions of'vtGL c 40, S 54;
Building Permit # - _ is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as define by MGL c
I11. S 150A.
The debris will be transported by:
tname of haultr)
I'lie Jebris will be disposed of in
(numr�f iici;rtY)
—/ �74—e —. _
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
Name(Business/Organimtion/Individual):_ S fsw�J a, r Z 7ja�
Address: o?6b
City/State/Zip: Phone #: i 7 ;TV V V7-Ye>
Are you an employer?Check the appropriate box: Type of project(required):
1.E� I am a employer with -36J 4. ❑ I am a general contractor and I 6. New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g• ❑ Demolition
working for me in any capacity, employees and have workers'
[No workers' comp. insurance comp. insurance.t 9• ❑ Building addition
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I L❑ Plumbing repairs or additions
myself. [Nu workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t a 152, §1(4),and we have no
employees. [No workers' 13.[; Othcr
comp. insurance required.]
*Any applicant that checks box#1 must also fill 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 anew affidavit indicating such.
;Contractors that check this box must attached an additional sheetzhowing-the'name cif the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
[am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic. Expiration Date:--'-3
Job Site Address: O S> City/State/Zip: o,•,.-�� vi 970
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 DIA for insurance coverage verification.
I do hereby certify under the airs and penalties of perjury that the information provided above is true and correct
j
Signature: _ Date' �.%���'7✓/68
Phone#:
Official use only. Do not write in this area,to be completed by city or town of ieial
City or Town: Permit/License#
Issuing Authority (circle one):
L Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
l
JB Sash & Door Co., Inc. JB Replacement Window P
s #:r 070538oposa
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Andersen Excellence Dealer 4
Manufacturers&Distributors C.� Marvin Showcase Dealer �J
DOORS•WINDOWS•FRAN[ES•MILLWORK Velux Skylights
280 Second Street,Chelsea,MA 02150 Interior&Exterior Doors '^ Route: NONE
® (617)884-8940 1-800-648-9339 Fax#(617)884-9288 Therma-Tru/Jeld-WenlSimpson l! Page: 1 of 8
ww .jbsash.com
Custom Manufacturing Shoe;},
��(( Quote: 02/20/08
D'1 Ship To: Sched:
PR0300 C()D INSTALLATION
iN COOK 34 ORNE STREET Print.Pd
ERNE STREET SALEM MA 01970 Date: 02/21/08
\LEM MA 01970 � �p� Time: 08:18 8:18 AM AM
ion e: (978) 144-5806 Phone:
attn: / Cell :
Entd: HALM In: 17 / Out: 17 Terms: COD
Your Order: DON COOK
Customer Instructions
Net
Line # Item Number Descri tion Quantit U/M Net Price Extended
0001.00 Remark: 32 ORNE STREET
0002.00 Remark: 1ST FLOOR
0003.00 Remark: **LIVING ROOM**
ITE 3.00 EACH 224.75 674.25
0004.00 SOMATHEWS ALL
VINYL NTILT CE BEREPLACEMENT T ALL HWINDOW
S/0=33 5/8 X 65
LOW E
2/1 GRILLE BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
