HomeMy WebLinkAbout49506-Z ¢ gUFF01 Town of Southold 8/16/2023
y� P.O.Box 1179
C4 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 44448 Date: 8/16/2023
THIS CERTIFIES that the building WINDOWS
Location of Property: 1565 Jacobs Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 79.-6-4.3
Subdivision: Filed Map No, Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/14/2023 pursuant to which Building Permit No. 49506 dated 7/21/2023
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:
ten window replacements to existing single family dwelling as applied for.
The certificate is issued to Thilberg Fam 2016 Irr Trt
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATEDtj
i
IW V
Aut ori e Si ature
saFFoi TOWN OF SOUTHOLD
moo �Cp�y 4 BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 49506 Date: 7/21/2023
Permission is hereby granted to:
Thilberg Fam 2016 Irr Trt
1565 Jacobs Ln
Southold, NY 11971
To: Construct an alteration to an existing single-family dwelling to replace ten windows
in-kind as applied for.
At premises located at:
1565 Jacobs Ln, Southold
SCTM # 473889
Sec/Block/Lot# 79.-6-4.3
Pursuant to application dated 6/14/2023 and approved by the Building Inspector.
To expire on 1/19/2025.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00
CO-RESIDENTIAL $50.00
Total: $250.00
Building Inspector
pE SOUIyO�
TOWN OF SOUTHOLD BUILDING DEPT.
CoormN631.765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [/] NSULATIOWCAULKING
FRAMING /STRAPPING [ FINAL Wtn&nd
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
i olcl/
DATE Y INSPECTORYZ�,.ol
TOWN OF SOUTHOLD BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax(631) 765-9502 haps://w\"v.southoldtownnv.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only L
PERMIT N0.
Building lnspector:_JYY�
J U N 14 2023
p'm ete,,,.,,,,
AP040phs an f1lle&66t in
applications Where ih,e-ApPiica is-nottheowne an,
ne6 Authori iitioh ioim fll)aje,,2)sfial1,6', pletibd.
"cbm Dwr_lt DEPT.
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Date: 6/15/23
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RTY."`
Name: Jack Thilberg_,.... SCTM#1, 000-
Project Address: 1665 Jacobs Ln Southold NY 11971
11
Phone#: .6.3l.-7651-9213.11.l".--. Email:
Mailing Address: same
CONTACT"P-E'RS6w'.'
Name: Scott Douqhman -Go Permits
MailingA I ddress: 1,0,5"Buttonball Ln Glastonbury,PTQ§033
Phone#: 303-946-8685 Email: permits@gopprMi or
7D&Id N"'P'R"6F`ES"S1"0N!
Name:
Mailing Address:
Phone# Email:
ON
TRACT'PRI,NFORMATION:,-:,
Name: Home Depot USA
Mailing Address: 2455 Paces Ferry Rd. Atlanta GA 30339
Phone#: 303-946-8685 s
'bPCRiP'-T10N OF.P"R"O' V6Stb:CONSTRUCTION E]NewStructure OAddition ElAlteration DRepair ElDemolition Estimated Cost of Project:
00therRemove and replace 10 windows,same size,no structural change. $ 11,019
Will the lot be re-graded? L]Yes *No Will excess fill be removed from premises? DYes ®No
PROPERTY iiNFORMATiON"
Existing use of property: single-family — Intended use of property: single family
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
. . .... ......
this property? ❑Yes ®No IF YES, PROVIDE A COPY.
®'theCk Box,'After Reading: ,The owner/contractor/design professional is responsible for'all drainage'and storm water issues as provided by;
`Chapter 236 of the.Town Code,.APPIiCATION I5 HEi;FBY MADE to the Building'Department forthe'issuance'of.a Building permit pursuant to the Building zone.,
Ordinance of.the Town of Southold,Suffolk,County,New York and other applicable Uinrs,ordinances or Regulations;for the construction of buildings;
aciditions,'alterations or for removal'ordemolition as herein described.;The applicant agrees to comply with all applicable laws;ordinances;building code,
housing.code,and?reguiation¢and to admit authorized Inspectors:on;p(emises aind'in buildiegts)for riecessary:inspections.False'statements inade.herein are,:-,
punishable as:a Crass::A.misdemeanor pursuant.to.section 210.45 gf:tFie New York State
Application Submitted By(print name): Jennifer Winke ®Authorized Agent ❑Owner
Signature of Applicant: ®ate:
STATE OF NEW YORK)
SS:
COUNTY OF Guilford )
Jennifer Winke being duly sworn,deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the Agent
(Contractor,Agent,Corporate Officer, etc.)
