Loading...
HomeMy WebLinkAbout49575-Z g1lfOtK pyo Town of Southold 8/30/2023 P.O.Box 1179 W 53095 Main Rd Gy�jo� �ao� i' Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44510 Date: 8/30/2023 THIS CERTIFIES that the building WINDOWS Location of Property: 1370 Ford Rd Southold SCTM#: 473889 Sec/Block/Lot: 87.4-14 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/11/2023 pursuant to which Building Permit No. 49575 dated 8/14/2023 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 Burns,James&Marie of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED17 &6cw Aut sized Signature SUF �� TOWN OF SOUTHOLD 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#: 49575 Date: 8/14/2023 Permission is hereby granted to: Burns, James 1421 Hideaway Bnd Wellington, FL 33414 To: install window replacements to existing single-family dwelling as applied for. At premises located at: 1370 Ford Rd Southold SCTM #473889 Sec/Block/Lot# 87.-1-14 Pursuant to application dated 7/11/2023 and approved by the Building Inspector. To expire on 2/12/2025. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CERTIFICATE OF OCCUPANCY $50.00 Total: $250.00 Building Inspector * # TOWN OF SOUTHOLD BUILDING DEPT. Coum, 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATION/CAULKING [ ] FRAMING/STRAPPING [ FINAL l��ht9t� [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION / [ ] PRE C/O [ ] RENTAL REMARKS: e,004 .Arz, DATE ANSPECTOR ?IELD INSPECTION REPORT DATE COMMENTS ,b t� 3 FOUNDATION (1ST) y ------------------------------------ C FOUNDATION (2ND) z 0 J a � ROUGH FRAMING& H PLUMBING INSULATION PER N.Y. STATE ENERGY CODE r -d�a3 Iti1i✓1a(ow 1ns�-�-ll co Olt- FINAL ADDITIONAL COMMENTS e c- n,59-3-) Z,'sp (gi j5p,-3 o �\m Z3 LAO t� O z x x d It y DocuSign Envelope ID:807C5835-9AOC-4l C7-B2F8-9836B56BCE79 TOWN OF SOUTHOLD—BUILDING DEPARTMENT, N .z} Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 https:Hww«.soutlioldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: JUN 3 0 2023 Applications,and'formsmust be.flled out,iii their..entrety.incomplete a PPlications,wil('nat be.accep�teo. Wl'ere,the Appticarit isnot the:owner.an B�1DD��DEQ° Owner s,Authorii lon�forr °{Rage 2)shall'be completed. . TOY Date: 6/26/23 OIIVN ER(S)`OF.PRQPERTY; Name: James Burns SCTM# 1000- �• Project Address: 1370 Ford Rd. Southold NY 11971 Phone#:..,(516).402-0432,..._................. ......_..........._....... . ........ ..Email:jjimbo.l..5.0.@ygho.o..com......... . Mailing Address: 1550 S. Harbor Rd. Southold IVY 11971 RSO Name:Sc9tt Dqughman Mailing Address: 105 Buttonball Ln. Glastonbury"CT 06033 Phone#: 303-946-8685 Email: permits@gopermits,,org DES!GN PROFESSIO,NAL INFORMATION: `: Name: n/a Mailing Address: Phone#: Email: Oil'TRA TORINFORMATION Name: Home"Depot_,! SA w. Mailing Address: 2455 Paces F erry Rd Atlanta_GA 30339 Phone#: 303-946-8685 Hil::P:P:,rmits@ggpprm.it§.org �iEscRlPTtoN oF.PROPqsEC�coNsvRuertotu ❑New Structure ❑Addition ❑Alteration RRepair ❑Demolition Estimated Cost of Project: El Other Remove and replace 6 windows, same size, no structural change. $12,737 Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No s 1 DocuSign Envelope ID:807C5835-9AOC-4l