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HomeMy WebLinkAbout49775-Z ''�pguE lye Town of Southold 10/20/2023 a P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 44675 Date: 10/20/2023 THIS CERTIFIES that the building WINDOWS Location of Property: 1000 Ninth St, Greenport SCTM#: 473889 Sec/Block/Lot: 46.-1-31.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/12/2023 pursuant to which Building Permit No. 49775 dated 9/25/2023 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: (Unit D35)window replacements to existing dwelling unit as applied for. The certificate is issued to Driftwood Cove Owners Inc of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED th rize 'gnature TOWN OF SOUTHOLD �`°So�FotKeel BUILDING DEPARTMENT TOWN CLERK'S OFFICE "may • 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#: 49775 Date: 9/25/2023 Permission is hereby granted to: Driftwood Cove Owners Inc c/o John King PO BOX 1186 Westhampton Beach, NY 11978 To: (Unit D35) install window replacements to existing dwelling unit as applied for. At premises located at: 1000 Ninth St, Greenport SCTM #473889 Sec/Block/Lot#46.-1-31.1 Pursuant to application dated 9/12/2023 and approved by the Building Inspector. To expire on 3/26/2025. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO-ALTERATION TO DWELLING $50.00 Total: $250.00 Building Inspector SO//Th° # # TOWN OF SOUTHOLD BUILDING DEPT. SE • °`ycourm ' 631-765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ r6SULATI0WCAULKING FRAMING /STRAPPING [ INALW1014 OWES [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL RE RKS: � 5 DATE �`� INSPECTOR IELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) ----------------------------------- FOUNDATION (2ND) ROUGH FRAMING& k PLUMBING Jq INSULATION PER N.Y. STATE ENERGY CODE ------ FINAL ADDITIONAL COMMENTS 0 A�l TOWN OF SOUTHOLD—BUILDING DEPARTMENT � Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 "y q� Telephone(631) 765-1802 Fax(631) 765-9502 https://www.soutlioldtownny.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector SEP 1 2 2023 ,APPIicati6ns a"nd'fo'rms must be,filled"dut in their entirety tncoinplete Building Department applications will not be accepted. Where the Applicant isnot the owner,.ari 'Town of Southold Owner's Authorization form,{Page 2)shall be completed,' Date: to ( a3 OWNER(S)OtF,PROPERM Name: �CJw"C-g1000- SCTM# Project Address: 1()()o 01-irh Phone#: ail: 43SVC5@o�w�� 1ne • �E- MailingAddress: ONTACT PERSON: Name: S L e c� w�-c�h _ °(� Q r w\.rAS (,0Z. Mailing Address: ( O 51 ��. �FA tom, . � �cv�N cx- d Cn C, Phone#: 3 G �j ' cl�lp- (.oEmail: I ('IMS-�s P �� -vvi��S . o D.ES[GN PROFESSIONAL INFORN[AT[ON:. Name: Mailing Address: Phone#: Email: CONTRACTOR 1NFORMATlON:•, Name: M 11 ailing Address:...,Q''LuSS. . Q'C.�..5. .�. �� 1-�`��.Gv� -�` 1�..� . 3 d31 Phone#: Email: - Qa Q -{-S _........ . . _......... cry c.-tS Q rr�� . ,'DESCRIPTION 01'PROF'.QSED:CONSTRUCTION'.- [--]New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other Rty'e\OJIL 0.-4 Cqc coo- W i►'�&OvyS, S CA w�c S( ? $ 23-�)C Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No 1 DocuSign Envelope ID:AF360A98-E9CB-462F-BEBE-B39086CB497D 4� ------....—�---,- ,— V — P ` .. E :i`�F Dirt Existing use,of property:„w M.".