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HomeMy WebLinkAbout44424-Z �S O4tp , Town of Southold 3/13/2020 G P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41144 Date: 3/13/2020 THIS CERTIFIES that the building WINDOWS Location of Property: 25235 Route 25, Cutchogue SCTM#: 473889 Sec/Block/Lot: 109.4-23 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/7/2019 pursuant to which Building Permit No. 44424 dated 11/18/2019 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: WINDOW REPLACEMENTS (2)IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR 8 The certificate is issued to Vinyard Knoll Ltd of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED tho e r ature TOWN OF SOUTHOLD BUILDING DEPARTMENT z ' TOWN CLERK'S OFFICE py o� . SOUTHOLD, NY - �pl � V 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#: 44424 Date: 11/18/2019 Permission is hereby granted to: ti Vinyard Knoll Ltd 25235 Main Rd PO BOX 988 Cutchogue, NY 11935 To: make window replacements as applied for. At premises located at: 25235 Route 25, Cutchogue SCTM # 473889 Sec/Block/Lot# 109.-1-23 Pursuant to application dated 11/7/2019 and approved by the Building Inspector. To expire on 5/19/2021. Fees: COMMERCIAL ADDITION/ALTERATION $250.00 -C MERCIAL $50.00 (; Total: $300.00 uildi g spector 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. New Construction: Old or Pre-existing Building: (check one) Location of Property: Pj OA4ye., House No. Street amlet Owner or Owners of Property: Tl D rfia_S Gd rjjL1- In Suffolk County Tax Map No 1000, Section Block Lot— Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: S1713a a ` 0 p/A L Health Dept.Approval: Underwriters Approval: - Planning Board Approval: I / Request for: Temporary Certificate Final Certificate: (check one) 04 Fee Submitted: $��Q �� JL plicant Signature AITMOIIIZA'I ION (Where the Appliwat is not the Owner) P lyDrm y. rasidiAg at a,S.2 3 (Print Property ow=.q.q rfnam':) (AR g Address) r �W�do ltc e orize t d �r f tD apply on my behalf w the SoUrhotd BWdino Dcp�t_ pmc s saga ?. (Date) c (Print Ownces Name) ` r7 r l { 1 �aOE SO//l�o ' # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 -_,.-INSPECTION, [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ - ] FOUNDATION-2ND- - [�^ LATIOWCAULKING U FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY- ` [ _ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ]-. ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS:- &41 DATE !.S INSPEC_ TOR 4 �6( 7D-XV FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) H ------------------------------------ C FOUNDATION (2ND) , • N z CIO � o t ROUGH FRAMING& PLUMBING H \ • 1 ljj N� n Vl INSULATION PER N.Y. y STATE ENERGY CODE vv �� s s FINAL ADD TI NAL COMMENTS `a O � O z H x d 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 11.971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 ( � Survey SoutholdTown.NorthFork.net PERMIT NO. t 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 20 Mail to: Ca 1) l Disapproved a/c i A��11 Phone- Expiration 20 R 0V A 8 1101,-ED Building Inspector A i h. i5.,'.,<�y(,��l ( APPLICATION FOR BUILDING PERMIT fl�i _r_.v r ,�,w m>.... Date 20 IFF 8IJIL[)II'a` i i.'_ l4i IL I765-1802 8AM T INSTRUCTIONS �`LG4/VI,>�, a''This applicatibii�MfflS'l1 be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 Sets plans,accurate plot plan to scale.Fee according to schedule. 1• FOUNDATION b Pjb't'glap�iShowpgjffation of lot and of buildings on premises,relationship to adjoining premises or public streets or FOR (=`dt&span", terways.,- !� Ie rrrr{{� t �; a The`work covered by this application may not be commenced before issuance of Building Permit. 1.s7. n�Vl.7 f'I i'{l,u,""A I(^ k' {.71 f�'qf'� r"-, INSUI A.r! ? d. pon approval,oflihis application,the Building Inspector will issue a Building Permit to the applicant.Such a permit I Ir��1L Sh ll-be kept on the premises available for inspection throughout the work. ('(_)I: :6';N6biiildinglsbjll,lie occupied or used in whole or in part for any purpose what so ever until the Building Inspector SE COkikuesla Certificate of Occupancy f..Eyery,b ildmg penmit shall expire if the work authorized has not commenced within 12 months after the date of ALL CONSTRI!