HomeMy WebLinkAbout45517-Z oy�guFFOl,�cp Town of Southold 5/1/2021
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a y� P.O.Box 1179
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o _ r 53095 Main Rd
y,�,0� ,dao Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41999 Date: 5/1/2021
THIS CERTIFIES that the building WINDOWS
Location of Property: 4170 Camp Mineola Rd,Mattituck
SCTM#: 473889 Sec/Block/Lot: 123.-5-21.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/16/2020 pursuant to which Building Permit No. 45517 dated 12/1/2020
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:
three replacement windows as applied for.
The certificate is issued to Villanueva,Raymond&Marie Jose'
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
A o -zed ig tore
TOWN OF SOUTHOLD
o�SufFoc,���
BUILDING DEPARTMENT
z ' TOWN CLERK'S OFFICE
"oy • o�� 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#: 45517 Date: 12/1/2020
Permission is hereby granted to:
Villanueva, Raymond
86-51 Palerno Street
Holliswood, NY 11423
To: install windows as applied for.
At premises located at:
4170 Camp Mineola Rd, Mattituck
SCTM #473889
Sec/Block/Lot# 123.-5-21.2
Pursuant to application dated 11/16/2020 and approved by the Building Inspector.
To expire on 6/2/2022.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CO-ALTERA TO DWEL ING $50.00
otal: $250.00
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$15.00
Date. ZO
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 4140 CAMP M/nIEou_- RD NIPMI7uCL NY
House No. Street Hamlet
Owner or Owners of Property: RAYMO� Vl(.LH'N G E t/A+
Suffolk County Tax Map No 1000,Section Block Lot -
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: EL2�� El/_/D
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted:$ 5V
Applicant Signature
Building DevartmeiltApplication
AUTHORIZATION
(Where the Applicant isnot the Owner)
I-1_9Hylvl 0 VILLANAV9) residing at �110 'RMP M1NGQU4jZJ-)
(Prim property, y owner's name) (Mailing Address)
M,q
f flj— T-U 92FZ do hereby authorize E L281 EM M EN,-Pp,,)
{Agent)
to apply on my behalf to the
Southold Building Department.
(0w4er's Signature) (Date)
Ito 10 v-�
(Print Owner's Name)
aNve gyef.A
�� O��Of SOUTyo!
* # TOWN OF SOUTHOLD BUILDING DEPT.
co 765-1802
INSPECTION =
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] NSULATION/CAULKING
[ ] FRAMING /STRAPPING [ FINAL r,-)foo ,5-
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ :] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
vV -
DATE Y INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
-------------------------------
FOUNDATION(2ND)
IL 11z
�o
ROUGH FRAMING&
PLUMBING Q
INSULATION PER N.Y.
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS -
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL:(631)765-1802 Planning Board approval
FAX:(631)765-9502 Survey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
E ed 20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ( 20 Mail to:gcofj• M6*MHN
Disapproved a/c 105 gU,r?�l�gf4((,Fe(rI!�a t� SIbA11gl/Qi`f G X033
U",
Ex ' on 120 ! J Is UINLMIFUL
' (.r �'��y�4, �``x, ector V E fl E���+ T I � T E
APPLICATION FOR BUILDING PERMIT F O C CU PA INI Y
NOV 1 6 2020 �^
Date // 20 ZO
INSTRUCTIONS
s'a!This pplication MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
r fsets,ofplans;ac;urati: Ip f,plan to scale.Fee according to schedule.
b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or
areas,and waterways.
c.The work covered by this application may not be commenced before issuance of Building Permit.
d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit
shall be kept on the premises available for inspection throughout the work.
e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an
addition six months.Thereafter,a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or
Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The
applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit
authorized inspectors I lo�p� e ,a dP building for necessary inspections.
