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HomeMy WebLinkAbout43874-Z 1 Town of Southold 8/21/2019 0 P.O.Box 1179 v' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40649 Date: 8/21/2019 THIS CERTIFIES that the building WINDOWS Location of Property: 2555 Youngs Ave Unit 15A, Southold SCTM#: 473889 Sec/Block/Lot: 63.1-1-21 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/11/2019 pursuant to which Building Permit No. 43874 dated 6/17/2019 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: REPLACEMENT WINDOWS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Granfort, Lucille&Salvator of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 00 rite ignature u� TOWN OF SOUTHOLD oo�°gtlFFU(,��o BUILDING DEPARTMENT ay p TOWN CLERK'S OFFICE oy Tti� SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 43874 Date: 6/17/2019 Permission is hereby granted to: Granfort, Lucille & Salvator 19 E 88th St#3F New York, NY 10128 To: install windows as applied for. At premises located at: 2555 Youngs Ave Unit 15A, Southold SCTM # 473889 Sec/Block/Lot# 63.1-1-21 Pursuant to application dated 6/11/2019 and approved by the Building Inspector. To expire on 12/16/2020. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO - TO DWELLING $50.00 otal: $250.00 1 Building Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use:, 1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- $.25 - 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$45.00, Commercial$15.00 Date. /7 New Construction: Old or Pre-existing Building: (check one) Location of Property: � � y0 c4-0-R& &A, U kL--'- House No. ' Str/eet Hamlet Owner or Owners of Property: - �a� V n �r V/'a` ,C,-f- Suffolk County Tax Map No 1000, Section 6,3 . / Block Lot Subdivision Filed Map. q Lot: ( Permit No. "T -� I(/ Date of Permit. Applicant: Health Dept. Approval: '; Underwriters Approval: Planning Board Approval: / Request for: Temporary.Certificate Final Certificate: ✓ (check one) Fee Submitted: $ '0 Go A icant Signature J 1 q R i l✓iY.L{.111ON, (Where the Applicant is not the,Owner) J, S.( v o�-�er G'�a�. c-} residin .at c SSS v k V, S (Print property-owner's•name) (Mailing Address) do hereby aiorize._ , v\ (Agent) �d Q���, � ��� _ to apply on my. behalfto#he Southold Building Department. (Owners Signature) (Date) (Print Owner's Name) OE so TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 INSPECTION - I FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION [ ] FRAMING /STRAPPING [V FINAL Wlrvto [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR FMLD INSPECTION REPORT .DATE COMMENTS- l� FOUNDATION(1ST) o0 . � y .................. .. 'FOUNDATION (2ND) z I ROUGH FRAMING& PLUMBING y INSULATION PER N. Y;- y STATE ENERGY CODE FINAL ADDITION,COMMENTS z • rn • 1 I H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E C Trustees C.O.Application Flood Permit Examined 20 Single&Separate Storm-Water Assessment Form Contact: Approved I 20 Mailto- 3 't�' cr"_ Disapproved a/c Phone: �U` Expiration 20 �qtBuilding Inspector r' � � APPLICATION FOR BUILDING PERMIT l Date (Y) - ,20 INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale.Fee according to schedule. b Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and waterways c.The work covered by this application may not be commenced before issuance of Building Permit d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. A, R "VE AS NO h ED ' DAT B.P.