�?!l,�,,� �a�<< < r-r REQ( �i��s�ua�de or as not`been`¢inplete'c� vithin 18 months from such date.If no zoning amendments or other regulations affecting the r STA prope?t}(11ae been egaced�inaeerim,the Building Inspector may authorize,in writing,the extension of the permit for an � It �T,Aadditian,six£noritli� eekerra-dew pemut shall be required. DESIGN OR C()rlt3P�T�tIk��I�1V� .11 rt;�$�Y MADE to the Building Department for the issuance of a Building Penmit pursuant to the Building Zone r m c e i own 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 witliall,apphcable laws,ordinances,building code,housing code,and regulations,and to admit i authonzed inspectors on premis"es and in building fo@rinegessfary inspections. rd`LA�1�'i�FU� N 0 V - 7 2019 (Si ature of applicant or name,if a cAl"g-od ation) f{` E HUU` a CERT I I 7� corp,doy ynna (Mailing address of applicant) State whether applicanYis owner,lessee,agent,archQY ct,engineer,general contractor,electrician,plumber or builder Name of owner of premises MA,5 p rfnalaY WITHEs Or= (As on the tax roll or lateN(Le" YORK ST, If applicant is a corporation,signature of duly authorized officer STATE TOWN CODES AS RE?UIRE (Name and title of corporate officer) ONS ®F Builders License No. Plumbers License No. Electricians License No. U. Other Trade's License No. 1. Location of land on which pro osed ork will be done: R52-35 House Number Street Hamlet County Tax Map No. 1000 Section 10q Block Lot p23 2 d Gs IeWemo /e Li`ef It Ito .S' Pt/4�faj C"c S Subdivision Filed Map No. Lot ` 2. State existing use and occupancy of premises and intEndd use and occupancy of proposed construction: a. Existing use and occupancy. W1UPC a�f b. Intended use and occupancy 2UM 3. Nature of work(check which applicable):New Building Addition Alteration Repair X Removal Demolition Other Work r (Description) 4. Estimated Cost - , Fee `777--- (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 d ) Q 14.Names of Owner of premises AS ,;°iddress 2Sz3� 11A gLPhone No. .Z��� Of G Name of Architect Address Phone No Name of Contractor Address1711 S ►► one No. Vand?15 a.Is this property within 100 feet of a tidal wetland or a freshwater *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,P OVIDE A COPY. STATE OAK) S: COUNTY O Y 1 being duly sworn,deposes and says that(s)he is the applicant (Nhme of individual signing contrac above named, (S)He is the AaEms: —� (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 l* M' that all statements contained in this application are true to the best of his knowledge and belief,and that the work w*�b�y� Types performed in the manner set forth in the application filed therewith. o before me s ' per, – z — Q7 C'� day of 20 al— ¢� ��s _ i� o' ~- f, A Ale 41 Notary ublic Signature of Applicant 0ia�%* f Go Permits, LLC 105 Buttonball Ln. Glastonbury, Ct 06033 Scoff Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org "WE UNDERSTAND THAT YOUR TIME IS MONEY" October 28, 2019 To: Town of Southold Building Department - Subject: Permit Application for: Thomas Gorman 25235 Main Road The above listed homeowner has contracted with Sears Home Improvements-to replace the windows in his home. The below listed documents are included with this letter. • Notarized permit application • CO Application • Check payable to Town of Southold for the permit fee and certificate of occupancy • 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 to submit documents on their behalf • Authorization signed by the homeowner • Windows specification spec sheet 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! ` ' NOV - 7 2019 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 Show Receipt Detail Pagel 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 Application Type:ConsumerAffairs/Licenses/Home Improvement/NA Address: Owner Name: Owner Address: Application Name: i Receipt No. 149086 Payment Method Ref Number Amount Paid Payment Date Cashier ID Received Comments Check 3148046 $1,800.00 09/21/2018 CLEMON RENEWAL Work Description: l Suffolk County Dept.of } Labor,Licensing&Consumer Affairs � r - HOME IMPROVEMENT LICENSE Name RICHARD TOUSEY Business Name HOME DEPOT U.S.A,INC. I This certifies that the E bearer is duly licensed License Number H-53429 by the County of Suffolk Issued:-. 