• w.. _.. Intended use of property: ��"". ` 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. C! eorttraoaiidgsigh professional Kr�!e Ponsibie fu"r alt drairiaje Ohd:s'toft Water issues as resided-li Cha{iter 7 S tt#tfiiti owii C ie,=APFLiCii f tl?lU 1S ER BY i AT inti;the: ral3iiiii i?egres3rsient fisr ilte ssy ricq oy a utlsiing Permit pursuant tot he Bujldin "Zone: t7rdStl�Yic#r0�'t?tt+'Yo�tslta�5q�if$1014;5c€t#'alk, unto,,;�ei�r�srr3t�ri13�th�a�g�Xi�6�ablet�ti±+`s,,-C3rziinnilces.lar'ite�utatisrns;td'rti��sir1stiticiivr�:tiftiia�iicEi>��s> ,;: .. ti�lltlssr3 it rati0fssar-$rst terYiariit pl'00*00"' h rein des4O6&Thd#plzc x111�igri Qs ctszrt by witfi al:epp;Ieabi3 laws,ciri3`snzipces;bz ilaing cndd ` lt+ausing Cade sold tati0ns r sf o'admi#0iatl10iix i supe tars^ais precrli�es a��d:"sal liilliding(s;,i®r: lnspeztiraris:FA st Tplrc is ri:Ao herein are, "lsuriixtlabir a��Elass A:ssiisderiiet�niir:�syi'suasit to`5ectiAn�3:t3.��=i%�.t}ie•�ie�rr;Yiult 5Y�8e AenaJ i.aia+::;:�.:..:,a. Application Submitted By(print name): 3.L'o.Vk i mVV-.a— RAuthorized Agent DOwner Signature of Applicant:, late: STATE OF.N&W YGRK-���- SS: COUNTY OF ut1 Y_ +LV%V, C✓ ids being duly sworn,deposes and says that(s)he is the applicant {Name of individual signing contract)above named,. r W (S)he is the � ��- (Contractor,Agent,Corporate Officer,etc.) of said ownerbr owners,.and is duly authorized to perforin 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"knowiedge and belief;and that the work will be performed in the manner set forth in the application file therewith.. Sworn before me this NM L V day of_f_)Q OO(Nl: ,20 2__ Notary " •: on '.ftv �pTAgy m PROPERTY QVINER AUTHORIZATION (Where the applicant is not the owner) %2,�� .Z�,.; A, �% �'YA M GO,``�� residing at_ d7L�CJ d'�. /r/1111�1�� zt do hereby authorize . �vvr�a �r' tvt .<-fid`��'^'�`��to apply on m po .lvglear Y.he,Town of Southold Building Department for approval as describer)herein. 9/6/2023 Fc4sa'&WnePs Signature Date, Print Owner's Name 1 2 Go Permits, LLC 105 Buttonball Ln. Glastonbury, Ct 06033 y 'f "WE UNDERSTAND THAT YOUR IS MONEY" SEP- 1 2 2023 Building Department To Whom It May Concern: Town of Southold 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 tal!' Home Depot License#'s-For the most current listing visit wNvw.Homedepot.coim/LicenseNumbers Adam Friedman Salesperson Name Registration#(Req.in CA,CT,ME,MD,MI,Nd,DC) Home Depot U.S.A.,Ine.("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_......._..... ',l. Service Providei Contact Iri$orxnation The Home Depot The Home Depot Service Provider Contact Name Service Provider Company Name (631) 478-6101 customercancellationnortheas� Phone# 89FRJ c vider Email Address Service Provider License#(s) 2. Customer Information'; _.. ..._.. M... .:..: . . _... ... _. . .. . I OLearyThomas Long Island F36893461 Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 1000 9th Street D35 Greenport NY 11944 Customer Address City State Zip (516) 924-5558I oosvcs@optonline.net Hoene Phone# Work Phone# Cell Phone# Customer Email Address f 3 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: IcustomercancelIationnortheast@homedepot.