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HomeMy WebLinkAbout44871-Z �o�g�ff01pcoG Town of Southold 2/2/2022 a d� P.O.Box 1179 0 1 $ 53095 Main Rd WQy�01 �ao� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 42738 Date: 2/2/2022 THIS CERTIFIES that the building WINDOWS Location of Property: 2555 Youngs Ave Unit 121), Southold SCTM#: 473889 Sec/Block/Lot: 63.2-1-36 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/26/2020 pursuant to which Building Permit No. 44871 dated 6/16/2020 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: windwo replacements to an existing dwelling as applied for. (Unit 12D) The certificate is issued to Jamotta,Joanne&Christopher of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED tho ized i nature S�EE Q TOWN OF SOUTHOLD �o�° kcoGy� BUILDING DEPARTMENT y ' 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#: 44871 Date: 6/16/2020 Permission is hereby granted to: Jamotta, Joanne 2120 Mill Rd Ronkonkoma, NY 11779 To: make alterations (window replacement) to an existing dwelling as applied for. At premises located at: 2555 Youngs Ave Unit 12D, Southold SCTM #473889 Sec/Block/Lot# 63.2-1-36 Pursuant to application-dated 5/26/2020 and approved by the Building Inspector. To expire on 12/16/2021_. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO-ALTERATION TO DWELLING $50.00 o a : $250.00 Build ng I spector Form No.6 TOWN OF SOUTBOLD BUILDING DEPARTMENT TOWN HALT. 765-1502 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 Und 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 plan requirements. B. For existing buildings(prior to April 9,L057)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. New Construction: Old or Pre-existing Building: X (check one) Location of Property: °9 555 YO C!A/G9 A-V r 12-_D S d U mmp House No. Street Hamlet Owner or Owners of Property: CK(Ill si o ptl4g/e JP M o T/—�4 Suffolk County Tax Map No 1000,Section Block Lot Subdivision / Filed Map. Lot: Permit No. Date of Permit. Applicant: ME/J_D20,,) Health Dept.Approval: Underwriters Approval: Planning Board Approval: V Request for. Temporary Certificate Final Certificate: (check one) Fee Submitted:$ SZ9. (2-0 �Q,�gQrt2� Applicant Signature OF SOUTyo * * TOWN OF SOUTHOLD BUILDING DEPT. cou765-1602 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION/CAUL ING [ ] FRAMING /STRAPPING [Vf FINAL , [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE [ INSPECTOR.=, t moi. FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION-(IST) y ------------------------------------- FOUNDATION (2ND) o : H ROUGH FRAMING& PLUMBING R I � r INStiLATION PER N.Y. ��H STATE ENERGY CODE FINAL ADDITIONAL COMMENTS Z �rn \ � ro � Oz x x d b H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do yon have or need the following,before applying? 4 TOWN HALL Board.of Health SOUTHOLD,NY 11971 4 setts of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 Survey SoutholdTownNorthFork.net PERMIT NO. Check Septic Form NY.S.DY–C. Trustees C-O-Application Flood Permit Examined 20 Single&Separate Storm-Water Assessment Form Contac 1 Approved 20 Mail to:S� Wu C9 h14P'N Disapproved ate los 8(diiQN8AW LO GLASIOrJelAa`l C1 p6o33 Phone:(EGO 95), .411 Z Expiration 120 r APPLICATION FOR BUILDING MAY 2 6 n20 Date 20 2� WSTRUCTIONS .,.a, s aliplication MUST he completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 setg'-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 he commenced before issuance of Building Permit