C7-B2F8-9836B56BCE79 pRC�PERTY'6iVi ORMATION:' Existing use of property: Intended use of property:Single fa.mII�O, _ use of property: si,n , le„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. Gh tickBoxAfter Reading:' The auvner%ontractor%design'ptofessional is responsi6ie4or all drainage and storm water issues as.pravided bjr _ 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 Oriliriaiice of the Tawn of;5nutholil 5uffo1li;County,New York and other applicable1aws,Ordinances or Regulations,for the construction of buildings," ;; additions,alterations,or„forremoval"or deir►olition`as"herein dpscribed..The applicant agrees Eocomply�irith.all applicable laws,ordinances;b' ':a housing cade.and r'egulatians;and;to:admit;autfibrized.in'spectoas"on premises and in buildings}#or necessary.inspections.False statements made hereirf are punishable as`a,.Class A misdemeanor pursuIaIntto Section 210.45 ofthe New York:State Penal Law: Application Submitted By(print name): Jennifer Winkle ®Authorized Agent ❑Owner Signature of Applicant: _ ®ate: (e/C)— STATE OF NEW YORK) SS: COUNTY OF Guilford ) r Jennifer Winkle being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the Agent I ("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. Tyriq L Garrison NOTARY PUBLIC Sworn before me this Rockingham County,NC �f My Commission Expires March 29,20,'8 Zfieday of dLA!jQ , 2023 d� Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) ,, James Burns residing at 1370 Ford Rd do hereby authorize J e n n ife r Vii n ke to apply on .ixiyp4"tq the Town of Southold Building Department for approval as described herein. �C,.wtt,S �jlAY1n,S 6/26/2023 Owner's Signature Date James Burns Print Owner's Name 2 !,a A4B.P. AS NOTED DATE. # s FEE BY: NOTIFY BUILDING DEPARTMENT AT 631-765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION-TWO REQUIRED FOR POURED CONCRETE 2. ROUGH-FRAMING& PLUMBING 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OFTHE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTON ERRORS COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF G BOARD SOUTHOLD TO'dVN TRUSTEES OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERT IFICATL­" OF OCCUPANCY I IF Z., MIM ,I ,IS M�n KAM , � .2'AriteaF�d:Gtass awl No 44:Gultes.Ces'r,4"t, No Grilles AND-N-1-01145-00001 0.2811.59 OM Simulated Divided Lite or Installed Interior Removable AND-N-141145-00002 0.28 1.59 0.29 0.49 22 10.2 Full Divided Lite AND-N-1-01163-00001 0.29 1.65 0.29 0.49 20 <0.2 li4 Finelight^(grilles-between-the-glass) AND-N-1-01151-00001 0.28 1.59 0.29 0.49 22 -0.2 No Grilles AND-N-i-01146410001 0.28 1.59 0.20 0.30 17 <0-2 Simulated Divided Lite or Installed Interior Removable AND-N-1-01146-00002 0.28 1.59 0.18 0.27 15 <0.2 0 Full Divided Lite AND-N-141164-00001 0.29 1.65 0.18 0.77 14 <0.2 Na Fln.light-(grflle�betwftn-the-glass) AND-N-1-01152-00001 0.28 1.59 S: 0.18 0.27 15 �0.2 Ag I t No Grilles AND-N-1-01147-00001 0.27 1.53 0.21 0.49 18 <0.2 a Simulated Divided Lite or Installed Interior Removable AN0.NA-0114740002 0.27 1.53 0.19 0.44 17 <0.2 a N Full Divided Lite AND-N-1-01165-00001 0.28 1.59 0.19 0." 