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1 LEVAL RD - BUILDING INSPECTION (2) , '�P Gk- �- G Zdi'- ' � d ��.G /!�� _ 'a --- 17it Comnwmrr;ilih of��1:u�;irhwc115 . . �/'1 y; �a Uu,irJ u(Iluilding Rrgul;itions anJ Sr;mJarJs C'fl'1'UF � �1 ;�� 1us.a:rchusrtts Siat¢ DuiiJing Codc. 79U CM1IR 1,�11:.�t � 'L,,•• /t.�ri.�rJ Ilur'tl// 13uiWing P¢rmit ,lpplir;itiun 'fo C'unstruct, R�p;�ir. R¢novat¢ Or Dcmulish a Unv-ur Tnn-Piuqrh• U�rrlliu,� Thi�Sretiun For 011iciul Uu Onl l3uilJing Pemiit Numbcr: __ Uat ,1p IimJ• )ui Jin�l)Illci�l(Nrinl� �un�) . ��I � Ualr SECTION I:SITE IN R�IATION I.I Property,lJJreea: �,2 ,�»�»��,��yP,k purcel,Vumben _ / L.Fv��L� �l�� I.la I�ihi�an nca trd strcet? ea no blap Numha I'urcal Nwnher t.! 2anln�In�onnutlont i.� Prop�rty Dlmen�lon�t Luniny Diytric� I'n�pu.cd U�—' Lut Arou Is Itl 4 Pronlugo�Ip 1,1 Bulldlna Setbuka(R) F'ron�Ywd SiJv Yunb R�ar Y;vJ Rry�� ProviJcd Rryuim) . Pruvid.d HCyU1R'd ��NVlt�ty� 1.6 1Vwter SuPP�Y�IM.G.1.c. aU.§»l 1.7 Ftaod Zone Inform�flons I.a S�w��Dlapo�al Sy�tem: Ihiblic O Prirato❑ Znna: _ UuuiJe Flood'Lun�? Chack iY �ue0 Munic(pd C On�(h Jiepunul y�ahm ❑ SECTIONI; PROPERTYOWNERSHIP� 1.1 Own�r�of Records /Zvnl r-v/iG�T� .�� Sl9GE'M N,una 1 Pnnq (uy.Si�lu./.IP / ��(/l/ R p Nu.:mJ Slnwl ' f elephun� Emuil AJdn.v� SECTION J: DBSCRIPTION OF PROPOSED WORK�(eheck oll that opply) New Con�truction Q E.rifling Buildiny❑ OwnenOceupied O Repmin�a) O Allerntfonf�) � Addi�iun ❑ Demulition ❑ Accrosory Bldy,❑ Numberof Unitt Oriaf�eacrip�ion of Propo�rd 1Vork': — Othe� O Sp.ciry: SECTIO�V �; ESTIJI.�TFD CO,VSTRUCTION COSTS ��❑ Estimarad Cosu: �L.ihur;md.\latrriahl O(11c1u1 Ufe Only I. DuilJing � I. Buildiny permi�Fee: S Indlcate hwv lee if JetrnnineJ: ! '. (ilearical s � OStandard Ciry.-Tu��n Applicuion Fee I ? 19unihing S ❑Tutal Projat Cusl�I ltem 6)x multiplier .� 1. Uther Frae: S �--" ' '�" �' � a. �I��di.mir.il ill� u'� i �j Lis�:__ - • '-----------_---'---- ` 11rch.mi..il if�r. '- — f �u ��n•ysi�in� 5 � fafal .\II h�tCf: S —' ._ .. .. . . �� Tula� PrnjCcf Cu�h. S 1 � ('hrcA Vu. ____( hocl, .\im�unt . _ _ l',uh \nt�quq: a ❑ P.iid in Full �l)ultiunding H.d,uice Dua: ��a�-t-� --� �7 v S�'- 5'Z 3 r- s� � � - , . ' tit:('I'IUN S: !'1)Ntil'R1�("flO�V tiF.RYI('h:S S.I C'ons�ructiun Sup�n ixur I.icenir lC tiLl ('j ��- -- .... �;.�r;��hi�� I ic�u,u Nwnhcr � � �r�(�l�a�^�? ��J(5..ati � _.. ._---- N.une�dCSl. 11��ldef Ii+ICSl. 11�xl�.•hclo��1.'_"- _ '- - �j6/, � - ' -'-'_---- 'f, � 1)eicripliun 3 �1.� �l -------_. .--- � � N��. .mJ Streel _�--- i 1 nresuieieJ�UuilJin f�i io ly,ilOtl cu. II.1 lic*IricluJ I:C1 Pdmil I)��cllin GU'vvr G 1 (�/�L.�S— -- � �r,�;,,�� l'ii�il'��n.Sia�c.Lll' HC NaHin Cawrin , . µ�y N'ind��v.mJ tiiJin ...--" gp 5alid I�ual I)urning Appliuncef Gr' �� Sr / �� I Inruluiion � p D¢moliliun 1'.I�• hunu �" �c, I'm:iil:�JJn�y �.2 Rr�IftcreJ Ilun�t Inq�rn�r��t Cuidrnelo�lFI1C) � �s� 2 1 S ,p� — IIIC' R¢yblr;ilion Nmnlxt li��+iriili��I)ul� L� I IIC Comp iq N,una ur IIIC Itmyi,tr�1it Nai — ^ � �/k�7lSd/I/ �jU � LITYII0IIIIM1Y9 Nu.;u�J 5 <<_ u�d 5 �3 S S6C "`G� �'�/-t!1//, �� r.i, n��e ci ITown.sinte zIP SECTIOIV 6i WORKER9'COMPEN9ATION INSUMIVCB AFFIDAVIT(M.G.1.e. Ill.