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HomeMy WebLinkAbout47557-Z � TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 47557 Date: 3/16/2022 Permission is hereby granted to: McLaughlin, Terence __ ____ .. _____ _..w__ _ ...„. 1885 Plum Island Ln . Orient, NY 11957 To: install window replacements to an existing single-family dwelling as applied for. At premises located at: 188_w 5 Plum Island Ln.,, Orient . __.__.... . ........ ��� _._m_.. _a._._..... --- ..... ..... .. ._._.__ �. ....u....._ SCTM # 473889 Sec/Block/Lot# 15.-5-3 Pursuant to application dated 2/1.5/20,22....._ and approved by the Building Inspector. p To expire on 9/15/2023. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO-ALTERATION TO DWELLING $50.00 Total: $250.00 d ............ Building Inspector TOWN OF SOUTHOLD —BUILDING DEPARTMENT d Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,ICY 11971-0959 p � Telephone (631) 765-1802 Fax (631) 765-9502 � u6 : ���i � :ml� "� a Date Received APPLICATION FOR BU11 DING PERMIT For office Use only I Ylil; PERMIT NO, w " '. Building llnspector:, _ Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date:1/27/22 OWNER(S)OF PROPERTY: Name:Terence Mclaughlin SCTM# 1000- ) 6- 5- 3 Project Address:1885 Plum island Lane Phone#: (516) 712-5740 _T__Email:tpmac1031{�7a aol.com Mailing Address:1885 Plum Island Lane CONTACT PERSON: Name:Jessica Schiff Mailing Address:105 Buttonball Ln, Glastonbury CT 06033 Phone#:347-541-4613 TEmail:permits@gopermits.org DESIGN PROFESSIONAL INFORMATION: Name: ,Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Home Depot USA Mailing Address:2455 Paces Ferry Rd, Atlanta GA 30339 Phone#:(347) 5414613 Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition1.0Alteration WRepair ❑Demolition Estimated Cost of Project: ❑Other Remove and replace 4 windows, like with like, no structural changes, $6894 Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes ... No 1 PROPERTY INFORMATION Existing use of pro perty:Res Intended use of property:Res Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? E]Yes No IF YES, PROVIDE A COPY. El Check Box After Reading: The owner/contractor/design professional Is responsible for all drainage and storm water Issues as provided by I Chapter 236 of the Town Code. 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,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable Lim,ordinances,building code, housI ng code and r and to admit authorized Inspectors on premises and In building(s)for necessary Inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210A5 of the New York State Penal Law. Application Submitted By(print name):Jessica Schiff @Authorized Agent DOwner Signature of Applicant: � S"4f Date: 11 STATE OF NEW YORK) SS: COUNTY OF $. ____being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the INA gict %J (Contractor,Agent, Corporate Officer,etc.) of said owner oro nrs,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief;and that the or will be performed in the manner set forth in the application file therewith. Sworn before me this day of UA 20 Notary Pu lit oY 1)[10I)ERI'Y OWNER AUM�101�U d f ZA` m WD4D)'AA ROSSI ' � w��,n vilavno (Where the applicant is not the owner) 440,0 ill,063 7' QaN^6e(j m wayno Expwei,,3m 4, Z( residing at hereby authorize ... to apply on my behalf to the Town of Southol Building Department for approval as described herein. Owner's Signature Date Print Owner's Name 2 II � waw s u's �.a.. � .me .