05/15/2014 t �rn.uE i Commissioner Expires: 1110112020 https:Hay.prod.county.suf/portlets/fee/receiptV iew.do?mode=view&autoPrint=false&recei... 9/21/2018 \ DATE(MWDONYYY) '`� �® CERTIFICATE OF LIABILITY INSURANCE F- 02/1112019 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(los)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 statemont on this certificate does not confer rights to the certificate holder in lieu of such endarsement(s). PRODUCER CONTACT MARSH USA,INC. TWO ALLIANCE PHONE aC 3560 LENOX ROAD,SUITE 2400 EMAIL ATLANTA,GA 30326 WSURE 9 AFFORDING COVERAGE NAICG CN101642069-Ho(mD-GAW-19-20 INSURER A:Old Re ubllc Insurance Co 24147 INSURED HOME DEPOT U.S.A.,INC. INSURER B:New H8 hire IAS Co 23841 • D18/A THE HOME DEPOT INSURER C:HomeRlsk Captive Insurance COAT 2455 PACES FERRY ROAD INsuaER o BUILDING G20 ATLANTA,GA 30339 INSURER E. INSURER F COVERAGES CERTIFICATE NUMBER: ATL-W4349185-17 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPEOFINSURANCE ADD BR POLICYNUMBER ICYPO EFF POLIIpYEXP LIMITS A X COMMERC[ALGENERALUAGILmr MWZY314574 0310112019 031012022 EACH OCCURRENCE $ 1,000,000 CLAIMS MADE El OCCUR DAMAGE EM SES Ea ocwr nce $ 1,000,000 X SIR:$1,000,000 MED EXP(Any one on) $ EXCLUDED PERSONAL&AOV INJURY S 1,000,000 GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE S 1,0001000 X POLICY❑j�a D LOC PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER: S A AUTOMOBILE LIABILITY MWT8314573 031012019 03012022 COMBINEDISWGLE IMIT $IFq 1,0001000 X ANY AUTO BODILY INJURY(Por person) $ OVVNEO SCHEDULED SELF INSURED AUTO PHY DMG GODLY INJURY(Per accklent AUTOS ONLY AUTOS ) $ HIRED NON-UNNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY (Par S UMBRELLALIAB HOCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S DEO RETENTIONS B WORKERS COMPENSATION WC 012717099(AK,NHNJ,VT) 20 X S A TE E AND EMPLOYERS'LIABILITY A1NYPROPRIETOWPARTNERIEXECUTIVE YIN WC 012717100{WI) 030112019 03/012020 E.L.EACH ACCIDENT S 5,000,000 OFFICERIMEMBEREXCWDED7 a NIA (Mandatory In NH) E.L.DISEASE-EAEMPLOYE S 5,000,000 If yes,descdbo under COnlInued on Addillonal P DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMrr S 55,000,000B C Excess Auto 297110011002019 03012019 031012020 UmH: 4.000 00 A Excess General Uab11f{y MWZX31458D 031012019 03012022 LknlC 8,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES(ACORD 101,Addiflartal Remarks Schedule,may be attached If more space Is roqutmd) CERTIFICATE HOLDER CANCELLATION Town of Southold-Binding Dept SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Hall Annex Building THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 Route 25,P.O.Box 1179 ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE of March USA Inc. Menashi Mukhedee M ol+•� = ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CNIO1642069 _ LOC#: Atlanta ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMED INSURED MARSH USA,INC. HOME DEPOT U.SA,INC. D/B/A THE HOME DEPOT POLICY NUMBER 2455 PACES FERRY ROAD BUILDING G20 CARRIER ATLANTA,GA 30339 NAIC CODE EFFECTWH 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: Canter.indemnity Insurance Company of North America Poky Number.WLR 065890549(At,ARFL,IDjkKS KY,LA,MS,MO,NE,NM,ND,OK,SC,SD,TN,WV,4VN) Effective Date;0310112019 Explralion Date:03101 020 (EL)Limit$5,000,000 Canter.New Hampstllre Insurance Company Poky Number:WC 0127170M(DC,DE HI,IN,MD,MN,MT NY,RI) EftecliueDate-00112019 Expkallon Date:03/01100 _r (EL)Umx$5,00D,00D Cartier.ACE American Insurance Company Policy Number:WCU C65890586(QSQ(AZ CA,IL,NC,ORVA,WA) Effective Date:03/0112019 Expiralion Date.03101/2020 (EL)Umit$4,000,000 SIR.