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 true to the best of his/her knowledge and belief;and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
—Ldayof fQ A 11 ,20x3
Notary Public
SPENSER R BULMER
NOTARY PUBLIC
Guiftd County.NC PROPERTY OWNER AUTHOREATION
M Commission Expires AUGUST 24,2027
(Where the applicant is not the owner) .
I, Jack Thilberg residing at 1565 Jacobs Ln
do hereby authorize Jennifer Winke- Go Permits to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Jack Thilberg
Print Owner's Name
2
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THIS CERTIFICATE IS ISSUED'AS A MATTER OF INFOR#AATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLRR, 'THIS
CERTIFICATE DOES NOT AFFIRMATIVELY On NEijAIITVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICWS
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 13ETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. _
IMPCIRTAW� N the tertiflcat8 holder Is an ADbITIONAi INSURED,the Poliey0es)Must have ADDITIONAL INSURED provisions or to endorsed. i
it SUBROGATION IS WAIVED) ebbs)to the terms and conditions of the rooky,co tsin pvficlss May require an rendortemont. A statement or,
i this cerWcAte does not confer rights to the certificate holder In lieu of such endorsements•
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CERTIFICATV:0 IN
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COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
APPROVED AS NOTED AS REQUIRED AND CONDITIONS OF
DATE a1-23B.P.# SOUTHOLD
FEE a 5b,Ob BY SOUTHOLD TOWN PLANNING BOARD
NOTIFY BUILDING DEPARTMENT AT
765-1802 8AM TO 4 PM FOR THE SOUTHOLD TOWN TRUSTEES
FOLLOWING INSPECTIONS:
1. FOUNDATION-TWO REQUIRED N.Y.S.DEC
FOR POURED CONCRETE
2. ROUGH-FRAMING,PLUMBING, I
STRAPPING, ELECTRICAL&CAULKING
3. INSULATION
4. FINAL-CONSTRUCTION &ELECTRICAL
MUST BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
Rome Improvement Agreement: Page I
Home Depot License#'s - For the most current listing visit www.Homedepot.com/LicenseNumbers
Adam Friedman
Salesperson Name Registration#(Req. in CA,CT,ME,MD,MI,NJ,DC)
Hoene 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.
__ .. .....-----
1. Service;Proviiier Contact Information„_,'
IThe Home DepotI IThe Home Depot
Service Provider Contact Name Service Provider Company Name
(631) 478-6101 customercancellationnortheast@homI
Phone 99HP62Ffflovider Email Address Service Provider License#(s)
2. Custom6r aiiformatio� ' ';
rg Jack Long Island F34556876 be
Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO#
;1565 Jacobs Lane Southold IN 11971
Customer Address City State Zip
1(631) 765- lackthilberg@gmail.com
.Home Phone# Work Phone# Cell Phone# Customer Email Address
3..N.OTIE:0 ': GHT TO.CANCEd:
YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING
THE SERVICE P.ROVIDE.R OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT:
customercancellationnortheast@homedepot.com
OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT:
140 Qser Avenue Hauppauge
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 ley: 105/r 27/2023
Customer's Signature Date
460 5(andard Form HT(II Ju 1.21)(c) Generated Uala D5.J27/2023 Lead;Po F'�a556-8?F ` °.1.('
r
Home Improvement Agreement: Page 2
4: Descri° 'tidn'of-:Work-to:'tie-Performed`
A detailed description of the work to be performed is included in the paragraph entitled Scope of Work,Specification,
Customer Summary Sheet, Quote Form, Estimate,Invoice or Measure which is included in this Agreement.
5: i•inticipatecl: very Date/Installation.Schedule .
Approximate Start Date: 11/23/2023 Approximate Finish Date: 12/23/2023 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.
b. Electronic,I-ecori iAuthorization
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 cornmunications 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.