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 40 Oser Avenue Hauppauge 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 MADE 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 RIGHT TO EL. Acknowledged by: 09/02j2o2s 11komer's Sign Date 460 StandardFomi111A(21Jul.21)(E) Generated Date Og/OZ/2023 Lead/PO# F368Q3.461 ° 0.1.12 Home Improvement .Agreement: Page 2 4;Description of Work to be Perfoei ned _ . . Adetailed 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. 15.Anticipated DeU Date,f Installation Schedule Approximate Start Date: 02/29/2024 Approximate Finish Date: 03/30/2024 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. Y _„ b. 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 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 by law, specified below or in a payment addendum. Contract Price: $ 18239.68 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 (If applicable, total amount of taxes included in Contract Price) Ylilaximum deposit ONL Y applicable in tL.lD, NIA,2VE(33%),JirJ, 69'1(99%) Deposit% 100.0 �� Deposit Amount$ 8239.68 Remaining Balance $ 0.0 .8.;FYnaztce Charges -. Any interest payments or other finance charges will be detennined 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 f%'Acceptance 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 09/02/2023 Customer's Signature Date X /s/The Home Depot 09/02/2023 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 I-800-466-3337 460 Standard FomtHIA(21kit.21)(E) Generated Date (grog/202'3 Lead/P0# P4.689-346.1— v 0.1.12 9/6/23,7:44 AM Mail-Mayers,Clifton W-Outlook Fwd: [EXTERNAL] RE: Driftwood Cove unit D35 Friedman, Adam <ADAM_FRIEDMAN@homedepot.com> Tue 9/5/2023 6:46 PM To:Mayers, Clifton W <CLIFTON_W_MAYERS@homedepot.com>;Keeley, Patricia G <PATRICIA_G_KEELEY@homedepot.com> Another approval came in. Thomas O'Leary Job. Number. 11249114 Get Outlook for iOS From: Keith Rankin<kuksu@optimum.net> Sent:Tuesday,September 5, 2023 6:02:35 PM To: Friedman,Adam<ADAM_FRIEDMAN@homedepot.com> Cc: 'Danette Carroll'<danette@islandeastmgmt.com>; '062 Scott Ferrari'<scootergreenport@yahoo.com> Subject: [EXTERNAL] RE: Driftwood Cove unit D35 This Message Is From an Untrusted Sender Report Suspicious You have not previously corresponded with this sender. Hi Adam, The board approved your project at the D35 unit in Driftwood Cove. Thanks Keith Rankin-Treasurer From: Friedman,Adam [mailto:ADAM_FRIEDMAN@homedepot.com] Sent:Sunday,September 3,2023 5:04 PM To: Keith Rankin<kuksu@optimum.net> Cc: 'Danette Carroll'<danette@ islandeastmgmt.com>; '062 Scott Ferrari'<scootergreenport@yahoo.com> Subject: Re: Driftwood Cove unit D35 To all, Please see attached insurance info/license and project specifications. Please let me know if you need any other information after reviewing the attached documents. Get Outlook for iOS [aka.ms] From: Keith Rankin<kuksu optimum.net> Sent:Saturday,September 2, 2023 8:20:03 PM To: Friedman,Adam<ADAM FRIEDMAN@ omedepot.com> https:/lo365mail.homedepot.com/mail/inbox/id/AAQkADdkZWQ2ODQxLTc4N mMtNDE500050Dk3LWY5ZTAzYWI l YTg2YgAQAKe6o%2B%2BWwM... 1/3 9/6/23,7:44 AM Mail-Mayers,Clifton W-Outlook Cc: 'Danette Carroll'<danette islandeastmgmt.com>; '062 Scott Ferrari'<scootergreenport _yahoo.com> Subject: [EXTERNAL] RE: Driftwood