� LicenseA's,. ..III � .�.@ � m� �... ........ ��' �'-mllr� � n�u�n� �� rn� �rr Orr rrrr .�.,:� �w....:..........�. .. `unkll� nrr�...... ....w.,,� ....�...w ................ '���&Vmrr Q �. Pum rr 4'rrnn� nw":�aff w4�1���� I i I ... Salesperson Name Registration # (Req. in CA,,CTME,N4D,N4I,NJ,DQ Holine Depot N . jnc,("110 nm Depot") umm Autfiorized ServiceIII:Im°m vmm mmm° named below will furnish, install NN m°mmN/or service the equipment fisted below mit: thic price, Wrins andconditions as mmm.mtfined on this foram. Ni Service Provider Contact Information ( ................................................ ......... . .......... pne n Non e II nepiiiwn p pne p porne p.rr ;'wot W ............... � ........................................................ ",o, ...v,. ,, � rr i Providic:r( �...mct Name Service Pi om,nmN i. Con .any Naine n.�.�.. �nri p n �4 ,u riuurr n rrrr� am eniat oii' 1 . . ..... �...��,�„,�.�.,,, ................ ...k PNic)ne 4 ��'� �nrr�����u�nr�rr�oder Einail Address m 1112rmrlrm e novm,�Jn»re. I icene 4(i") 2. ,ustoliner Iiii1formation .0 p u ghfirrr � e:,rrw^n� �'n� �� �p. �.�..p p��s��.p.�.�.�.,,�. R....�,.�.�,e....�..�.. �.��� n n1uw u stomm ei 1,,ast Name mime (.''uustome First P114ame Sulwre 4/Branch N111,ia mn N:Nrrmstu umne 1,ead/ PO 1 .......... Ru n Wanrrup p a �'m erre rr rrt VP e, .................,.ww ...,.�. � . ....a . tpn,a @uaop wu m� ....................................................... ....... ,a...................., N N�none# Work ����mw ne# mull Nf hon ustom�m n Email� mmmui mm mNmm e 3. NOTICE F G'. °. ' EL YOU MA I V w Q l NN°l " " NNle,II"' .LW""'. OR . NIS : THE E NN 1111011]WER, OR STORE DIRECTLY; EMAILING &lllmARVICE PROVIDER Al'�w cans orrrruumrrc,,:rrncew la flon nor thewnu�u�u1iom ^ciepot co nu ® ,� �,�...... ...... .... .... ._... ... ... ... ... .... .... ._... ,... .... .. _.e , ......._,.,,. ...._...... .. ,. n . , OR DELIVERING WRITTEN NOTICETO HOME DEPOT' A,T: � rr Avenue p p���nuu �w�unn � � p � p! .,,,, ,,.... ...... .. .,.,.,.,., ..,, �,,.,,,.,,., �,,,.. Addiress Ity State Zip ItY I NIG� HE THIRD BUSINESS DAV AFTER INS, UNLESS HE STATE, SUPPLEMENT PROVIDES A N NfIIIN FERENNN l' "..0 N N °1 n .L TION ""'Nu llll IO N STATE ('-I ONTAINS A FORM TO USE IF ONE IS SPEC[FICA 11,11" PRESCRIBED BY ��,AW IN 1101UZ STAXE VOUR PAYMENT(S)i WIIA, BE kfili. .°URNED WITHIN TEN (10) BIJSINESS AAS AFTER HOME I' II" NN ECI T OF YOUR. NOTICE. 11' 'OLJ uINN "'" AVAILABLE'�� ���'�' MANN' 1 ICS IIIIf��,NIIIIN�� ° '" HOME °' � NNS 11111'N�, � N" DEPOT011t. SERVICE PROVIDER, AT ' UNN IIIIIN RVJ:"E ADDRESS, AXI) IIN SNNBST N "'N I L ..fl" IIE N :NIIIN�', �N�� N - N Alli ' ��i DELIVERED, �ANV �N'� :�NRCII P NII �N�N I)IS 1 "N"ERIA �S NIII)EI � VERE��� ., . OR YOU MA V CONTAC'I' HOME IIIINW11 . °" FOR INSTRUCTIONS REGARDING" RETURN Sill N Si l Ii E N I" N' 110 M El DEPOT'S POT'' III NN�'NN^ N IIIIIN'N HE, I.A,W REQUIRESTHATTHE HOME DEPOT GIVE VOIJA NNN10E E'' 14:,AuN'NING 'OU�� �RIGHT TO CANCE1, PLEASE SIGN BEi,OW TO ACKNOWLEDGETHAT YOU HAVE. BEEN GIVEN ORAI, NN' R I E