� 25C(6)) Worken Compenauloe�^��o^ce°mdavil mu�t be campleted and submined with thi�applicedon. Failura ta Provid° �hi�afildavit will result in tha denial of tha I:auance of the buildinQ permit. SignedAtlidavitAltached? Yes ..,•••,••• No...........� SECTIOIV 7�t OWNER AUTHORIZATION TO 8B CO�IPLETED W HEN OWIVER'9 AGENT OR CONTRACTOR APPLIES FUR BUILDINC PERb11T I,aa O��ner of�ha subject property.hereby nu�horiza Iicatlon. ta act on my behnlf,in all mutten relative to work authorized by thl�bulldin�{perm�t upP Duta I'nnt Uwiw�f Nwnu lElectranic SiunuWrc) SECTION 7b:OWNEiI� OR AUTFIOtIIZED.►GENT DECLARdTtOIV By en�ering iny numi'c„i n.'s hr re ana�„`u'iQ�o hhe beet of my knowledga and ndentondingQ infurmnliun containad in this opD D�ta I'rinl l)��i ur:\wh�+tircd�\`CtII�V N11111�(I'IC�lfVI11C SIuIIAIUN) vo res� I inut regisiaral inbhe�Hume hnprovan�tnt1Cm�r IcwrIHlCI Progr ml.n�all�u� `have acass to the�bivatiun��racror v�,��,��i��.�r SuJr.v�iylnfomr�un un he Conlstruction Supen ior Lia1nse cin be found atC Pru�ru.��,�n be`tbunJ m � \1 han subsc�nli�l��rk is plann.d, pru�iJa ihe inl'urmativa bciow: �including y;uage. tinishtJ basemcnt itli.s,dc.ks��r porclu I'�+t,J tloor arc�i�y. �1.1 .�------'- f labii.ibla ruom count - -. . . . . . � lrtoii li�ing ,iroa i iy. il.� ... ._. _... . .. �wnhcr ol'h.Jruunu . . . . � \wuh.ral'lirepla.ei .. ... _ . - --- \wube�ul'hallh,uht . . . I i �unihcr ol'ha�hnwmt , . - � �umh.r ol�..Ai� p��rch�s , I'�p��i(he.�luigi�.t.in Il��an I'n.la�.J �� \��t ii�CJ��IIIy NQCIII I � � ..�'�q.l� ��lU��'�I \��IIIIfC �'J�qAL� Illlll �`C•Uh�111111C�� f"�JI�I� ��fu�dCl��t)1•� Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant information �t r�r r/t Please Print Legibly. Nnine(Busiii,s�organizatiorulndividual): etetc-614Mr"//}J[.(/%SQviZ Address: X t// City/State/Zip: rN �& V&4 Phone ✓E: Are you a pl'yer?Cheek the appro CITY OF S.U.E,NI, NLkSSACHLSETTS Typo of project (required): 1. am a umploycr with' • 3 BUILDING DEPARTNIEINT � ' It 120 WASHINGTON STREET, 31e FLOOR TEL (978) 745-9595 listed on the attached sheet, t F.ALx (978) 7.10-9846 KI\[BERL.EY DRISCOLL These sub -contractors have MAYOR T Hoa(AS ST.1'tFxxx workers' comp. insurance. 5. 0 We are a corporation and its DIRECTOR OF PUBLIC PROPERTY/BCILDING COSL\IIssioNER Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant information �t r�r r/t Please Print Legibly. Nnine(Busiii,s�organizatiorulndividual): etetc-614Mr"//}J[.(/%SQviZ Address: X t// City/State/Zip: rN �& V&4 Phone ✓E: Are you a pl'yer?Cheek the appro box: Typo of project (required): 1. am a umploycr with' 4. 0 1 am a general contractor and 1 6. 0 New construction employees (full and/or part-time).• have hired the sub- contractors 2.0 1 am a sole proprietor or partner• listed on the attached sheet, t 7. 0 Remodeling ship and have no employees These sub -contractors have 8. 0 Demolition working for me in any capacity. (No workers' comp. insurance workers' comp. insurance. 5. 