Cove unit D35 Adam, Here is Danette's contact information: Danette Carroll Island East Management P.O. Box 1186 25 Sunset Ave Westhampton Beach, NY 11978 631-288-6646 office 631-288-6001 fax From: Friedman,Adam [mailto:ADAM FRIEDMAN@homedepot.com] Sent:Saturday,September 2, 2023 4:39 PM To: Keith Rankin<kuksu optimum.net> Cc:'Danette Carroll'<danette@islandeastmgmt.com>; '062 Scott Ferrari'<scootergreenport _yahoo.com> Subject: Re: Driftwood Cove unit D35 Great. Do you have a contact phone number for Danette Carroll. I will send over the necessary documents for HOA approval. Adam. Get Outlook for iOS [aka.ms] From: Keith Rankin<kuksu optimum.net> Sent:Saturday,September 2, 2023 4:02:51 PM To: Friedman,Adam<Adam Friedman@ omedepot.com> Cc:'Danette Carroll'<danette islandeastmgmt.com>; '062 Scott Ferrari'<scootergreenport _yahoo.com> Subject: [EXTERNAL] Driftwood Cove unit D35 Hi Adam, Please submit a copy of the contract with window specs,the contractors license and insurance information to our property manager.They will review and distribute to the board of directors for approval.Your customer should be doing this.You can email the above to: Danette Carroll danetteL@islandeastmgmt.com Thanks Keith Rankin-Treasurer The information in this Internet Email is confidential and may be legally privileged.It is intended solely for the addressee.Access to this Email by anyone else is unauthorized.If you are not the intended recipient,any disclosure,copying,distribution or any action taken or omitted to be taken in reliance on it, is prohibited and may be unlawful.When addressed to our clients any opinions or advice contained in this Email are subject to the terms and conditions expressed in any applicable governing The Home Depot terms of business or client engagement letter.The Home Depot disclaims all responsibility and https://o365mail.homedepot.com/mail/inbox/id/AAQkADdkZWQ20DQxLTc4NmMtNDE500050Dk3LWY5ZTAzYW I1 YTg2YgAQAKe6o%2B%2BWwM... 2/3 Labor,.Licensing&Consumer Affairs HOME IMPROVEMENT LICENSE Name RICHARD TOUSEY B,usiness,Name This certifies that the aearar is duly licensed HOME DEPOT USA INC(14 SUPPS) ?y the County of Suffolk License Plumber:H-534.29 Rosalie Drago ' Issued= 05115%2014 Commissfoner Expires: 1110112024 ?y .`.This,license is the property oftuffolk County ` Department of Labor,.Licensing,&'Consumer Affairs.. a Possession of this iloonse.does not guarantee Its validity. Additional Business Name License Categbry H1-GC DATE(MM/DDIYYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 0310312023 1.. 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: PHOE TWO ALLIANCE CENTER AICNNo, 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 43575 HOME DEPOT U.S.A.,INC. INSURER C:ACE Amedcan Insurance Company 22667 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 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 LIMITS LTR POLICY NUMBER MMIDD MMIDD A X COMMERCIAL GENERAL LIABILITY MWZY316648 03/01/2022 03/01/2025 EACH OCCURRENCE $ 1,000,000 DAMAGE ToRENTED CLAIMS-MADE M OCCUR 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: GENERALAGGREGATE $ 2,000,000 X POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY MWTB316649 03/0112022 03101/2025 COMBINED SINGLE LIMIT Ea ccident $ 1,000,000 a X1ANY 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 UMBRELLALIAB 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 RETENTION$ $ B WORKERS COMPENSATION SCFC50668198(WI) 03 0 2023 03/01/2024 X PER oTH- AND EMPLOYERS'LIABILITY STATUTE ER C ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N WLRC50668150(MT) 03101/2023 03/01/2024 5,000,000 OFFICERIMEMBEREXCLUDED? FN N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 5,000,000 If yes,describe under Continued on Additional Page E.L.DISEASE-POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS below 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 A"" 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(OSI)(GA,MI,NV,OH,UT) Effective Date:0310112023 Expiration Date:03101/2024 (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:03101/2024 (EL)Limit:$5,000,000 TX Employers XS Indemnity: Carrier2urich American Insurance Company Policy Number:NSL1138319(TX) Effective Date:03101/2023 Expiration Date:03/01/2024 (EL)Limit:$6,000,000 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#: Atlanta AC"R o 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 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 "'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 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Workers' Compensation Lair Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. C-105.2(9-17) REVERSE APP,ROVED AS NOTED oA • ' ,5 B.P# �aCCUNAN�Y' ��i �;=,eBY: NOTIFY BUILDING DEPARTMENT AT USE IS UNLAWFUL 631 765-1602 8AMTO4PM FOR THE WITHOUT CERTIFICI FOLLOWING INSPECTIONS: 1. FOUNDATION-TWO REQUIRED OF OCCUPANCY FOR POURED CONCRETE -2. ROUGH-FRAMING &PLUMBING 3. INSULATION 4. FINAL-CONSTRUCTION MUST BE COMPLETE FOR C.O. All CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUC T ON ERRORS COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF v . S ulC— -r0'ry' d�t�NNING BOARC ' T�USTEES WINDOW SPECIFICATION SHEET - Spec.Sheet#: F36893461 Sheet: 1 of 1 Customer: Thomas OLeary Job#; F36893461 Consultant: Adam Friedman Date: 09102/2023 New Window Hinge Locations Existing Window 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,RorS Glass Misc Items Hardware Code Screens For doors use a o o Mull "S"=stationary or r r m w o N H "X"=operating w Style Wraps -� m` a t7 zr r 'e Room Floor Code (YIN) Style Code Series Code w i IT 6 ci a > i > _ STD,White, GlassPack- METAL, 1 LIV 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR STD,White, GlassPack: METAL, 2 LIV 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR STD,White, GlassPack: METAL, 3 KITCH 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR S1D,White, GlassPack: METAL, 4 KITCH 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR STD,White, GlassPack: METAL, 5 BED1 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR STD,White, GlassPack: METAL, 6 BED1 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR STD,White, GlassPack: METAL, 7 BED2 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR STD,White, GlassPack: METAL, 8 BED2 1st DH- Y DH 6100 WH WH 32 52 84 S, WH,W C ALL 2 1 ALL 2 1 Standard STORM, ALDER GBG H WRAP,LSR SPECIAL CONSIDERATIONS: 1:White,2:White,3:White,4:White,5:White,6:White,7:White,8:White 'rap 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) r ,,���.