05.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 1.00 EACH 1,610.25 1,610.25
00
VINYL TILT REPLACEMENT WINDOW
11 S/0=39 5/8 X 65
l INSULATING GLASS
5 FULL DIAMOND TOP WITH
5 VERTICALE BELOW (LEADED)
OVER1
WHITE HALF SCREEN
0006.00 Remark: **DINING ROOM**
0007.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 224.75 449.50
VINYL TILT REPLACEMENT WINDOW
S/0=33 5/8 X 65
LOW E
2/1 GRILLE BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
JB Sash & Door Co., Inc. JB Replacement Wndows Proposal
Manufacturers&Distributors Andersen Excellence Dealer Quo #: 070538
DOORS•WINDOWS•FRAMES •MILLWORK Marvin Showcase Dealer
Velux Skylights
280 Second Street,Chelsea,MA 02150 Interior 8 Exterior Doors
® (617)884-8940 1-800-648-9339 Fax#(617)884-9288 Therma-Tru/Jeld-Wen/Simpson Route: NONE
www.jbsash.com Custom Manufacturing Shop Page: 2 of 8
Quote: 02/20/08
To: PR0300 Ship To: Sched:
DON COOK INSTALLATION
34 ORNE STREET 34 ORNE STREET Printed
SALEM MA 01970 SALEM MA 01970 Date: 02/21/08
Time: 08:18 AM
Phone: (978) 144-5806 Phone:
Attn: / Cell :
Entd: AA LM In: 17 / Out: 17 Terms: COD Your Order: DON COOK
Net
Line # Item Number _ Description _ Quantity UiM Net Price Extended
0008.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 1.00 EACH 224.75 224.75
VINYL TILT REPLACEMENT WINDOW
S/0=39 5/8 X 65
LOW E
211 GRILLE BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
0009.00 Remark: **KITCHEN**
ill 0010.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 224.75 449.50
VINYL TILT REPLACEMENT WINDOW
S/0=33 5/8 X 65
LOW E
211 GRILLE BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
0011.00 Remark: **BEDROOM I**
I
j 0012.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 194.30 388.60
VINYL TILT REPLACEMENT WINDOW
S/0=25 5/8 X 65
LOW E
1/1 LAYOUT
WHITE HALF SCREEN
WHITE HARDWARE
0013.00 Remark: **BEDROOM II**
I
I
i
i
JB Sash & Door Co., Inc. JB Replacement Windows Proposal
Manufacturers&Distributors Andersen Excellence Dealer Quo #: 070538
DOORS•WINDOWS •FRAMES •MILLWORK Marvin Showcase Dealer
Vemx skylights
280 Second Street,Chelsea,MA 02150 Interior&Exterior Doors Route: NONE
(617)884-8940 1-800-648-9339 Fax4(617)884-9288 Therma-Tru/Jeld-Wen/Simpson Page: 3 of 8
a
8
www.jbsash.com Custom Manufacturing Shop
Quote: 02/20/08
To: PRO3O0 Ship To: Sched:
WON COOK INSTALLATION
34 ORNE STREET 34 ORNE STREET Printed
SALEM MA 01970 SALEM MA 01970 Date: 02/21/08
Time: 08:18 AM
Phone: (978) 144-5806 Phone:
Attn: / Cell :
Entd: AA LM In: 17 / Out: 17 Terms: COD Your Order: DON COOK
Net
Line # Item Number Description Quantity U/M Net Price Extended
0014.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 194.30 388.60
VINYL TILT REPLACEMENT WINDOW
S/O=25 5/8 X 65
LOW E
1/1 LAYOUT
WHITE HALF SCREEN
WHITE HARDWARE
10015.00 Remark: **BATH**
0016.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 1.00 EACH 364.00 364.00
VINYL TILT REPLACEMENT WINDOW
S/0=21 5/8 X 65
TEMPERED OBSCURE LOW E
INSULATING GLASS
1/1 LAYOUT
WHITE HALF SCREEN
WHITE HARDWARE
0017.00 Remark: 34 ORNE STREET