16 <0-2 Fl.elightl-(grilles-beteen-the-glass) ANE�N-1-01153-00001 0.27 1.53 0.19 0.44 17 -0.2 No Grilles AND-N-1-0114440001 0.29 1.65 0.52 0.60 - <0-2 ,r Simulated Divided Lite or Installed Interior Removable AND-N-1-01144-00002 0.29 1.65 0.48 0.54 31 <0-2 -4 q Full Divided Lit. AN0.N-1-01162-00001 0.29 1.65 0.48 0.54 31 <02 Firelight-(grilles-between-the-glass) AND-N.1-01150-00001 0.29 1 1.65 0.48 1 0.64 1 31 10-2 RA i! No Grilles AND-N-1-M246-00001 0.24 1.36 0.31 0.53 28 <0.2 � Simulated Divided Lite or Installed Interior Removable AND-N-1-01246-00002 0.24 1.36 0.28 0.48 26 <0.2 Full Divided Lite AND-N-1-01255-00001 0.26 1.48 0.28 0.48 24 0.2 N-- Firellght"(grilles-between-the-glass) AND-N-1-01249-00001 0.24 1.36 1 0.28 0.48 26 0.2 No No Grill.. AND-N-1-01247-00001 0.24 1.36 0.21 0.48 22 0.2 0 Simulated Divided Lite or Installed Interior Removable AND-N-1-01247-00002 0.24 1.36 0.19 0.43 21 0.2 NC S Ati 7- Full Divided Lite AND-N-1-01256-00001 0.25 1.42 o.19 a.43 20 -0.2 r�c 1,23 400 Series • Casement Finelight�(grilles-between-the-glass) AND-N-1-01250-00001 0.24 1.36 0.19 0.43 21 -0.2 031 P-1 - No Grilles AND-N-1-01245-00001 0.25 1.42 0.48 0.58 36 0.2 73 ,r Simulated Divided Lite or Installed Interior Removable AND-N-1-01245-00002 0.25 M Full Divided Lite AND-N-1-01254-00001 0.26 - - - Eli Finelight-(grilles-between-th"lass) AND-N-1-01248-00001 0.25 Simulated Divided Lite or Installed Interior Removable AND-N-1-01145-0003 0.28 1.59 0.26 0.44 20 <0.2 Full Divided Lite AND-N-1-01169-00001 0.29 1.65 0.26 0.44 19 <02 Firelight-(grilles-between-the-glass) AND-N-1-01157-00001 0.29 1.65 0.29 0.49 20 -0.2 NC Simulated Divided Lite or Installed Interior Removable AND-N-i-01146-00003 0.28 1.59 0.17 0.25 X15 <0.2 14P Full Divided Lite AND-N-1-01170-00001 0.29 1.65 0.17 0.25 13 <0.2 Firelight-(grille-between-the-glass) AND-N-1-01158-00001 0.30 1.70 0.18 0.2T 13 <0-2 Ne I I I Simulated Divided Lite or Installed Interior Removable AND-N-1-01147-00003 0.27 1.53 0.18 0.40 17 <0.2 Full Divided Lite AND-N-1-01171-00001 0.28 1.59 0.18 0.40 Is <0.2 Sc 'n Finelight-(grilles-between-the-glass) AND.N.1-41159-00001 0.29 1.65 0.19 0.44 15 <0.2 NC Simulated Divided Lite or Installed Interior Removable AND-N-1-01I44-00003 0.29 1.65 0.43 0.49 29 <0.2 Full Divided Lite z AND-N-1-01168-00001 0.29 1.65 1 0.43 1 0.49 1 29 <0-2 q Firelight'"(grilles-between-the-glass) AN0.N-1-01156-00001 0.30 1.70 0.48 0." 30 -0-2 Simulated Divided Ute of installed Interior Removable t AND-N-1-01246-00003 0.24 1.36 0.26 0.43 25 <0.2 C acFullDivided Lite AND-N-1-01258-000611 0.26 1.48 0.26 0.43 Z2 <0.2 a FinelightTM(grilles-between-th"Iass) AND-N-1-01252.00001 0.25 1.42 0.28 0.48 25 <02 NC 1c Simulated Divided Lite or Installed Interior Removable AND-N-1-01247-00003 0.24 1.36 0.17 0.39 20 -0.2 NP, q- ' Full Divided Lite AND-N-1-01259-00001 0.25 1.42 0.17 0.39 19 <0.2 E= - wt 3 Finelight^(grilles-betweon-thaglass) AND-N-1-01253-00001 0.25 1.42 0.19 0.43 20 <0.2 Th;s information is for reference only. erf;)imance varies by unit size and options selected. Page 2 of 155 Data is wrrent as of O-bor 15.2014 and,;Uhjol!o.auge See o.1-96S-p.q.1 for r3,,er ;i'iC unit performance information,please contact your dealer or Andersen Sales Representative. J MO ••g s%i+'�.M ;r` `.9w,^�! ->.a ,•.' .