N' NOTICE I NINA Y01JR RIG N( AN(A' N Acknowledged by! 7 :1 e,. Customers s nSigrrma;W.tur Date ,1/p rPq a 'n, 1�s^�tr,�rr"d..D,�r n n .,, f 0 " //o /r/ r/ /p r i s spsasms c ssy -e uusy® ps 4. Description tionn of Work to be Performed descriptionA detailed uml`the work to be pucmycmnuµncd is included in the pnauapysap h cnutpnlu d !b(op e ol'Anor ,,Specification, toiner n uu�uwu�miiySheet, Quote Form, Estimate, Invoice or s ue which is uuu(puuuped uuu this A,gr m >u teiiut,, d. Anticipated :Depnimlnlnnny Dat /Installation Ssdadule 2 .. nnmtpuurDme 7/2520 fAnppnFinish ApnmmmsAlll dates are mupupuu°mmspmmmum.sum and to unforeseen u�uu�ummmummu��p�uuu�iiuu.h on events °�uuuu��u�uum , ��" ' �u� pumum n�mwuu�uuincluding ginclement ` pu� pp �upp� ur, u Iluuwmmup `u�u delays, ummmu delaysiiimm. d. Electronic Rec r°4,s, Authorization "mou.0 am emidi:,1:11d too a paper er uaopy of this Agreement if yo ap oose, If you consent to an e...mailed c k)l!D ", °ou.mmm uunsent applies, to this Agreement and all subsequent dccuum cnts and written communications aaucationms uicpatcd to edits .An.Ameemcmni�l. El con astpumd YOUl'� smms�uce Providcu you n°u.nay update your email address withdrawyour consent,umn, or obtain a paper copy of the A.dnre ernunnnt 133 mmnlancd documents nts aur no charge, By providing ycu.us consent and scu ml7+unmpp yci um. entail admpiess above, you con/:inn that you have access to a computer duan can receive and open cmumaii is aii wud PDF doe lnmmmnietu:s. Cmm Contract Price a nmip Payinesit Schedule aynma:!nt ofthe Contract Price is due cpacnu spdunpnng Unless a different payment schedule is nanqumlred by laiv, sl'��u��ms�uil�mcs�l. llie mow or in a paynient adde ndiamsn. Contract Price,- [6894M � Includes all applicable taxes, p aclUdes punnannc � � Vmmargess, p P Cm.p.cs Cin°s: c....,..... (pp apnpappcapnpc, total ansmmnnumm of taxes included uuu nuuiu�mcm nn�n°/nnn�suuumm dep,e'nde 011111.1'a'7 11h., mble in AID, AWA, YVI"' (33%), ,X111 X111 p%p / (99 yo Deposit dW,,p �nnn(n nu......., � Deposit Annncuunnt d sass s2 ppcnunapnnnung 111 slsuinu,mn .un . lldpnnus n e C;dmnsppes Any, mnmfi es pus°,,Vrne nips or other finance charges will be dctcmnunlmncd by Customer's scpualats; m alrRismlder or loan agreement, tin °unm'pmun lu Horne nne ep of is NOT a party, and will be in addition to Customer's payment e nt is ndei this Au ,Vecmn°mcm°m (Dui,ustoi ner is sunlpjcct to the semis and conditions of the cardholder or loan adsccm°mncmn , as ttlll)n'I licaWle No pm nds should be made payable to dcros�lcc Provider,' however, Service provider may collect Cu stomnme `s payments mnnads payable to Hirinnc Depot, d. A.cce nusnnun and .d.nnn pnsmspaatdasn By signing l elosv you authorize Horne Depot to: (a( arrange for Service Provider to pnmunpnnm.msm any Se viices or b) order and mmcaundc ppsu. the delivery of special unsdcs merchandise, including special cmmdcucm umunum°cl a nmise that may be custom mnadc, as specified in this Agreement o not sign if blank or incomplete (Service pun°mens udcur ws or l)er°r tmmuid muimin':mrma " n need �to be provided to You la en ) By signing,you acknowledge that, p�)'"ppnum IP��naave nm�m�mmlw a nm:lcsmptand,�N n u:mWWmsrW mnn.a� and am n a M wpmllu . u ���� A Ap�wuu�c�u°n.u�un �� in m��s cmntmscn ', um�u.cluu.d�lad tlnc Clcccsal p"cm��ndptic�nns and �d� s �Am:n1lnlnlsnnnn rnn.