$1,000,000SIR for t e,Wes of AZ,CA,IL,NC,ORVA,IYA Carder.National Union Fire Insurance Company Policy Number:XVIC 5565598(OSI)(CO,CT,GA,ME MI,NV,OH,PA UT) EffecWe Date:03N112019 Expiration Date:03101/2020 (EL)Llmil:$4,000,000 $1,000,000 SIR for the states of CO,ME,NV,MI,OH,PA,UT 5750,000 SIR for the state of GA $=,ODD SIR for the gate of CT Carrier.National Unlon Fire Insurance Company Poky Number.)MIC 5%5597(QSq(MA) Effective Dale:0310112019 Expiratlon Datm 0310102D (EL)Umti:64,5W,000 SIR 55001000 TX Employers XS Indemnity.. Camtec194fts Union Insurance Company Policy Number.TNS 065221019(TX) Effoctive Data:03101!2019 Fxpfration Data:03/0112020 (EL)Limit 610,000,OOD 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: CNIO1642069 _ LOC#: Atlanta AC40RIDO® ADDITIONAL REMARKS SCHEDULE Page 3 of 3 AGENCY NAMEDINSURED MARSH USA,INC, HOME DEPOT U.S.A.,INC. DIBIATHE HOME DEPOT POLICY NUMBER 2455 PACES FERRY ROAD BUILDING G20 ATLANTA,GA 30339 CARRIER 77C CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insuranoe '"HOME DEPOT INSUREDST" The Horne Depot,Inc The Home Depot U.S.A.,Inc. Home Depot USA,Inc.dba The Home Depot Home Depot USA,Inc,dba Your OlherWarehouse,LLC Hoare Depot of Puerto Rico,Inc. Home Depot Product Aukdty,LLC Home DepotSlore SuppoA Inc. Red Beacon,LLC Home Depot U.S.A.,Ma dba Interline Brands Bamea Coppedield Eagle Maintenance SUpply Hardware Express Isran Maintenance USA Rerwvallons Plus Supplyxorks US Lock wilmar. CleanSource JanPak AmSon Sexauer Trayco Zip Technologies ACORD 101 (2008101) ©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-MUTYJMY Roofing Siding -, Windows Insulation 1- 298.00 3226.95 Gutters/Covers Entry Door MUTYJMY 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 Amoun 1 3524.95 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 4601`I HDE Customer Agreement(24 Jul.18) v 0.1.8 DATE: 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: D Mn A 1 4 (W All/ - :� il L i Location: � �� ih Authorized Agent Go Permits LLC go Selvice Agent Name Best Regards, Lice ee Signature License Number NOTE: PLEASE MAIL PERMIT TO: �P- kQMP-0kAQP- r-- JEFFRGV! KUHR NOTARY PUBLIC,S ��t OF�'E�"`'YORK THD At-Home Services, In . Registration J Jcti. ;`,U600�58i 40 Oser Avenue• Suite 17•Hauppauge,IVY 117 Quafified in�iWioik County Phone:631-478-6101•Fax:631-435-4837•Toll Free:877 fission fres Mereh Z- ,�Q_ Andersen Woqd SPEC SHEET SC: Sofia Porta Measure Tech: INSTALLER: Branch Name. Long Island Job#- 1-MUTYJMY Prepared By ISM: Ship To Location• Customer Name- Thomas GormanSPEC SPR Date, 10/23)2019 Page 1 of 1 SHEET# REF# NEW WINDOW UNIT - _ - ` Hung Casement LOCK Hardware OPTION! OPTIONS - . .,_ - - . - - , . • Screen `x ,`. _ - - - - (ST or (Traditional_ (Stand = - - - ,WH Folding Stone _ Is - - - - _ include - orWhIle Option .. FULL DH Frame - Included - - _ In BAS '-Hung _ included MISC. Existing Window Andersen .. , - FRAMI INSER Sash Glass In Base ' - Glass 'unit SASH UFT .'_m SASE - LABOR TEMI Typo ' Window TYPE '.GWar(FINah ',I SOS 2E SOLD(Tip;ti TIP)''I MEASURETECHSIZE ONLY ONLY Opklorv, Casement HanrAutg Options OPTI6rj pito) Grille Options(PER SASH PRICING), - - OPTION,pricing) OPTIONS unit pdcingj' OPTION TOTAL MTBSM Intedo TW SC UI Standard #Bars #Bars #Bars #Bars Pattern MISC Location Exishn Series incl Exteno Finish Jam Standar (W. Size Grid Exterior Interior Vert Honz Vert Honz & Labor Winds Type Style Color Color Liner Size AW + CODE WALL SILL Sash Hing Temp Screen Type Grid Grid Pattern (per (per Locatio (Per (Per Location ObscureFinish Finis Flnlsh Item Roo Flo. Code CODE CODE CODE COD Colo Code �Wid& Helght HEIOH Wldth Height DEPT ANGL Split Venting Handing Style CODE Options CODE Color Color CODE sash) sash) CODE Sash) Sash) CODE CODE CODE Type COD Type CODE CODES 1 OF 2nd DH 1400 DH 1WH WH 28 53 81 STD TRU GBG WH WH COLO 2,2 1,1 ALL WH STD WH STD WH WRAP C NIAL 2 OF 2nd DH 1400 DH JWH JWH 28 53 81 STD TRU GBG JWH WH COLO 2,2 1.1 ALL WH STD WH STD WH WRAP C NIAL ` BAYlBDWWINOOW ` SC/YlsmtlerNobs.Malude Nbo.Wtror,MuU Sbci(O - ° MANUFACTURER NOTES.