�i�• '�:�E!"w..�- �+^t;:.;;t�.X.,, O NIN 2 rk- O 141 10, No Grilles AND-N46,O08.58-00001 0.28 S. 0.28 0.48 21 V11 Simulated Divided Lite(SOL)or Installed Interior Removable AND-1,14M-008511-O0002 0.28 i.59 0.26 0,43 20 0.2 58 H� H6 - - Flnelight-(grilles-between-thejlm) AND-N-85-00865-00001 0.28 L59 0.26 0.43 20 <0.2 58 I A I V1 HFinelight"w/Exterior Applied(FLE) AND-N-85-O0865-00001 0.29 L59 0.26 0.43 20 .0.2 58 Full Divided Lite(FDL) AND-N-9"103300001 0.28 L59 0.26 0.43 20 <0.2 58 No Grilles.. AND-N-85-00860-00001 027 LSS 0.19 0..3 17 <0.2 59 Simulated Divided Lite(SDL)or Installed Interior Removable AND-N 0.27 L53 0.17 0.39 16 <0.2 59 Flrielfgtkt^(grilles-bet-the-gl-) AND-N-gS-00867-00001 0.27 L53 0.17 039 is 59 Flnellght"W/Exterior Applied(FLE) AND-N-85-00867-00001 0.27 L53 0.17 0.39 16 <0.2 59 tr Full Divided Lite(FDL) AND-N-85-01035-0000I 0.29 L59 0.17 0.39 Is <0.2 59 No Grilles AND-1,1435-001357-00001 028 1.59 0.47 0.53 32 <0.2 53 Simulated Divided Lite(SDL)or Installed Interior Removable AND-N-85-00957-DODOZ 028 L59 0.42 0.48 Z9 <0.2 58 - - - Fmelight"(firilles-between-the-glass) AND-N-3500864-00001 0.28 1.59 0.4Z 0.48 Z9 <0.2 58 Fiimalight"w/Exterior Applied(FLE) AND-N-85-0086400001 O.Z3 1.59 0.420.48 29 <0.2 53 Full Divided Ute(FDLl AND-N-85-01032-00001 0.29 L65 28 �0.2 58 No Grilles AND-N-85-00862-0000I 0.25 li-Q 0.28 0.47 25 <0.2 47 Simulated Divided Lite(SDL)or Installed Interior Removable AND-N-85-00962-00002 0.25 1.42 0.25 0.42 23 <0.2 47 Flnellght"(grilles-betwet-the-eass) AND41-85-00MS-Oooi 0.25 1-42 0.25 0.42 23 <0.2. 47 Finelightm wl Exterior Applied(FLE) AND-N-85 OWS-00001 0.75 L42 025 OA2 23 102 47 rX Full Divided Lite(FDL) AND-N-85-01037-00001 0.26 L48 025 0.42 72 <0,Z 47 '4C No Grilles AND-1,14I500863-00001 0.24 1.36 0.18 0.42 20 <0.2 48 Simulated Divided Lite(SDL)or Installed Interior Removable AND-N-95-003634M= "48 0.24 1-36 0.17 OM 20 .02 Series Ili Awning Z Finelightm(grilles-between-th"ass) AND-N-&S-00870-00001 0.24 36 0.17 OM 20 �0.2 48 E Finelight-w/Exterior Applied(FLE) AND-N-ILIOMO-omi 0.24 1.36 0.17 038 20 <02 48 Full Divided Lite(FDL) AND41-95-01039-0=1 0.25 �-�- O- • vvi Simulated Divided Lite(SDL)or Installed Interior Removable AND-N-35-00858-00003 0.28 L59 023 039 Is <0.2 Sa Y Finelighm(grilles-between-the-1;las,$) AND-N-85-00872-00001 0.28 1.59 0.26 0.43 20 <D.2 53 Firelight"w/Exterior Applied(FLE) o/a n/a n/a r/a n/. n/a Full Divided Lite(FOL) n/a n/a n/a n/a o/a ./a n/. - - - - Simulated Divided Lite(SDL)or Installed Interior Removable AND-N-85-00860-001)(13 0.27 L53 0.16 0.35 16 <0 2 59 NC Il-light- AND-N-I&5-00874-03001 0.27 L53 0.17 039 16 <0.2 59 o M Firielight-W/Exterior Applied(FLE) n/a n/. n/. /a n/a n/a n/a . . . Full Divided Lite(FDL) n/a n/a n/a n/a rl. Simulated Divided Lite(SDL)or Installed Interior Removable AND-N-8S-00857-00003 0.28 I.59 OM 0.43 7.7 <0.2 M w Finelightm(grilles-between-the•.Jass) AND-N-95-OOV1-00001 0.28 159 0.42 0.48 29 <0.2 58 Mnehight"w/Exterior Applied(FLE) n/a ri/a n/a n/a -/a n/a n/. ri/. tt Full Divided Lite(FOL) ./,i n/a n/a n/a n/a n/a n/a n/a Simulated Divided Lite(SDL)or Installed Interior Removable AND-1,1415-00862-00003 0.25 1.42 0.23 038 22 <0.2 47 Finelightm(grilles-hetween-the-eas) AND-N-85-001376,00001 0.Z5 L42 MZS 0.42 23 0.2 47 o Krielight-w/Exterior Applied(FLE) n/a r/a n/a n/a n/a n/a n/a n/a Full Divided Lite(FDL) r/. q/. .1. n/a n/a n/. n/. Simulated Divided Lite(SDL)or Installed Interior Removable AND-N,115-00863-00003 0.24 1.36 0.15 034 19 <0.2 48 Flnelight"(grilles-betwee.