„ �mCmsm�mp, (pl.( p�u�:uum. ,:ire mmeceiI(rlapm a coo immp tete copy of this Agreemm e nt, (ppm( all rights and interests uunudcm iris Agreement ate solely vested inn the person Rusted as A.�C'nustemnneu" above-, and (iv) Electronic signatures msllpp be deemed originals lu r enrollIllmmmui°pxisenu. � h d iQ �ob ,,,, . .., „�_r„ „e p::"mmstn;un°mucro°u p�uuuuu"muu.ure prate A �� ���� ww ..w .. �wawao . ',/Aluc . ��.� ..............-....m.......o. ,-------- ................ ............... The p loine Depot Digital Signature pyatu;. For mpmunmstions related to, your installation, conntact Service Provider a (�„�. . 7"8 ” "0 F,or m n.V otpmcm-concerns, confact The Home pey)mmt at 1-800-466-333 Noy➢E1irarNrd.ae rP Y rruxxo kdM W r'I li,m? :;.I)a,➢''J CuencimLd O m. /.2.10.,2.2 L ad p'Q1��'i m p'B�a„'�J �,fi,t��.Y�.7._ .a.ng TATWorker STAs' CERTIFICATE OF TE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only� I b.Business Telephone Number of Insured Home Depot USA,Inc. 770-433-8211 2455 Paces Ferry Rd.,C-20 Atlanta,GA 30339 1 c,NYS Unemployment Insurance Employer Registration Number of Insured 76011130 Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,ie.,a Wrap-Up Policy) Number 58-1853319 .......... .......... ......... 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) New Hampshire Insurance Company Town of Southold 53095 Route 25 3b.Policy Number of Entity Listed in Box"I a" Southold.NY 11971 WC 058240268 3c.Policy effective period 03/01/2021 to 03/01/2022 ­.­­......................... 3d.The Proprietor,Partners or Executive Officers are included.(only check box if all paMers/officers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"T'insures the business referenced above in box"l a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under fte—m JA on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this for is approved by the insurance carrier ori licensed agent,or until the policy expiration date listed In box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation pol,icy indicated on this form,if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Michael Price .............. ....................­.­­­­..­__....................._­­......... (Print name of authorized representative or licensed agent of insurance carrier) Approved by, 02/27/2021 ..........__............................................................. (Sgnature) (Date) Title: CIE0 North America Telephone Number of authorized representative or licensed agent of insurance carrier: 212770-7000 ____................. Please Note- Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www,wcb.ny.gov Workers' Compensation Law Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1 The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general orspecial statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. C-105.2 (9-17) REVERSE Workers' mCERTIFICATE OF INSURANCE COVERAGE sfA Lapeiiisaton Board DISABILITY AND PAIDiLY LEAVE BENEFITS PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrierµ...................__._.. 