HomeMy WebLinkAbout42979-Z ��OgU fF alk a� Town of Southold 9/27/2020
P.O.Box 1179
cm
o5 53095 Main Rd
: o�'!•`y Southold,New York 11971
�72XP'J
CERTIFICATE OF OCCUPANCY
No: 41481 Date: 9/27/2020
THIS CERTIFIES that the building WINDOWS
Location of Property: 225 King St, Orient
SCTM#: 473889 Sec/Block/Lot: 26.4-26
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/21/2018 pursuant to which Building Permit No. 42979 dated 8/30/2018
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:
r_placement windows as applied for.
The certificate is issued to Nolan C G Rvc Liv Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ut 4zedlSignature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Co TOWN CLERK'S OFFICE
Vo . 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#: 42979 Date: 8/30/2018
Permission is hereby granted to:
Nolan C G Rvc Liv Trt
914 White St
Key West, FL 33040
To: replace windows as applied for.
At premises located at:
225 King St, Orient
SCTM # 473889
Sec/Block/Lot# 26.-1-26
Pursuant to application dated 8/21/2018 and approved by the Building Inspector.
To expire on 2/29/2020.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
CO -ALTERATION TO DWELLING $50.00
Total: $250.00
, f
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 I%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 pian 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. 8/15/18
New Construction: Old or Pre-existing Building:_ X (check one)
Location of Property: 225 King Street Orient
House No. Street Hamlet
Owner or Owners of Property: Caroline Nolan
Suffolk County Tax Map No 1000,Section 26 Block 1 Lot 26
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: Jennifer Winke
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: X (check one)
Fee Submitted: $ 50.00
i
Vic,ft Signature
pF SOUTyo�
# # TOWN OF SOUTHOLD BUILDING DEPT.
`ycourm, '' 765.1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[' ] FOUNDATION 2ND [ ] I ULATION/CAULKING
[ ] FRAMING /STRAPPING [vf FINALlf)140 kL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE INSPECTORIX4 lyz
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(IST)
--------------------------------------
'FOUNDATION (2ND)
z
�o
ROUGH FRAMING&
PLUMBING y
• O
INSULATION PER N.Y:
STATE ENERGY CODE
1 Qi
FINAL
ADDITIONAL COMMENTS
� o
z
G) m
°z
d
b
H
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applymg`i
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL:(631)765-1802 Planning Board approval
FAX:(631)765-9502 rvcy
SoutholdTown.NorthFork.net PERMIT NO. heck
Septic Form _
N.Y.S D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 120 Single&Separate
Storm-Plater Assessment Form
? � Contact:
�
Approved 20 l Mail to- Scott Doughman "
Disapproved a/c 105 Butterball Ln Gastonbury,CT 06033
Phone: 860-952-4112
Expiration 0
Inspe r
B9
AUG2 �201� �r1,1:,AaiL'�. .,1".,:�JIL„.:�uxa.I�.1@%L;<
Date August 15 12018
INSTRUCTIONS
T t ' r F1�EFUST be completely filled in by typewriter or m 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.
l 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
P
( rV of applicant or name,if a corporation)
sow haw k
(Mailing address of applicant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
Agent _
Name of owner of premises Caroline Nolan
(As on the tax roll or latest deed)
If applicant is a corporation,signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. _
Plumbers License No.
Electricians License No. _
Other Trade's License No.. _
1. Location of land on which proposed work will be done:
225 King Street Orient _
House Number Street Hamlet
CountyTax Map No 1000 Section__ 26 Block 1 _Lot 26 _
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy residential
b. Intended use and occupancy residential
3. Nature of work(check which applicable):New Building =Addition Alteration X
Repair Removal Demolition _Othar Work
(Description)
4. Estimated Cost $30,349.66 Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units 1 ,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 X
13.Will lot be re-graded?YES_NO X Will excess fill be removed from premises?YES_NO_
14.Names of Owner of premises Caroline Nolan Address 225 Kma St,Onent,NY 11957 Phone No. 305-304-4380
Name of Architect Address Phone No
Name of Contractor Sears Home Improvements Address 1024 Honda Central Parkway phone No. 860-952-4112
Longwood,FL 32750-7579
15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO X
*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 X
*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 suspect co This properly?*YES NO
*IF YES,PROVIDE ACOPY.