0 We are a corporation and its 9, 0 Building addition required.) officers have exercised their 10.0 Electrical repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MGL 1 I.0 Plumbing repairs or udditions myself. (No workers' camp. C. 152, § 1(4), and we have no 12.0 Roof repairs insurance required.] t employees. LNo workers' ) 3.❑Other comp, insurance required.) •Any applicsnl teat checks box AI must also fill uut the section befowshowing their workers' compenw.iun policy imi'n ation. ' I Lvneowrxcs who submit this aRidnvit indicating They arc doing all work and then hire outride commcmn m,u submit a new aitndavil indicting such :Conimlars that check This box must attached an additiunul sheet showing the mane of the subtonirwoo and their worker' camp. policy infommtion. I am on employer that is providing workers' compeasadon insurance for my employees Below is the policy and job site informatfam insurance Company Name: Policy 4 or Self ices. Lic, d: d 4V Gu L U O Expiration Date: 13 Job Site Address: I L //I91-- City/Slateaip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration data). Failure to secure coverage m required under Section 23A of vJGL c. 152 can lead to the imposition of criminal penalties of a f inc up to S 1,500.00 ond/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a line of up to S'_50.00 a day against file violator. 13e advised that a copy of this statement may be rurwardud to the Office of Investigations of the DIA for insurance coverage verification. t do hereby e miry und� the pu{�s uu�penuhles of perjury that the hefururwlon provided above is true used c orrect ;�9 Qf]ic•ial use duly. Do not write in //Its arru, to be completed by city or town n/jic/ab City nr Tuwn: PermitlLicenteft Issuing Aulbority (circle ane): I. Board of health 2. Building Department .3. Citytfown Clerk 4. Electrical 11"pector 5. Plumbing Inspector 6.Other Contact Terson; _ __ Phone CITY OF S.U1 EM, N-LkSSACHUSETTS BLILD4\G DEP.iRTMENT \ 120 WASHINGTON STREET, 3" FLOOR TEL (978) 745-9595 FAX (978) 740-9846 KI\BERLEY DRISCOLL AVL NYOR T'HO\rAS ST.PIERRa DIRECTOR OF PUBLIC PROPERTY/BUILDING COWMISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL 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 defined by MGL c 111, S 150A. The debris will be transported by: RrcN/arU f%9/�%iISO'/�r (name of hauler) The debris will be disposed of in : S4/- �- R1 - (name of facility) (address of facility) Icbrisa lf: d'n Inature of permit applicant date All dimensions _size designations given are subject to verification on job site and adjustment to fit job conditions. This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. Designed: 7/28/2012 Printed: 7/28/2012 fk000030 Legend Drawing #: 1 No Scale. irtntcnt nY' Public Sufct) RcgttYntiiut`Llcense Construction nd:�rJs pcY: 1 Bo:trd of Buil(lin'_Su ervisor P / ¢. License: CS 30000 ir y. RICHARD d MADISON 3 MADISON AVE =_ w. ADIS AND, MA 01834 INrr "-` 3 •1 Expiration: 71211201 18274.' Trq:.. ommisplon:r. ..