1a.Legal Name&Address„of Insured(use„street address only) m mWWW.1 b.Business Telephone Number of Insured _._-- w.w...._.. ... HOME DEPOT U.S.A.,INC. 446-8(57-7093 2455 PACES FERRY OA NIN ATLANTA,GA 30339 1c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e., Wrap-Up Policy) 581853319 �-Y..'ams and Ad d ss o ity.Mµeesting Proof of _�,�_ ,.. - 3a"Na"me of insurance Carrier M_.,__..,______.M,_..www�..www.....ww...._w... Coverage(Entity eig Listed as the Certificate Holder) TOWN OF SOUTHOLDHARTFORD LIFE AND ACCIDENT 53095 ROUTE 25 3b Policy Number of Entity Listed in Box"la” SOUTHOLD, NY 11971 LNY713657 c Policy effective period 01-01-2022 to 12-31-2022 .Policy provides the following benefits: RJ A.Both disabilityand paid family leave benefits. Disability benefits only. C.Paid family leave benefits only. 5.Policovers: 9A.All of the employees ploys eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees: Under penalty of perjury,I certify that 1 am an authorized representative or licensed agent of the insurance carrier referenced above and that the named Insured has NYS Disabilityand/or Paid Family Leave Benefits insurance coverage as described above. Date 12-29-2021 r „ min�td .... _................ gi nature of insutanoo Cartier a autd wired representative or NYS t toonsed insurance agent of that _ nre ler)__, � li . ..ri .. t kns�arteaatoo carrier) .........._ irector,Statutory Services .Telephone_ umber (212)553-8074 ..__..._ Name and Title Elizabeth Tella Assistant D Gtor,.. a _ .. ... ..m _ ..�_ IMPORTANT, If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. ail It directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to theWorkers'Compensation Board,Plans Acceptance Unit,PO Box 5200,Binghamton,NY 13902-5200. PART 2.To be completed the NYS Workers' Compensation Board (Only If Box 4C or 5 of Part 1 has been checked) York �.....v_._ _.�_ .. ... State of New Workers' Compensation According to information ain ins by the NYS Workers'Compensation Board,the above-named employer has complied it the NYS Disabilityand Paid Family Leave Benefits Law with respect to all of his/her employees. Date (Signature of Authorized NYS Workers'Compeneation Board Employee) Teleane u rName and Tette /ease Note:Only Insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed Insurance agents of those insurance carriers are authorized to Issue Form DB-120.1.Insurance brokers are NOT authorized to Issue this form. DB-120.1 (10-17) Additional Instructions f r Form D13-120.1 By signing this form, the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in box"l a"for disability and/or paid family leave benefits under the New York State Disability and Paid Family Leave Benefits Law. The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed as the certificate holder in Box 2. The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is cancelled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from coverage indicated on this Certificate. (These notices my be sent by regular mail.)Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in Box 3c, whichever is earlier This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Disability and/or Paid family Leave Benefits contract of insurance only while the underlying policy is in effect. Please Note: Upon the cancellation-of the disability and/or paid family leave benefits policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of NYS Disability and/or Paid Family-Leave Benefits Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Disability and Paid Family Leave Benefits Law. DISABILITY IFAMILY LEAVE FIT LAW §220. Su d. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits and after January first, two thousand and twenty-one, the payment of family leave benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to fray any disability benefits to any such employee if so employed. (b) The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first, two thousand eighteen, the payment of family leave benefits for all employees has been secured as provided by this article. DB-120.1(1 17)Reverse Go Permits, LLC 105 Buttonball Ln. Glastonbury, CT 06033 �J Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 y,u scottdoughman@gopermits.org February 16, 2022 To: Town of Southold Re: 1885 Plum Island Ln. Enclosed you will find check for the additional permit fee of $50 for the window replacement job at the address above. If you have any questions, feel free to call me at the number listed below. When the permit is ready, please email a copy to: Thank you! Jennifer Winke, Permit Expediter Go Permits, LLC Phone: 303-946-8685 Fax: 866-697-0768 jenniferwinke@gopermits.org Go Permits, LLC 105 Buttonball Ln, Glastonbury CT 06033 www.gopermits.org WINDOVSPECIFICATION SHEET Spec;Sheet# t 1Yscov@S Sheet.. of.t Customer: Terence Mclaughlin -Job.# }-1Y8COV55: ` - Conslaltant Aiism Friedman 4ate Existing Window y " Hinge Locations Measurements , Gnds% y y Product Options Labor Options- From outside, -Left to Right LocationBays,.Bows 9 .,Pe 9 #of bars #of bars Csmnts,t Pni, uses,R or S- I, •Glass Misc�Items Hardware Code a Screens For doors use ` . o LL r� stationary or w Style Wraps p m m "X"=operating Room Floor Code (YIN) Style Code ',Series Code ;:> PIn-, T<720,STD White;`, METAL- 1 BATH 1st 1 PNL Y 2 PNL 6500 WK - az 35 22 TMP ;FuII,:;,GlassPack. HURR,- X. S Standard WRAP,iSR' 5500 WH BZ 23 34- .; 2 BATH 1st SHS Y DH b7 F r WH W' C ALL 1 1 `.ALL 1 1 STbLWhttepTMPOFu11 HURRMETAL� GBG H SR ' ..� .;'� ,`Gi spackl;5tandard�= WRAP L as P7<120 ISTD,White,' METAL; 3 BED 1st 1 PNL Y 2 PNL 6500; WH 82 58" 46 1D4 F WH W C ALL .2 4 ALL 2 4 Glasspack:Standard, HIGH, X S GBG N WRAF,LSR PT<120 STf) White,. METAL, a BED 1st SHS Y DH 6500 WH Bz, 35 70 105 } F WH W' C ALL 2 2 ALL 2 2 TMP Fu11GIassPack, H•URR; GBG W S Standard WRAP,L W t : r s;. v J I, t' v "'.. ' r� � E SPECtAC.CON$ICERATIONS 1:Dark Bronze,2i Dark Bronze 3 Dark Bronze 4;White " Custom C for Window DooFWra F&I A ! P a Wrap Color ! P ' a Interior Casing Type ; Bay,or Bow windowa - ' ) Sealboard material(vinyl only-Biroh or Oak) ZOZZ <: Bay Project Angle(30 or 45) Bay Flanker Type(DH,SH,or Csmnt)' UILDXNG DEPT N OF SOUTHOLD Top of window to soffit(inches) 4 If tied to offit,color of soffit Material 1 have reviewed and ggreawlth all the job speci[ications.above and the Construct Roof(Yes or No)' Special Tgrms and Conddions on the following page Garden Window: . Seatboar»Mater al(vinyl only-White Pionte,Birch or Oak) `. r( { 4 .. .k Y` The - Depot Products - . . Dated. 130/2018 Simonton Y 'ill • • Wdh Grids Style Glass Package 7 Glazing Spacer IG G.at`';HGC SHGG �- ..:•s .,�:.