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HomeMy WebLinkAbout44021-Z pg�ffOt,t oG Town of Southold 9/11/2019 P.O.Box 1179 y T 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40688 Date: 9/11/2019 THIS CERTIFIES that the building WINDOWS Location of Property: 395 Kouros Rd,New Suffolk SCTM#: 473889 Sec/Block/Lot: 117.-6-11.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/24/2019 pursuant to which Building Permit No. 44021 dated 7/30/2019 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 (5)TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Foschi,Olivia&Kretschman,Joel of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED i 9Auhd Signature fYR== TOWN OF SOUTHOLD o�gUFFO(,�CpG. BUILDING DEPARTMENT TOWN CLERK'S OFFICE o . r� 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#: 44021 Date: 7/30/2019 Permission is hereby granted to: Foschi, Olivia & Kretschman, Joel PO BOX 119 New Suffolk, NY 11956 To: replace windows as applied for. At premises located at: 395 Kouros Rd, New Suffolk SCTM # 473889 Sec/Block/Lot# 117.-6-11.1 Pursuant to application dated 7/24/2019 and approved by the Building Inspector. To expire on 1/28/2021. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00 CO -ALTERATION TO DWELLING $50.00 Total: $250.00 r 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$15.00, Commercial$15.00 Date. M New Construction: Old or Pre-existing Building: (check one) / Location of Property: 3 S KD jif" Poa) lUe u) 5V l Gc House No. Street Hamlet Owner or Owners of Property: J de j�f Peh Suffolk County Tax Map No 1000, Section H7 Block Lot Subdivision Filed Map. Lot: Permit No. O�1 Date of Permit. Applicant A &` Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) 156 00 Fee Submitted:$ `-® pplicant Signature Building Department Application ATJMORIZA TION (Where the Applicant is not the Owner) l I, L�� 9`�TSC lM n _residing at_ ,�qS (Print property owner's name) (Mailing Address) c 1 _ do hereby authorize 9-0 m rn ( gent) Lo a E 02 t, S L L C to apply on my behalf to the Southold Building Department_ 7/16/19 (Owner net SIgnatti-e) (Date) Joel Krets hman (Print Owner's Name) DATE: D ATTN: Town Building Inspector RE: PERMIT AUTHORIZATION LETTER To Whom It May Concern: In accordance with Public Act 91-95, this letter serves as written authorization and notification that Go Permits LLC, and its employees and agents have the authority to represent us in the procurement of permits and pertinent documentation on our behalf. This letter or a photocopy thereof may be regarded by any building official as it's authority to recognize Go Permits LLC as our authorized Agent to sign on our behalf applications for permits and any other related documents that may be required by you, and we agree that, for all purposes,we and not Go Permits LLC or it's employees and agents shall be deemed to be the signer of any such applications and related documents. Scope of work: DIAJ�Ja 14js"'- 'wfl_g' bb Location: .3 o U[0S 60.1 .Authorized Agent Go Permits LLC ` l ervice Agent Name Best Regards, Lice see Signature P ' t 912i&License Number NOTE: PLEASE MAIL PERMIT TO: Y4 JEFFREY KLAIR NOTARY PUBLIC. i E QF tiEVNI YORK THD At-Home Services,In Registratio,.l jt) 01 s,,,16004581 40 Oser Avenue• Suite 17•Hauppauge,NY 117 Qualified in'zu;i�in -our' Phone:631-478-6101•Fax:631-435-4837•Toll Free:877 ission€x ires Mareh V'g©_ �O OF So�lyo # # TOWN OF SOUTHOLD BUILDING DEPT. Comm, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ,/�,,_ .9� [ ] FRAMING /STRAPPING FINAL Xl [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: kit, �iv c d DATEA - t - A fn4ae,4INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS b FOUNDATION(1ST) SO -------------------------------- FOUNDATION(2ND) tr�j IL 11 z - o ROUGH FRAMING& GQ tr1 PLUMBING r INSULATION PER N.Y. y STATE ENERGY CODE G Cz FINAL ADDITIONAL COMMENTS kee, 2 25-0 3All , rn X O z x d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? �sTOWN HALL Board of Health t SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 t Survey. SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form ` IqC N.Y.S.D.E.C. NI k Trustees �1 �� C.O.Application r" �S JLPNN pod Permit Examined 20 g p ingle&Separate 7Storm-Water Assessment Form 1 c�g � "'� Contact: r Approved ii� 20 Mail top: J//�� // (tet/ //� 11 / Disapproved ad .10�5 8 q ff/o n(OQ�LId�./lCr1. t Y�iAs7an 1�✓r y CT t�6� Expiration 20 D p �����`�';� , r 1\' Building pector l...h r �a APPLICATION FOR BUILDING PERMIT J U L 2 4 2019 } Date 20_Lt INSTRUCTIONS {gyaffiapi�'aYtq" MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,,accurate•glotltl to scale.Fee according to schedule. b:Plot plan"showing ocation 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. F t ( gnature of applicant or name,if a co oration) ------ r Poi SATE: -��, ,�ya.y i;�Le�;� la�,. 17� a,- ' (Mailing address offaapplicant) TIFY w'ether applicaT is-o"�Ey,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder 76 1802 TO ; c'M FOLLQ1.ti'ii-�:.��ng�,r�t�GT1(71J.S: rOU+ '�1 w�teyV�o �c ses s PLY WITH ALL CODES OF FUS POUF� � (As on the tax roll or I ODES Qn is a co poral on,sig s ature of dul authorized officer �Y���ORK STATE 2. RQl.1f,apPlt rp I'm Y 3 �sl11 910 w llsT AS REQUIRED AND CONDITIONS O 4 `10 L _ C(Namb�n �i e(of corporate officer) SOUTHOLD TOWN ZBA t{tl�d7s L-di nse-o.�, n c cT THE BEP umbers Ic�iise rFd."-'� _ ,�,�vy SOUTHOLD TOWN PLANNING BOARD ALL C I C�„'g�iiat�LtcVab&6_1 J REQlO`t�ieisTtdda'�Sl�ices'e�1�b? �g - SOUTHOLDTOWNTRUSTEES YORK 5 i A f g TRUC`i 10N r.0t N.Y.S.DEC BEgIIaNL.6hr�tion of�and o�hich propo d wor will be done: � 3 q,� !'1('i 11 E'er& 90,0 YV C I J V /1 House Number Street Hamlet County Tax Map No. 1000 Section Block Lot ��mou� q- Y&cp_ 5 w; ao_s l,'! w� like,, mw, Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises�}d int nde use and occupancy of proposed construction: a. Existing use and occupancy f e S, �Lp h l a.� b. Intended use and occupancy re S I 3. Nature of work(check which applicable):New Building Addition Alteration Repair�X Removal Demolition Other Work �D 4. Estimated Cost �(� „ Fee (Description) (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 14.Names of Owner of premisesle.I KjAJ Address S fo Phone No.It?