DATE• v� R P I
(Signature of applicant or name,if a corporation)
FEE' 3813 ��lE2so�.De SCtiiuze Pe, tc 601
NO 1 FY BUILD! : r.i i. NT ,AT (Mailing address of applicant)
765-1602 B Vii 1" - 7'd FOR THE
State- tvher�Iapplicdinti is owner,lessee agent,architect,engineer,general contractor,electrician,plumber or builder
A.&E P/%
d. r'VUId IJ/11 IVIV 14\., Ilw\.�V:1 tLU
Name IdTowneroll'premises M,W 4YM10A10 V1IL(AMUC04
2. POUGH - F!,MAIM, u F-'LUu'It IMi (As on the tax roll or latest deed),n,,� 1 T�L�. WITH ALL CODESES
U�,�
If app)ig7ot Li's_d,corporation,signature of duly authorized officer 1�,f YORK K S OF
s ins _ ria. r�zi r T n5; ori��T ATE & TOM4 CODES
gil T O title of corporate)officer) AS REQUIRED A, ^'^
BuildgTEicenspNo.,._.,,H. �.3,(%Zg,__T 1E S OF
F L Ne i h '—' ;lul`I v.„—.i_i_ 'v'--. Tii i��
Plum�merns iLtcense Noy _ __ __. SOUTHOLD TOWN Z
Elec@etabsIL`cggseNo.ut- i riC VUuc� r•ilffv
Other�Tra'd`es-'L'icense� d.i Fitbt'UN5 tilt U
DESIGN OR CONSTRUCTION ERRORS. SOU N PLANNING BOARD
1. Lo ation of land on which proposed work will be done: S OLD TOWN TRUSTEES
41 '0 CAMP m1rde0LA � AilUGr— my //��2 ,
House Number Street et I •d.v.
County Tax Map No. 1000 Section 1 2 3 Block Jr Lot .2 1.22
96MOVC 11-nU 2Z�J 4CP 3 (11 N,v01/&� 0,(�E 1111—H L/11,r', A/0 S1�lGfU2A�- GNf}fVGES
t Subdivision I CQD 1 2 2 Filed Map No. � Lot d �• 2
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy. 06S 1 l7F P/T/ft,, —S/W LC— OCA-M/L i
b. Intended use and occupr—AMiL Y
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work 1J/,Vj;004/5 2EPGACEM6,4�_
/I (Description)
4. Estimated Cost. 4 333 Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business,commercial or mixed occupancy,specify nature and extent of each type of use.
7. Dimensions of existing structures,if any:Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction:Front Rear Depth
Height Number of Stories
9. Size of lot:Front Rear Depth
10.Date of Purchase Name of Former Owner
11.Zone or use district in which premises are situated
12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO
13.Will lot be re-graded?YES NO Will excess fill be removed from premises?YES NO
2pYMo1v.' 4i30 cAMP nl0Eoc* A9 9/� 630—5Sy3
14.Names of Owner of premises V 1LLANUEVH Address NX27U04 IVY Phone No.
Name of Architect Address Phone No
Name of Contractor 40/I15 .DEPOT US Pr Address.2456fACES FOBYhone No.
ATaAom,6 fA 3i> 3
15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO
*IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED.
b.Is this property within 300 feet of a tidal wetland?*YES NO,�C
*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.
1WN01S
STATE OF Pv EWz^RK)
SS:
COUNTY OF �t )
/4 SIV being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
C�}�e t o Z OFFICIAL SEAL
(S)He is the PEREZ
(Contractor,Agent,Corporate Officer,etc.) Elthis
PUBLIC,STATE OF ILLINOIS
ISSt.ION EXPIRES 03/29/2021
of said owner or owners,and is duly authorized to perform or have performed the said work and to makep cation;,that all statements contained in this application are true to the best of his knowledge and belieft and that be
performed in the manner set forth in the application filed therewith.
Sworn to before me tbis
day of h1 OY P atb cr 20"L;E>
,..�_
--C> .
6< -_ � &m' ud,
Notary Public Signature of Applicant
HU20
A`C ® n02IDD/VYYYj
�..� CERTIFICATE OF LIABILITY INSURANCEpy„�g,g
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 pollcy(les)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 endorsemen a.