d-Upon approval of this application,the Building Inspector will issue a Building Permit to the applicanL Such a permit shall be kept on the premises available for inspection throughout the wow 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 Budding Inspector may authorize,in writing,the extension of the permit for an addition six months.Thcr eafhx,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuaacc of a Building Permit pursuant to the Building Zone Ordinance ofthe Town of Southold,Suffolk Comity,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. (Sigmatrue of applicant ori if a corporation) 3g1-q 9-MeQso,v op semi i,Ee- Pic, Ool4)9 (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,phmmber or builder ; Name of owner ofpremises CM12)S/QPKEe J)9MOT7- } (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.— H -534-29 Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: -2555 YQuNG�s AVE laJ sou 1001 House Number Street Hamlet County Tax Map No. 1000 Section r Block Lot (� jQFMOVE A/0 aF_PbPCE 4 Ellf\10(00 � L11GE GI!� L11<E ND S'-g"C UP-Rt' ' GHICIINGISS., Subdivision Filed Map No. Lot .y 2. State existing use and occupancy ofpremises and intended use and occupancy ofproposed construction: a Existing use and occupancy RFS!f NG l F/4 M/ b. Intended use and occupancy F S! F/J f 1�(, s//�/(�'(,E F/iM r t,tf 3. Nature of work(check which applicable):New Building Addition Alteration Repair X_Removal Demolition Other Work Irl t QbO W P,F—PLA eE MEi J i ,p (Description) 4. Estimated Cost 3 O Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor ff garage,number of cats 6. Nbusmess,commercial or mixed occupancy,specify nature and extent of each type ofuse. 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.W111 lot be re-graded?YES NO Will excess fill be removed from premises?YES -NO 14.Names of Owner of premisesCHQ/ST0PHE2 100 Addres45'5S YOUNG$ AVP-Phone No.T63 Q z X11—Sl cq Name of Architect WAddress ab Phone No Name of Contractor HOME .DEPOT LISA Address 2 455 f/M FEB Y APhone No. 6'O 5.Z- 1 2 ArL/arrr/;, 04 30333 15 a-Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO k *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_LC *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 properly?*YES NO *IF YES,PROVIDE A COPY. 1l,UNoIS STATE OF Y OFFICIAL SEAL SS: ELIJAH RTNOTARY PUISLICSTIE OFILLINOIS COUNTY OF COO 1C, ) �l2(3l F!y} M Ft1��0� MY COMMISSION EXPIRES 04/24/2021 being duly swom,deposes and says (Name of individual signing contract)above named, (S)He is the A&EN r (Contractor,Agent,Corporate Officer,ctc-) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are hue to the best of his knowledge and belief,and that the work will be performed in the manner set forth in the application filed therewith. Sworn to ore me this &V of A 20 Notary Public Signature of Applicant . „ � .�, ., �,r DATE(MMMIDAWM A`R" CERTIFICATE OF LIABILITY INSURANCE 011 020 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: OLDERIMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poiicy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME- MARSH USA,INC. PHONE TWO ALLIANCE CENTER ac .OM: AIC No): 3560 LENOX ROAD,SUITE 2400 E NAIL ATLANTA,GA 30326 ADDREss: AFFORDING COVERAGE NAIC$ CN101642069-HomeD-GAW:20-21 INSURER A:Old Republic Insurance Co 24147 INSURID HE HOME DEPOT,INC. INSURER e-New Ham fl Ins Go 23841 HOME DEPOT U.S.A.,INC. INSURER c:HomeRisk Capfwe Insurance Company 2455 PACES FERRY ROAD INSURERD: BUILDING