# (Signa of applicant or name,if a corporation) FE ,.�„-... BY: _� �aCe( ��n..vla-�C� (��✓ems Co So a Y 7 MOTIF BUILDING DFPF�,R TIENT ,AT (Mailing address of applicant) Staff&SvWh&aip'p`)ioanTQ ownep',1&s A,a�ent,architect,engineer,general contractor,electrician,plumber or builder FO ,WING- �IIpPECTIONS: �,rSi`Irhty - TWO EPOUIRED F R POURED CONCRETE, � ODES OF NaTe U ri��er i m a (As on the tax roll o a S STATE gt TOVViV CODES If aiplitclaclitlliaTN�p o'ration,si atu a duly authorized officer PIE 4. FINAL - CONISTRUCI N �� AS REQUIRED APD-C I F E(c1CNNMIM.fif'lEof�'Mrp 'rate officer) BuM, (Lrs&9!q -pFNTc�,TION SHALL MEET THE y^�,T�9oe_ P1u�,beer@IAF nF'rHF('(1f1F�OF NF.W Elegpt� 1�n�seSS a, - i 1 e= OtigiiCel,50 � MGRS. 111) 1. Location of landon which proposed work will be done- House Number Street Hamlet County Tax Map No. 1000 Section b3' � Block Lot Subdivision Filed Map No. Lot x 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy I��bl� `---(- b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration i 1-\Ao W 5 Repair_K_Removal Demolition Other Work (Description) 4. Estimated Cost 0 a Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of existing structures,if any:Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front Rear Depth 10.Date of Purchase Name of Former Owner 11.Zone or use district in which premises are situated 12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO 13.Will lot be re-graded?YES NO Will excess fill be removed`)from premises?YES_NO— S O_ Scc-Cua4-�- asss 'Zdw'z 7�� ��8 14.Names of Owner of premises d rA^ Address l < ^h`!S p-Phone No. 3� 3 Name of Architect Address Phone No Name of Contractor Address hone No. 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of a tidal wetland?*YES NO *IF YES,D.E.C.PERMITS MAY BE REQUIRED. 16.Provide survey,to scale,with accurate foundation plan and distances to property lines. 17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18.Are there any covenants and restrictions with respect to this property?*YES NO *IF YES,PROVIDE A COPY. STATE OF NrW-rMM) (� SS. COUNTY OF JC&V jq,"A J-41.-- being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (Contractor,Agent,Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be . performed in the manner set forth in the application filed therewith. Sworn to before me thi —day of 20� AApplicnt KATY CAR®AJAL C Notary Public-State,of Colorado- Notar ID 2016.4042272 Notary Publ gnMy Commission Expires Nov 4,2020 Go Permits, LLC 105 Buttonball Ln. Glastonbury, Ct 06033 Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org "WE UNDERSTAND THAT YOUR TIME IS MONEY" To Whom It May Concern: Enclosed you will find a building permit application and check. If you have any questions regarding this application, feel free to call me at the number listed below. Please note the following: • Please mail original permit to the owner. • Please fax or e-mail a copy of the permit and receipt to: Fax: 860-430-6719 (attn: Scott Doughman) Email: permits@gopermits.org • If fax or e-mail is not available, please mail a copy of the permit and receipt to: Go Permits, LLC 105 Buttonball Ln. Glastonbury, CT 06033 Thank you! Jennifer Winke, Permit Expediter Go Permits, LLC Phone: 303-946-8685 Fax: 866-697-0768 jenniferwinke@gopermits.org Go Permits LLC, 105'Buttonball Ln. Glastonbury CT 06033, scottdoughman@gopermits.org 7 ® DATE(MMIDD/YYYY) A�Ro CERTIFICATE OF LIABILITY INSURANCE 0210612019 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 have ADDITIONAL INSURED provisions or 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 CONTACT NAME: MARSH USA,INC PHONE FAX TWO ALLIANCE CENTER AIC No Ext): (AIC, AIC No). 