•y, q;,�sr_f '�Iyr"y.•'^�3f{ ns4^i'�;Sr'� Or: iTp✓arl� '��' KrIth+;mitts :• r'� •�l ei1 r a 1 9 G ..,Z312r�a':i�"�akai°.;�, •SA?. .•�+c•-•� �•, Y <•,--' gitive'8;'A Fa��.- ;� ,.. :.;u �.. rte_ Awning 6500 Base ProSotar Supercept 716' 026 . 0.23 , o a 02S 0.21 o c aa� Casement 6500 Base 7M, 026 '0.24 a c a o 0.26 ' 0.22 m o o o Transom_ 650013ase ProSolar Supercept i' 0.27 0.32 0 0 0.27 : 029 O o DoubtFr Hung 6500 Ease Pro5olar Supercept 7V 029 ' 0.26 0.29 : 0.27 o n Picture Casement (NH) "6500 Base ProSolar Supercept Ito 0.26 ! 0.28 0276 025 Picture 6500 Base PiaSolar Supercept 718' 0.27 0.29 o e. 0.27 0.26 2'Panel Slider 6500 Base ProSolar Suparccpt 715" _0.29 : 0.26 c 0.29 0:23 3 Panel Sliders 6500 Base ibProPro Solar Supercept 718^' 029 0.25 0 � 0.28 0.23 a 4 } Garden Door(dk) __ 6ZO Eiteg,Star ProSolar SUN Super Spacer 1^ a.30 0.24 0 "c a 0.300.21 Patio Door,1NOV0 8500.'Base Pro Solar Super Spact 1' 0. Nooses located evw1 where EXCEPT.Arizona,CoMfomfe,Idaho,fdo�ack,.RSetat7e co.Oregon,Utah,and Washington. Awning(Inc Hopper) 6100:Base Pro Solar Intercept 718^ 0.?7 0.24 v o o r a.28 : 021 0 0 0 0 Casement 610_0 Base Pro Solar _Intorcop .718" 0.2g7_01..24 0.27 0.22 Double-Horny J �6100 Ei1i�'�y Star Pro SWar� Supe pt -0:30 " 0.30 o 0.30 _0.27 Picture Casement(No itiarjU} 6100 Base Pro Solar Intwr-W. vol 0.27 0.23 0 o 0.2-1 025 0 0 0 0 Pictun 6100`Basa Oro Solar Intercept :,f4" 0 7 0.31 o a 0.27 028 e o 2 Panel Slider 6100 Base Pro Solar Intercept ata' 0.30 ' 0-28 3 Panel Slider, 6.100 Base Pro_Solar Interoopi 374" 0.30 i 0.29 0.30 ; 0.27 0 s ® 8 t 8 FlnfnealnceiYortevCiycvhcrc E7[CEF7:drizana,Cslifomfo,lriatro,'N Voata,t4evrMc.,d o,Oregon,Mh,sod t�fashirtgtan.. Patio Door INOVO 6�00•Energ}+"Star W Pro Solar Supe Spacsx_1 0.28 ; 0.2a" o 0 0.28 : 0.2 0 0 o Patio Door NARROWFRAME.;6i00(i?D05)Base Pro Solar Intercept 314^ 0.28 ; 0.30 0' 0 028 1) ,s o u e Homes iocateed only in fanordag merkets:Dakes,Dmwe,Detroit,Phila,RaarFt,crn AU,Lung fshind,NY, Awning '620013ose Pro SolarSHADE Supercept1140.27 0.25 o a e o 0.26 0.23 0 0 o 0 Casement - 6200Si3 Pro Sptar'SHADE Supercepi0.26 O.ifi o o m; .0 029 ' O.i7 e ® PPicture Casement-NIl .6200 Base Pro Solar SHADE SuparcaPt0:25 ' 021 o 6 o v 0.25 ; 0.19Picture Window G200:Baso Pro Solar SHADE Supercept0.26 0.24 e o n. c, 0.26 ; 022 �' :o a m Single Hung u00 Basra Pro Solar SHADE Supercept 3/4" 0.28 ' 0.23 0 0' c v 0.23 : 021 c c Single Slider 6200.Baso Pro Solar SHADE Supercept 3f4" 0.28 0.23 o u o 0.28 . 0.21 , o 3'Panet Slider' 6200 Base Pro Solar SHADE Supe cent 31a" 0.28 OM P o o a" ,028 021 o c o Nornas located in coastal areas. Awning. SB�'30aVL Energy Star PS"SUy'Lami Sup9xeepti 1" 0.26 a 023 o c o' 0 0.26 0.21 o a c c Casement $B+30OVL Base PSILarni Super Spacer 1 025 0.23 0 0 a. ca 0.25 0.21 w o 0 0 Double Hung SB+'300VL Base P.SIL3mi SuperSpacer 1, 0.29 025 m 'a.�o a 0.29 0.23 o e o c Slider 813-�300VL Base PS I Lami tntcrcept 1' i7.2 025 0 o e o 029 0.23. Patio or 5rer 1 B+300VL ETC 366 PS Shade I Lami Super Spa " 0.30 ; 0.19 0 0 0 �., _ � � e �-^ Garden Door(CH)_._. SB+300,VL Base PS/Lami Super spacer Y 0.30 i 028 U o 0.30 i 015 o d c o Dots indicate Entergy Stor tori f od for that zone _ •a i