G20 ATLANTA,GA 30339 INSURER E: INSURER - INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004353439-33 REVISION NUMBER:25 THIS 1S 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. LTR ADDLTYPE OF INSURANCE INM POLICYNUMBER POLICY IDDDEFF MIDDI� LTR LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY314574 03/01/2019 0310112022 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE O OCCUR PPREEMMISEESO RENTED ocraorence $ 1,000,000 X SIR$1,000,000 MED EXP(Any one person) $ EXCLUDED PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,060 X POLICY❑JECT �LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ A AUTomomLELIABILrry MWT8314573 03101/2019 03101/2022 COMBINEDSINGII LIMIT $ 1,000,000 Ea accident AINY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per acddent) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPI32TYDAMAGE $ AUTOS ONLY AUTOS ONLY acdd� X UMBRELLALfA6OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WC 02309M(AK,NH,NJ,VT) 01 Q31012021 X PER �- AND EMPLOYERS LIABILI Y STATUTE F12 B ANYPROPRIETOR/PARTNER EXECUTIVE Y/N WC 023096005(WI) 031012020 03MV2021 E.L.EACH ACCIDENT $ 5,000,000 OFFICERIMEMBEREXCLUDED? ❑N NIA (Mandatory in NH) EL..DISEASE-EAEMPLOYEE $ 5,000,000 If yas,descube under Continued On Additnal Page F-L DISEASE-POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS below C Excess Auto 297110011002020 03/01/2020 03/01/2021 Limit: 4,000,000 A Excess General L(alnk MWZX 314580 03/012019 03/012071 Link 8,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING G-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZEDREPRESENTATIVE of Marsh USA Inc, Manashi Mukherjee �Lcauan►,. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 2 DATE: 0 512,&1 ZO 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 PENOVE A A 0 P-aO&A-C P- LI1N-Dozl, SAME Size Nb S��ctCl'Lit��4c� CH�iv 'S. Location: -255T YOU&IO A yE 12 � o ) Authorized Agent Go Permits LLC HE AILDROrJ Service Agent Name Best Regards, Lic ee Signature t RaW&License Number NOTE: PLEASE MAIL PERMIT TO: 1'x'1 E H DMSO 14NF2 JA JEFFRE J.KURR NOTARY PUBLIC, THD At-Home Services In 40 Oser Avenue• Suite 17•Hauppauge,NY 117 Qualified in��ifo�k Cnuniy Wim fres{ylareh Phone:631-478-6101•Fax:631-435-4837•Toll Free:877 !� - Go Permits,LLC 105 Buttonball Ln. • Glastonbury,Ct 06033 Scott Doughman Phone:860-952-4112 Fax:-860-430-6719 ' scottdoughman@gopermits.org "WE UNDERSTAND THAT YOUR TIME IS MONEY" May 26th, 2020 To:Town of Southold Building Department Subject: Permit Application for: Christopher Jamotta 2555 Youngs Ave 12D 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 Home.Depot detailing scope of work • Home Depot USA Suffolk County License • Certificate of Insurance • Letter of Authorization from The Home Depot allowing GoPermits to submit documents on their behalf • Authorization signed by the homeowner • Windows specification spec sheet Please note the following: `^ • Please mail original permit to the owner. - _ - • Please fax or e-mail a copy of the permit and receipt to: y MAY 2 6 2020 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 Cr 06033,scottdoughman@gopermits.org Home Improvement Agreement: Pagel Home"Depot License rs- For-the most currerit'listing www.Homedepot.com/Li&enseNumbers NY:Amherst HI-04712,Lockport 2395;Buffalo LT12-10023782,City Tonawanda 33257,East Hampton 4499,Long Beach 4917,.N.Tonawanda 368.16, Nassau County H1171050000- H1771053000, New York City 0900456-DCA,.900457-DCA, 