-Ldq- 10 7 Name of Architect Address S Phone No Name of Contractor p Address c s hone No.940.9S�A` fW"h, Gq 19,33,q y 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES N ' O " *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. �'j1Plife L,S STATE OF NEW YORK) KIMBERLY J.BOWMAN COUNTY OF J • •'� _ NOTARY PUBLIC FOR THE 0t)#,qM1,0jj being duly swom,deposes ziad$ 5 apphcantSTATE OF OHIO ,aFP s. (Name f individual signin contrac ove named, •'=' �` -:�c� My Commission Expires - (S)He is the 7yy,�a•O��••' September 29, 2019 &Co :9 ntractor,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 this day of _ 20� o blic gnature of Applicant Go Permits, LLC 105 Buttonball Ln. Glastonbury,Ct 06033 , r=� Scoff Doughman Phone:860-952-4112 w- Fax:860-430-6719 scottdoughman@gopermits.org "WE UNDERSTAND THAT YOUR TIME IS MONEY" July 17, 2019 To: Town of Southold Building Department Subject: Permit Application for: Joel Kretschman 395 Kouros Road The above listed homeowner has contracted with The Home Depot to replace the windows in his home. The below listed documents are included with this letter. • Notarized permit application • CO Application • Check for$250 payable to Town of Southold • Contract with The Home Depot detailing scope of work • Home Depot USA Suffolk County License ® Certificate of Insurance • Letter of Authorization from The Home Depot allowing GoPermits,LLC to submit documents on their behalf a Windows specification pec sI�eet • AvAoriza-4lai, s;sn.0 by home 010aer, 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:scottdoughman@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! Stephanie Bottomley, Permit Expediter Go Permits, LLC Phone: 513-293-2060 stephaniebottomley@gopermits.org Go Permits LLC, 105 Buttonball Ln. Glastonbury CT 06033, scottdoughman@gopermits.org Suffolk County Dept.of Labors Ucensing&ConsunterAfrairs HOME IMPROVEMENT LICENSE Name ]RICHARD TOUSEY Bossiness Name -da. HOME OF-POT U.SA INC. This Certifies that the bearer is duty Licensed License Number H.53429 by the County of Suffouc Issued: 05/1512014 Garnaussioner Expires: 11101172020 DA7E(MMIDDPfYY1t) O CERTIFICATE OF LIABILITY INSURANCE otiosrzois 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 MARSH USA,INC. FAX TWO ALLIANCE CENTER A/CNE.No Ext): No): 3560 LENOX ROAD,SUITE 2400 EMAIL ADDRESS, ATLANTA,GA 30326 INSURERS AFFORDING COVERAGE MAIC# CN101642069-HomeD-GAW-19-20 INSURER A:Old Republic Insurance Co 24147 INSURED THE HOME DEPOT,INC. INSURER B:New Hampshire Ins Co 23841 HOME DEPOT U.SA,INC. INSURER c:HomeRisk Captive Insurance Company 2455 PACES FERRY ROAD INSURER D BUILDING C-20 ATLANTA,GA 30339 INSURER E: INSURERF: 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE 1 SD POLICY NUMBER MMMD D LIMA A X COMMERCIAL GENERAL LIABILITY MWZY314574 03/01/2019 03/01/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR DAMAGE TORENT 1,000,000 PREMISES Ea occurrence) $ X SIR:$1,000,000 MED EXP(Any one person) $ EXCLUDED PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1,000,000 GENERAL AGGREGATE $ X JECa LOC PRODUCTS-COMP/OPAGG $ 1,000,000 POLICY 1:1 OTHER: $ MWB31453 0310112019 03101/2022 OMBINSINGLE LIMIT AUTOMoeILELIABILITY Eaa.d $ 1,000,000 X ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED SELF INSURED AUTO PHY DMG AUTOS ONLY AUTOS BODILY INJURY Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY r acc dent UHBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ F—TDED I I RETENTIONS $ B woRKERRs coMPENSATION WC 012717099(AK,NH,NJ,VT) 0310112019 03/01/2020 X PER oTH- B AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETORIPARTNERIExECUnVE WC 012717100(WI) 03101/2019 