PRODUCER C C
MARSH USA,INC, I PAX
TWO ALLIANCE CENTER PHONE
3560 LENOX ROAD,SUITE 2400 •MAIL
ATLANTA,GA 30326
INSUREP48)AFFORDING COVERAGE NAIGd
CN101642069-HemeD•GAW19.20 INSURER A:Old R ublicInsuranceGo 24147
INSURED OME DEPOT U.S.A„INC. INSURER B:New Hampshire Ins Co 23941
D181A THE HOME DEPOT INSURER C.HomeNsk Captive Insurance Comilany
2455 PACES FERRY ROAD INSURER D:
BUILDINGG20
ATLANTA,GA 30339 INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: ATL-00434916547 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.
ILSR TYPEOFMSURANCE A00 SBR J=WVD pOLICYNUMBER M Ip EFF POLIOYEXP ,LIMITS
A X COMMERCIALCENERALL,ABILITY MWZY314574 0301/20119 0310112022 EACHOCCURRENCE S 1,000,000
WMGE TO RENTED
CLAIMS-MADE X�OCCUR PREMISFS Eo ocaerre S _1,000,000
X SIR:EI,=,00D MED EXP one n $ EXCLUDED
PERSONAL&AOV INJURY $ 1AD0,000
GEN LAGGREGATELIMIT APPLIES PER. GENERALAGGREGATE $ 11000,000
X POLICY❑Mor E-1 LOC PRODUCTS-CO1,IPIOPAGG S 11000,000
OTHER: S
A AUTOMOBILE LIABILITY MWO314573 03!0112019 0310112022 cOMatINdEDsI GLE IMIT $ 1,000,000
X ANYAUTO BODILY INJURY(Par person) $
OWNED SCHEDULED SELF INSURED AUTO PHY D61G BODILY INJURY(Per accident) $
AUTOS ONLYAUTOS
HIRED NON4YWNED PROPERTY DAMAGE $
AUTOS ONLY P
AUTOS ONLY (Per floddant)
S
UMBRELLILIAII HOCCUR EACH OCCURRENCE S
EXCESSLIAB CIAIMS-MAOE AGGREGATE S
DED RETENTION S
B WORKERS COMPENSATION WCO 2717099(AKNHAJ 03M11019 1 20 X 3 A TE OTH
AND EMPLOYERS'LIABILITY YIN 03x'0112019 03101202U
B WC 012717100(W� ,000,000
OFFICE IMEMB REXC UDEDfECUTNE a NIA E.L.EFJICHACCIDENT S
(Mandatory In SEREXCLUDED7 5,000,000
(MundatorytnNH) E.C.DISEASE-EA EMPLOYE S
It yes,describe ander Continued CS Additional Page E.L DISEASE-POLICY LIMIT S 51000,000
oESCRMION OFOPERATIONS belay
C Excw Auto 297110011002019 03!01/2019 0310iQ020 tirmfl: 4,000,000
A Excess Gonoml Liability MWZX31400 0310112019 0310172022 Lmit: 8,000,000
OESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES(ACORD lot,Additional Remarks Schedule,maybe alftechad If Moro space In tociUltod)
CERTIFICATE HOLDER CANCELLATION
Town of SoutIdd•Building Dept SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town Hap Annex Building . THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
54375 Route 25,P.O.Box 1179', ACCORDANCE WITH THE POLICY P_ROV1310NS.
Southold,NY 11971
AUTHORIZED REPRESS iTATIVE
of Marsh USA Ino.
Manashl Mukherjee -
0 1888-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
AcEm&CUSTOMER ID: CM01642069
_ LOC o. Atlanta
ADDITIONAL REMARKS SCHEDULE Page 2 of 3
AGENCY NAp 01BlfAT�
AIARSII USA,INC: - NOlIEOEPOT USA,�.