�-------- t .i. Jute lo'Y< ', Af� e, i a iness �a � Yd. < <' n iu ar uair Es 6t vnecs �rn .n0.1t ,'-+�NTEi(?fITRACTOR .ypu DBA 4STRU3T,ON y_ �( MADISON AVE r� _ g� 9 -IOVELAND,. MA 0183" ry Undersecrers r i 4 } SPECIAL SERVICES CUSTOMER INVOICE Page 1 of 10 NO. 2686-242605 ---------------------------------------------- Store 2686 SALEM,MA Phone: (978) 741-929q j 50 TRADERS WAY Salesperson: AMC5333 SALEM, MA 01970 Reviewer: Name Home Phone REPRINT • WALTON RON (781)484-7271 Address 1 LEVAL RD WmR Phone (781) 438-9358 Company Name citySALEM JobDesadption KITCHEN 2012-08-13 09:31 sa'eMA Z'p 01970-2815 o°°"y ESSEX j CUSTOMERiPICKUP{#1 MERCHANDISE AND SERVICE SUMMARY od`to� st me right to limit the quantities of merchandise rs REF # W08 SKU # 515-664 Customer Pickup/ Will Call STOCK MERCHANDISE TO BE PICKED UP: -REF#is "� SKU OTY t UM s 4s rwu ..,. „ DESCRIPTION - a � i aPI.:. TAX PRI EXTENSION' R04 307-231 1.00 EA ROCHESTER BISC DROP IN 1 -BASIN SINK/ N 139.00 139.00 R07 528-953 1.001 EAJ BANBURY 1 HDL KITCH FAUCET W/SPRAY SS / $98.001 $98.00 SCHEDULED PICKUP DATE: 08/15/2012 • • $237.00 s _.- ; Il&IO TOMER PICKUP `= REF #W08— ," 1 . n Q VENDOR DIRECT�Sl IP #1 �.., TO: CUSTOMER S/O - MERCHANDISE TO BE SHIPPED: S/O KRAFTMAID ESTIMATED ARRIVAL DATE: 09/01/2012 FACTORY P.O. #86595249 nREF# s s""SKU k OTY r. °PI TAX NPRICEEACH " EXTENSION:' S0901 157-644 1.00 EA 830.2D / B30.2D BASE 30.2 630.2D FSIDES:B HINGES:B Y $292.35 $292.35* 50902 157-644 1.00 EA FPEB / FPEB FURNI P OOD ENDS BOTH % / ATT:B30.2D FPEB Y $43.85 $43.85* FSI DES:B S0903 157-644 1.00 EA SDI15 / SDI1 DRAWER INSERT 15 (FACTORY IN / ATT:B30.2D SDI15 Y $35.40 $35.40* FSID '** CONTINUED ON NEXT PAGE *** WILL -CALL MERCHA P Will -Call items in the store for 7 days only. Check your current order status online at w .myhdorder.com Page 1 of 10 No. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 2 of 10 NO. 2686-242605 jt�cVENDOR DIRECTSHIP #1 TO: CUSTOMER S0904 157-644 1.001 EA B15L / B15L BASE 15L / B15L FSIDES:B HINGES:L Y $178.77 $178.77- S0905 157-644 1.00 EA SB30 / SB30 SINK BASE 30 / SB30 FSIDES:B HINGES:B Y $207.52 $207.52- S0906 157-644 1.00 EA BBCU36{L} / BBCU36{L} BASE BLIND CORNER UNIVERSAL 36 / BBCU36{L} Y $209.97 $209.97* FSIDES:L HINGES:L S0907 157-644 1.00 EA FIB36 / FIB36 FLOATING ISLAND BASE 36 / FIB36 FSIDES:B HINGES:B Y $507.58 $507.58* S0908 157-644 1.00 EA B12R / Bl 213 BASE 12R / Bl 2R FSIDES:B HINGES:R Y $170.36 $170.36* S0909 157-644 1.00 EA REP1 1/2.90{L} / REP1 1/2.90{L} REFRIGERATOR END PANEL 1 / REP1 Y $109.01 $109.01* 1/2.90 L FSIDES:B HINGES:L MODS: W=1" H=90" D=24" S0910 157-644 1.00 EA FPEB / FPEB FURNITURE PLYWOOD ENDS BOTH %/ ATT:REPi 1/2.90{L} Y $16.35 $16.35* FPEB FSIDES:B S0911 157-644 1.00 EA REP1 1/2.90{R} / REP1 1/2.90{R} REFRIGERATOR END PANEL 1 / REP1 Y $109.01 $109.01- 109.01*1/2.90 R FSIDES:B HINGES:R MODS: W=1" H=90" D=24" 1/2.901R) S0912 157-644 1.00 EA FPEB / FPEB FURNITURE PLYWOOD ENDS BOTH %/ ATT:REP1 1/2.90{R}Y $16.35 $16.35* FPEB FSIDES:B S0913 157-644 2.00 EA W3036 / W3036 WALL 3036 / W3036 FSIDES:B HINGES:B Y $260.10 $520.20* 50914 157-644 2.00 EA FPEB/ FPEB FURNITURE PLYWOOD ENDS BOTH %/ATT:W3036 FPEB Y $39.02 $78.04* FSIDES:B S0915 157-644 1.00 EA V45CB / V45CB VALANCE CORBEL 45 {WALL} / V45CB FSIDES:B HINGES:L Y $79.92 $79.92* MODS: W=43 1/2" H=5 1/2" D=0 3/4" S0916 157-644 2.00 EA WF3.30 / WF3.30 WALL FILLER 3 30"H {WALL} / WF3.30 FSIDES:B HINGES:L Y $21.73 $43.46* MODS: W=0 