0018.00 Remark: 2ND FLOOR
0019.00 Remark: **LIVING ROOM**
0020.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 3.00 EACH 224.75 674.25
VINYL TILT REPLACEMENT WINDOWS
S/O=33 5/8 X 65
LOW E
211 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
JB Sash & Door Co., Inc. JB Replacement Wndows Proposal
Manufacturers&Distributors Andersen Excellence Dealer Quo #: 070538
DOORS•WINDOWS •FRAMES •MILLWORK Marvin Showcase Dealer
Velu280 Second Street,Chelsea,MA 02150 Intel Skylights
Interior&Exterior Doors Route: NONE
(617)884-8940 1-800-648-9339 Fax#(617)884-9288 Therma-Tru/Jeld-Wen/Simpson Page: 4 of 8
do www.jbsash.com Custom Manufacturing Shop
Quote: 02/20/08
To: PR0300 Ship To: Sched:
DON COOK INSTALLATION
34 ORNE STREET 34 ORNE STREET Printed
SALEM MA 01970 SALEM MA 01970 Date: 02/21/08
Time: 08:18 AM
Phone: (978) 144-5806 Phone:
Attn: / Cell :
Entd: AALM In: 17 / Out: 17 Terms: COD Your Order: DON COOK
Net
Line # Item Number Description Quantity U/M Net Price Extended
0021.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 1.00 EACH 1.610.25 1,610.25
VINYL TILT REPLACEMENT WINDOW
S/0=39 5/8 X 65
INSULATING GLASS
5 FULL LEADED DIAMOND TOP
OVER 5 VERTICLE BELOW OVER 1
WHITE HALF SCREEN
WHITE HARDWARE
i0022.00 Remark: **DINING ROOM**
0023.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 224.75 449.50
j VINYL TILT REPLACEMENT WINDOW
S/0=33 5/8 X 65
LOW E
211 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
0024.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 1.00 EACH 224.75 224.75
VINYL TILT REPLACEMENT WINDOW
S/0=39 5/8 X 65
LOW E
j 211 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
0025.00 Remark: **KITCHEN**
0026.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 224.75 4 49.50
VINYL TILT REPLACEMENT WINDOWS
S/0=33 5/8 X 65
LOW E
211 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
JB Sash & Door Co., Inc. JS Replacement Windows Proposal
Manufacturers&Distributors Andersen Excellence Dealer Quo #: 070538
DOORS•WINDOWS•FRAMES •MILLWORK Marvin Showcase Dealer
Velux Skylights
280 Second Street,Chelsea,MA 02150 Interior 8 Exterior Doors
® (617)884-8940 1-800-648-9339 Fax#(617)884-9288 Therma-Tru/Jeld-Wen]Simpson Route: NONE
www.jbsash.com Custom Manufacturing Shop Page: 5 of 8
Quote: 02/20/O8
To: PR0300 Ship To: Sched:
DON COOK INSTALLATION
34 ORNE STREET 34 ORNE STREET Printed
SALEM MA 01970 SALEM MA 01970 Date: 02/21/08
Time: 08:18 AM
Phone: (978) 144-5806 Phone:
Attu: / Cell :
Entd: AA LM In: 17 / Out: 17 Terms: COD Your Order: DON COOK
Net
Line # Item Number __ Description -Quantity U/M Net Price Extended
0027.00 Remark: **BEDROOM I**
0028.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 194.30 388.60
VINYL TILT REPLACEMENT WINDOW
S/0=25 5/8 X 65
LOW E
1/1 LAYOUT
WHITE HALF SCREEN
WHITE HARDWARE
i
' 0029.00 Remark: **BEDROOM II**
0030.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 194.30 388.60
VINYL TILT REPLACEMENT WINDOW
S/0=25 5/8 X 65
LOW E
1/1 LAYOUT
WHITE HALF SCREEN
WHITE HARDWARE
0031.00 Remark: **BATH**
