HomeMy WebLinkAbout52505-Z ho�aof SOUIyo`o Town of Southold
* P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 46888 Date: 03/08/2026
THIS CERTIFIES that the building SINGLE FAMILY DWELLING-ALTERATION
Location of Property: 305 Olivia Ln Cutchogue, NY 11935
Sec/Block/Lot: 83.4-5
Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: 10/21/2025
Pursuant to which Building Permit No. 52505 and dated: 12/03/2025
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:
One replacement window in kind in the living room as applied for.
The certificate is issued to: Deborah Moelis ,Jeffey Moelis
Of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL:
ELECTRICAL CERTIFICATE:
PLUMBERS CERTIFICATION:
Au on Sig ature
Of SO yolo TOWN OF SOUTHOLD
BUILDING DEPARTMENT
• SOUTHOLD, NY
o�y��UNT'1•��
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#: 52505 Date: 12/03/2025
Permission is hereby granted to:
Deborah Moelis
310 W 72nd St#41-11
New York, NY 10023
To:
Install replacement window in kind as applied for.
Premises Located at:
305 Olivia Ln, Cutchogue, NY 11935
SCTIVI#83.-4-5
Pursuant to application dated 10/21/2025 and approved by the Building Inspector.
To expire on 12/03/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition&Alteration $250.00
CO-RESIDENTIAL $100.00
Total $3350.00
Building Inspector
rjf so
# * TOWN OF SOUTHOLD BUILDING DEPT.
`ycoorm, 631-765-1802
,,.,. a� INSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] NSULATION/CAULKING
J FRAMING /S T RAPPiiVG [v J .Fii�aAL'v 1 i"�`-�°"j
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL
REMARKS:
r
DATE INSPECTO
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST) — --- - — -
--------------------------------------
C
FOUNDATION (2ND) _
z
O
4 ..IJ``9
ROUGH FRAMING& - W
PLUMBING G
r
t�
INSULATION PER N. Y. - — �
STATE ENERGY CODE —
FINAL
ADDITIONAL COMMENTS
G
- Z
rn
- X
2
r�
— o
Docusign Envelope ID:AE1144BA-7069-45A0-ABEB-62AE1607CAE9
c�yFFDL
�,. TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
VVI
Telephone(631) 765-1802 Fax (631) 765-9502 https://www.southoldtownnyov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only WE
PERMIT NO. Building Inspector: 2
OCT
Appltcaftonsanti forms must belled out In thetr-enttrer Incomplete ;<
appllcations'wtil not be accepted: Where the=Appllcan#is not the owner,an Building Department
Llwner`s Ayfhorl af�on orm{Pale 21 shall be completed TO, 0' southoid
Date:10/9/25
OWNERS)OF PROPERTY'
Name:Deborah Moelis SCTM#1000-
Project Address:305 Olivia Ln
Phone#.646-229-2496 w _ Email:dmoelis@yahoo com
WMailing Address:305 Olivia Ln, Cutchogue, NY 11935
Name:Jennifer Winke - Go Permits LLC
Mailing Address:105 Buttonball Ln. Glastonbury. CT 06033
Phone#:303-946-8685 Email:permits@gopermits.org _
dESIGN-;PROFESSIONAL INFO itiYlAT1'QN 0
Name:n/a
Mailing Address:
Phone#: Email:
CONTRACTQR IhIFORl1l1ATtON N3,Name:Home Depot USA
Mailing Address2455 Paces FerryRd.„Atlanta, GA 30339
Phone#:303-946-8685 ..____...w... Email perm,its@gopermits
DESCRIPTION OF PRt?P05ED GONSLftUCTION X
z
El New Structure ❑Addition ❑Alteration Repair ❑Demolition Estimated Cost of Project:
0Other Remove and replace 1 window,same size,no structural change. $3309
Will the lot be re-graded? ❑Yes BNo Will excess fill be removed from premises? ❑Yes RNo
1
Docusign Envelope ID:AE1144BA-7069-45A0-ABEB-62AE1607CAE9
PRtSIERTYIIVFORMATIQN _ w
Existing use of property sin le family—, Intended use of property Sin le family
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes BNo IF YES, PROVIDE A COPY.
