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HomeMy WebLinkAbout49139-Z �o�g�FFDLKcoGy Town of Southold 6/17/2023 P.O.Box 1179 3 �� 53095 Main Rd y o�+ Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44206 Date: 6/8/2023 THIS CERTIFIES that the building WINDOWS Location of Property: 1825 Carroll Ave,Peconic SCTM#: 473889 Sec/Block/Lot: 74.-3-10 Subdivision: Filed Map No. Lot'No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/20/2023 pursuant to which Building Permit No. 49139 dated 4/19/2023 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: window replacements to existing single-family dwelling as applied for. 6/17/2023 Corrected for Certificate of Occupancy number only. The certificate is issued to Parker,Diane&Ors. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Auth rized i nature c,VFFO� r aoy0 COGyc Town of Southold 6/8/2023 P.O.Box 1179 CO W x 53095 Main Rd Wo4,j Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44140 Date: 6/8/2023 THIS CERTIFIES that the building WINDOWS Location of Property: 1825 Carroll Ave,Peconic SCTM#: 473889 Sec/Block/Lot: 74.-3-10 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3/20/2023 pursuant to which Building Permit No. 49139 dated 4/19/2023 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: window replacements to existing single-family dwelling as applied for. The certificate is issued to Parker,Diane&Ors. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Aut rize ignature TOWN OF SOUTHOLD FF0I,4� BUILDING DEPARTMENT a TOWN CLERK'S OFFICE SOUTHOLD, NY vx 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#: 49139 Date: 4/19/2023 Permission is hereby granted to: Parker, Diane PO BOX 307 Peconic, NY 11958 To: install window replacements to existing single-family dwelling as applied for. At premises located at: 1825 Carroll Ave, Peconic SCTM # 473889 Sec/Block/Lot# 74.-3-10 Pursuant to application dated 3/20/2023 and approved by the Building Inspector. To expire on 10/18/2024. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO-ALTERATION TO DWELLING $50.00 Total: $250.00 Bui di p ctor fav- �x�e TOWN OF SOUTHOLD—BUILDING DEPARTMENT �,w Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 https://-%v-vv%v.southoldtowniiy.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: I� If 'UrID l MAR 2 0 2023 Applicafi6ns;and fcirins must;be'filled out in ihei�entirety.Incomplete. applications Wili not be accepted. Where.th"e Applicantis not thieoauwrier,`an:' SULDING DEPS: Owner's Authorization;fgrm{Page 2}shall lie completed.: TOWN OFSOO THOLD Date: O{MNER{S}"OF PROPER'T'Y:",.. Name: �� ayto` �o.,rl�cr- SCTM#1000- " Project Address: V-\,tt,_ Phone#: L12 Email: �peo-al-.cac� Ill�•�� �I.00- c�.-�, Mailing Address: IZ—I S C,e-r-c4l ;4rvr,. Pr-Gw,, -c CONTA&PERSON: " - Name: .._._.-... . S C9� _ �....._..�.. ..-._!,'_'�'1...�_...v.d�YP AP I"✓v. t-��..__.._._....�._......__._w.,-.......__..._....._.__...._........_... .._....-...._. ... . . ........ Mailing Address: i oS �.- �. •1t c.1.�- Q �y. +�-��� �-T 0 l U�,3 Phone#: 3dS- 1F11q lv- 121L10" Email: cry^i=* �oPervh i DESIGN.PROI+ESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION; Name: Mailing Address: Qq sSS PC-c eS �erel, Phone#: 63 —Ol Ll to— �(c Email: �rw. -�s CJ 1Pc r-VK'��S. O' ._.._....._...................__...._.. __ ...._... .."... ........ ......._.._. _._... ........w__._".w..........."