-`.._...-k .. :;,�,:. r 5. psi Fait . • 11 Awning 6500 Base ProSolar Supercept 7Ar 026 1. .0:23 , o v o 026 ' 021 0 0 0 Casement 6500 Base ProSolar Supercept 7/8" 0.26 0.24 c 0 o o 0.26 f 0.22 © Transom 8500 Base ProSotar Supercept i' 027 { 0.32 ® ® 0.27 ; 0.29 ubte-Hung 6500 Kase ProSolar SupemW - 7/ir 0.29 0.26. 0 0.29 1. .0.24 a o 0 Picture Casement (NH) 6500 Base ProSolar Supercept. 7/8° 0.26 0:28 a ..o 0.26 1, 0.25 0 0 0101 Picture 6500 Base ProSolar Supercept 71W. 0.27 ' 029 0 0. 0.27 0.26 ®. ane/Slide 6500 Base Pro$olar.. Supercept 7/8" 0.29 0.26 ® 029 023 ® o 3'Panel Sliders 6500 Base(s-21 sgft) Pro Solar -Supercept 7/6" 0.290.26 ® 0.28 0.23 ® o m i.. • 11 r • • ' Garden floor(CH) 6500 EneEgy Star ProSolar SUN SuperSpacer -'1" 1 0:30 j '0.24 101 ol 61m -0.30 1 0:21 0 ® ® a Patio Door INOVO...<.:.. 6500 Base Pro Solar Super Spacer 1^ 1 0.28 ..026e_ ® '0.31 ., '023 a .a '0 .o • / 1 Elomes Ionated everywhere EXCEPT:Arizaw California,Idaho,Nevadk New Afexfco,Oregon.U th,and {Nash/trgton: Awning(Inc Hopper) 8100 Base Pro'Solar Intercept 7/8" 02g-24 0 0 .® 0 0.28 0:21. o 0 0 0 Casement 6100 Base Pro Solar Intercept 718" .0.224 c o o d 027 0.22 a Double-Hun 6100 Ene Star Pro Solar Supercept 3/4" 0. 30 a 0.30 0.27'Picture Casement-(Notlaige) 6100 Base Pro Solar Intercept .7/8"; 0. 28 . _®: ® 0.27. .0:25 e ® ® e Picture 6100 Base Pro Solar Intercept 314• 027 0.37 ® © 027.....-0.28,. o, ;o 2 Panel Slider 6100 Base Pro Solar kderc ept 314" 0:30.. ._928 0 0.30,j O.27 ®, . 3'Panel Slider 6100 BasePro Solar... Intercept, .. 3!4". 0.30 029 0 0.30 1. 027 • of Doi Hbmes locateii®venywbere BAsor.:Arfmna,Galli m1a,Idaho.Xevada,Newtlledeo,Oregon,Utah,and tr4nashkWfft. Patio Door 1NOVO '6100 Ens-...°Staff Pro Solar Supec'Spacer 1" 02$ ' 026 ® m i 0.28 023 o v e .o Patio DoorWARROW FRAME...6100(PD05).'Base.. . . . . Pro Solar... . . . . . tdfetrrept 3/4" 0:28. ...0:30 . .a ® 0 e i. 0:28 t 026. 4l n9 . .. . • 1 / Homes located/on /n fo/Iowl .marks&:Dalfas,Deaver,De6n1t PlHla;Northern W Longlsland HY. Awning ..:. .:6200 Base Tiro Solar SHADE. Supercept ]'31,r .027 � 0:25- o ® o 0 0:26 023 o m 0 . Casement 6200 Base Pro Solar SHADE Supercept 026 ' VAS d. .Q o ® 0:29 0:17 Acture Casement=NH .6200 Base Pro Solar SHADE Supercept 0.25 ! 021 0 ® o m •0 25 Z 0.19 0 0 0 Picture Window 6200 Base Pro Solar SHADE Supercept . . 0.26 024v v. o. p 0.26 0.22 v. o o a Single Hung 6200 Base Pro Solar SHADE.._. SupereW. 028 023 . ® s e ® 0 28 1021 0 o e Singte.Slider. 6200 Base ProSolarSHADE Supert 028 023. ° ° a 028 t.„021 0 03 Panel Seder 6200 ease Pro Solar SHADE Supprcept 028:: .0.23_ ... _® _®. _m_ 0:28 E..:O 21 ® o 0 I .9 -ff.Hal 1-311 M11 i MWILTA ted tn`caastval arm Awning SB+300VL Energy Star PS SUN/Lami Sypercept 1^ 025 1 023 0 0 0 ® 0.26 : 021 ® 016 m Casement SB+300VL Base - - PS/I.ami Super.Spacer 1" . 025- 0:23 ® v s v 025 f 021 e Double Hung St3+300VL Base . . PS/!ami Super Spacxt..1.'. 1.029 0:25 ®' o o e 029 .023 0 ®` o. :®11 .. Slider SB+300VL Base PS/Lami Intercept 1^ 029 0125 o e o ® 029 j. 0:23 ? e Patio Door SB+300VL ETC 366 PS Shade/L:arni Super.Spacer 1° 0:30 } 0:19 o a o o • Garden.Door(C _-..__. SB+300VL Base PS/Lami Super.Spacer 1 0.30 '. 0.28 e o 0.30 . 0.25 0 ® o 0. •Dots indicate Energy Star.certified for that zone