03/01/2020 Ell-EACH ACCIDENT $ 5,000,000 OFFICERIMEMBEREXCLUDED? ❑N NIA (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 5,000,000 If yes describe under Continued on Additional Page DESCRIPTION OF OPERATIONS below a 9 EL DISEASE-POLICY LIMIT $ 5,000,000 C Excess Auto 297110011002019 03101/2019 03/01/2020 Limit 4,000,000 A Excess General Liability MWZX 314580 03/01/2019 03/0112022 Limit 8,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be 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 AUTHOR17FDREPRESENTATIVE of Marsh USA Inc. Manashi Mukhegee �(tt4ara,�c.d �vl wets e ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 _ LOC#: Atlanta ® ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMED INSURED MARSH USA,INC- THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. POUCY NUMBER 2455 PACES FERRY ROAD BUILDING G-20 ATLANTA,GA 30339 CARRIER MAIC CODE EFFECTIVE DATE:- ADDITIONAL ATEADDITIONAL REMARKS THIS ADDRIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE- Certificate of Liability Insurance Workers Compensation Continued. Cartier.Indemnity Insurance Company of North Amenia Policy Number.WLR C65890549(AL AR FI ID,IA,KS KY I A,MS,MO,NE,NM,ND,OK,SG,SD,TN,WV,WY) Effective Date:03/012019 Expiration Date:03/012020 (EL)Lima$5,000,000 Cartier Nav Hampshire Insurance Company PaGcy Number.WC 012717098(DC,DE,HI,IN,MD MN,MT,NY,RI) Effective Date:031012019 Expiration Date.0310112020 (EL)Limit$5,000,000 Carrier ACE American Insurance Company Policy Number.WCU 065890566(QSI)(AZ,CA IL,NC,ORVA WA) Effective Date:03/012019 Expirabon Date:03/012020 (EL)Urn t$4.000.000 SIR:$1,000,000 SIR far the states of A2;CA,IL,NC,OR,VA WA Cartier.National Union Fre Insurance Company Policy Number.XWC 5565596(QSI)(CO,CT,GA,ME M1,NV,OH,PA,U1) Effective date:03/012019 Expiration Date.0310112020 (EL)Limit$4,000,000 $1,000,000 SIR for the states of CO,ME,NV,MI,OH,PA,Ur $750,000 SIR for the state of GA $350,000 SIR for the state of CT Cartier.National Union Fre Insurance Company Policy Number.XWC 5565597(QSI)(MA) Effective Date:0310112019 Expiration Date:0310112020 (EL)Limt$4,500,000 SIR:$500,000 TX Employers XS Indemnity; Carderl linos Union Insurance Company Policy Number.TNS C65221019(IN Effective Date:031012019 Expiration Date:03!012020 (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 ACC)Rv ADDITIONAL REMARKS SCHEDULE Page 3 of 3 AGENCY NAMED INSURED MARSH USA,INC. THE HOME DEPOT,INC. HOME DEPOT U.SA,INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 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.SA,Inc dba Interline Brands Barnett Copperfield Eagle Maintenance Supply Hardware Express Leran Mamtenance USA Renovations Plus Supplyworks US Lack Wilmar CleanSource _ JanPak AmSan Sexauer Trayco Zip Technologies ACORD 101(2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Home Improvement Agreement: Scope of Work Scope of Work Job#: Products: Spec. Install Product Total Sheet(s)#: Price: Price: Sales: 1-MAMFL5A Roofing Siding , Windows Insulation 1- 745.00 4894.12 Gutters/Covers Entry Door MAMFL5A Roofing Siding Windows Insulation Gutters/Covers Entry Door Roofing Siding Windows Insulation Gutters/Covers Entry Door Roofing Siding Windows Insulation Gutters/Covers Entry Door Roofing Siding Windows Insulation Gutters/Covers Entry