........ _ __._ ............._........... ...... .DESCRIPTION OF PROPOSED.CONSTRUCTION.."'" ❑New Structure ❑Additionfp A_lteration ❑Repair ❑Demolition Estimated Cost of Project: [XOther _W 11�B V�-�f�(�e Zr►�e.��,Q, $ �LOL Will the lot be re-graded? ❑Yes CJNo Will excess fill be removed from premises? ❑Yes ❑No �t,w�ov� 0��C ��1 �r-e � W I�o�a►�.rS� � a��. S � ze r 1 uocuaign tnveiope w:vrraaao�o-ts i4u-+ttu-Hto�.-ruaorruu �.H ; .. ".� Ex! n :.us8a1#: _ g F�3 P p�. rifer : .,. ,.; :, , �Y-.:-:.. . �. .. :rMy- deid�use_of: r+� l - ,:, , zone:csrVse,r31sirtct;rF!'—ii remjsesA sifua d•;.,::;.-.;:.°; '.Are tFiere art. ;ca enar�ts an&resfrrctioris i lith res i ° _ ;P., rty. l�No Ii..YES PRC)1lIDE A COPY. Appl icf� ., ri�sLib:: i>rit ita�Yi lJ�n• authorized Agent 00w6er signatufe of Abid M: �- _.�..,._.>w_._...... "�:....' :DateSTATE OF7 : S� 5: - r i r• ;c Zu - - - being,ciuiy s�vc rri lepo�es:anri says that(s)he is.the appiicarit (Name.tif:jrsiiviiiulsghin : ritat; toe'narrieci , ., 5)he s i. the ` raiwtrgeit''Co`• ` ae;,{3ffacr:etc: of said.awnes.or,:oiniriers,;anti is,tiuty;,autii?nzed tr3:p'ei-Foi`in:or,hatie_;erfoarmeitle.said work and to snake end file.this ' ;.; ,, „ .application;"that ailstaterrients rxinta�ned tq thts application are true;;tcs'ttie:i st'o#'liisJher.kaiowtedge and aOl d that the Workwill:be pe orrried iri`ttie;mat�ni r set forth ih fihe;appiicati Sworn.be#oreme this : „ . , lcia�v of 2Q3 Nina' Public S%NSER.R BUEMER': <' Guilford Coiinty,:NC AUTHOR. 'C My:C®mtr)fi@fiaifes�i�llli 24 2027 (1lSfi��rethe'a��licai�t:is:na�tlz�;ov�ir�2r , • rho°°:liege �y;; c �: `; t��� 77 fit. ...- ,..,",..,,.,.....,.... .,.,. y,, - "b �y�autf�oj ii2���;` ;; ' `i.�{;-- 'U .Tik� to a ! on ....' 3:.:,•,.,:, ,. ... ,. ply. m �ye#ialf'}.p`t1ieTuyun:csf:St�uthoirt:.Bu Docas�gnedby:,;..::'„: rl r g 04'a r�approvaI a i! rtmeritfo ,rlescriber'.lereiri . 3 14/2>'2,, 0 3 7FFF 8FA41' gli i.7.{N it $ 3 5'S atEltE Print Owner's rami' ` 3 *OE SOUT�O� # # TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]' RENTAL REMARKS: i blt.) In-S4kj I Cs DATE �� E23 INSPECTOR *pF SOUT,fO� # # TOWN OF SOUTHOLD BUILDING DEPT. urm", 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATION/CAULKING [ ] FRAMING /STRAPPING [ FINAL 01nOW S [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: GLce-z 5's - c p A,4 ck rN4e-zp- ClvznQw DATE INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS �■o FOUNDATION(1ST) t ------------------------------------- FOUNDATION(2ND) 00 O N y ROUGH FRAMING& PLUMBING G ro INSULATION PER N.Y. X4 STATE ENERGY CODE 1 5�•aa �o aGG�ss — cov ��, 4-a1 o� W�kwk u itk &.Amu alanlg FINAL ADDITION4 COMMENTS aT7 3 . o Z �rn t� o y z x x d b y Go Permits, LLC 105 Buttonball Ln. Glastonbury, Ct 06033 4" urrll�IUU�'° "WE UNDERSTAND THAT YOUR TIME IS MONEY" To Whom It May Concern: Enclosed you will find a building permit application and check. If you have any questions regarding this application, feel free to call me at the number listed below. Please note the following: • Please mail original permit to the owner. • Please e-mail a copy of the permit and receipt to: Email: permits@gopermits.org 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, scottdoughman@gopermits.org Home Improvement Agreement: Page 1 Home Depot License#'s- For the most current listing visit www.Homedel2ot.com/LicenseNumbers Adam Friedman Salesperson Name Registration#(Req.in CA,CT,ME,MD,MI,NJ,DC) Home Depot U.S.A.,Inc.