STATE OF i4EW-MR)C51k0r"d*
SS:
COUNTY OF AQ
being duly sworn,deposes and says that(s)he is the applicant
Wefdualsib ing contracA above named,
(S)He is the_ (�% —/ / ` SEYBOLD
�cr
(Contractor,Agent,Corporate Offoer,etc.) NOTARY PUBLIC
ST TE OF CO RADO
of said owner or owners,and is duly authorized to perform or have performed the s d work QTQ i jD692Mplicati n;
that all statements contained in this application are true to the best of his knowledge nd#?WMftNtt"1RLJSdllhO22
performed in the manner set forth in the application filed therewith.
Swbrn to llefore me this �
_J 57}{)4_-_ 20
day 0f
N is S(Iure o Applicant
Go Permits, LLC
105 Buttonball I.n.
Glastonbury, Ct 06033
e a Scott Dovghman
Phone: 860-952-4112
Fax: 860-430-6710
scottdoughman@gopermits.org
"WE UNDERSTAND THAT YOUR TIME IS MONEY"
August 15, 2018
To: Town of Southold Building Department
Subject: Permit Application for: Caroline Nolan, 225 King Street, Orient, NY
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 for$250 payable to Town of Southold
• Contract with Sears detailing scope of work
• Sears Home Improvements Suffolk County License
• Certificate of Insurance
• 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 61
'D � d
• 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!
!ennife'r Winke, Permit Expediter,
Go Per LLC
Phone: 303-946-8685
Email:jenniferwinke@gopermits.org
Go Permits LLC, 105 Buttonball Ln. Glastonbury C1 06033, scottdoughman@gopermits.org
Job:24374707 Page 1 of 7
1111111111111111 Off ce Location: LONG ISLAND
Proposal Date 08/11/2018 Job Number 24374707 Sears Home Improvement Products,Inc.
Customer Name 59easrrs 102 BOX 522290
CAROLINE NOLAN 1024 FLORIDAIDA
CENTRAL PARKWAY
Customer's Home Phone Customer's Work Phone LONGWOOD,FL 32750-7579
(305) 304-4380 Home Improvement Products PHONE(800)469-4663
Street Address Contractor License/Registration Number
225 KING ST ESTIMATE AND PROPOSAL NYC DEPT OF CONSUMER AFFAIRS HIC#1225
166;NASSAU H1809170000;PUTNAM
City State JZip Code PC3159-A;ROCKLAND H-9990-A6-00-00;
ORIENT NY 11957 Is installation within city limits? SUFFOLK 41506-1-1;WESTCHESTER
Installation Address County SUFFOLKYes1No NO WC-18371-1-106;YONKERS4213
Billing Address(if different from above) City State Zip Code Project Consultant Name&License No.(if applicable)
JOHN FELDMAN 2058280-DCA
.---.'bescription'of the Pro ect and Description of"ttie.Siohifiicant Materials to'bi,'Used arid,E uipment tape installed :: _
Interior Products / Exterior Products Home Warranty
[:]Vinyl Siding []Roofing ❑HVAC ❑Kitchen Remodeling ❑Countertop ❑Whole House
❑Coating ❑Windows ❑Attic Insulation ❑Cabinet Refacing []Flooring ❑System
❑Painting []Doors ❑Garage Doors ❑Bathroom ❑Appliance
SPECIAL INSTRUCTIONS:
SUBJECT TO INSPECTION -- INSTALL SEARS WEATHERBEATER PLUS WINDOWS
MOLD REMEDIATION: This Estimate and Proposal assumes that no mold remediation will be needed during installation work. If, upon inspection
by the contractor or others, it is learned that mold remediation is necessary then Customer must arrange and pay for such remediation by a qualified
person prior to the start or continuation of work. If Customer fails to arrange for necessary mold remediation within thirty(30)days, Sears may cancel this
contract upon written notice to Customer.