Door Subtotal Sales Tax 0.00 Total Contract Amount 5639.12 Notes: Warranty: The warranty on the work identified above is listed in the General Terms and Conditions, or if applicable,specified in the following documents: Warranty Name(s): 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 18) v 0.1.8 Andersen Wood SPEC SHEET SC: Vance Comerford Measure Tech: INSTALLER: Branch Name. Long Island Job#: 1-MAMFLBA Prepared By, ISM: Ship To Location' Customer Name: JOEL KRETSCHMAN Date 07/12/2019 Page 1 of 2 SPEC SPR SHEET# REF# -. NEW,WINOOW UNIT-,- - _ - , - - -„ •. - - - _ Hung _ 'Casement LOCK - Hardware .;` , - -. . • OPTION! OPTIONS Screen - ,(STar i= (Traditional - _ ` (Standen WH Folding Stone ' Is ' included or White Option FULL DH Frame Included - _ In BASE Hung included MISC Existing Wmdow •Andersen' FRAMI INSER Sash ' � Glass In Base Glass unit, SASH UFT In SASE LABOR M ,Type; Widdow TYPE Color/Flnleh SC SIZE SOLO(Tip to TIP) MEASURE TECH SIZE ONLY-ONLY Option', Casement Handling Opttons OPTION price) Grille Oph.ns(PER'SASH PRICING)„s, OPTION pricing) OPTIONS unit pricing), OPRON TOTAL MTHSM Intedo TW SC UI Standard #Bars #Bars #Bars #Bars Pattern MISC Location Existin Series Windo Fxterlo Flnleh Jam Standar (WIDT Slze Grid Exterior Interior Vert Horiz Vert Hartz & Labor Wintlo Type Style Color Color Liner Size AW + CODE WA SILL Sash Hing Temp Screen Type Grid Grid Pattern (per (per Lochuo (Per (Per Location Obscur Finish Finis Finish Item Roo Floo Code CODE CODE CODE COD Color Code Witt Helght HEIGH Width Height DEPT ANGL Split Venting Handing Sryle CODE Options CODE Color Color CODE sash) sash) CODE Sash) Sash) CODE CODE CODE Type COD Type CODE CODES 1 KIT 1st DH 100 SH WH WH 31 �34 66STD none WH STD WH STD WH WRAP CH 2 LAU 1st DH 1100 SH WH WH 36 151 87 STD none WH STD WH STD WH WRAP, N RMW 3 OF 2nd 2 PNL 100 1 PNL WH WH 71 47 110 S X STD none WH STD WH STD WH C 4 BED 1st DH-0 100 SHO WH WH 36 70 106 60/40Botta none �WH [TI) WH STD WH WRAP 60/40 1 1 STD m, _U I , - ^'"• " -MANBPADT6RER NOTE6 gnUudo musing locallon6; BAY/BOWWINDOW - 6GlnatellorNol..(InclutloMle0.L.boy Mu116Wck Opdone,epactal condition.,Use Item ldenWy windowydaor) eoceseorloe,Ueeltemlto ltlenilly wlntlow/door) Pwlenton Angle(Bay,30•or 45•) Top of window to 6one(Inches) Wrap Color(1) While,Wrap Color(2) While,Wrap Color(4) White Bay WNdow FI.Mm(DH f Casement) Wldtlt al Orerhong(Incl..) Constru.Root t(Vas/No) If tied to 8011,color of Soft material t Thm I hire gueramea tat new shingles w111 masta st na c w •NEW DOOR UNIT WINDOW&, _ - - DOOR ITEM ' „Anderson •" ^ tMEA6URE FULL FRAME _ Glase scree Hinge - r MULL/STACK `"t`d Energy Star' AW Trim for g4 Existing Door Type Door TYPE Color/Rnlsh .SC SIZE SOLD(Tip to TIP). TECH SIZE ONLY Grille Options(PER SASH PRICING) OPTION Option Option 'Hinged and Gliding Door Optlon-s OPTIONS MISC LABOR OPTIONS Options Radius Unit PD NaMern Assembl Est TOTAL (200, Not. Sma Location Intedo UI RO/ Insuring PD PD Gliding Hinged 400,& meeteeun Existing Series Extedo Finish Standar (WIDTH TIP Ext Extenslo Grid Exterio Interlo #Bar #Bar Door Door A-Ser Lock Lock Options soog«� Capolery Door Type Style Color Color Size AW + to Jamb Jamb Type Grid Grid Pette ert(P ra(P bsar Scree IN or # Venting Venting gilding HRDW HROW Keyed Mulled/ Special