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 30326 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC/t CN101642069-HomeD-GAW-19.20 INSURER A:Old Republic Insurance Co 24147 INSURED THE HOME DEPOT,INC. INSURER 13:New Hampshire Ins Co 23841 HOME DEPOT U S A.,INC INSURER C:HomeRlsk Captive Insurance Company 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 ATLANTA,GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004353439-28 REVISION NUMBER: 21 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'P.OLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADDL SUBR POLICY EFF POLICY EXP LIMBS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY MWZY314574 03/01/2019 03/01/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTELT-- CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ 1,000,000 X SIR $1,000,000 MED EXP(Any one person) $ EXCLUDED PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 1,000,000 X POLICY a PRO- LOC PRODUCTS-COMP/OP AGG $ 1,000,000 JECT OTHER A AUTOMOBILE LIABILITY MWTB314573 03/01/2019 03/01/2022 Ea aBIN DtSINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B PER WORKERS COMPENSATION WC 012717099(AK,NH,NJ,VT) I 1 03/01/2020 X STATUTE I I ERH ' AND EMPLOYERSLIABILITY B YIN WC 012717100(WI) 03!01!2019 03/01/2020 E L.EACH ACCIDENT � N/A $ 5,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE' y OFFICER/M EMBER EXCLUE 5,000,000 (Mandatory in NH) E L.DISEASE-EA EMPLOYEE $ If yes,describe under Continued on Additional Page 5,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ C Excess Auto 297110011002019 03/01/2019 03/01/2020 Limit. 4,000,000 A Excess General Liability MWZX 314580 03/01/2019 03/01/2022 Limit. 8,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING G20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukheryee ,3Yi a�.tao ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 LOC#: Atlanta AcoR" ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMED INSURED MARSH USA,INC THE HOME DEPOT,INC HOME DEPOT U S A,INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING G20 ATLANTA,GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued. Carrier Indemnity Insurance Company of North America Policy Number WLR C65890549(AL,AR,FL,ID,IA,KS,KY,LA,MS,MO,NE,NM,ND,OK,SC,SD,TN,WV,WY) Effective Date:03101/2019 Expiration Date:03/01/2020 (EL)Limit$5,000,000 Carrier.New Hampshire Insurance Company Policy Number WC 012717098 (DC,DE,HI,IN,MD,MN,MT,NY,RI) Effective Date 03/01/2019 Expiration Date,03/01/2020 (EL)Limit$5,000,000 Camey.ACE Amencan Insurance Company Policy Number.WCU C65890586(QSI) (AZ,CA,IL,NC,OR,VA WA) Effective Date.03/0112019 Expiration Date:03/01/2020 (EL)limit.$4,000,000 SIR:$1,000,000 SIR for the states of AZ,CA,IL,NC,OR,VA,WA Carrier National Union Fire Insurance Company Policy Number.XWC 5565596(QSI)(CO,CT,GA,ME,MI,NV,OH,PA,UT) Effective Date 0310112019 Expiration Date 0310112020 (EL)Limit$4,000,000 $1,000,000 SIR for the states of CO,ME,NV,MI,OH,PA,UT t $750,000 SIR for the state of GA $350,000 SIR for the state of CT Carrier National Union Fire Insurance Company Policy Number.XWC 5565597(QSI)(MA) Effective Date 03/0112019 Expiration Date*03/01/2020 (EL)Limit$4,500,000 SIR-$500,000 TX Employers XS Indemnity Carrierlltinios Union Insurance Company Policy Number TNS C65221019(TX) Effective Date 03101/2019 Expiration Date.03/01/2020 (EL)Limit.