7. Contract Price;mrd'PAvment.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: $ 111019.24 Includes all applicable taxes. Excludes finance charges.*
Sales Tax: $ 10.00 (If applicable, total amount of taxes included in Contract Price)
"Maximum deposit 01VLY applicable in IVID, 31A, t'IIF(33%), NT, W1(99%)
Deposit% 25.0 Deposit Amount$ 2754.81 Remaining Balance $ 8264.43
8.'1a ma>roce.Charges ,
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 terns 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. Ace'eptAuce and Authorization _
By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (lb)
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 05/2712023
Customer's Signature Date
X I/s/The Home Depot 05/27/2023
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 Form HI.A(21 Jul.21)(1:) Generated nate 05197/90.2g Lea(UPOA Fg4F568Z6 V 0.1.12
WINDOW SPECIFICATION SHEET - Spec.Sheet#: F34656876 Sheet: 1 of 2
Customer: Jack Thilberg ,Joh#:F34556876 Consultant: Adam Friedman Date: 0512712023
New Window
Hinge Locations
Existing Window Measurements Grids Product Options Labor Options From outside,
Left to Right
Bays,Bows
Location Calor Rough Opening #of bars #of bars Csmnts,1 Phi,
use L,RorS
Glass
Misc Items
Hardware
Screens Code
For doors use
`g t7 c o o `o U o Mull "S'=stationary or
t L m U N N "X"=operating
WTR..mFlo.r
Style Wraps 'm `m a m n C7 3 z 6 .e P 9
I= Code (YIN) Style Code Series Code w 3 = H rri 0 a > _ > i
FULL SCR,STD,White, METAL,
1 BED1 2nd DH- Y DH 6500 WH WH 36 50 86 GlassPack:Standard WRAP,LSR
ALDER
FULL SCR,STD,White, METAL,
2 BED1 2nd DH- Y DH 6500 WH WH 36 50 86 GlassPack:Standard WRAP,LSR
ALDER
STD,White,TMP:Full, METAL,
3 BATH 2nd Ct- Y C1-o 6500 WH WH 24 38 62 GlassPack:Standard WRAP,LSR L
ALDER
FULL SCR,STD,White, METAL,
4 BED2 2nd DH- Y DH 6500 WH WH 36 50 86 GlassPack:Standard WRAP,LSR
ALDER
FULL SCR,STD,White, METAL,
5 BED2 2nd DH- Y DH 6500 WH WH 36 50 86 GlassPack:Standard WRAP,LSR
ALDER
STD,White,TMP:Full, METAL,
6 BATH 1st C1- Y C1-0 6500 WH WH 24 38 62 GlassPack:Standard WRAP,LSR L
ALDER
FULL SCR,STD,White, METAL,
7 BED3 1st DH- Y DH 6500 WH WH 36 50 86 GlassPack:Standard WRAP,LSR
ALDER
FULL SCR,STD,White, METAL,
8 BED3 1st DH- Y DH 6500 WH WH 36 so 86 GlassPack:Standard WRAP,LSR
ALDER
H � L
SPECIAL CONSIDERATIONS:
1:White,2:White,3:White,4:White,5:White,6:White,7:White,8: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,color of soffit material I have reviewed and agree with all the job specifications above and the
Construct Roof(Yes or No)' Special Terms and Conditions on the following page
Garden Window.
Seatboard Material(vinyl only-White Pionite,Birch or Oak)
WINDOW SPECIFICATION SHEET - Spec.Sheet#: F34556876 Sheet: 2 of 2 `
Customer: Jack Thilberg Job#:F34556876 Consultant: Adam Friedman Date: 05/27/2023
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
Hardware Misc Items
Screens Code
_ For doors use
9
LL E `o Mull "S"=stationary or
Style Wraps ro a 2. ntm7 `o jb m r m L "X"=operating
Room Floor Code (Y/N) Style Code Series Code 5 w 3 = r vi ci a > _ > i
FULL SCR,STD,White, METAL,
9 BED4 1st DH- Y DH 6500 WH WH 36 50 86 GlassPack:Standard WRAP,LSR
ALDER
FULL SCR,STD,White, METAL,
10 BED4 1st DH- Y DH 6500 WH WH 36 50 86 GlassPack:Standard WRAP,LSR
ALDER
SPECIAL CONSIDERATIONS:
9:White,10:White
Wrap Color
Interior Casing Type
Bay or Bow window:
eatboard 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,color of soffit material 1 have reviewed and agree with all the job specifications above and the
Construct Roof(Yes or No)' Special Terms and Conditions on the following page
Garden Window:
Seatboard Material(vinyl only-White Pionite,Birch or Oak)
Dated: 6),01 S120,
,rte: ��� .�..�:.'.•.; ,�:�?, - ;�.=s�io,:t-�..ln"-:
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Awning 6500 Base ProSolar Supercept _718"n0.26105.23 o c o 0.26 0.21asement6500 Base ProSolar Supercept 7/8" 0 0 o o" 0.26 0.22 0 0ransom 6500 Base ProSolar Supercept •t' 0 0 0.27 : 0.29 0 0
ar Supercept 7/8" 0 0.29 0.24 0 0 0
Picture Casement (NH) 6500 Base ProSolar Supercept 718" 026 . 0.28 0 0 026 : 0.25 0 0 0
Picture _ 6500 Base ProSolar Supercept 718" 0.27 0.29 0 0 0.27 0.26 o 0
2'Panel Slider_ 6500 Base ProSolar Supercept 7116• 029 0.26 0 0,29 0-23 0 OR 0
3 Panel Sliders 6500 Base(s 21 8gft) Pro Solar Supercept 718" 0.29 0.26 0 0.28 0.23 0 0 0
Garden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" 1,0.30 0.24 0 0 0 0 0,30 0.21 0 o a a
Patio Door(NOVO 6500.Base, Pro Solar Super Spacer. 1" 0.28 0.26 0 0 0.31 0.23 0 0 o u
• 6 Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and
VYasfrfngton.