BMTHEN011$DEPOT
p01lCYNUMBER 2456 PACE$FHWROAD
BtBIDINGC-20
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ADDITIONAL REMARKS
THIS ADDITIONAL REMARK$FOAM IS A SCHEDULE TO ACORD FORAM
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ACM 101(2008101) ®2008 ACORD CORPORATION. All tights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: CNI 01642069
LOC#: Atlanta
A�'�0 ADDITIONAL REMARKS SCHEDULE Page 3 of 3
AGENCY NAMEDINSURED -
MARSH USA,INC. HOMEDEPOT U.S.A.,INC.
OIBIATHE HONE DEPOT
POLICY NUMBER 2455 PACES FERRY ROAD
BUILDING=
ATLANTA GA 30339
CARRIER NAtC 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—
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Home Depot USA Inc.dba Your OtherWereleuse,LLC
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Hardware Express
Laran
Maintenance USA
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Supplyworks
US Lock
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ACORD 101(2008101) @ 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
11/82020 h 9.1(appa2sufldkcounlynygrn/caldcaportall
DCA Portal
License and Complaint/ Violation Look Up
Use the form below to search for License and Complaint/Violation information.Search
by First and Last name,Business name,Phone number,or License number.Please note:
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Suffolk County Government, 2020
MtpsJ/apps2.su8otk-untynYgovIcaldeap"Y 1N
" -� Go Permits, LLC
' 105 Buttonball Ln.
0 Glastonbury,Ct 06033
Scott Doughman
U L�J!� LI lJ U Phone:860-952-4112
Fax:860-430-6719
scottdoughman@gopermits.org
"WE UNDERSTAND THAT YOUR TIME IS MONEY"
November 12, 2020
To: Town of Southold Building Department
Subject: Permit Application for: Raymond Villanueva 4170 Camp Mineola Rd. Mattituck, 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,th s letter',',1 =
• Notarized permit application N 0 V 1 G 2020
• CO Application
• Check for$250 payable to Town of Southold
• Contract with Home Depot detailing scope of work
Home Depot Suffolk County License
• Certificate of Insurance
• Letter of Authorization from Home Depot allowing GoPermits to submit documents on their behalf
• 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:permits@@gopermits.org
• If fax or e-mail is not available, please mail a copy of the permit and receipt to:
Go Permits, LLC
105 Buttonball Ln.
Glastonbury,CT 06033
Thank you!
Ella Mendron, Permit Expediter
Go Permits, LLC
Phone: 847-671-4606
elzbietamendron@gopermits.org
Go Permits LLC, 105 Buttonball Ln. Glastonbury CT 06033,_scottdoughman@gopermits.org
DATE: I lo�iL
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: P_,,6l'1CV,E o4� 66PL4CE [ll1-1L0>0A(5,
SR/ye S12F ND STP_,WCi a P;9 L !rS:
Location: _ 4190 C&np MANE OGS
M&rr/TUC
Authorized Agent Go Permits LLC EL?�I�T�}- MEN/J LOrJ
Service Agent Name
Best Regards,
Liceee Signature P ' t N , e &License Number
NOTE: PLEASE MAIL PERMIT TO:
i KUI-IR
JEFFRE�'.. -
NOTARY PUi3UC,=f r 1 E oar 1'49'%'YORK
THD At-Home Services,In Registration ivc? o t KU6Q04581
40 Oser Avenue- Suite 17*Hauppauge,NY 117 Qualified in�_uiio+r County
Phone-631-478-6101eFax:631-435-4837•Toll Free:877 issionE iresMlereh2 >?q
Andersen Wood SPEC SHEET SC: Vance Comerford Measure Tech: INSTALLER:
Branch Name: Long Island Job#- 1-tU69NM2Q Prepared By. ISM:
Ship TO Location: Customer Name: RAYMOND VILLANUEVA Date: 11/07/2020 Page, of 1 SPEC SPR
SHEET# REFS
OEM
NEW WINDOW UNIT
` Hung Casement
- LOCK Hardware
- - - - - OPTION OPTIONS
Screen + , (ST or ;(Traditional
` - -
(Standen WH -Fokpng Stone
fincludec or White option `
FULL DH Frame - Included - I., In BAS -HU `- mcluded MISC
"`Exlsf ng Window Ander'n r - RAM INSER Sash Glass In Bess Glass -unit SASH LIFT m BASE
LABOR
Type Wmck;wTfPEj or/Fmish 1, SC SIZE SOLD(Tip to TIP) i MEASURE TECH SIZE ONLY ONLY Optionj Casement Har cffir g Op IOPTIOh price) - Wife Options(PER SASH PRICING) OPTION pndng) OPTIONS unit pndrg)' OPTIO
TOTAL MTASM
IMeo TW SC UI Standard #Bare #Bars *Bars #Bars Paris MISC
Exlshn Series EAUrkr Finish Jamt Standen (WID Size Grid Exterior hdeda n,Vert HoVert Hertz & Labor
Wind Type Style Color Color Un Size AW + CODE W SILL Sash Hing Temp Susan Type Grid Grid Paaem (per (per Lonrho (Per (Per Location ObscureFinish An l Finlsh Rem
R F Code CODE COD CODE COD Col Coda Height E Height D AN Sprit Venhng/Hann g Style CODE Options COD Color Cobr CODE sash) sash) CODE Sash) Sash) CODE CODE CODE Type COD Type CODE CODES
1 BAT 2nd SB-CI 400 CI-I- WH PINE 28 1411 174 L STD none WH STD WH STD WH WRAP
H SPL
2 BAT 2nd SS-C1 400 C7-1- WH PINE 26 48 74 L STD none WH STD WH STD WH WRAP
H SPL
3 BAT 2nd SB-C1 400 C1-1- WH PINE 26 48 74 L STD none WH STD WH STD WH WRAP
H SPL
BAY/BOWWWCCW SCA-tasxNetu.Onexrds Ulm L2bw,Nun 8tadk0PH- .epslelweletieu,Um ft—ft.ltlmtlywindow/door) MANUFACTURER NOTES:MW%"0-2 WdEo6
Aewamrlec,Ueu Item#to tdenllry window/dm
Pko�tlan AngU lee%'30•a 4S') Top d Wudowto sotm(hkdea7
ell Wit l—Flenkare(DH/Ceaement) YAdtnot O�mnarg(Indies)
CNTs udrbd1(Yea/Na) htiedtos^wIRotso ffww l
IThere iq no parewee Met new shanginw a
NEW DOOR UNfT '
WINDOW& -
' DOOR ^,x
fTEM - Andersen r. MEASURE .FULL FRAME - `Glass Saco Hinge z.'. . MULL/STACK. Energy Star AW Tdm tor'
"o, Existing Door Type Door TYPE Color/Flnbh :SC SIZE SOLD Mp b TIP) TECH SIZE ONLY Grillo Options(PERSASH PRICING)' OPTIO Option Optim_ - Hbgod and GOd)ng Door Options OPTIONS- MISC LABOR OPTIONS Options, Radius Uidt
PD N..V—
Assembi Est
TOTAL (200, rota
Location Intedol UI RO/ IrvsMng PD PD Gliding Hinged 400,& un
Fid Se Exte Finish Stand (WIDTH TIP Fxt Extansb Grid Exterio hneric # #B Door Door ASer Lock Lock Options ell Dinar
Door Type Style Color Color Size AW + to Jam JemIs Type Grid Grid Pette riz(P bscu Scree IN or # Venting Venting gilding IRTD HRDW Keyed Mulled Special % t
F Code COD COD CODE COD Code Width Heigh HEIGH Hal TIP Size Location COD Color Color COD Sash Sash CODE CODE OUT Pansh Handkg Handln only) Type Finish Lock Stacked Notes MISC Labor Rem CODES Y..N Profile
No Width
No AW CoiV,
Wraps
#of
boxes
No Color
Approval pant Nome RAYMOND VILLANUEVA Ttb Home Owner
ANDERSEN®400 SERIES WINDOW AND DOOR NFRC/ENERGY STAR®INFORMATION
E
This document provides NFRC certified U-Factor,Solar Heat Gain Coefficient(SHGC)and Visible Transmittance(VT)values for Andersen®products along
with the corresponding ENERGY STAR®Version 6.0(2015)dimate zones in which the product and glass type are certified.