0900458-DCA,0910621-13CA,0910622-DCA,0920734-DCA,0922474-DCA,0968605-DCA,1003822-DCA,1003823- DCA,1003825-DCA,1003828-DCA,1003830-13CA,1003833-DCA,1026224-DCA,1075580-DCA,1129555-DCA,1129556- DCA,.1129557-DCA,.1129562-DCA,_1129564-DCA,.1133444-DCA,.1152032-DCA,.1152034-DCA,.1152035-DCA,.1152036- . . DCA, 1152038-DCA,1152039-DCA,1152040-DCA,1178447-DCA,1186042-DCA,1212045-DCA,1223272-DCA,1251871- DCA,1318292-DCA,Niagara Falls 971,Putnam County PC 689,Rockland County H-06464,Southampton L002442, Suffolk County 47874-ME, 55323-ME, 53429-H, 57713-H, 54888-MP, 50222-MP,Town of Tonawanda:1854,Westchester_ County WC184841-106,Yonkers 5675,47874-ME Vance Comerford Salesperson Name: Registration No. (d applicable): Home Depot U.S.A., Inc. rHome Depot") or Service Provider named-below will'fumish, install andt or service the equipment listed below at the price,terms and conditions as outlined on this form. Jamotta 11Christopher [ Long Island . 1=118ifFBHF Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 2555 Youngs Avenue 12D I Southold INY 111971 Customer Address City State Zip (631) 241-5100 'omo@optonline.net Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU-MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 4.0 Oser.Avenue Suite.1.7 Hauppauge NY 1.1.788 Address City State Zip Or Email: customercancellationnortheast@homedepot.com Service Provider Email Address BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE -SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD.THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S)WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE.YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE -SAME CONDITION AS WHEN DELIVERED,ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY-CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL -AND WRITTEN NOTIC_, O YOUR fIlGHT TP4WkKEL Acknowledged by: 05/12/2020 CUs mer' ignature Date Contract Price an Payment Sc edule - Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: $ 11138.00 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 j (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME(33%), NJ, WI(99%) Dep. 125.0 % Deposit Amount $ 1284.5 Remaining Balance $ 853.50 The Home Depot-240 Paoes Ferry Rte,IM Btay.Ba,ewanta,GeoM=3a=- CMe:1-8 4e0Fi M)r=Cugm=Aseemeid(24JuL sad c—sailed[late 05/12/2020 lead"o _ 1-1181CFBHF V ai_11 Home Improvement Agreement: Page2 ku Finance Charges: *Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement,to which The Home Depot is NOT a party,and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payment(s)made payable.to The-Home Depot. Insurance proceeds will will not be used to pay some or all of the total amount of sale. Description-of Work.to.be Performed: Installation of 1windows A more detailed description of the work to be performed is included in the section entitled Scope of Work which appears on page F3-1 of this Agreement. Anticipated.Delivery.Date/installation Schedule- Approximate Start Date: 07/07/2020 Approximate Finish Date: 08/04/2020 Alldates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. Electronic Records Authorization: You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy,your -consent applies to this Agreement and all subsequent documents and written communications related to this agreement By contacting your Service Provider,you may update your email address,withdraw your consent, or obtain a paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email address above,-you