(include meOngloWIoaa, _ - _ _ pUonA opscid contlkttxte,Usl hwn#to ldwraty WlrWaxhtoor) : wR�sorle0.Uio Ilam#to ldtntly wlntlovordoor) Prgection Angla(Bay 30°or 450) Topcl Wndow to Sonit(Inches) Wrap Color(1) White,Wrap Color(2) White Bay Wndm Rankers(DH/Casement) Wtllh of Ov'rh9ng(Inclwa) Contact Fred 1(Yes/No) II tied to Soeh,color a Soffit material IThereisnogtiara.,eet a news nges Ri inaton a sting color a - -- NEW DOOR UNIT -- - - - - - - -- ` - • - _ - - _ - - - WINDOW& - --_ DOOR - REM `, F, Andersen MEASURE FULL FRAME Glasa Scree H1nge ,,,` _ _ MULL/STACK - Energy Star• AW Trimtor l Existing Door Type Door TYPE Coto/Flnish _`SC SIZE SOLD(Tip wnp) TECH SIZE ONLY .:&Me Optloris(PER SASH PRICING) OPTIO Option Optic `-� Hinged and Gtidiilg Doan Options'- --`-OPTIONS� `�'�MISC tASok OPTIONS _ Options � Radius Unit PD Nonhem Assembi ESP TOTAL (200 Not' Location meean Interior UI R0/ Inswing PD PD Gliding Hinged 400,& is Existing Serle Externo Flnlsh Standar (WIDTH TIP EM Extenslo Grid Extedo Interi. #Ba #Bar poor Door A-Ser Lock Look Option ail omen Door Type Style ..or Color Size AW + to Jamb Jamb Type Grid Grid Palle rt(P) ra(P bscur Scree IN or # Venting Venbng gliding HRDW HRDW Keyed Mulled/ Special i�os'U wbe?ary Roo Fluor Code COD COD CODE CODE Code Width Hoigh HEIGHTWldt Helgh TIP Size Location COD Color Color CODE Sash Sash) CODE CODE OUT Panels Handing Handing only) Type Finish Lock Stacked Notes MISC Labor Item CODES Y'aor No profile No Width No AWCOU tamps #of boxes Color Approval_ Pdnt Name Thomas Gorman nse Home Owner Horne Improvement Agreemen :: PPage-lDl Home Depot License#'s -For the most current listing www.Hocmede_ /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,1129564-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 Sofia Porta 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. Gorman IThomas Long_Island 1-MUTYJMY Customer Last Name Customer First Name Store"#/Branch Name Customer Lead/PO# 25235 MAIN ROAD Cutchogue 1NY 11935 Customer Address City State Zip {215) 896-9180 1 levcgorman@comcast.het 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 INY 111788 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 9F YGWRIGVr TO CAN L. Acknowledged by: 10/23/2019 /Customer's Signatur Date Contract Price and Payment Schedule ayme t 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: $ 3524.95 j Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 (If applicable) *Maximum deposit ONLY applicable in PJ0; MA, ME(33%), NJ, W1(9061) Dep. 125.0 % Deposit Amount $ 881.24 j Remaining Balance $ 12643.71 The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 46OR FIDE Oj=mer ATMr ctd(24 JO,16) v 0-79 Home Improvement Agreement Paget 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 loanment under this Agreement. Customer is subject to the terms and conditions of the cardholder or 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 nr all of the total amount of sale. Description of Work to be ftftmed: Installation of 1windows A r A more detaildd description o t e work to a performed is includedin e-section,entitled cope o Work which appears on page J5___1 of this Agreement. Anticipated Delivery Date/Installation Schedule A� p�oximate Start Date: 12/18/2619 Approximate Finish Date: 01/15/2020 A Alfdates are approximate and subject to change based on unforeseen events including inclement 41 �Rseather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. .Electronic Records Authorization: l You are entitled to a paper copy of this Agreement if you,choose. If you consent'to ad 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 emalls and PDF documents. Binitialing this paragraph, 1 consent to receive only electronic records related to this transaction. Initial Accebtance 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 If 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 complete copy of this Agreement. Keep it to protect your legal rights. X 10/23/2019 The Home Depot us omers 5ignIture Date ervlce Provider ame 10/23/2019 40 Oser Avenue Suite 17 Go-WnerMf appliqaWpjsate SerwcerF—ovl er ress X 10/23/2019 Hauppauge INY 11788 1�re _n_IB�_elftdlfof Home a of atecity tate i Service Provider Phone NUmber service Provider License um er The Homo Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 460F1 HDE Cu=mer Agreement(24 Jul.IS) v 0.1 e The Home Depot General Terms & Conditions 