("Home Depot") or Authorized Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. it Provider Contact Info =niafion" The Home Depot The Home Depot Service Provider Contact Name Service Provider Company Name (631)478-6101 customercancellationnortheast@homede Phone# _ _Service_Provider Email Address Service Provider License#(s) 2;.Customer.Information 7i PARKER DIANA Long Island IF32411611 Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 1875 Carroll Ave Peconic INY 111958 Customer Address City State Zip (631)507-8302 beachcodyblue@yahoo.com Home Phone# Work Phone# Cell Phone# Customer Email Address i3:.NOTICE`OF`RIGHT TO"CANCEL`. YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT: customercancellationnortheast@homedepot.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 40 Oser AvenueHauppauge NY 111788 Address City State Zip BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged by: _ Customer's Signature Date 460 Standard Form IIIA( 1 I.2l)( �- xv 0.1.122/28/202 , JtV(y-5,TP 2^09bA0:7F958 ^.. Home Improvement Agreement: Page 2 4:Descri tiPon^of.Work.to be Performed _. v. _ .� _ _._ _. A detailed description of the work to be performed is included in the paragraphryentitled Scope of Work, Specification, Customer Summary Sheet, Quote Form, Estimate, Invoice or Measure which is included in this Agreement. S:Anticipated Delivery_Date%..Installation:Schedule' Approximate Start Date: 08/27/2023 Approximate Finish Date: 09/26/2023 All dates 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. 6:Elec77 tronic'Recoirds 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 and open emails and PDF documents. 17-Contract.Price an`d Pa inent'Schedule.< 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: $ 14991.25 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 (If applicable, total amount of taxes included in Contract Price) *Maximum deposit ONLY applicable in MD,MA, ME (33%), NJ, WI(99%) Deposit o o 100.0 Deposit Amount$ 4991.25 Remaining Balance $ o.o T 8 Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which 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 payments made payable to Home Depot. [,9, Aece tance and:Authorization By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services 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 or permitting information may need to be provided to You later.)By signing,you acknowledge that: (i)You have read,understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; (iii)all rights and interests under this Agreement are solely vested in the person listed as "Customer" above; and(iv) Electronic signatures will be deemed originals for all purposes. X 02/28/23 L Customer's Signature Date X /s/The Home Depot 02/28/2023 The Home Depot Digital Signature Date For questions related to your installation, contact Service Provider at (631)478-6101 For any other concerns, contact The Home Depot at 1-800-466-3337 460 Standard FormI1IA( I 1.21)( 2/28/202ene�ee.� , �� n....l1ll.�eaL' .7 �. .. v 0.1.12 r- l�G A�!