3/4" H=12" D=12" S0917 157-644 1.00 EA W2112L / W2112L WALL 2112L / W2112L FSIDES:B HINGES:L Y $129.35 $129.35* S0918 157-644 1.00 EA W2112R / W2112R WALL 2112R / W2112R FSIDES:B HINGES:R Y $129.35 $129.35* S0919 157-644 1.00 EA WBC3636L / WBC3636L WALL BLIND CORNER 3636L / WBC3636L FSIDES:L Y $248.18 $248.18* HINGES:L S0920 157-644 1.00 EA FPEB / FPEB FURNITURE PLYWOOD ENDS BOTH %/ ATT:WBC3636L FPEB Y $37.23 $37.23* FSIDES:B S0921 157-644 1.00 EA W936R / W936R WALL 936R / W936R FSIDES:B HINGES:R Y $134.60 $134.60* S0922 157-644 1.00 EA FPEB/ FPEB FURNITURE PLYWOOD ENDS BOTH %/ATT:W936R FPEB Y $20.19 $20.19* FSIDES:B S0923 157-644 1.00 EA WF3.42 / WF3.42 WALL FILLER 3 42"H {WALL} / WF3.42 FSIDES:B HINGES:L Y $31.20 $31.20* MODS: W=1 1/4" H=36" D=12" S0924 157-644 1.00 EA W3018 / W3018 WALL 3018 / W3018 FSIDES:B HINGES:B Y $160.89 $160.89* S0925 157-644 1.00 EA W1236R / W1236R WALL 1236R / W1236R FSIDES:B HINGES:R Y $151.08 $151.08* S0926 157-644 1.00 EA FPEB/ FPEB FURNITURE PLYWOOD ENDS BOTH %/ATT:W1236R FPEB Y $22.66 $22.66* FSIDES:B S0927 157-644 1.00 EA WR3318 / WR3318 WALL REFRIGERATOR 3318 / WR3318 FSIDES:B $251.33 $251.33* HINGES:B ;9j; CONTINUED ON NEXT PAGE *'* " Indicates Item markdown Page 2 of 10 NO. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 3 of 10 No. 2686-242605 CT SHIP #1 *VENDOR DIRE(Contin e '. TO:CUSTOMER TREF .,M S0928 157-644 1.00 EA OSC8 / OSC8 OUTSIDE CORNER ACCESSORY / OSC8 HINGES:L Y $21.73 $21.73* S0929 157-644 3.00 EA SH08 / SH08 SHOE MOLDING ACCESSORY / SH08 HINGES:L Y $21.03 $63.09* S0930 157-644 6.00 EA 7025 / 7025 7025 - ANT PWTR & COPPER / 7025 HINGES:L Y $8.76 $52.56* S0931 157-644 22.00 EA 7026 / 7026 7026 - ANT PWTR & COPPER / 7026 HINGES:L Y 8.76 $192.72* S0932 157-644 4.00 EA SCM8 / SCM8 SOFFIT CROWN MOLDING / SCM8 Y $35.40 $141.60* S0933 157-644 4.00 EA LSTR8 / LSTR8 LARGE STARTER MOLDING / LSTR8 Y $145.12 $580.48* S0934 157-644 2.00 EA MTK8 / MTK8 MATCHING TOE KICK / MTK8 Y $9.46 $18.92* S09FR 506-658 1.00 KITCHEN CABINET FREIGHT Y $195.01 $195.01 VENDOR - SPECIAL INSTRUCTIONS: LINE: KMFRAME DSTYLE:CHOSEN DOOR STYLE USTYLE:213N4 DWRSTYLE:NO OPTION WOOD:NO OPTION FINISH:HSO HDW:7026 DSGNR:AMC5333 VENDOR WILL SHIP M�-A WER1 WALTON RON ADDRESS: 1 LEVAL RD CITY: SALEM STATE: MA ZIP: 01970- 2815 COUNTY: ESSEX SALES TAX RATE: 6.250 • $5,200.31 PHONE: 781 484-7271 ALTERNATE PHONE: PAGER: "4' P = END OF VENDOR DIRECT SHIP �R?e, 4 4 INSTALLATION #1 ? TREF .,M #101 ESTIMATED INSTALL BEGIN DATE: 08/24/2012 ESTIMATED INSTALL END DATE: 09/24/2012 BASIC INSTALLATION LABOR: ` k`, DESCRIPTION' n,,,<i a ,OTY _,UM 3 TAX :PRICE EACH?.,,EXTENSION 282-627 IKITCHEN POINT -NAT/ 0.00 EA N $0.01 $0.00 INSTALLATION SITE NAME. WALTON RON INSTALL LABOR CHARGE: $0.00 ADDRESS: 1 LEVAL RD TRIP CHARGE: $0.00 *** CONTINUED ON NEXT PAGE *** ; * Indicates item markdown Page 3 of 10 NO. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 4 of 10 No. 2686-242605 m INSTALLATION #1 .cwt4" ` ' (Contnued)1 REF #101 CITY: SALEM STATE: MA ZIP: 01970-2815 CREDIT FOR DEPOSIT/MEASURE: $0.00 COUNTY: ESSEX SALES TAX RATE: 0.000 TAX: Merchandise - Y LABOR - N $0.00 PHONE: 781 438-9358 ALTERNATE PHONE: 781 438-9358 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: INSTALLING SKYLIGHTS REMOVAL OF VINYL FLOORING STRUCTURAL MODIFICATIONS MUST BE APPROVED BY REGIONAL SERVICES VENT IN WALL MANAGER OR INSTALL MERCHANT ALTERATIONS TO EXTERIOR OF HOME 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/DELIVERY 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, *'* CONTINUED ON NEXT PAGE *** Page 4 of 10 NO. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 5 of 10 No. 2686-242605 >� INSTALLATION;#1 t�;;� � REF #101 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 QiN0—, END OF INSTALL #1 51 '=.n #2 `'. PINSTALLASiS,ION y >W' > s .�.r. s€fib. REF # 110 ESTIMATED INSTALL BEGIN DATE: 07/28/2012 ESTIMATED INSTALL END DATE: 08/27/2012 BASIC INSTALLATION LABOR: _ . =' az.S UM _s TAX SION SKU >- 1 t -` :.. - DESCRIPTION .t: h M'_. , = r= , ' QTY (PRICE EACH ` EXTEN 772-078 GRANITE 3CM-NAT/ 0.001 SF N $0.01 $0.00 OPTIONAL LABOR SELECTED INCLUDES: OPTION` 'i =s,'..,.� '� E ''._.r .., 3 'd DESCRIPTION t , -_ , ..-.. ' , &. _-x ' QTY : ? UM TAX `PRICE EACH :iEXTENSION 2 COUNTERTOP/BACKSPLASH - GROUP B/CACTUS MSI 0.001 SFJ N 1 $58.00 $0.00 7 1 EDGE DETAIL - GROUP A/BEVEL 0.001 LFI N 0.00 $0.00 INSTALLATION SITE NAMEIWALTON RON INSTALL LABOR CHARGE: $0.00 ADDRESS: 1 LEVAL RD TRIP CHARGE: $0.00 CITY: SALEM STATE: MA ZIP: 01970-2815 CREDIT FOR DEPOSIT/MEASURE: $0.00 COUNTY: ESSEX SALES TAX RATE: 6.250 TAX: Merchandise - N LABOR - N • $0.00 "' CONTINUED ON NEXT PAGE Page 5 of 10 NO. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 6 of 10 No. 2686-242605 INSTALLATION #2 ," :' ri. ,max >`.:... '-� µ (Continued) t t ..s'.*m''n- oFF im n PHONE: 781 484-7271 ALTERNATE PHONE: BASIC INSTALLATION LABOR INCLUDES: ' IN HOME INSPECTION TO VERIFY LAYOUT, MEASUREMENTS, SPECIAL ' SUBTOP OR SUPPORT STRIPS INSTALLATION REQUIREMENTS AND TEMPLATING `GROUP A EDGE DETAIL ' BASIC INSTALLATION OF COUNTERTOP ' FINAL CLEAN UP OF ALL DEBRIS RELATED TO INSTALLATION ' ONE SINK OR COOKTOP CUTOUT (TOPMOUNT) PER PROJECT ' DELIVERY WITHIN 30 MILE RADIUS OF STORE ' FAUCET HOLE DRILLING (UP TO 4 HOLES) ' FINAL INSPECTION WITH CUSTOMER INCLUDING INSTRUCTIONS ON ' WALL SUPPORT CLEATS AS NEEDED AT CORNER CABINETS CARE AND/OR TEST PRODUCT TO ENSURE PROPER OPERATION • EASED OR RADIUS CORNERS UP TO 3/4" MAX EASED EDGE ON BACKSPLASH (ALL EXPOSED EDGES) UNLESS STATED ABOVE THIS INSTALLATION DOES NOT INCLUDE: )OW SILLS, GARDEN WINDOWS AND PASS THROUGHS MILEAGE BEYOND 60 MILES FROM STORE ONE WAY NET BUMP OUT REPAIR OR ALTERATIONS TO EXISTING CABINETRY AROUND POSTS OR ODD SHAPES WARRANTY ON TRAVERTINE, MARBLE OR HONED GRANITE DORT MATERIALS FOR OVERHANG (REQUIRED FOR OVERHANGS >6") EDGES ON BACKSPLASH SPECIAL NOTES: "CHILDREN AND PETS MUST BE KEPT AWAY FROM THE WORK AREA . CANCELLING APPOINTMENTS WITH INSTALLERS OR MISSING SCHEDULED APPOINTMENTS MAY LEAD TO ADDITIONAL CHARGES ' REFER TO PRODUCT MANUAL FOR SPECIFIC WARRANTY AND MAINTENANCE INFORMATION. ' IF UNFORESEEN LABOR IS NEEDED TO REPAIR DAMAGE FROM WATER, TERMITES, ELECTRICAL OR PLUMBING PROBLEMS, THERE IS AN ADDED CHARGE WHICH MAY NOT BE AVAILABLE FROM HOME DEPOT