-th.-glass) 0.24 L36 0.17 O.0 20 .0.2 48 .2 AN---" X melight'wl Exterior Applied(FLE) n/a nla rla o/a n/. n/a /a n/a Full Divided Lite(FDL) n/a n/. a This information is for reference only. Performance varies by unit size and options selected. Page 12 of 75 Data is-rent as of January 2017 and is subject to change. See page 1 for more information. For specific unit performance information,please contact your dealer or Andersen Sales Representative. Andersen Wood SPEC SHEET SC: Adam Friedman Measure Tech: INSTALLER: Branch Name: Long Island Job#: F35146903 Prepared By: ISM: Ship To Location: Customer Name: lames burns Date: 06/13/2023 Pa, ; NEW WINDOW71 - r` t , p r.r`' - �S een .ii { StnIll Oarc - - „ F L F .i. U L DH r5me' ncklded . ..-..r .:.=.w... 'F�cls n t#I{i - h ndow. Andersen, ,c 8.. ._ . , . ..' .. .._... .. .,:.... ,FRAM IN SER 'Sasti' ... . . - ._ .._,�._ _. :.. ,..-,.,. ..., .. _ ..,. :_. r:�' ,Glass' -In Base' - - - R Win T E P dav+ YP SCSI E.SO . Cno Z ID:' to:Tl .W1FJ1S RETE'HSI Y. U C ZEs IONL ONLYEons _ - YPei" asemeriFHari '' T (TIP ),. �•O ' OPT ribe - - _ P _dlrcr9. P :P I:' - •:Orit� titins(PEFi�SASH'PR(EING'- : •: - _GP ). a TOTAL MT/ISM Interio TW SC ul Standard #Bars #Bars #Bars #E' Location Existin Series Windo Exterio Finish Jamb Standar (WIDTHSize Grid Exterior Interior Vert Horiz Vert H. Windo Type Style Color Color Liner Size AW + CODE WALL SILL Sash Hing Temp Screen Type Grid Grid Pattern (per (per Locatio (Per (F Roo Floo Code CODE CODE CODE COD Color Code Widt Height HEIGH Width Height DEPT ANGL Split Venting/Handing Style CODE Options CODE Color Color CODE sash) sash) CODE Sash) SI 1 BED 1st Cl- 400 Cl- WH WH 33 36 69 R STD none 1 ALDE FF- R SPL 2 BED 1st Cl- 400 Cl- WH WH 33 36 69 L STD none 2 ALDE FF- R SPL 3 BED 1st Cl- 400 Cl- WH WH 33 36 69 R STD none 3 ALDE FF- R SPL 4 BED 1st Cl- 400 C1- 1VH WH 33 33 66 L STD none 3 ALDE FF- R SPL -- -. BAY/BOW:WIND05N=:.'., .:-..:; .;=.:c i r ,.SCJirista to,Notes:liieiu0s R11sa'latior`rduli Slsekdoeis'' -dal can3ftlorit`r;Use kem s to id f OP .� Projection Angle:(Bay:30°or 450) Top of Window to Soffit(inches) Bay Window Flankers(OH/Casement) Width of Overhang(inches) Construct Roof 1(Yes/No) If tied to Soffit,color of Soffit material I There is no guarantee that new shingles will match existing color. ' -NEW.'DOOR UNIT-..; k 0.. .... .S ••:. rr Andersen. .MEASURE ..FULLF AME , t:-�' R •Glass.`Scree :Nii7,» Ml3CL"PSTP - >i#a 4'r. i ' P Ex n aotT e. -,Doo t ' �; <,. TY E :;Eo r sh•.�> S.. Z_S TIP - 9 .YP tp(P rt1 51 OLD: to, ";TECH SIZE+' , ONLY •- ;G;ilfe'O tins.PER'SASH t'RICING a°�OPTtO+ Q'Gdn`O tIo `r'Hi?`"ed.a",'Glidin`• �Uons'='`' ,�-;.,•.''•.:::, ... •OPTION: :. ,. ,r.,.- . . CrIP )..: PU .