confirm that you have access to a computer-that can- receive anreceive and open emails and PDF documents. inl ialing this paragraph, l consent to receive only electronic records related to this transaction. Initial A ce and Authorization: By signing below,you authorize Home Depot to (a) arrange for Service Provider to perform Installation and/or(b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's/permitting information may need to be provided to You later.) By signing, you acknowledge that you have read,understand,-and accept this Agreement in its entirety,including the General Terms and Conditions and State Supplement, if any.You further acknowledge receiving a comp) co y of th' reement. Keep it to protect your legal rights. X _ 05/12/2020 The Horne Depot Custo er's Signature Date Service Provider Name X 05/12/2020 40 Oser Avenue Suite 17 _ -Signer(if plicable) Date Service Provider Address X 05/12/2020 Hauppauge NY 11788 Sig epot Date City State Zip 50061-HS,R-1-128533-13-00262 Service Provid r Phone Number Service Provider License Number The Hmm Depot-2455 Swes Fr R=c.x w:Md_q.B-3, -cum Cam 14MAN-33V 460F1RDEQmtonerAWeweM(24Jd18) G—raledDaw )5f191909n Le-uPOF 1-1181(mur= v 0.1.11 WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1-11OKFBHF Sheet: 1 of 1 CUetoRier: Chrlstopher Jamotte Job#:1-118KFBHF Consultant: Vance Comerford Date: 06/12/2020 Now Window Inge Locations Existing Window Moosurements Grids Product Options Labor Options From outside, Loft to Right Bays,Bowe Location Color Rough Opening #of bars #of bare Cemnts,I Pni, use L,R or 8 Glass Mlmc Items > Hardware Screens Code For doom use e p c Mull "8"■staeonary or style Wraps g q F] ">r' operating Coda TF1o.1FI..1 (YIN) Style Coda Series Code s, 5 STC,White, OlassPeoki F,WRAP, 1 KITCH lit SB-PW Y PW 0100 WH WH 32 so B1 B, WH,W C ALL 2 3 ALL 2 9 Stonderd RMW,LSR OBO H SPECIAL CONSIDERATIONSt 1i White Wrap Color MISC1 t Capping two windows extra next to picture Interior Casing Type Bay or Bow window: 8estboard material(vinyl only-Biroh or Oak) lay Pro)oot Angle(3o or 46) ay Flanker Type(DH,SH,or Caroni) Top of window to soffit(Inchon) If tied to Soffit,colo of soffit material I have reviewed and agreo with all the job specifications above and the Construct.Roof(Yea or No)' Special Terme and Conditions on the following page Garden Window: eMboord Materiel(vinyl only-Whlla Montle,Birch or Oak) Show Receipt Detail Page 1 of 2 RECEIPT Suffolk County Government SUFFOLK COUNTY LABOR,LICENSING&CONSUMER AFFAIRS P.O.SOX 6100 HAUPPAUGE,NY 11788 James M.Andrews Application:H-53429 Application Type:ConsumerAffairs/f.icenses/Home ImprovernerlYNA Address: Owner Name: Owner Address: Application Name: Receipt No. 149086 Payment Method Ret Number Amount Paid Payment Date Cashier ID Received comments Check 3148046 $1,800.00 09/21/2018 CLEMON RENEWAL Work Description: Suffolk County Dept of Labor,Licensing&Consumer Affairs d Lr i . HOME IMPROVEMENT LICENSE Name RICHARD TOUSEY Business-Name HOME DEPOT U.S.A,INC. f This certifies that the bearer is.duiylicensed License Number H-53429 i by the County of-Suffolk 05/15/2014 Issued: " Commissioner sir Expires: .1110112020 i https://ay.prod.count3,.suf/portlets/fee/receiptV iew.do?mode=view&autoPrint=false&recei... 9/21/2018 COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES 6 . AS REQUIRED AN CONDITI NS OF SOU T HOLD TOWN NOTIFY B 81 Am T����,�P.