ASBESTOS ABATEMENT:This Estimate and Proposal assumes that there are no asbestos containing materials("ACMs")that would be disturbed in
the performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work,
then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange
for necessary asbestos abatement within thirty(30)days,Sears may cancel this contract upon written notice to Customer.
The TOTAL PRICE including all labor,material,taxes and any applicable discount is $ 30,349.66 Contract Price $30,349.66
Earnest Money $ 500.00 State Sales Tax $ 0.00
*INITIAL PAYMENT(Not to exceed 30%of TOTAL PRICE;payment is due prior to Local Sales Tax $ 0.00
ordering of product;.excludes HVAC in which the INITIAL PAYMENT is 100%.) $8,604.90
initial Payment Subtotal $9,104.90
FINAL PAYMENT(balance payable upon completion of job) $21,244.76 Total Amount Due $ 30,349.66
*The Initial Payment is due prior to Sears ordering products.A Cancellation Fee of up to$ 500.00 plus any incurred materials costs,up to 30%
of the Total Price,may be assessed.
1
Financing:The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Card Payment Addendum made a part of andl
incorporated into this contract by reference.
All of the above check boxes(and associated Product Addendum(s)),"Work NOT to be done:","Additional work to be done:","Special Instructions:",
"Mold Remediation","Asbestos Abatement,"and"Financing:"sections have been reviewed by and explained to me.Product Addendum(s)islare
made a part of and incorporated into this contract by reference. n
Customer(s)initials Cbn
NOTICE TO BUYER:YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT,ANY TIME PRIOR TO MIDNIGHT OF THE THIRD(3) BUSINESS DAY,
FIVE (5) BUSINESS DAYS IN MARYLAND, (FIVE ,(5) BUSINESS DAYS IN ALASKA, SEVEN (7) BUSINESS DAYS IN MARYLAND, FIFTEEN(15)
BUSINESS DAYS IN NORTH DAKOTA IF YOU ARE 65 OR OLDER) AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF
CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT,
SKI-(Dig.) Rev 10/16/17
AGENCY CUSTOMER 10: 570000034159
LOC#:
ADDITIONAL s L SCHEDULE Page _ of
AGENCY NAMSDWSURED
Aon Risk Services Central, Inc. Sears Home Improvement Products Inc.
POLICY NUMBER
see certificate Number: 570072481479,
CARRIER NAiC COLE
See certificate Number: 570072481479 EF}ECTWEDATE:
ADDITIONAL REMARKS
Th11S ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certific9te of Liability Insurance
INSURER(S)AFFORDING COVERAGE NAlC
INSURER
INSURER
INSURER
INSURER
ipr p�=Al, p'OLICggS if a policy below does not include limit inforlwtion,refer to the corresponding policy on the ACORD
Certificate form for policy limits.
WI
WR ADDL SU13R POLICY POLICY
LTR TYPEOFINSVRdNCE LKSD wt'D Policy1NV.19ER nCTIVE E3MRATIOX WIFFS
DATE DATE
y135DDIIIY Ail D1YYYt
WIORKERS COMPENSATION
8 N/A SCFC65226315 08/01/2018' 01 01/2019 "
Wi
ACORD 101(20MOt) 492008 AGORD CORPORATION.All rights roserved.
Tho ACORO name and logo aro registered marks of ACORD
I-
,� CERTIFICATE OF LIABILITY INSURANCEI
DAT"3MIOOD'IYYYY)
'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(les)must have ADDITIONAL INSUED provisions or 9 endorse .I
SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this cc
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAME*
CA FACT
Aon Risk Services Central, Inc. (866) 263-7122 FAx (800) 353-0105 y
Chicago IL Office two•Na Exc): (ATC.No.: zs
200 East Randolph E-MAIL b
Chicago IL 60601 USA ADDRESS:
INSURER(S)AFFORDING COVERAGE NA10 0
INSURED INSURER A. ACE American Insurance Company 22667
Sears Home Improvement Products Inc. INSURER at ACE Fire Underwriters Insurance Co. 20702
1024 Florida central Parkway
Longwood FL 32750 USA INSURERC:
INSURER D'
INSURER E:
i7fECRER F.