{ _. )._ .. . P. P_ ��.,-t� n9 rid, g door:OP PD Assembl li,--c tion TOTAL (200, Interio UI RO/ Inswing PD PD Gliding Hinged 400,& Existing Series ExteriorFinish Standar (WIDTH TIP Ext Extensio Grid Exterio Interio #Bar #Bar Door Door A-Ser Lock Lock Optional Door Type Style Color Calor Size AW + to Jamb Jamb Type Grid Grid Patter ert(P Qriz(P bscur Scree IN or # Venting/Venting gliding HRDW HRDW Keyed Mulled 1 Sp FlooCode COD CODE CODE CODE Code Width Heigh HEIGHT Width Heigh TIP Size Location CODE,Color Color CODE Sash) Sash) CODE I CODE OUT Panels Handing Handing only) Type Finish Lock Stacked N. Approval Print Name lames burns Title Home Owner Y' Andersen good SPEC SHEET SC: Adan,Friednlar' Measure Tech: INSTALLER: Branch Name: Long Island Job#: F35146903 Prepared By: -ISM: Ship To Location: Customer Name: lames burns Date: 06/13/2023 Pa, NEW.WINDOW UN)T -1 = - 7 9 '�Scr > - a lands c 7. 4 i t /tr ''r - • ,1 F *" ULLDH 'F a� � r rtie x - `Irlcltided - 'E n `s. 3 xisti W"'dow In der Alt Sen r "r�` ,FR AM IN 9_ SER 'Sa'� - - ass B...e :,.y,. '' as T e Wmdrn/- E rIF n := _ 7YP _ Colo i h.• ._ IZE. P. e e is SCS SOLD t t TI - =MEASUR T Y" G:,,..:.ter.,.. TE YP _ _ R o„ .)', E EGH,SIZE. ONL .ONLY;O G :'_:<='.CasemahLHandt'rn"O tions:`"i' OPT _ P. ?.. 9_ P_ =:priw)?. - .:;Qnlla,Optilin$,(PER•SASH PRICING}- TOTAL MT/ISM Interio TW SC UI Standard #Bars #Bars #Bars #1 Location Existric Series Windov Exterioi Finish Jamb Standar (WIDTF Size Grid Exterior Interior Vert Horiz Vert H. Windo Type Style Calor Color Liner Size AW + CODE WALL SILL Sash Hing Temp Screen Type Grid Grid Pattern (per (per Locatio (Per (F Roo Fl.oi Code CODE CODE CODE CODE Color Cade Widt Height HEIGHT Width Height DEPT ANGLE Split Venting Handing Style CODE Options CODE Color Color CODE sash) sash) CODE Sash) SI 5 BED 1st Cl- 400 Cl- WH WH 33 33 66 R STD none 2 ALDE FF- R SPL 6 BAT 1st AWN- 100 AWN1 WH WH 20 21 41 x Full, none H ALDE STD R -BAY/BOW YlINDOW:. - ,SCAnstatler.tJotee:!elude Mlaa`Ub''r'Mntl Sta tl 1" -1 .<• rF"> '•i (n o, ok op ons,specla cottdtf ossa Use Nin11'/to Id Projection Angle:(say:300 or 450) Top of Window to Soffit(inches) Bay Window Flankers(01-11 Casement) Width of Overhang(inches) Construct Roof 1(Yes I No) If tied to SoNit,color of sottn material 1 There is no guarantee that new shingles wilt match existing color. -:NEW:DOOR`UNIT , , -.-. , „ .x .... .,. ,, E :. :.- Ande sen ..,... .,, .•.. MEASURE'.: •FU L FRAME , L -Glass' ],O-.Uo .. ' .._".• '' . '..;"' ' '.'., . , MULLl.STA #':, ;Extsting Door,Typo..,Door.TYPEr. Cobt/Fins11 ,n SIZE 80LD(rt;to TIP '' '.'TECH'SIZE: ONLY. Grilb O tions P.ER'SASH'PRICING OPTIO O'UoI'ed' ' Gt diB ) P (. }., P.. H ng and. ng Dao%Optidiss' PD Assembl TOTAL (200,, Location Interio UI RO 1 Inswing PD PD Gliding Hinged 400,& Existing Series Exterio Finish Standar (WIDTH TIP Ext Extensio Grid Exterio Interio #Bar #Bar Door Door A-Ser Lock Lock Optional Door Type Style Color Color Size AW + to Jamb Jamb Type Grid Grid Patter ert(P Ariz(P bscur Scree IN or # Venting Venting gliding HRDW HRDW Keyed Mulled/ Sp Roo Fioo Code COD CODE CODE CODE Code Width Heigh HEIGHT Width.Heigh TIP Size Location COD Color Color CODE Sash Sash) CODE CODE OUT Panel Handing Handing only) Type Finish Lock Stacked N. Approval Print Name)aures burns Tile Home Owner Go Permits, LLC 105 Buttonball Ln. Glastonbury, Ct 06033 a C P�7 �p��'q,k I 5 • ' 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: o 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. Glasionbury CT 06033, scottdoughman@gopermits.org Nome Improvement Agreement: Page 1 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) 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. w._._... ............... .