1. DEFINITIONS: "Agreement" means the Home Improvement Agreement between You and Home Depot, plus (a) any Change Orders; (b) the State Supplement, if any; (c) these General Terms and Conditions ("General Conditions") and any documents referenced in or attached to any of the foregoing. "Defect" means any Services that are found not to be as warranted. "Home" means the real property, fixtures and any physical improvements where the Services are performed."Services" means (1) the delivery and furnishing of goods, equipment, materials, and hardware; and (II) any related labor and services, including without limitation, construction, consultation, fabrication, erection, installation, inspection, maintenance, repair, and testing. "Service Provider" means an independent contractor, authorized by Home Depot, and its employees, agents, and subcontractors. "Work Area" means any property, buildings, or structures necessary for the staging, temporary storing and performance of the Services. "You"/"Your" means the customer identified in the Agreement. 2. HOME DEPOT'S RESPONSIBILITIES: Home Depot or Service Provider will complete the Services in a workmanlike manner and in accordance with applicable law without causing damage to Your Home, provided, however, that Home Depot or Service Provider will not start or continue with any Services upon discovery of any condition at Your Home that Home Depot or Service Provider deems in its sole discretion to be hazardous or unsafe. Unless specifically contracted to do so, neither Home Depot nor Service Provider is obligated to repair such pre-existing hazardous or unsafe conditions. 3. ASSIGNMENT/SUBCONTRACTING: Home Depot and Service Provider may assign this Agreement, or any right herein, or any monies due or to become due hereunder, and may delegate or subcontract any obligations or Services hereunder without Your consent. This Agreement shall not be assigned by You without first receiving Home Depot's written consent, which may be denied in Home Depot's sole discretion. 4. YOUR RESPONSIBILITIES: (a) Payment: You agree to pay Home Depot in full for the Services pursuant to the terms of this Agreement. (b) Safe Access: You agree to provide Home Depot and Service Provider Safe Access to Your Home. "Safe Access" means safe and complete access to the Work Area, including, without limitation: (1) obtaining in advance of the Services consent, permission, or relief from any covenants, easements, restrictions, or other legal encumbrances affecting the Work Area; (2) providing the location of utilities, whether underground, concealed, overhead or visible, to Home Depot or Service Provider; (3) removing from the Work Area physical impediments, hazards, and building code or zoning violations that affect directly or indirectly the Work Area; (4) removing unsafe working conditions and hazardous materials, including environmental hazards, from the Work Area; (5) providing sanitary facilities to Home Depot or Service Provider convenient to the Work Area (or, alternatively, paying for the rental costs of such facilities); (6) providing all utilities, including without limitation, power, water, ventilation and climate control, in and for the Work Area; (7) removing from and protecting against minors, pets, guests and visitors in the Work Area; (8) keeping permits, if required, visible at all times; (9) disengaging, suspending or terminating any security systems protecting the Work Area; (10) providing adequate temporary storage space as needed for Home Depot's or Service Provider's performance of the Services; and (11) not interfering, impeding, impacting or otherwise disrupting the Work Area at any time during Home Depot's or Service Provider's performance of the Services. (c) No Performance: Services are to be performed by Home Depot or Service Provider. If You attempt to perform or assist with the Services in any way, You assume all risk for property damage and for injury to Yourself and others. 