COVERAGES CERTIFICATE NUMBER:570072481479 REVISION NUMBER:
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. Limits shown are as requested
LTR TYPE OF INSURANCE I D POLICY NUMBER pp�pryyyy, h1Ny LIMITS
X COMMERCIAL GENERAL LIABILITY � HDDG EACH OCCURRENCE $510001000
LYAlf�a R Oc' X�O.n UR 11FI.Mas 2.cxunence) $5,0()0,000
MED EXP(Any one omon) Excluded
PERSONAL&ADV INJURY $5,000,000
GENLAGGREGATELiwrrAPPLIESPEP. GENERALAGGREGATE $5,000,000
p8, ❑LOC I PRODUCTS•COIAP OP AGv^ t $S,000,000
x POLICY F N
i OTHER• a
A I AUTOMOBILE LIABILITY ISA H25159895 08/01/2018 01/01/2019 COMBINED SINGLE LWIT
A ISA H25159871 08/01/2018 01/01/Z019 I aaocicrsl _I $5,000,000
A ANYAUTO ISA H2S1S9883 08/01/2018 01/01/2019 BODILY IIJURY(Per Person)
�__
OWNED SCHEDULED BODILY INJURY(Per awident)
01
x AUTOS ONLY AUTOS
X HIREDAUTOS x NON-OWNED PRDPERTY_DAh%GE
1 ONLY AUToS ONLY (Per aCmcwl'
St
U,Y,BRELLALIAB OCCUR EACH OCCURRENCE
EXCESS LIAR CLAWS-MADE AGGREGATE
DED1 IRETENTION
A WORKERS COMPENSATION AND 1 y:cuC65 26 73 58/011201903_OZ 2019 X pER OTH-
EMPLOYERS,LIABILITY Y i N li OH WA, WV 5 AlUTE
i XNYPROPRIEMPARTNERtEXECUTWE �"" ELEACHACCOENT S2,000,000
A 3 OFFICERIAEMSEREXCLUDED? N NiA srlLRC65226236 OSI01J2018 01/01/2019
j (MandstoryInNH) All Other States EL.DJSE2E2Eh1pLoYEE $2.0001000
It ws.describe under_
1 DESCRIPTION OF O?£RATiOUS be;Lw E L DISEASE•POLiCY LIMIT I $2,000,000.—
I
DESCRIPTION OF OPERATIONS i LOCATIONS 1 VEHICLES(ACORD 101,Additional Rerraft Schedule,maybe attached H more space is required)
Evidence of Coverage.
CERTIFICATE HOLDER CANCELLATiON
ShOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF;NOTICE WILL BE D=LIVERED IN ACCORDANCE WITH THE
POLICY FROVISIONS.
Sears Home Improvement Products Inc. AUTHORLLEDREPRESENTATIVE
1024 Florida Central Parkway
Longwood FL 32750 USA
@1988.2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016105) The ACORD name and logo are registered marks of ACORD
v
A P OVED AS NOTED
DATE B.P.# .COMPLY WITH ALL CODES OF
NEW YORK STATE &TOWN CODES
FEE: ` BY: ' AS"REQUIRED AblD C�"�.-.-ITIOUSO
NOTIF BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE S
FOLLOWING INSPECTIONS: aSFTRUS5TEE$
ppp
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW �;"CUPANCY OR
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. "U S F IS UNLAWFUL
1
WITHOUT CERTIFICATE
OF OCCUPANCY
Job:P4374707` Page 2 of 7
Window Addendum
Consult tion Info
Lead Number: 24374707 Date: os/11/2018 Sales Rep: JOHN FELDMAN
Customer Name: CAROLINE NOLAN Phone: 3053044380
Address: 225 KING ST
City: I ORIENT State:I NY Zipcode: 11957
Description of the Project and Description of the Significant Materialsto be Used and Equipment to be Installed
1. Remove existing units to be replaced. (PLEASE NOTE: The removed units are likely to be damaged.)
2. Prepare openings as necessary to receive replacement units. (NO finish work other than normal installation is to
be done unless otherwise noted below.)
3. Installation includes the clean-up of all job-related debris upon completion of the job.
4. (If applicable)After the completion of the project,the customer will be responsible for the application and removal
(storage)of shutter panels. In the event that the project requires the installation of storm shutters or egress windows,
Sears Home Improvement Products, Inc. ("Sears")will not re-install any affected security bars.