__. .._ .�._..e ___._..._.,.___------- _..._...... __.__._ 1. Service'Provider.Contact..Irtformation 6 The Home Depot The Home Depot Service Provider Contact Name Service Provider Company Name (631) 478-6101 customercancellationnortheast@hom Phone# 99HRJOV6vider Email Address Service Provider License#(s) i Z.Customer'Informatio» burns lames Long Island F35146903 Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# south horbor Southold � NY 11971 Customer Address City State Zip (516) 402-0432 jjimbo150@yahoo.com Home Phone# Work Phone# Cell Phone# Customer Email Address 3:.NOTICE.OF RIGH.TO-CANCEL:... .. - YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT- ce liationnortheast@homedepot.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 40 Oser AvenueHauppauge NY 11788 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 CON'T'AINS 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 DEPO'T'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: 06/13/2023 Cu omer's Signature Date 4-0 Standard Pori 111A(21 Jul.21)(E) Gwnaa(Ld Dalc Lead/PO4 v 0.1.12 Home Improvement Agreement: Page 2 4.,Descriptin dMork to be 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: Anticipated Delivery%Date/Installation-Schedule, Approximate Start Date: 12/10/2023 Approximate Finish Date: 01/09/2024. 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. &Electronic Records Apt oirixation 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. 7:Contract,Price and Payment Schedule Payment of the Contract Price is due upon signing unless a different payment schedule is required bylaw, specified below or in a payment addendum. Contract Price: $ 12737.60 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 19.00 (If applicable, total amount of taxes included in Contract Price) *.Maximum deposit ONLY applicable in iVD,M,1, i11 (33%),A'.1, W1(99%) Deposit 125.0 Deposit Amount$ 3184.4 Remaining Balance $ 9553;2 8:Finance.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 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. %Acceptance arid-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 �Sigmnature 023 ustomer's Date X I/s/The Home Depot.. 06/13/2023 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 Nome Depot at 1-800-466-3337 460 Standard Form HI.A(21 Jul.21)(6) Generated Date Lcad,'PO4v 0.1.12 �:?