0032.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 1.00 EACH 364.00 364.00
VINYL TILT REPLACEMENT WINDOW
S/0=21 5/8 X 65
TEMPERED OBSCURE LOW E
INSULATING GLASS
1/1 LAYOUT
WHITE HALF SCREEN
WHITE HARDWARE (NOTE A)
0033.00 Remark: 3RD FLOOR
j 0034.00 Remark: **BEDROOM I**
i
I
aJB Sash & Door Co., Inc. JB Replacement Windows Proposal
Manufacturers&Distributors Andersen Excellence Dealer Quo #: 070538
DOORS•WINDOWS•FRAMES•NfILLWORK Marvin Showcase Dealer
Velux Skylights
280 Second Street,Chelsea,MA 02150 Interior&Exterior Doors
(617)884-8940 1-800-648-9339 Fax#(617)884-9288 Therma-Tru/Jell-wen/Simpson Route: NONE
www.jbsash.com Custom Manufacturing Shop Page: 6 of 8
Quote: 02/20/08
To: PR0300 Ship To: Sched:
DON COOK INSTALLATION
34 ORNE STREET 34 ORNE STREET Printed
SALEM MA 01970 SALEM MA 01970 Date: 02/21/08
Time: 08:18 AM
Phone: (978) 144-5806 Phone:
Attn: / Cell :
Entd: HALM In: 17 / Out: 17 Terms: COD Your Order: DON COOK
Net
Line # Item Number Description Quantity U/M Net Price Extended
0035.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 2O1.55 403.10
VINYL TILT REPLACEMENT WINDOW
S/0=31 5/8 X 57
LOW E
211 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
0036.00 Remark: **BEDROOM II**
0037.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 2O1.55 403.10
VINYL TILT REPLACEMENT WINDOW
S/0=31 5/8 X 57
LOW E
211 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
I
0038.00 Remark: **BEDROOM III**
0039.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 2.00 EACH 2O1.55 403.10
VINYL TILT REPLACEMENT WINDOW
S/0=23 5/8 X 45
LOW E
211 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
0040.00 Remark: **REAR STAIR**
I
I
i
I
Ali
JB Sash & Door Co., Inc. JB Replacement Windows Proposal
Manufacturers&Distributors Andersen Excellence Dealer Quo #: 070538
DOORS•WINDOWS•FRAMES •MILLWORK Marvin Showcase Dealer
Velux Skylights
280 Second Street,Chelsea,MA 02150
Interior&Exterior Doors Route: NONE
(617)884-8940 1-800-648-9339 Fax#(617)884-9288 Therma-Tru/Jeld-Wen/Simpson Page: 7 of 8
®38
www.jbsash.com Custom Manufacturing Shop
Quote: 02/20/08
To: PR0300 Ship To: Sched:
DON COOK INSTALLATION
34 ORNE STREET 34 ORNE STREET Printed
SALEM MA 01970 SALEM MA 01970 Date: 02/21/08
Time: 08:18 AM
Phone: (978) 144-5806 Phone:
Attn: / Cell :
L_L1Entd: AALM In: 17 / Out: 17 Terms: COD Your Order: DON COOKNet
ne # Item Number Description Quantity U/M Net Price Extended
0041.00 SOMATHEWS ALLIANCE BELMONT ALL WHITE 1.00 EACH 358.30 358.30
VINYL TILT REPLACEMENT WINDOW
S/0=33 5/8 X 65
TEMPERED LOW E
2/1 GRILLES BETWEEN GLASS
WHITE HALF SCREEN
WHITE HARDWARE
0042.00 INSTALL INSULATION OF WEIGHT POCKETS 1.00 EACH 875.00 875.00
I
0043.00 INSTALL INSTALLATION OF ABOVE 1.00 EACH 7,500.00 7,500.00
INCLUDING REMOVAL OF DEBRIS
FROM JOBSITE
0044.00 Remark: NOTE A: THE INSIDE CASING OF
THIS WINDOW ARE NAILED TO
THE EXISTING STOPS.
0045.00 Remark: NOTE B: TO HAVE THE 2 LEADED
GLASS TOP SASH REPLACED
WITH 2/1 GRILLES BETWEEN
GLASS DEDUCT $2,909.55 FROM
THE ABOVE TOTAL.