Awning(Inc Hopper) 6100 Base Pro Solar intercept 7/8" 0.27 0.24 0 o 0 o 0.28 0.21 0 0 0 0
Casement 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 0 0 0 0 0,27 0.22 0 o 0 0
Double-Hung _ 6100 Energy Star Pro Solar Supercept 314" '0.30 0.30 0 0,30 : 0.27 0 0 0
Picture Casement(No Hinge) 6100"Base Pro Solar Intercept 7/8" 0.27 0,28 o o 0.27 0.25 o o o a
aPicture 6100 Base Pro Solar Intercept 314" 0.27 0.31 0 01 L 0.27 028 o 0
2 Panel Slider 6100 Base Pro Solar Intercept 39" 0.30 . 0,28 A0 0.30 0,27 0
3 Panel Slider 6100 Base Pro Solar Intercept 314" 0.30 , 0.29 0 0.30 0.27EM
0
o =Ioca�tedere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and
Patio Door INOVO 6100 Energy Star Pro SolarSuper Spacer 1" 0.28 0.26 0 0_ 028 0.23 0 0 0 0
Patio Door NARROW FRAME 6100(PD05):Base Pro Solar_ Intercept 314" 0.28 0.30 0 0 0.28 0.26 a o
® Homes located only in fallowing markets:Dallas,Denver;Detrm4 Phila,Northern NJ,Long Island,NY.
Awning 6200 Base Pro Solar SHADE Supercept 3/4 0.27 025 0 o D a 0.26 0-29 0 0 0 0
Casement 6200,Base Pro Solar SHADE Supercept 3"' 0.26 0.18 0 o 0 0 0,29 0,17 0 o o a
_Picture Casement-NH 6200•Base Pro Solar SHADE Supercept 314" 0.25 : 0.21 o o o o 0.25 0.19 o o 0 0
Picture Window 6200 Base Pro Solar SHADE Supercept 314" 0.26 0.24 o o 0 0 0.26 : 022 o o 0 o
�SrngleHung 6200 Base Pro Solar SHADE Supercept 314" 0.28 : 0.23 o o o � 0.28 0-21 0 0 0
Single Slider 6200 Base Pro Solar SHADE Supercept 314" 0.28 ' 0,23 0 0 0 0.28 . 0.21 o a o
-3-Panel Slider 6200 Base Pro Solar SHADE Supercept 3/4" 028 0.23 0 0 0 0.28 : 0.21 0 0 0
Homes located in coastal areas.
Awning SB+300VL Energy Star PS SUN/Lami Supercept 1" 0.26 ' 023 0 0 0 0 0.26 0.21 a c o 0
Casement SB+300VL Base PS/Lami Super Spacer 1" 0.25 0.23 o 0 o o 0.25 0.21 0 0 0 0
Double Hung SB+300VL Base PS/Lami Super Spacer 1" 0.29 0.25 o 0 o o 0.29 0.23 o 0 0 0
Slider v SB+300VL Base PS/Lam! Intercept 1" 0.29 0.25 0 o v a 0,29 i 0.23 o 0 o 0
xPatio Door SB+300VL ETC 366 PS Shade/Lamm Super Spacer 1" 0.30 0,19 o o ra o o -
_Garden Door(CH)_ SB+300VL Base _ PS/Lami _ Super Spacer 1" 0.30 " 0.28 0 0 0.30 025 o o 0
Dots indicate Energy Star certified for that zone �_