�:.69-Q3— ATE AC40RCERTIFICATE OF LIABILITY INSURANCE D0310312023DmYY) 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: HOE TWO ALLIANCE CENTER AIC NNo. Ext): AIC No): 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 30326 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# CN101642069-HomeD-GAW.22-25 INSURER A:Old Republic Insurance Co 24147 INSURED THE HOME DEPOT,INC. INSURER B:Indemnity Ins Co Of North America 43,975 HOME DEPOT U.S.A.,INC. INSURER C:ACE American Insurance Company 22667 2455 PACES FERRY ROAD BUILDING C-20 INSURER D 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 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSINSD WVD POLICY NUMBER MMIDD MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY 316648 03/01/2022 03101/2025 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 X SIR:$1,000,000 MED EXP(Any one person) $ EXCLUDED PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY D PRO JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY MWTB316649 03/01/2022 03/0112025 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB X OCCUR MWZX 316647 03/01/2022 03/01/2025 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I I RETENTION$ $ B WORKERS COMPENSATION SCFC50668198(WI) 03 01/2023 03/01/2024 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER C Y/N WLRC50668150( )MT 03/01/2023 03/0112024 E.L.EACH ACCIDENT $ ANYPROPRIETOR/PARTNER/EXECUTIVE 5,000,000 OFFICER/MEMBEREXCLUDED? ❑N NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 5,000,000 If yes,describe under Continued on Additional Page 5,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/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. 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 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 _ LOC#: Atlanta ACIORUP P ADDITIONAL REMARKS SCHEDULE Page 2 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 CARRIER NAIC CODE 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,NC,NE,NM,ND,OK,SC,SD,TN,VA,WV,WY) Effective Date:03/01/2023 Expiration Date:03/01/2024 (EL)Limit:$5,000,000 Carrier:Safety National Casualty Corporation Policy Number:SP4068090(QSI)(CA,OR,WA) Effective Date:03/01/2023 Expiration Date:03/01/2024 (EL)Limit:$5,000,000 SIR:$1,000,000 Carrier:ACE American Insurance Company Policy Number:WCUC50668095(QSI)(GA,MI,NV,OH,UT) Effective Date:03/01/2023 Expiration Date:03/01/2024 (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,MA,MD,ME,MN,NH,NJ,NY,PA,RI,VT) Effective Date:03/01/2023 Expiration Date:03/01/2024 (EL)Limit:$5,000,000 TX Employers XS Indemnity: Carrier:Zudch American Insurance Company Policy Number:NSL1138319(TX) Effective Date:03/01/2023 Expiration Date:03/01/2024 (EL)Limit:$6,000,000 SIR:$5,000,000 ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 _ LOC#: Atlanta AC® 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 CARRIER NCODE AIC 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.I.Holding Company,Inc. Askuity,Inc. Home Depot Management Company,LLC ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ��•—••Za.+ o rbaasr::a9a/giBy <:. '� ,::......... ROM .it f ROVMivr LICENSE Mare w r RfcHARD TOUSEY rficrtiti�stiiat;ttt;;; l3itpis ,idutvt� , d 1y ficen a;.; . " t soreDr:�c�r:U,sA f v t sUPt�si;: >,yine�ouaty`,of'eutfolk �-: .. Licerise,Num60r;'i" '34 F�® ali i�ragc is*Uerl: 6511512014 ' Carm;ssfondr; Expire.: I VDI/2024 Th,is.licenso.is the propperty*f Su Elk Cd'unty w ' D3 pa'cment 6f t�bcr,•L Tcenci'ri -�Cdnsum4 Affairs. ' Pa�€sess;iSnaF ttt=�ii�ins�'daes not guiirantee.iis vatliiity. . Atlditioriat?6usinei:Nome,