Check BgxAfterReading* The owner/contractor/design professgnal is responsible for all drainage and storm water issues as provided by
'Chapter,236 of the�orlvn Cods APPLfCAT101Y 15 HEREBY MADE t th Bmldin Department iorA a issuance of a Build�n�perm t pursuant to the Builds Zone
Ortllnance;:of the Tow+in of Southold,Suffolk,Caurrty,New York and dthe�applcable Laws,Ordinances or Regulation�,.for the construction of bungs, ;
addttions;ralterattonsor for reindWor demol�tiort as here�rt described The applicant agrees to comply with all appl�iable laws ordmances;3bu�ld�ng tiode,
housing utefe and egulatians and to admit authutixed mspectars on premises,and m building(s) or necessary inspections False statements q►ade herein are
�.pumstiabl as a Class A misdemeanor,pursuant to Section"210'45 Niw York State Penal Law
Application Submitted By(print name):Jennifer Winke-GO Permits BAuthorized Agent ❑Owner
., _...._...__
Signature of Applicant: Date: /U�(7
STATE OF NEW YORK)
SS:
COUNTY OF Guilford )
Jennifer Winke- Go Permits being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)a$ove 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 C)
day of 20�`v
Notak Public
Sydney Holston
PROPERTY OWNER AUTHORIZATION NOTARY PUBLIC
(Where the applicant is not the owner) Guilford County,NC
My Commission Expires October 04,202
Deborah Moelis residing at 305 Olivia Ln
do Wreby authorize Jennifer Winkle - Go Permits to apply on
m PgMI..to the Town of Southold Building Department for approval as described herein.
j—�-L 1 0/1 712 0 2 5
Owner's Signature Date
Deborah Moelis
Print Owner's Name
2
Go Permits, LLC
105 Buttonball Ln.
Glastonbury, Ct 06033
� r r
WE UNDERSTAND THAT YOUR TIME IS MONEY
r
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!
r
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
r •y
Home Improvement Agreement: Page 1
Home Depot License#'s -For the most current listing visit www.Homedepot.coin/LicenseNumbers
Adam Friedman
Salesperson Name Registration#- CA, CT,ME,MD,MI,NJ,DC only
Home Depot U.S.A., Inc. ("Home Depot") or its Authorized Service Provider named below will furnish, install, or
service the equipment listed below at the price,terms, and conditions set forth in this Agreement.
11 Service Pra�der,Contact Information:, F . � f y
M .
The Home Depot The Home Depot
Service Provider Contact Name Service Provider Company Name
(631)478-6101 ahs_ccwlongisland@homedepot.com
Phone# Service Provider Email Address
MOELIS DEBORAH � Long Island F54225722
Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO#
305 Olivia Lane Cutchogue NY 11935
Customer Address City State Zip
(646)229-2496 dmoelis@yahoo.com
Home Phone# Work Phone# Cell Phone# Customer Email Address
3:NOTICE OF'RIGI=IT TU CANC a =
YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING
THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT:
lahs�_ccwiongisland@homedepot.com
OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT:
40 Oser Avenue . Hauppauge -- 1 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
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. ANY MERCHANDISE OR MATERIALS DELIVERED TO
YOU MUST BE MADE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER
AT YOUR ADDRESS LISTED ABOVE AND IN SUBSTANTIALLY THE SAME CONDITION AS
WHEN DELIVERED.YOU MAY ALSO 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 HiA( e t 25 E) ene to a 9� 025 a 4 2572 v 6.0.0
'U968 Ah Moelis 9/12/202�. 919. `4.
`y
Home Improvement Agreement: Page 2
�4,Descrip on�.of Work to be Pe�cformed�', _ _ ,A detailed description of the work to be performed is included in the paragraph or document entitled Scope of
Work, Specification, Customer Summary Sheet, Quote Form, Estimate, Invoice, or Measure which is included in
this Agreement.
(5 : nticipated DeL�exy Date lFin_staXlatitn Schedule x
t-�..._....:
Approximate Start Date: ovo9/2o s Approximate Finish Date: 02/0812o2s
All dates are approximate and subject to change due to various circumstances such as weather,manufacturing delays,
obtaining permits or HOA approvals
You are entitled to a paper and electronic 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. Contact your Service Provider to update Your email address, withdraw Your consent to electronic
records, 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.