5. MODIFICATIONS AND CHANGE ORDERS: Without invalidating this Agreement, You may authorize Home Depot or Service Provider to perform Services beyond the scope of the Agreement ("Change Order"). A Change Order shall be issued by Home Depot or Service Provider on behalf of Home Depot, which You may accept by signing. Upon Your signing of the Change Order, it shall become part of this Agreement, subject to all of the terms of the Agreement. Change Order may also result from Home Depot or Service Provider encountering conditions at the Work Area that impact, impede or otherwise The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 4601`I HDE Customer Agreement(24 Jul.18) v 0.1.8 bj The Home Depot General Terms & Conditions interfere with the performance of the Services, requiring an increase in cost, time, or both. Following the discovery of any conditions that impact, impede or otherwise cause the Work Area not to have Safe Access, Home Depot may immediately ask for a Change Order or discontinue the Services without further obligation to You. If You decline a Change Order request, You or Home Depot may terminate this Agreement. 6. TITLE AND RISK OF LOSS: The title to and risk of loss for any materials or goods provided to You that originate from Home Depot shall pass to You when paid in full by (1) You or (2)the Service Provider as part of the Services. Title to any other materials or goods provided by Service Provider shall pass to You upon completion of the Services. 7. WARRANTY AND LIMITATION ON WARRANTIES: (a) Warranty: Unless otherwise stated in the Agreement, Home Depot warrants for 1 year from the completion date that all Services shall (i) be performed with good workmanship and (ii) conform to the requirements of the Agreement. During the warranty period and within a reasonable time after receiving notice from You of a warranty claim, Home Depot may, at its sole option (i) correct or replace each Defect, or (ii) remove each Defect and refund the full purchase price thereof to You; provided, however, that all warranties are voided if (1) anyone other than Home Depot or Service Provider performs work upon or otherwise modifies any materials or Services provided under this Agreement, or (2) You fail to pay Home Depot as provided in this Agreement. (b) Limitation on Warranties: THE WARRANTIES PROVIDED IN THIS AGREEMENT ARE STRICTLY LIMITED TO THE FOREGOING EXPRESS WARRANTIES CONTAINED IN PARAGRAPH 7A, IN THE WARRANTY SECTION OF THE AGREEMENT, IF ANY, OR IN THE STATE SUPPLEMENT, IF ANY. YOU ACKNOWLEDGE AND AGREE THAT NO OTHER WARRANTIES ARE MADE OR GIVEN BY HOME DEPOT OR SERVICE PROVIDER, INCLUDING ANY WARRANTY FOR FITNESS OF PURPOSE, WARRANTY OF MERCHANTABILITY, OR ANY OTHER ORAL, EXPRESS OR IMPLIED WARRANTIES. HOME DEPOT'S EXPRESS WARRANTIES ARE VOIDED FOR ANY DEFECT CAUSED BY ABUSE, MISUSE, NEGLECT, ACTS OF GOD, LACK OF PRESCRIBED OR STANDARD MAINTENANCE, OR IMPROPER CARE/CLEANING. ANY MANUFACTURER'S WARRANTIES PROVIDED FOR GOODS, MATERIALS, OR EQUIPMENT WILL BE PASSED THROUGH BY HOME DEPOT TO YOU, AND YOU AGREE TO LOOK SOLELY TO SUCH MANUFACTURER FOR REMEDY OF ANY DEFECT IN SUCH GOODS, MATERIALS, AND EQUIPMENT. HOME DEPOT MAY ASSIST YOU WITH WARRANTY CLAIMS AGAINST MANUFACTURERS. 8. TERMINATION: This Agreement may be terminated by Home Depot for its convenience, and by either party for cause if the other parry fails to correct a material breach within ten (10) days after receiving notice from the non-breaching parry identifying the breach. In the event Home Depot terminates this Agreement because You fail to provide Safe Access to perform the Services, or if either party terminates the Agreement because You decline a Change Order request resulting from unforeseen or hazardous conditions, then You shall pay Home Depot for Services provided through the date of termination plus any costs or expenses incurred by Home Depot or Service Provider as a result of the termination. 