These products rated,certified and labeled y National Fenestration Rating Council® (NFRC)-a non-profit organization that provides fair,
accurate and credible energy performance ratings for windows and doors.
Many of our products meet the stringent energy efficiency certification criteria set by the U.S.Environmental Protection
Agency and the U.S.Department of Energy. The certification criteria is based on the heat gain and loss of each product in
various regions of the country. Check the Andersen product performance available at www.andersenwindows.com for units
that are ENERGY STAR certified.
United States ENERGY STARO Canada EMERY STAR@
Climate Zone Criteria Climate Zone Criteria
ENuillay sTAYO
® Northern ZONE 3
$ = c ZONE 2
ZONE 1
a �n South Central �"#�' •r ,
'�.n -
Southern
Windows
Doors
4Chrnate "sT.�uV=„�°oEj.""gtIGC� gaiittg ;';ti=' 4;. "z""`'=s'�'y�h-�„ °n'°�.;.',`. - ,. ,�` 5';,;:•., '`-r
Zone
=•�":3�� =�-_.=,+`daa Levet �U'F��o[�fa:a•��;�a.�L�GG�q�rr-,,, wr.;,h ,� a
'0.27 c Any Preeagrtive u s 0.17 r No Rating f
f` C1`s3' f12�jr?` s025� 5025
F: s' squtrcalagt,4f
Q29' ktJ T','4. Ergjjjgi;t Noes0A0
`�� 'sem^„(?Bkfontfa
3:030
North-Central
Southern s0�5
SouthCan ai
Air Leakage for Sfiding Doors503drrU
!cer '12 i sQ30 s040 Ali LeakageforSvmgmgQoorss0.5clrnW
s0.0 s025
MLeakages0.3cfmlft'r ii•'.s�"'i':,w,•,�,aemo�,`Gmif:�-”r'�s;k�:.r�""�k2�`,�r��!��ar,�;�ix�a.��T w,,,�.
r MUM ft'
Solar Heat Gain Coeticlent
•The efkcbve date W the Northern Zone presatdive ,
anu egWvalard anmgy performance uadia tar twndawa
isJanuarY1,2016 � '
Far NFRC certified total unit performance forunits with capubw breathertubes,picase rehrto the High Altluude Informadon section foreach unit
,U-Factordefines theanrount of heatloss through the total unitin Ow/hroft-F,medic in W/nam The lowerthevalimtheless the heatislosithmughthemoiraproduct
'Solar Heat Galn meff(dent(SHGCdefines the fraction of solar radiation admitted thmugh the glass both dlrectlytransmRted and absorbed and subsequemty released lmvard.The loaner thevalue,the less beat Istmnsndtted
through the product
svtsWTrarrmttttance(Vri measures how much 4htmmesthrough a product Wm and frarrse).The higherthevalm from Oto l the mom daylight the product feu in overthe produces total unitar"VisibleTrartvnitiance '
b measured overthe38oto 769 nanometerportion of theWuspamm
NFRC ratings am based on modeling bV a third partyagency asvalidated byan fndep¢ndertttest lab in 0amp0ance With NFRCrpogr2m and procedural requirements.
This data is amsratessonoecember 15,2014.Dueto ongoing product changes,updated test resdUornew industry standards or fequhemenss,ft data maychanieouertime.Due tovadatiom in dealer and distributor E
lnvemmYl¢ve pmductsthaweremanufactured before December15,2014thatwMedesigned,test and labeled with dfferent NFRCvatues maystill be available.Chedtthe labels on the iaodua padogingto confirm NFRC '
values.Radrigsare forshesspedMd bywMfortesttng and rsriarkadmr.RotMgs mayvatydepending on use oftemperedglass,dtfferent�tleoptiorrs,&Zforhlgb oftwc,etc.
All markswheredenoted are trademarks of their respective owners.
02014 Andersen Corporation.AD rights reserved.