$10,000,000 SIR$1,000,000 ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 LOC#: Atlanta A�o ADDITIONAL REMARKS SCHEDULE Page 3 of 3 AGENCY NAMED INSURED MARSH USA,INC THE HOME DEPOT,INC HOME DEPOT U.S A,INC POLICY NUMBER 2455 PACES FERRY ROAD BUILDING G20 ATLANTA,GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance HOME DEPOT INSUREDS— The Home Depot,Inc. The Home Depot U S A,Inc Home Depot USA,Inc dba The Home Depot Home Depot USA,Inc dba Your Other Warehouse,LLC Home Depot of Puerto Rico,Inc Home Depot Product Authority,LLC Home Depot Store Support,Inc Red Beacon,LLC Home Depot U S A,Inc.dba Interline Brands Barnett Copperriield Eagle Maintenance Supply Hardware Express Leran Maintenance USA Renovations Plus Supplyworks US Lock Wilmar CleanSource JanPak AmSan Sexauer Trayco Zip Technologies t ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Show Receipt Detail Page 1 of 2 RECEIPT Suffolk County Government SUFFOLK COUNTY LABOR, LICENSING.&CONSUMER AFFAIRS P.O. BOX 6100 HAUPPAUGE,NY 11788 James M.Andrews Application:H-53429 AppiieationYype:ConsumerAffairs/Licenses/Home ImprovementlNA Address: Owner Name: Owner Address: Application Name: Receipt No. 149086 PaymentMethod Ref Number Amount Paid Payment Date Cashier ID Recelved. Comments Check 3148046 $1,800.00 09/21/2018 CLEMON RENEWAL Work'Descrlptlon: 01,04,9004100"AN Or' i 17 �1t1 .IMpOVEMI Ctt1._EN5E �RtCJiARD-1 Ey- y4' y1�1Q'-.tl+ d'r.. .; #iJJl41EYQEPD7x Thlsc ►#i#e rW*-, i �er_. y�4'Ic�ii ::' is nse;l�umtiery j 534 9 b�r�t}ieCo[trstYpfS°�ii[o,�j��.; �_. -• = • ,- � ,..... , 'i P https://.ay.prod.count3,.suf/portlets/fee/receiptView.do?mode=view&aiitoPrint=false&rccei... 9/21/2018 Home Improvement Agreement: Pagel fa Home Depot License #'s - For the most current listing www.Homedepot.com/LicenseNumbers NY: Amherst HI-04712, Lockport 2395; Buffalo LT12-10023782, City Tonawanda 33257, East Hampton 4499, Long Beach 4917, N. Tonawanda 368.16, Nassau County H1171050000- H1771053000, New York City 0900456-DCA, 900457-DCA, 0900458-DCA, 0910621-DCA, 0910622-DCA, 0920734-DCA, 0922474-DCA, 0968605-DCA, 1003822-DCA, 1003823- DCA, 1003825-DCA, 1003828-DCA, 1003830-DCA, 1003833-DCA, 1026224-DCA, 1075580-DCA, 1129555-DCA,1129556- DCA, 1129557-DCA, 1129562-DCA, 11,29564-DCA, 1133444-DCA, 1152032-DCA, 1152034-DCA, 1152035-DCA, 1152036- DCA, 1152038-DCA, 1152039-DCA, 1152040-DCA, 1178447-DCA, 1186042-DCA, 1212045-DCA, 1223272-DCA, 1251871- DCA, 1318292-DCA, Niagara Falls 971, Putnam County PC 689, Rockland County H-06464, Southampton L002442, Suffolk County 47874-ME, 55323-ME, 53429-H, 57713-H, 54888-MP, 50222-MP, Town of Tonawanda: 1854, Westchester County WC18484H06, Yonkers 5675, 47874-ME Vance Comerford Salesperson Name: Registration No. (if applicable): Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/ or service the equipment listed below at the price, terms and conditions as outlined on this form. GRANFORT SALVATOR Long Island 1-M7Q7TUY Customer Last Name Customer First Name Store#/ Branch Name Customer Lead/ PO# 2555 Youngs Ave Unit 15A uthold NY 11971 So Customer Address City State Zip (631) 