9. CHOICE OF LAW: SEVERABILITY: This Agreement shall be governed by and interpreted in accordance with the laws of the State where the Project is physically located. The parties intend for the terms and conditions in the Agreement to be complementary, consistent, and enforceable under applicable laws. In the event any term or condition in the Agreement violates applicable law, such term or condition shall be severed from the Agreement, but only to the extent necessary to avoid such violation, without invalidating any other terms and conditions of the Agreement. The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-500466-3337 4601`1 HDE Customer Agreement(24 Jul.18) y 0.1.6 The Home Depot General Terms & Conditions 10. ENTIRE AGREEMENT: This Agreement is the final, integrated, and exclusive expression of the parties' understanding, which supersedes all prior offers, orders, understandings, representations, proposals, confirmations, and negotiations between the parties, whether oral or written. No course of dealing, usage of trade, course of performance, course of conduct, or any other evidence of additional or different terms shall be admissible to contradict or vary any term in the Agreement. 11. SECURITY INTERESTS: LIENS: If You make all payments as required under this Agreement, no security interest will be placed against Your property by Home Depot. If a security interest is placed on Your property, it creates a lien, mortgage, or other claim against Your property to secure payment and may cause a loss,of Your property if You fail to pay as requested. After paying on any completed phase of the Services and before making any further payments, You should request from Home Depot or Service Provider a signed, unconditional release from, or waiver of, any right to place any claim against Your property applicable to the work then completed. You may ask an attorney about Your rights to discharge security interests. 12. RETURNS: Custom order merchandise (i.e., goods that are custom made, uniquely altered, colormatched, shaped, sized, or otherwise uniquely designed or fitted to the requirements of a particular space) is non-returnable, and its purchase price cannot be refunded unless Home Depot or Service Provider (1) incorrectly ordered item, or (2) damaged item beyond repair. Special order merchandise may be returned, and a refund for all or part of the purchase price provided, in the discretion of Home Depot. Please contact Your store for additional details concerning returns. 13. AGREEMENT/SERVICE ORDER COMMUNICATION PREFERENCES: You can visit www.homedepot.com > In- Store Special Orders at any time to access Your account for the following: (1) Update Your Agreement/Service Order Communication Preferences (email, text, Auto Call); (2) Contact Home Depot for order assistance; (3) View latest order status; or (4) Take action to schedule pickup for Your Service Orders. To stop any of the following communications You may visit www.homedepot.com > In-Store Special Orders to access Your account to update Your Agreement/ Service Order Communication Preferences, contact The Home Depot, and take action on orders. If You signed up to receive updates about Your Agreement/Service Order(s) via: (a)Text Message Communications, You may receive multiple messages per order (including current and future orders) via automated technology to the mobile phone number You provided. The total number of messages received depends on the number of orders placed and order activity. Standard message and data rates apply. Not all carriers covered. You can text STOP to 97710 to stop (You will be sent a confirmation message). Call 1-877-467-2581 or 1-800-466-3337 for help; (b) Electronic voice communications (Auto Call), You may receive multiple pre-recorded phone calls per order (including current and future orders) via automated technology to the phone number You provided. The total number of calls received depends on the number of orders placed and order activity. You can press 9 during a call to opt out or call 800-HOME-DEPOT for help; or(c) Email Communications, You may receive multiple Emails per order (including current and future orders) via automated technology to the Email address You provided. The total number of Emails received depends on the number of orders placed and order activity. The Home Depot-2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-4664337 4601`1 HDE Customer Agreement(24 Jul.18) v 0.1.8