�h® CERTIFICATE OF LIABILITY INSURANCE D0'i03122010D1YYW} 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 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 endorsement(s). PRODUCER CONTACT MARSH USA,INC. NAME: PHONE FAX TWO ALLIANCE CENTER ,yQ,i ,-(AIC NaJ_-------------- 3560 LENOX ROAD,SUITE 2400 ADDRESS: ATLANTA,GA 30326 - ---- ----- INSURER(S)AFFORDING COVERAGE CN1016d2069 HomeD-UAW:22-25 INSURER A:Old Republic insurance Co ;24147 INSURED INSURER B:lydemni Ins Co Of North America 43575 THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. INSURER C:ACE American Insurance Company _ 122667 -- ---— 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 -.---..------- --_______ ATLANTA,GA 30339 INSURER E INSURER F: { COVERAGES CERTIFICATE NUMBER: ATL-005314714-06 REVISION NUMBER: 1 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 j 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. iLT R -- ADDL S BR POLICY EFF pOIJCY EXP I —_-------------�- -_---I LTR TYPE OF INSURANCE POLICY NUMBER M D MMIDD 1 LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY 316648 08101/2022 10310112025 EACH OCCURRENCE I S 1,000,000 i DAMAGE TO RENTED CLAIMS-b1ADE I OCCUR j PREMISES(Ee o urrence� 1,000,000! X SIR:51,000,000 j ---—---~ _ I MED EXP(Any one person) SEXCLUDED PERSONAL 8 ADV INJURY T S 1,000 10 GE,VL AGGREGATE LIMIT APPLIES PER I I i I2,000,000 I GENERAL AGGREGATE S _ X 1 POLICY 1`— JE 17 LOC i PRODUCTS•COMPIOF AGG I S —- 2,000•000 OTHER: { —....._.-P AGG-S------------ I A "AUTOMOBILE LIABILITY j �MWTB316649 10310112022 03/0112025 COMBINED SINGLE LIMIT ! $ 1,000,000 -- i (Ea accident -- -- -_--.__-- - X i ANY AUTO BODILY INJURY(Per person) S j OWNED —I SCHEDULED 1 SELF INSURED AUTO PHY DMG BODILY INJURY(Par accident) 3 i AUTOS ONLY �-f AUTOS { j LI HIRED NON-OWNED I PROPERTY DAMAGE—-T'-- ------ - " 1 AUTOS ONLY 1 AUTOS ONLY I Per accidentL_,.--__-_____.!$_ I i j I $ -------_ -_I UMBRELLA UAB X I OCCUR j MWZx 816647 03101/2072 03/01/2025 EACH OCCURRENCE S —,u 10.000.000 X j EXCESS LIAR I 10,000,000- AGGREGATE $ DED RETENTION S I S B 3 WORKERS COMPENSATION ( i SCFC50668198(WI) 3 0 1202 03/01/2024 X STA UTE I ERS C ANYP OPROiETORiPA ER:CU;ivE Y 1 N 1 1 WLRC50668150(MT) 03;D112023 03101/2024 {OFFICERWEIABEREXCLUDED? a NIA I ! E.L.EACH ACCIDENT j S _-- (Mandatory in NH) ? I E.L.DISEASE-EA EMPLOYEE]S 5,000,000 If yes,describe under 1 Continued on Additional Pae 1 t— i DESCRIPTION OF OPERATIONS below 1 I E.L.DISEASE-POLICY LIMIT IS 5.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED IF REQUIRED BY WRITTEN CONTRACT ON THE ABOVE GENERAL LIABILITY POLICY,BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED. i CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 ROUTE 25 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 1179 ACCORDANCE WITH THE POLICY PROVISIONS. ! SOUTHOLD,NY 11971 AUTHORIZED REPRESENTATIVE '?r"•11 22.5 r7csc. 01988-2016 ACORD CORPORATION. All rights reserved, ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 _ LOC#: Atlanta ACCOR" ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMEDINSURED MARSH USA,INC. THE HOME DEPOT,INC. HOME DEPOT U.SA,INC, POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 CARRIER NAIC CODE ATLANTA,GA 30339 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued: Carrier:Safety National Casualty Corporation ! Policy Number.LDS4068089(AL,AR.AZ,FL,ID,IA,IL.KS,KY,LA,MS.MO,A'sC,NE,NM,ND,OK,SC,SD,TN,VA,WV,Vti'Y) i Effective Data 0 310 112023 i Expiration Date:03/0112024 (EL)Limit$5,000,000 Comer:Safety National Casualty Corporation Policy Number.SP408WMQSl)(CA,OR,WA) Effective