Wb,? Roo Floo Code COD CODE CODE CODE Code Width Haight aigh HEIGHT Widt Haigh TIP Size Location COD Color Color CODE Sash Sash) CODE CODE OUT ParelE Handing Handing only) Type Finish Lock Stacked Notes I MISC Labor Item CODES Y..Nc ProNe No Width No AW C.,V Wraps �bo f es Noor Apprwel Print Name JOEL KRETSCHMAN mg.Home Owner Andersen Wood SPEC SHEET SC: Vance Comerford Measure Tech: INSTALLER: Branch Name Long Island Job#: 1-MAMFLSA Prepared By. ISM: Ship To Location Customer Name' JOEL KRETSCHMAN Date 07/12/2019 Page 2 of 2 SPEC SPR SHEET# REF# ' NEW WINDOW UNIT - + Hung Casement LOCK Hardware ' OPTION! OPTIONS r Screen, } (ST or (Traditional " istandarc WH Folding Stone is Included or White Option r FULL OH Frame , included , ,In BASE Hung Included MISC Existing Window Andersen FRAME INSER Sash Glass In Base - Glass unit +SASH UFT In BASE LABOR TEMI Type Wind—TYPE Color(Fmish SC SIZE SOLD(Tip to TIP) .MEASURE TECH SIZE ONLY ONLY OpOoni Casement Handling Options OPTION- price) - Grille Options(PER SASH PRICING) - OPT10N pricing) OPTIONS unit pricing) OPTION TOTAL MTASM Inteno TW SC UI Standard #Sars #Bars #Sacs #Bars Pattern MISC Location Existin Series Windo Exterio Finish Jam Standar (WIDT Size Grid Exterior Interior Vert Hertz Vert Hertz 8 Labor Windo Type Style Color Color Liner Size AW + CODE WA SILL Sash Hing Temp Screen Type Grid Grid Pattern (par (per LOcatio (Per (Per Location Obscur Finish Finis Finish Item Roo Floo Code CODE CODE CODE COD Colo Code Widt Height HEIOH Width Height DEPT ANGL Split Venting Handing Style CODE Options CODE Color Color CODE sash) sash) CODE Sash) Sash) CODE CODE CODE Type CODE Type CODE CODES 6 BED 1st DH-O 100 SHO WH WH 36 70 106 60/40 Botto none WH STD WH STD WH WRAP in, 60/40 STD BAY/BOWWINDOW _ SC/InstalierNotos(Includet im Labor,Mull SteckOption,epmllconditions,Use Item OW ldandty,window/door) MANUFACTURER acesaUse Item is dud�mWindoWdow) eeaeuse Item#(e Identity window/door) Prciscilon Angls(Ssy 30•oraa°) Topd Wind-to Soxit(Inohoe) Wrap Color(5) White Say Window Flanks,,1;71 Casement) Wldih d OVarnonp(Inches) Construct Rod 1(Yes/No) It tied Ie Solis odor of Soffit material IThw.s no guarantee thin re—hingeir 111 rinaten ox1iningc w NEW DOOR UNIT - ' WINDOW& DOOR ITEM AndersenMEASURE .FULL FRAME + Glass, Scree Hingo MULL/STACK - - Energy Star AW Trim for #- -Exisang Door Type Door TYPE Color/FlN_sh ,S_C SIZE SOLD(rip to TIP) TECH SIZE ONLY Grillo Options(PER SASH PRICING) OPTION Option Option - _Hinged and Gliding Door Options -OPTIONS MISC LABOR OPTIONS Options Radius Unit PD Northern Assemb) ES? TOTAL (200, Nda Location Interco UI Rol Inswing PD PD Gliding Hinged 400,& m ensu Existing Series ExteriorFinish Standar (WIDTH TIP Ext Extenslo Grid Ex Eric Interco #Bar,ABar, Door Door A-Ser Lock Lock Options all the, Ca 01 Door Type Style Gator Color Size AW + to Jamh Jamb Type Grid Grill Pane en( riz(P bscur Scree IN or # Venting Venting gliding HRDW HRDW Keyed MulledI Special za,a� tubet� Roo Floo Code COD CODE CODE CODE Code Width Heigh HEIGHT Widt Heigh TIP Size Location COD Color Color CODE Sash Sash CODE CODE OUT Panel Handing Handing only) Type Finish Lock Stacked Notes MISC Labor Item CODES Yesor No Profile No Wldlh AW Coil/ Wraps "of boxes Color Approval Print Name JOEL KRETSCHMAN mee Home Owner