5. (If applicable) In the event Sears is unable for whatever reason to obtain the proper permits prior to the
commencement of any work, Sears will refund any previous payment and this contract will be automatically
canceled.
Summary of Window Order Addendum (see detailed Window Order Addendum for more information):
Type: WB PLUS (WINCORE) Quantity: 34
Type: Quantity:
.Type: Quantity:
Type: Quantity:
Type: Quantity:
APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE:
The work will start approximately TBD (Approximate Start Date)
It will be substantially completed by approximately TBD (Approximate Completion Date)
These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products,Inc.("Sears")or at any other
time by mutual written agreement.Customer understands that the Approximate Start Date is only an estimated date and the Customer will be
contacted prior to this date to schedule the actual start date.
The TOTAL PRICE including all labor,material,
taxes and any discount is $ 30,349.66 Contract Price $ 30,349.66
Initial Payment(not to exceed 30%of Total 9,104.90 0.00 o 0.00
Price unless Special Order) $ State Sales Tax ( /o)$
Final Payment(balance payable upon
completion of job) $ 21,244.76 Local Sales Tax ( 8.63 %)$ 0.00
The Initial Payment is due prior to Sears ordering products. Total Amount Due $ 30,34 9.66
Jo6:24374707 Page 3 of 7
Additional work to be done:
SUBJECT TO INSPECTION -- REPLACE ROTTEN WOOD AS NEEDED
Work NOT to be done: Removal or moving or any walls; flooring, painting, wallpaper work; repairs of water or termite-
damage to sub-floors or walls; electrical or plumbing work outside of this kitchen or bath project.
SEARS'LIMITED WARRANTY ON INSTALLATION
In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is
installed),if the workmanship(or application)of any Sears'arranged installation proves faulty within(i)one year for Weatherbeater Value Line,(ii)
two years for Weatherbeater Plus,or(iii)three years for Weatherbeater Max,and Weatherbeater Storm,then upon notice from you Sears will cause
such faults to be corrected by repair at nb additional cost to you.If Sears determines that repair is not commercially practicable or cannot be timely
made,then,at Sears'sole discretion,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by
calling Sears Home Improvement Products at 1-800-222-5030,Option 4.This warranty gives you specific legal rights,and you may also have
other rights that vary from State to State.
Proposal Items
,'E Aw„f ' T'. '+i -'C:� 'n�-n &i+• �� 1 i- ' ' 'Q�.° � �!!—'.4',V�ty[ps�^'yo4
it E J Pt cat rc.a. ; OOR
c.W.? d'aft w
i -
W020 Wincore. WB PLUS(Wincore) Per Job 1.00
W751 Additional Labor. Lead Safe-Windows Each 34.00
Zone-W-H Zone Charge. Zone Charge H Per Job 1.00
r
Job:24374707 s Page 4 of 7
1024 Florida Central Pkwy ORDER: 243747070005
Longwood,FL ORDER DATE: 8/11/2018
searaEST.DELIVERY DATE: 8/13/2018
HOME SERVICES ORDER CONTACT: John Feldman
WINDOW ORDER ADDENDUM
INVOICE INFORMATION SHIPPING INFORMATION
[LONG ISLAND]
SHIP VIA:
24374707000 8/11/2018 24374707 0
n 5
1 DOUBLE HUNG 12 31 W X 50 H
WHITE
LT WOODGRAIN —
LOWE/ARGON/LEEP !