765-9485 1 Igranfo6@aol.com Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 40 Oser Avenue Suite 17 [Hauppauge NY 11788 Ha Address City State Zip Or Email: customercancellationnortheast@homedepot.com Service Provider Email Address BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YAPR RIG T T ANCEL. Acknowledged by:• , 06/05/2019 usto is ignature Date Contract Price and Pavmerft Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: $ 11702.00 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00. (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME(33%), NJ, Wl(999o) Dep. 125.0 % Deposit Amount $ 425.5 Remaining Balance $ 11276.50 The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta, Georgia 30339-Customer Care:1-800-466-3337 4601`1 HDE Customer Agreement(24 Jul.18) v 0.1.8 Home Improvement Agreement: Page2 r� Finance Charges: *Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which The Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payment(s) made payable to The Home Depot. Insurance proceeds will will not be used to pay some or all of the total amqunt of sale. Description of Work to be Performed: Installation of Windows' A more detailed description of the work to be performed is included in the section entitled Scopeof Work which appears on page 0 of this Agreement. Anticipated Delivery Date/Installation Schedule Approximate Start Date: 07/31/2019 Approximate Finish Date: 08/28/2019 All dates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. Electronic Records Authorization: You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and written communications related to this agreement. By contacting your Service Provider, you may update your email address, withdraw your consent, or obtain a,paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email address above, you confirm that you have access to a computer that can receive and open emails and PDF documents. y ni . ling this paragraph, I consent to receive only electronic records related to this transaction. Initial Acceptance and Authorization: By signing below, you authorize Home Depot to (a) arrange for Service Provider to perform Installation and/or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign 1f blank or incomplete. (Service Provider's/permitting information may need to be provided to You later.) By signing, you acknowledge that you have read, understand, and accept this Agreement in its entirety, including the General Terms and Conditions and State Supplement, if any. You further acknowledge receiving a comple copy o this r ent. Keep it to protect your legal rights. X 06/05/2019 The Home Depot ustomer's Signature Date Service Provider Name X I 06/05/2019 J 40 Oser Avenue Suite 17 Signer i pp icab a Date Service Provider Address X 06/05/2019 Hauppauge NY 11788 n Pehalf of Home Depot Date Gity State Zip 50061-HS, R-1-128533-13-00262 Service Provider Phone Number Service Provider License Number The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta, Georgia 30339-Customer Care:1-800-466-3337 460F1 HDE Customer Agreement(24 Jul.16) v 0.1.6 WINDOW SPECIFICATION SHEET - Spec Sheet#' 1-M707TUY Sheet 1 of 1 Customer-SALVATOR GRANFORT .lob#:1-M7Q7TUY Consultant. Vance Comerford Date: 06/05/2019 New Window Hinge Locations Existing Window Measurements Grids Product Options Labor Options From outside, Left to Right Bays,Bows Location Color Rough Opening #of bars #of bars Csmnts,t Pnl, use L,R or S Glass Misc Items Hardware Code Screens For doors use b Mull "S"=stationary or E H N „x„=operating Style Wraps Room FI or Code (Y/N) Style Code Series Code u 3 x ui U oa > r > _ STD,White, WRAP, 1 LIV 1st DH Y DH 6100 WH WH 31 00 5800 89 F, WH,W c ALL 2 1 ALL 2 1 Glass Pack.Standard RMW,LSR GBG H STD,White, WRAP, 2 BED 1st DH Y DH 6100 WH WH 31 00 5800 89 F, WH,W C ALL 2 1 ALL 2 1 GlassPack•Standard RMW,LSR GBG H SPECIAL CONSIDERATIONS. 