Date:031012023 Expiration Date:0310112024 (EL)Limit:$5,000,000 SIR:S1,000.000 Carrier:ACE American Insurance Company Policy Number.WCUC5066W95(CSI)(GAMI.NV.OH,UT) Effecfive Date:03:`x112023 Expiration Date:0310112024 (EL)Limit:$4,000,000 SIR:$1,000,000 SIR(GA):$750,000 Carrier:Indemnity Insurance Company of North America Policy Number.WLRC50668058(AK,CO,CT,DC,DE HI,IN,MkMD,ME,MN,NH.NJ,NY,PA,RI,VT) Effective Date:03101/2023 Expiration Date:0 31 0 112 0 24 (EL)Limit:$5,000,000 TX Employers XS Indemnity: Carrier.Zurich American Insurance Company Policy Number.NSL1138319(TX) Effective Date:0310112023 I Expiration Date:03/012024 1 (EL)Limit:$6 000,000 1 SIR:$5,000,000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 _ LOC#: Alianta ADDITIONAL REMARKS SCHEDULE page 3 of 3 AGENCY NAMED INSURED MARSH USA,INC, THE HOME DEPOT,INC. HOME DEPOT U.S.A,INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 ATLANTA,GA 30339 j CARRIER NAIC CODE j 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— The Home Depot,Inc. Home Depot U.S.A.Inc. Home Depot U.S.A.,Inc,dba The Home Depot Home Depot of Puerto Rico,Inc. Home Depot Product Authority,LLC Home Depot Store Support,Inc. Red Beacon,LLC H.D.V.1.Holding Company,Inc. Askufty.Inc. Home Depot Management Company,LLC I I i I S ACORD 101 (2008101) ©2008 ACORD CORPORATION. Ali rights reserved. The ACORD name and logo are registered marks of ACORD APPR VED AS NOTED DATE: B.P.# FEE:19— 3Y:._ NOTIFY BUILDING CIEPA'RTMENT AT 765-1802 8 AM TO 4 Pm FOR THE FOLLOWING INSPECTICONS: 1. FOUNDATION — TV%0' RE'QUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL — CONSTRUCTION MUST BE COMPLETE r,-;i c1.0. ALL CONSTRUCTi'N SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF !�LTHOLD TOWN ZBA SOI._17 �d dING BOARD im—700-70—INN-1 STEES N.Y.v.DE0 OCCUPANCY OR USE IS 'UNLAWFUL WITHOUT CERTIFICA- '. OF OCCUPANCY WINDOW SPECIFICATION SHEET - Spec.Sheet#: F32411611 Sheet: 1 of 1 Customer: DIANA PARKER Job#: F32411611 Consultant: Adam Friedman Date: 02/28/2023 New Window Existing Window Hinge Locations Measurements Grids Product Options Labor Options From outside, Left to Right Bays,Bows Location Color Rough Opening #of bars #of bars Csmnts,1 Pnl, use L,R or S Glass Misc Items Hardware Code Screens For doors use o u c9 0 `o 9 Mull "S"=stationary or Coy U N V 0 "X"=operating Style Wraps 'd °� v •y a o m d .o .o m .S Room Floor Code (Y/N) Style Code Series Code t 3 x 5 I—vi 0 a � > x > x STD,White,TMP:Full, EXT C, 1 BATH 1st DH- Y DH 6100 WH WH 24 41 65 GlassPack:Standard WRAP,LSR ALDER STD,White, GlassPack: EXT C, 2 BED1 1st DH- Y DH 6100 WH WH 30 54 84 Standard WRAP,LSR ALDER STD,White, GlassPack: EXT C, 3 BED2 'Ist DH- Y DH 6100 WH WH 30 54 84 Standard WRAP,LSR ALDER STD,White, GlassPack: EXT C, 4 BED2 1st DH- Y DH 6100 WH WH 30 54 84 Standard WRAP,LSR ALDER STD,White, GlassPack: EXT C, 5 KITCH 1st DH- Y DH 6100 WH WH 36 40 76 Standard WRAP,LSR ALDER SPECIAL CONSIDERATIONS: 1:White,2:White,3:White,4:White,5:White Wrap Color Interior Casing Type Bay or Bow window: Seatboard material(vinyl only-Birch or Oak) Bay Project Angle(30 or 45) Bay Flanker Type(DH,SH,or Csmnt) Top of window to soffit(inches) If tied to soffit,calor of soffit material I have reviewed and agree with all the job specifications above and the Construct Root(Yes or No) Special Terms and Conditions on the following page Garden Window: Seatboard Material(vinyl only-White Pionite,Birch The Home Depot - Thermal Value of Products Manufactured by Simonton < ¢yd,��by ^,A{,r. S y ."