SO THE CUSTOMER MUST HIRE THEIR OWN CONTRACTOR TO MAKE THE REPAIRS. ` AN ADULT OVER 18 YEARS OF AGE WITH THE AUTHORITY TO MAKE DECISIONS ABOUT YOUR INSTALLATION MUST BE PRESENT DURING THE INSPECTION (WHEN APPLICABLE), DELIVERY AND INSTALLATION Page 6 of 10 No. 2686-242605 Customer Copy ALL BREAKABLES AND/OR VALUABLE OBJECTS MUST BE REMOVED FROM THE WORK AREA PRIOR TO INSTALLATION ' ADDITIONAL CHARGES AT THE JOBSITE MAY BE NECESSARY TO COMPLETE THE JOB AND/OR BRING THE INSTALL INTO COMPLIANCE WITH LOCAL AND/OR STATE CODES THE INSTALLER MAY DECLINE TO INSTALL THE JOB IF IN THEIR PROFESSIONAL OPINION IT SEEMS UNSAFE, IN VIOLATION OF STATE OR LOCAL CODES OR CANNOT BE PERFORMED TO INDUSTRY STANDARDS ' FISSURES AND VEINING REFERRED TO AS'PITTING" ARE NATURAL FEATURES INHERENT IN MOTHER NATURE. SLAB VIEWING IS RECOMMENDED. SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 7 of 10 No. 2686-242605 „„ 7- v _ INSTALLATION #2 - ,<. ed) ,:n -(Continut Y REF#110 n "END OF INSTALL #2�N ,`INSTAL`LATION�#3' ilhw ll tt, _ REF# 111 ESTIMATED INSTALL BEGIN DATE: 08/11/2012 ESTIMATED INSTALL END DATE: 09/10/2012 BASIC INSTALLATION LABOR m_ `SKU '1, at4'd :w t,, y t4 !`i U} „..'. x,,:KFDESCRIPTION -. * r ., r. , .€ .._ QTY'S: , UM v TAX PRICE EACH s „EXTENSION x' 772-078 GRANITE 3CM-NAT/ 1.00 qFl N 1 $0.01 OPTIONAL LABOR SELECTED INCLUDES: OPTION, "=+=v�1'?I'"01t .HAW@DESCRIPTIONi.""``„4`Ye=,tt ,,+m'>' 'QTY SUM,' TAX :PRICE EACH' °EXTENSION 1 COUNTERTOP/BACKSPLASH - GROUP A/BAINBROOK BROWN 30.00 SF N $49.00 $1,470.00 7 EDGE DETAIL - GROUP ABEVEL 13.00 LF N $0.00 $0.00 23 UNDERMOUNT INSTALLATION -STAINLESS STEEL (LABOR ONLY - FINISHED EDGE, 1.00 EA N $249.00 $249.00 MOUNTING AND CRADLE)/ INSTALLATION SITE NAMES' WALTON RON INSTALL LABOR CHARGE: $1,719.01 ADDRESS: 1 LEVAL RD TRIP CHARGE: $0.00 CITY: SALEM STATE: MA ZIP: 01970-2815 CREDIT FOR DEPOSIT/MEASURE: $0.00 COUNTY: ESSEX SALES TAX RATE: 0.000 TAX: Merchandise - N LABOR - N • $1,547.11 PHONE: 781 484-7271 ALTERNATE PHONE: INSTALLER SPECIAL INSTRUCTIONS: THIS IS NEW PO TO REPLACE PO#86455749 THAT HAS BEEN CANCELED GUST HAS CHANGED GROUP COLOR FROM BTOA .. ''r=�',�: END OF INSTALL43.`� ` .,"� REF # 112 ESTIMATED INSTALL BEGIN DATE: 08/11/2012 ESTIMATED INSTALL END DATE: 09/10/2012 Page 7 of 10 No. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 8 of 10 No. 2686-242605 INSTALLATION #4 y` REF #112 MERCHANDISE TO BE INSTALLED: �< REF #" r SKU QTY" UM - �A�,„ ,-" DESCRIPTION ';`r..� ," R04 307-231 1.00 EA ROCHESTER BISC DROP IN 1 -BASIN SINK R07 528-953 1.00 EA BANBURY 1 HDL KITCH FAUCET W/SPRAY SS S0901 157-644 1.00 EA 1330.21) BASE 30.2DRAWER S0902 157-644 1.00 EA FPEB FURNITURE PLYWOOD ENDS BOTH % S0903 157-644 1.00 EA SDI15 SPICE DRAWER INSERT 15 FACTORY IN S0904 157-644 1.00 EA 615E BASE 15L S0905 157-644 1.00 EA SB30 SINK BASE 30 S0906 157-644 1.00 EA BBCU36 L BASE BLIND CORNER UNIVERSAL 36 S0907 157-644 1.00 EA FIB36 FLOATING ISLAND BASE 36 S0908 157-644 1.00 EA B12R BASE 12R S0909 157-644 1.00 EA REP1 1/2.90[Ll REFRIGERATOR END PANEL 1 S0910 157.644 1.00 EA FPEB FURNITURE PLYWOOD ENDS BOTH % S0911 157-644 1.00 EA REP1 1/2.90JR) REFRIGERATOR END