DOUBLE STRENGTH
FULL SCREEN
MAX CLEARANCE DIMENSIONS=[25.75 X
17.5625]
2 DOUBLE HUNG 1 30 W X 47 H
i
WHITE -
LOWE/ARGON/LEEP
DOUBLE STRENGTH
FULL SCREEN
MAX CLEARANCE DIMENSIONS=[24.75 X
16.0625]
3 DOUBLE HUNG 4 24 W X 36 H
WHITE
LOWE/ARGON/LEEP
DOUBLE STRENGTH
FULL SCREEN
MAX CLEARANCE DIMENSIONS=[18.75 X
10.5625]
4 DOUBLE HUNG 7 24 W X 38 H '
t
WHITE
LT WOODGRAIN
LOW E/ARGON/LEEP --'
DOUBLE STRENGTH
FULL SCREEN
MAX CLEARANCE DIMENSIONS=[18.75 X
11.5625]
5 DOUBLE HUNG 7 23 W X 35 H
WHITE
LOWE/ARGON/LEEP
DOUBLE STRENGTH
FULL SCREEN
MAX CLEARANCE DIMENSIONS=[17.75 X
10.0625]
Job:24374707 a Page 5 of 7
;43747
=70 o o 0
8/11/2018 24374707 0
� o
DOUBLE HUNG 1 24 W X 38 H
WHITE
LOWE/ARGON/LEEP 1
DOUBLE STRENGTH --
HALF SCREEN
MAX CLEARANCE DIMENSIONS=[18.75 X
11.5625]
7 DOUBLE HUNG 1 24 W X 38 H
WHITE
LT WOODGRAIN j
LOWE/ARGON/LEEP --
DOUBLE STRENGTH
HALF SCREEN
MAX CLEARANCE DIMENSIONS=118.75 X
11.5625]
8 DOUBLE HUNG 1 31 W X 47 H I t
i
WHITE �----- ,
LT WOODGRAIN f
LOWE/ARGON/LEEP i
DOUBLE STRENGTH
HALF SCREEN
MAX CLEARANCE DIMENSIONS=[25.75 X
16.0625]
TOTALS: 34
COMMENT:
P
Job:24374707 Page 6 of 7
ADDITIONAL PROVISIONS
Proposal and Approval.Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached
sketches and specif cation sheets for the TOTAL PRICE shown. This offer must be approved by the Installation Department. If this is a credit sale or a
payment on completion sale, it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in
accordance with the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation
has been completed are Sears property and will be removed by Sears.
Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials
or installation NOT furnished or arranged by Sears.Sears'installation contractor(s)will obtain all building permits required by local law. For homes located
in historic or landmark zoning districts, Customer will be responsible for obtaining required approvals and related permits prior to the commencement
of work on this contract.
Authorization. I authorize Sears to: (1) arrange for a contractor(licensed where required by law) to make the installation of materials; (2) issue a work
order for this installation to a contractor;(3)inspect the installation;and (4)pay the contractor when the installation is complete if I have signed a certificate
that the installation has been completed to my satisfaction.
Delays in Installation.I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,government regulations or
any causes beyond Sears'control.
Oral Agreements and Changes in Contract. I understand that there are no,oral agreements between Sears and me.Everything I expect Sears to do has
been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears.
Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special
work described in this contract.
Electrical & Plumbing Service. I will provide adequate electrical and/or plumbing service(s) to run any newly installed appliances or other furnishings. If
the electrical and/or plumbing service(s) do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary
changes at my expense unless Sears has agreed in this contract to make the changes.
Payment.I will pay Sears the cash price that covers the price of material and installation as shown on the first page.
Warranty Information.Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is displayed in the Product
Addendum.
(Dig.)Rev 06/07/17
Job•24374707 Page 7 of 7
NOTICE TO BUYER
1. DO NOT SIGN THEAGREEMENT IFANYOF THE SPACES INTENDED FORTHEAGREED TERMS TO THE EXTENT OF THEAVAILABLE INFORMATION
ARE LEFT BLANK.
2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS.
3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO
A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES.
4. YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE(3)BUSINESS DAYS,FIVE(5)BUSINESS
DAYS IN MARYLAND,(FIVE(5)BUSINESS DAYS IN ALASKA,SEVEN(7)BUSINESS DAYS IN MARYLAND,FIFTEEN(15)BUSINESS DAYS IN NORTH
DAKOTA IF YOU ARE 65 OR OLDER)FROM THE ABOVE DATE.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION
OF THIS RIGHT.FAILURE TO EXERCISE THIS OPTION,HOWEVER,WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL
SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING"I HEREBY RESCIND'AND ADDING YOUR
NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS.