�t FOR ARE SOUTHOL N PLANNING BOARD 765-182 SO . FOLLOWING INSPECTIONS: �-�,�G RECIUIRED OLD TOWN TRUSTEES FOUNDATION - (-�r TE '.S.DEC FOR POURED C„ ARE ROUGH - FRAiJi1NG & PLUM 81NG 3. INSULATION c i �t,TlO�I ��UST 4. FINAL - CONFflPti Cv. OR BE CGMPLE f L MEET THE OCCUPANCY ALL CONSTRUCTIR� SEGGDESOFNEvN USE IS UNLAWFUL REOUIRENIEN T RT RESPONSIBLE FOR YORK STATE WITHOUT CERTIFICATE DESIGN OR CONSTRUCTION ERROR OF OCCUPANCY IR MRS r • • • 01 Mine MENOTIMAKII RIM=• • • • • Dated: 5/3012098 c Style Glass Package Glazing Spacer 1( U SWIG., U SHGC t wfth argon) Fac' s Fact is • Awning 6500 Base ProSolar Supercept 7-1-V 026 0.23 • • • 0.26 0.21 • s a Casement 6500 Base ProSolar Superceprt 7/a' 0-26 0.24 • • • + 0.26 0.22 • • • • Transom 6500 Base ProSolar Supernopt 1' 027 0.32 • • 027 0.29 • • Double-Hung 6500 Base ProSoiar Supercept 7te' 0.29 0.26 + 0.29 0.24 • • • Picture Casement (NH) 6500 Base ProSolar Supercept 718" 0.26 0.28 • • 0.26 025 • • • • Picture - _ 6500 Base - ProSolar Supercept Vir 027 0.29 • • 0.27 026 • • 2 Panel Slider 6500 Base ProSolar Supercept 718' 0.29 0.26 • 0.29 023 • • • 3 Panel Sliders 6500 Base(s 21 Sgtt) Pro Solar Supercept 7Ar 029 0.26 a 028 0.23 • a • • 11 r • • ' Garden Door(CH) 13500 Enwgy Star ProSolar SUN Super Spacer 1 0.30 0.24 • • • 0 0.30 0.21 • e • • Patio Door INOVO 6500 Bess Pro Solar Super Spacer 0.25 026 e • 0.31 0.23 • o • a �® '6100 os/acated everywhere ACCEPT:Arizona,Cal:tomia.ttlaho,Nevada,New Mexico,Oregon,Ufah,and Washington. Awning(Inc MOP6100 Base Pro Solar intercept Ito' 0.27 0.24 0 0 0.28 0.21 • • • • Casement 6100 Base Pro Solar Intercept 7r8" 0.27 0.24e o 0 0 0.27 0.22 • • e o Double-Hung 6100 EneM Stw Pro Solar Su percept 3'-;' 0.30 0.30re 0.3G 0.27 • • • Picture Casement(too alae) 6100 Baso Pro Solar tnterrept 718" 027 0.28 • 027 0.25 • • o e Picture 6100 Base Pro Solar truercept 314' 027 0.31 e 0.27 0.28 • • 2 Panel Slider 6100 Base Pro Solar Intercept 314' 0.30 0.28 0.30 0.27 • 3 Panel Slider 6100 Base Pro Solar Intercept V4- 0.30 0.29 a 1 1 0.30 0-27 • • We 10cow•veoYA are rte:monk CaW-T la,lrlM0.Nevada,New Mexico,Oregon,tltah,and Patio Door 1NOV0 6100 Energy Star Pro Solar Super Spacer 1• 0.28 0.26 • -I 1 1 0.28 0.23 • • • - Patio Door NARROW FRAME 6100 5)Base Pro Solar Intercept 314-1 0.28 0.30 folol 1 1 0.28 0.26 • • • / Homes located only in fallowing markets:Darter,Deaver,Demo/{PhAk Northam NJ, L.Qop lsgrrlr!tJY. Awning 6200 Base Pro Solar SHADE Supercept 3W 027 0.25 • • -lei 026 0,23 • • • • Casement 6200 Base Pro Solar SHADE Supercept 314' 026 0.18 0 • • • me • • • Picture Casement-NH 6200 Base Pro Solar SHADE Supercept If C 0.25 0.21 e • • • • • •Picture Window 6200 Base Pro Solar SHADE Supercept 314' 026 0.24 • • • • • •Single Hung 6200 Base Pro Solar SHADE Supercept 3/4• 0.28 0.23 • • • • e •Single Slider 6200 Base Pro Solar SHADE Supercrpt 314' 028 023 • • • • • • 3 Panel Sfider 6200Base Pro Solar SHADE Supercept V4- 0.28 0.23 • • • • • • &1=11 --IM. • i mes located In coastal areas. Awning SB+300VL Energy Star PS SUN)Lami Supercept 1' 0.26 0.23 • • • • 0.26 0.21 lei• • e Casement SB+300VL Base PS/Lami Super Spacer 1` 025 0.23 • • • *I 0,25 021 • • • • Double Hung SB+300VL Base PS1Lami Super Spacer 1 0.29 0.25 • • • • 0.29 023 • • • • Slider SID+300VL Base PS t Lami -_ Intercept 1' 0,_29_ 025 • • • • 029 023 • • • • Patio Door SB+300VL ETC 366 - PS Shane/Lami Super Spacer 1' 0.30 0.19 • • • • Garden Door CH SB+300VL Base PS/Lami 0.30 025 • • • • _._._��__- Super Spacer 1' 0.30 028 • • Dots indic8te tn•ryy b'tar certified for that zone L TI .►