1 White,2.White Wrap Color Interior Casing Type Bay or Bow window eatboard material(vinyl only-Birch or Oak) Bay Project Angle(30 or 45) Bay Flanker Type(DH,SH,or Csmnt) Top of window to soffit(Inches) If tied to soffit,color of soffit material I have reviewed and agree with all the job specifications above and the Construct Root(Yes or No)' Special Terms and Conditions on the following page Garden Window eatboard Material(vinyl only-White Pionne,Birch or Oak) Y, '�e'db ' 81 onton -"Th.e�,ma[..Value,"of,'P.r'o'du'cts."Mah:uf�.ctu- 0 Dated: 613012018 With Grids p4 p. 7 IS A, a 'A IN I -Pala, ml��12 '�T--� L. -W w mp. Awning C)SOd Base Prosolar Buperoept Ila" 0.26 0.23.. 0 1,• 0,26 1 021 0 a 0 6500 Base �AD.2G 1 6�26 0.2 a o a o Casement 0.24 -2 Transom 6500 Base. ProSojai_ Su • 0.'27 6-29 e!�t� T 0.27 0.'32 v Doubl"Ung 650 Base OroSO'Ibr Uperp W 718- OA -0,26 e ,029 0.24 0 0 0, Picture Casement {NH) 0 0 0 '6506 Base S!JP=Wt 6.�G -0.28 * *1 0-26 Picture 6500 Bas6 027 0.29 60.27 026 1611011 1 1 1 2'Panet.Srider 6500 Base Ordsb.r .!Supeecept 0 L-212 1126 O-M 0.23 0 3 Panel Sliders Pro, 7�e, 0- 026 -4)"em- 29 0.28 0.23 1 1 G*deih,Do6r,'(C tj) FrosolaeSUN S6l*-irs= 71 .0,40-1 0.24 1 qI ol A*1 0.30 1 0.21 14101010 Ptifio•PoorINOVO-.. S -1" 1' q -1-j 0.31 1 0:23 10101010 6500�13L , PEio,6Olar- -.uperSppcer ;Z8 1 �026 I*1:o] U. LIWiere P&9-P'r-A&OwCAftm)a.'Idaho,MevvdiV ffewMealco,Oregon,L)&k and Awn 0.24 o 0.28 0.21 (Inc ftj%i) -tIOO-&qs6- I.rttp Tar O:v I Qai6ment il&base pro.Solar lnt2rc2pt, 71T, 0:27 0.24 4 Ao 0, 0.27 0.22 Picture Casement ffip*4rge) fntetcgpt- 718 0.27 1 '0.28 Picture 6100, 027 02B 0'28 3.0anef Slider, .'W.I 0 0.30 9-27 U&k and Patio Do'or,I OVO 6100 Eii6V u 01&1 0 M6 ,q I I I.0m, 1, 23 1'*1,4 1 War' S,_O'er- -a 0. �p-O'golav 'wj02a-j-�0!2j*j-'-j _j j,'G.2al MZ6,1.61*1 I Patid-Dopr E, 6 Win fDI'0Wngmw*W=DpIks,,Denver,,De&*4 Mia,qarftiern NJ,Long Island,AM �fn B2Q0,$ase 0-25 026' 023 Cak ment 620b Base Pro War SHADE Eupercept 0.16 a' -t, R 0.29 0.17 9 Plcture'basement-'NH 620.QBase '3)V 0:26 1 0.21 ;'0:26 1 0.19 Picture Wthd6w -pro Solar;; Supercppt &W i 014- WiS 1 0.22 SlEile Hung, 6260iBase Pip Solat SHADE, -Sup,erbi# -1V- O."M 0.2811 021 Singh 4 LSILtdei 6200,Base Fro Solar SupeqMpt *0 b� 1 '0.2'3' 0.21 -.'-pt 3 Panel Slider 6200 Base z­Pro,SolarSMDEE Sups rc ept vwn 28 I 'n' fwl:628 21 )Ioivai;located'In coasWatea& Awning 813+MOVE ElfidiW;Star PS,SUNA.,ami Sbpercept 0261 0.23 s� a a • '026 '0.21 01010101 Casement SB-360VL Bate _ PSILami. Super Spacer I,- 0425 1 023' 61 0-25 0.21 to 0 o o Double Hung SB+300VC Base 5upxSpatw V 0291 0.25 • 0 Q 0.29 023 e o Slider SB+360VL Base, ?,L''aet't Intercept- Y 0.29 '025 a a V? 0. '029 6.23 1! o a 0 Patio Door 88+300VL ETC 366, PS StiddeIUrii -&04Sj5i* I OM 0,19 v 6 9 o Garden Door(bH) SB+3(JdVL Base PS/Lami, superspaco 0:301 028_L-I-I 1 1 0:30 I 0.25 •Dots inckwe 5perW-Star certified for..umtzone