PANEL 1 S0912 157-644 1.00 EA FPEB FURNITURE PLYWOOD ENDS BOTH % S0913 1 157-644 2.00 EA W3036 WALL 3036 S0914 157-644 2.00 EA FPEB FURNITURE PLYWOOD ENDS BOTH % S0915 157-644 1.00 EA V45CB VALANCE CORBEL 45 WALL 50916 157-644 2.00 EA WF3.30 WALL FILLER 3 30"H WALL S0917 157-644 1.00 EA W2112L WALL 2112L S0918 157-644 1.00 EA W2112R WALL 2112R 50919 157-644 1.001 EA WBC3636L WALL BLIND CORNER 3636L S0920 157-644 1 1.00 EA FPEB FURNITURE PLYWOOD ENDS BOTH % S0921 157-644 1 1.001 EA W936R WALL 936R S0922 157-644 1.00 EA FPEB FURNITURE PLYWOOD ENDS BOTH % S0923 157-644 1.00 EA WF3.42 WALL FILLER 3 42"H WALL CONTINUED ON NEXT PAGE*** Page 8 of 10 No. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 9 of 10 No. 2686-242605 INSTALLATIONS#4 �.` $y:s '^(Continued) REF #112 50924 157-644 1.00 EA W3018 WALL 3018 S0925 157-644 1.00 EA W1236R WALL 1236R S0926 157-644 1.00 EA FPEB FURNITURE PLYWOOD ENDS BOTH % S0927 157-644 1.00 EA WR3318 WALL REFRIGERATOR 3318 S0928 157-644 1.00 EA OSC8 OUTSIDE CORNER ACCESSOR S0929 157-644 3.00 EA SH08 SHOE MOLDING ACCESSORY S0930 157-644 6.00 EA 7025 7025 - ANT PWTR & COPPER S0931 157-644 22.00 EA 7026 7026 - ANT PWTR & COPPER S0932 157-644 4.00 EA SCM8 SOFFIT CROWN MOLDING S0933 1 157-644 4.00 EA LSTR8 LARGE STARTER MOLDING S0934 1 157-644 2.00 EA MTK8 MATCHING TOE KICK BASIC INSTALLATION LABOR: .. " ' .; , DESCRIPTIN 'en, .UM PRICE FICH', EXTENSION 282-627 IKITCHEN POINT -NAT/ 1.00 EA N 0.01 $0.01 OPTIONAL LABOR SELECTED INCLUDES: OPTION .""� y,v '' "i r =,"_ --"` _ " *€ ,:DESCRIPT10`S N QTY :�� . UM TAX "PRICE EACH `EXTENSION 3: 1 KITCHEN CABINETS WORKSHEET POINTS FOR DEMOLITION, DEBRIS REMOVAL, ELECTRICAL, PLUMBING AND APPLIANCES (UTILIZE THE KITCHEN POINT WORKSHEET TO OBTAIN TOTAL NUMBER OF POINTS)/ 33.00 EA N $29.00 $957.00 2 PER CABINET INSTALLATION (INCLUDES WALL, BASE, PANTRY, PENINSULA OVEN & APPLIANCE CABINETS. INCLUDES SHELVES, FILLERS, SCRIBE, TOE KICK, HANDLES & KNOBS.) KEY THE NUMBER OF CABINETS TO BE INSTALLED IN THE QUANTITY SECTION./ 14.00 EA N $69.00 $966.00 3 PERMIT AND ADMINISTRATIVE FEE QTY X $1.00)/ 625.00 EAI N $1.00 $625.00 5 PER POINT - PLUMBING AND ELECTRICAL ONLY/ 157.00 EAJ N 1 $20.00 $3,140.00 INSTALLATION SITE NAME-' WALTON RON INSTALL LABOR CHARGE: $5,688.01 ADDRESS: 1 LEVAL RD TRIP CHARGE: $0.00 CITY: SALEM STATE: MA ZIP: 01970-2815 CREDIT FOR DEPOSIT/MEASURE: $0.00 COUNTY: ESSEX SALES TAX RATE: 0.000 TAX: Merchandise - Y LABOR - N $568801 '<d'•' CONTINUED ON NEXT PAGE "' =1 Page 9 of 10 NO. 2686-242605 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALTON Page 10 of 10No. 2686-242605 INSTAL IPHONE: (781)484-7271 ALTERNATE PHONE: I I TOTAL CHARGES OF ALL MERCHANDISE & SERVICES PAYMENTTERMS: 1/3 UPFRONT DEPOSIT FOR INSTALLATION/LABOR Goo o 0 SALES TAX $12,672.43 $325.02 TOTAL $12997.45 BALANCE mir 't; 654.35 ORDER No.' 2686-242605,` ff AK; END'OF 0 I v alga -ww=n,t sm Page 10 of 10 No. 2686-242605 Customer Copy Removal of vinyl flooring unless in installers professional opinion that the job meets industry manageable under The Home Depot Hazardous Materials SOP Customer Signature: deo' ' Date i3 I i 1 Z Associate Signature: Da