I
I
I
I
I
I
I
JB Sash & Door Co., Inc. JB Replacement Windows Proposal
Manufacturers&Distributors Andersen Excellence Dealer Quo #: 070538
DOORS•WINDOWS •FRAMES•MILLWORK Marvin Showcase Dealer
280 Second Street,Chelsea,NIA 02150 Velux Skylights
Interior&Exterior Doors® Route: NONE(617)884-8940 1-800-648-9339 Fax#(617)884-9288 Therma-Tru/Jeld-Wen/Simpson
Custom P Page: 8 of 8 Shop
Quote: 02/20/08
To: PR0300 Ship To: Sched:
DON COOK INSTALLATION
34 ORNE STREET 34 ORNE STREET Printed
SALEM MA 01970 SALEM MA 01970 Date: 02/21/08
Time: 08:18 AM
Phone: (978) 144-5806 Phone:
Attn: / Cell :
Entd: AALM In: 17 / Out: 17 Terms: COD Your Order: DON COOK
Net
iLine # Item Number Description Quantity U/M Net Price Extended
i
J.B. Sash & Door Co. takes no responsibility for unforeseen deterioration of structural
members in walls in which new window or door units are to be installed. We also will not
be held responsible for changes to plumbing or electrical systems. Furthermore, existing
shutters. storm windows, and shades may not fit once your new replacement windows are
installed, and as such is the responsibility of the homeowner.
Payment in full is to be collected by installers at the conclusion of all jobs. In
situations where punch list items exist at the completion of installation, JB Sash
will determine a reasonable amount of the balance due to be retained by the customer
until punch list item(s) have been completed. Any and all costs incurred in collection
of outstanding balances. whether or not resulting in litigation. including but not
limited to reasonable attorney's fees are the responsibility of the undersigned.
We PROPOSE hereby to furnish material and labor - complete in accordance with
above specifications. for the sum of:
NINETEEN THOUSAND FIVE HUNDRED SEVENTY-FOUR DOLLARS AND 83 CENTS 19,574.83
-----------------------------------___-------------------------------______________
Payment to be made as follows: 33 1/3% DEPOSIT
BALANCE DUE C.O.D.
Authorized Signatu e:
JBS MASS. HOME IMPROVEMENT CONTRACTOR REGI 52
ACCEPTANCE OF PROPOSAL - The above prices, specifications and conditions are
satisfactory and are hereby accepted. You are
authorized to do the work as specified.
j Payment will bemade as outlined. above.__.a. ._
Date of acceptance: Signature: 7�, c r, y JrtT
PRICES SUBJECT TO CHANGE WITHOUT NOTICE
ICI
Merchandise. . . : 19,041.50
Tax. . . . . . . . . . . : 533.33
Misc Charges. . : 0.00
Quote Total . . . : 19.574.83
JB Sash & Door Co., Inc.
280 Second Street Chelsea MA 02150 Tel (617)884-8940 Fax (617)884-9288 Website www.'bsash.com
Workers Compensation: WCI-111-243 358-014 LIBERTY MUTUAL
Liability: BKW 065306266 OHIO MUTUAL
Board{oamcu�t,'u1s a ✓lfamrc/rT<oetft -
Board of Buil$ing Regulaf. ns and Stafldards.
Construction Supervisor License
License: CS 67268
ExpI ation--trU211.2009 Tr# 10085 .
Restn�ctvn. :IG� j
RICHARD L BERTOLAMI' j
M SUNSET DR
BURLINGTON MA 01803" Commissioner
-�� � a112P. T%Cl`;�lP1jb2C��/'LfC1CjfX��2 ,E(�G4YtG4
Board of Biuldtng Regulat ns and Standar s
One Ashburton Place - Room 1301
• - Roston_ Massachusetts 02] 08
Rome Inlprovvenient Contractor Registration �
Registration: 152085
Type: Private Corporation
Expirat=on; 7/28/2008
J B SAH & DOOR CO, INC. !
RICHARD BERTOLAMI
280 SECOND STREET
CHELSEA, MA 02150
i
Update Address and return card. stark reason for change.
Address Renewal Employment Lost Card
pcE 7,At Ca SOM-05/X PCAa£4
k Ir al bull tin License vi i egistratiton 1 Ihd for In IA idut usl nnlN'
HOME IMPROVEMENT CONTRACTOR before the eipiration (late. If found return to:
a Board of Building R miations mid Standard,
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Une.Ashbm ton i'lac,Rua 1301
Expiration r. 8 DOE Boston. �I i ),1t7A
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