5. CANCELLATION FEE. I UNDERSTAND THAT SEARS, UPON ENTERING INTO THIS AGREEMENT, WILL PROMPTLY INCUR SIGNIFICANT
COSTS TO START MY PROJECT. FOR THIS REASON, I AGREE THAT SEARS HOME IMPROVEMENT PRODUCTS WILL RETAIN AS A
CANCELLATION FEE THE"EARNEST MONEY"AMOUNT SHOWN AS PART OF THE TOTAL PRICE IN THE EVENT THAT I ELECT TO
CANCEL THE AGREEMENT AT ANY TIME AFTER THE EXPIRATION OF ANY LEGAL RIGHT OF RECISION. THIS CANCELLATION FEE WILL
BE 1N ADDITION TO'ANY AMOUNTS I MAY OWE, AND WHICH I AGREE SEARS MAY RECOVER DIRECTLY FROM MY INITIAL PAYMENT, ,
FOR MATERIALS ALREADY ORDERED BY SEARS PRIOR TO CANCELLATION.
6. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO
REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT.
NOTICE TO NEW YORK RESIDENTS ONLY
Any contractor,subcontractor,or materialman who provides home improvement goods and services pursuant to your home improvement contract
and was not paid may have a valid legal claim against your property known as a mechanics lien.Any mechanics lien filed against your property
may be discharged.Payment of the agreed-upon price under the home improvement contract prior to filing a mechanics lien may invalidate such
lien.The owner may contact an attorney to determine his rights to discharge the mechanics lien.
In accordance with Subdivision Four of Section 71-A of the New York Lien Law,Sears has posted a bond with SAFECO INSURANCE COMPANY OF
AMERICA,a surety company licensed by the State of New York,guarantying the proper application by Sears of any cash payments or cash deposit
received from the customer under this home improvement contract prior to the substantial completion of the work.The surety bond is in lieu of the
escrow requirements of the New York Lien Law.Written notification of any and all claims asserted by the customer under this bond,along with a
copy of the customer's contract,should be sent to:Sears Home Improvement Products,Inc.,P.O.Box 522290,Longwood,FL 32752-2290.
At any time during the performance of this contract,the contractor may demand and shall be entitled to receive in full from
the owner advance payment for any materials that are necessary to perform this contract.
Customer(s)initials ov& IF
NOTICE TO NEW YORK CITY RESIDENTS ONLY
The contractor agrees to furnish the buyer with a certificate of Workers'Compensations Insurance prior to commencement of work pursuant to the
contract. Pursuant to section 221(a)(2)of Title 6 of the Rules of the City of New York,the contractor[Sears]and the owner[you]have determined
that a definite completion date is NOT to be of the essence.
C� 08/11/2018 08/11/2018
fNV.1ME nWaN
Customer's signature Date Customer's signature Date
Date
Q"'
Accepted by Sears Home Improvement Products,Inc.("Sears')on 08/11/2018 by. /0 " a�
Date Management Representative
NY (Dig.) Rev 06/07/17
Sears Window Comparison Sheet
*For Bre Stor Northern Crmow Zone(See Districts Below
Flov.31=016 t
31(4'Beveled Frame 31/4"Beveled frame 31/4"Countoured Frame
Fusion Welded Fusion Welded Y1j Fusion Welded
Sloped Sill Sloped Sia Sloped Sin
Frame Accessory Trade In&Out Accessory Tract In&Out Accessory Trade In&Out
Balance Covers Balance Covers No Balance Covers
Constant force Coil Spring Balance System Constant Force Coil Spring Balance System Constant Force Cali Spring Balance System
Brass Rollers Brass Rollers Brass Rollers