`Y'ry•8°'' w�y3F[ �fI�w' •-v �1(t1.r7r%dS gi�f Esc'Is`.�:�� i {all is %`JligoifJC h Aa 6500 Awning 6500,'Base" ProSolar._ Supercept, ..778" 0.26'f, 0:23.. : © © �: 0:26 ; ..0.21`, fl fl` Casement , 6500 Base PraSala� Supercept_ 718": `.0.26 0:24: Transom . 6500 Base: . .... . . _ 9':., 0:27.F. 0.$2 6 © fl27 029 a o _.. .. . ProSola� Superirept. - Double-Hung 6500.Base PtoSolar Supercept. 718": 0:29.' 026. Pictuie,Casement.,(NH) 6500.64se PrbSolar Supercept 718": '0.26 j 0,28 a: o" Picture 6560 Bass . . : , m 027 0.26 :b 2'.Panel Slider. 650QBase Pro$olar.,_ , : . 026 23 _ 8, 3 Panel Slide-m. 6500,Base:(s 2t sgej- Pro:Solar. . - Supercept_.. 778 ;0 29.: ,026 0' 028..;..023. GardenDoor.(CH) ;6500`Energ Star ProSolar.SUN,' Super Spacer: .1 '0:30 ;::0.24'141711:91 w 7 .,o :a 0.30,= .0:21, Patio Door(NOVO. :, 6500.Base Pro.Soiar Super Spacer 1^ j 0.28 1. 0.26.1a "a: 0.31 / / Ifomen located Werywhere"09E r_Araona,,California,labho,Nevada,-New Mexico Oregon,Utah,and � tNashiirgton.", Awning-(lnc Hopper). ..... 6100 Base :;. Pro Solan: Intercept 718" :.0:27,i 0.24 o m ®. o `fl:28 0:21 0 :0 Casement 6f00,.Base Pro;Solar', Intercept;... 718": 0:27, :0:24 ® :®. o a 0:27'.. 0.22' ouble-Hu ' 6,100,.Erie" Star.. ProSola� Supercept $14°; "0:30 0:30 q, 0:30 fl:27 a ® a Picture ase ttlent(No`H>nge) 6TOO,Base_ Pro Solar' intercept:,.. ".,718^ .027',, 0:28,, .® ;o: _027.1." 0:25 . Picture ;614D'.Base Pio Solar tnterCept;: 3I4 0:27 0.3 t © a 0.27 028 m m 2 Panel:Slider....., ....., 61008ase... . -Pro Solar li tercept. 314" 0:80' 0:28 g 0.30 0:27 0 3:Panel"Slider 6100 Base.. _. ,:,'Pro Solar Intercept,-, 314" 0:30 0:30.° 027 . es 1 / ] • • Fluri losate 0verywherre:EKCEPt.Adz*na,'Catftmia,.{daho,,Nevada,New Mexico,Oregon,Utah,,and ►Nastiington. Patio,Door lNOVO 6'IPO;Energy:Star . . ..`" .." .:Pro:Solar ._:. . .:5uper5liacer...:T 0.28, 1. .0.26 Pati6'Door NARROW FRAME 6100',(PDO$}Base,'.:;... . Pro Shlar• ,Intercept, 314:': '"0 28 i -0.30,1,0.1- 0:28 j Nkweslocatedonlylnfollow/ngnrarkets:;ONllas,Denver,Aq oit Phil-,Nor0em W,46,iglstand,NY. wnm 9 6200_Base ... ;Pro 8614r:SHADE, .. . 314 '027 1 S _ 0.26 023 fl o d Casement. :6200.Base Pro:Solar$HADE Supercepf 3!A", OcZES : 0.18 i _._0:17_ Picturei'Casement-NH:" :6200.136sa Pro,SolarSHADE ,Supecept ." 84;:' 'fl25 a 021 : �. `®. 6 © :0:25-I, 0:19 Picture Windordi 5joo`Beipe :Pro SolarSHADE Su ": Pmept. 314 . , 0:5&: 0:24: o' MIM 0:22 .ca. �a Ingle,HunPro Selar SHADE Su*'cept 3i4;" 0:28:: 023 e0`.21 agle Slider 6200Base P'roSo1arSHADESupercept. 314 0,28; ( 0.23: ;0.21; o o .o3 Panei Slider6200Base "P_ro.SoiarSNADE ..5upercepY. . ,314"- .028.:...023. 021;. . : p • i - . ' 1 / Homes located in.coastai areas- Awning'.,.,.... :. SB+300VL Enero�Star PS.SUN/Gami Supercept yr: 026 i :0:23' 4. :© o: 'm 0:26' 0:21 , . . Casement: . SB*.;tbdVL_6ase, ..'. PSA dmi'.__.: Superspacer. 1" 025 '0:23 Ep 0:25`} 0.21. o mPSll:arr Super Spacer10.25; Slider SB+300VL Base PS i Laird Intercept T 0.29 0.25 © -+? ® a 029,;1 .0:23 -Patio Door.. . S8+;300VL ETC.366';., : P,S Stiada'/{arrii Super'Spdbe T" 030. 666 Garden Door(CH), SB+`300V,L.base .. :PSILattii Super Spacer. ,1^. `0:30 0.28 a :e 0:30 0.25 a •Dots indicata Energg:Star.certed for that zone