Dual Cam Locks w/Tilt Latch Dual Cam Locks w/Tilt Latch Dual Cam Locks
Fusion Welded Fusion Welded Fusion Welded
Foam Filled Sash Chambered Sash Chambered Sash
Sash Triple Barrier Weathor-stripping Triple Barrier Weather-stripping Triple Barrier Weatheratripptng
Interlocking Meeting Rail interlocking Meeting Rail Interlocking Meeting Rag
Lift Poll UR Rail Extruded Rail
Dual vent Latches Dual Vent Latches Sin a VentLatch
Triple Glaze Dual Pane Dual Pene
Double Strength Double Strength Single Strength
l 1'IGU 3/4"iGU 3/4°IGU
Glas9 Dual!rrterecept Spacers Intercept Spacer intercept Spacer
Dual P&nes of soft i:nar Low E il34ti Coat.inti$Cn CJai Lcvi i Soft Coat Low E
Dual Argon tilled Gas Chambers Argon Filled Argon Filled
Tempered Available Tempered Available Tempered Available
wmi E-Star Upgrade Available
Obscure Obscure Obscure
Decorative Glass Options Glue Chip Glue Chip
Raingiass Rain lass
Semen Full Screen Standard Fiberglass Full Screen Standard Fiberglass Full Screen Standard Fiberglass
White White White
Tan Tan Tan
Clay Clay Clay
Interior White Oak Woodgrain White Oak Woodgrain
Light Oak Woodgrein Light Oak Woodgrain
Dark Oak Woodgraln DarkOak Woodgrain
Maple Woodgraln Maple Woodgrain
Colors Cherry Woodgraln Charrywbodgrain
White White White
Tan Tan Tan
Clay Clay Clay
Exterior Mesa Red Mesa Red
Hunter Green Hunter Green
Earth Tone Earth Tone
Brown Brown
Bronze Bronze
Colonial Colonial Colonial
Grids Prairie Prairie Prairie
Perimeter Perimeter Perimeter
Coulile Hung Double Hung Double Hung
Picture Window Picture Window Picture Window
Casements,Sliders Casements,Sliders Casements,Sliders
,des Bays,Bows says,sows
Garden Windows Garden Windows
Geometria Geometries Geometrkx
Endvent Endvent Endvent
Patio Door Patio Door Patio Door-Std ONLY
Yes Yes No
Vinyl Lifetime Lifetime Lifetime
Hardware Uretime Lifetime Lifetime
Screens Lifetime Lifetime Lifetime
0.20 yrs 100% 0-10 yrs 100% 0•5 vrs 100?5
Glass-obstruction 21.30 yrs 25% 11-20 yrs" 5 yrs plus 0%
31 yrs plus 50% 20 yrs plus d%
Glass=breakage Lifetime 20 Yrs 10 Yrs
Labor 3 Yrs 1 Yr
U-Factor 0.23 0.25 0.30
R-Value 4.20 4.01 3.32
SHGC 0.18 0.20 0.22
Visible Transmittance 0.32 0A2 0.49
fThe above thermal performance volun are bared an a Double Hung Window without grids or JarceTent
Ri��iptC'o}3} Pace of
a �
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SUFFOLK COUNTY DEPT OF LABOR,
LICENSING & CONSUMER AFFAIRS
PAYMENT RECEIPT
RECEIPT NO. 321931
SEARS HOME IMPROVEMENT PRODUCTS INC
1024 FLORIDA CENTRAL PKWY
LONGWOOD FL 32750
DIB/A:
Recd From: SEARS HOVE IMPROVEMENT PRODUCTS ate:
NYMAN INC 0912812016
Payment Type: No: Drawn On:
14ECK 100727322 BANK OF AMERICA
7CateFgory Service Fee Violation Slip No Remarks
tractorC- Lle Renew, $400.00
33 SUFFOLK COUNtY DEPT OF LABOA,
} ;" LICENSING L CONSUMER AFFAIRS
ME IMPROVEMENT
CONTRACTOR
ALFRED W NYMAN
This arfmts that ft
beet6riS duly SEARS HOME IMPROVEMENT PRODUCTS
NC
GC@Tmed by the
County otSuffoNc °oib"'
415MH �I4 �oo6
`°"'"� "'°"°1trn" ` 11l091Z018
REC'D BY: icense#i Registration#:
CL 1506
TOTAL:
Remarks: $400.00
ATTENTION HOME IMPROVEMENT CONTRACTORS Suffolk County Code Chapter 563-17(D)
states: All advertising for Nome improvement contracting shalt contain the number of the Home
Improvement license.
Customer copy
http:.7sutloikealreceiptcopv.aspx"ID-327 1y;1 9,'21$'2016