-z
7 Contract Pace andPayment SciecXule
Payment of the Contract Price is due upon signing unless a different payment schedule is required by law,is specified
below, or is in a payment addendum.
Contract Price: $ 13309.63 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, HMI(99%)
Deposit% 25.0 Deposit Amount$ 827 41 Remaining Balance $
2482 22
8.Fanance Chaff
Any interest payments or other finance charges will be determined by Your cardholder or loan agreement, to which
Home Depot is NOT a party,and wil) not affect the payment due under this Agreement.You are 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 Youry�Xmede payable to Home Depot
7777
9.Acceptance and Aut�arizaon _ „ iz
By signing below,You authorize Home Depot to:(a)arrange for Service Provider to perform the Services;or(b)order
and arrange for the delivery of special order merchandise,including any custom made special order merchandise, as
specified in this Agreement. Further, You acknowledge: (i) You have read and understand this Agreement; (ii) You
have accepted this Agreement in its entirety, including the General Conditions and State Supplement (if any); (iii)
You are receiving a complete copy of this Agreement; (iv) all rights and interests under this Agreement, including
interest in the property where Services are performed, are solely vested in the person listed as "Customer" above;
and (v) electronic signatures will be deemed originals for all purposes. Do not sign if blank or incomplete. Service
Provider's or permitting information may need to be provided to You in writing at a later date.
777777777771
X �. 09/12/25'
Customer's Signature Date
X /s/The Home Depot 09/11/2025
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
460Standard Form HIA((}2�SSept�25� M Moelis 9'12'2O2�v'17 te�§f.Aw /, �25 &Td 4 4 257 v 6.0.0
r
�11
H . ME
SERVICE:S.
January 10, 2026
Deborah Moelis
305 Olivia Lane
Cutchogue, NY 11935
k
Permit Number: 52505 €;
Building Department: 631-765-1802 press 0 JAN 3 2026
Home Depot Job Number: SO-20250912-5224741
RE: Permit Finalization
14
Dear Deborah Moelis,
Congratulations on your completed home improvement project with The Home Depot.
We've been unsuccessful in our attempts to contact you concerning finalization of your
permit. The finalization process typically takes less than 15 minutes and the inspection
is necessary to close out the permit with the city.
If you'd like me to schedule the inspection for you, I'd be happy to assist. Please feel
free to send me a couple of date options that work best for your availability. You can
reach me via text or phone 603-521-0444; samanthanoone@gopermits.org.
Alternatively, if you prefer to coordinate directly, you may contact your building
department using the number provided above. Just reference your permit number when
calling, and they'll help you set up a time that's convenient for you.
Thank you again for choosing Home Depot as we truly value your business.
Best Regards,
The Home Depot USA, Inc
The Home Depot 2455 Paces Ferry Rd C-20 Atlanta GA 30339 Ph: (800) 395-8563
04
DI A • AL • =1 -
�I off
1
•
it • •r •
.,•.. a �� a er�'.t 1R'' y *,. sx,. �".c4 � �^� "i, ,. 4 r,,
�i e �„piq,}-a � F• 1 r. d f ,�' f F Y A Ytn � �' ",� 'tF.�` t
>'.�� R p ,�b.i+xE* a !i"�, n .r m,F"w :+Aew,8 y
" �x'' ,r. -s".E'-�.Y 'd'
tCn. a�. '• S 'r t '"�.."t , iT s ..„yF,� a.4
4-1
.x ■.t . ,+ c� "��{ f • e
v k r S ,: ,_1 r-, �' e' sr ,� �".t •�` y ..xx��,,d' "Y' �a r t''�"7
•Y f 3 ;'« .' j ' td'• t.Xi^", o°+i L� �•0 'fi.:. -L 'yy
.aYIt�r•� a,S^�-�,,��'w� '�� t�''��F x .:. _,
ti � `+ � t t *�r T� , i� r}� � .s+ep' r ?:2 � .�b,�T4X.;r•.
'�� #c`Jrj
�^ #i{n �c"y'
305 OM;ivia. L;�ne,,.Cut-b- u Y il.93
. .
^
r
1 Living Room Quantity 1
4' Options
,{ Product
Details
Descnptron v 100.:Senes Prcture/Transom'PWTR insert
Product Windows
7
I{, !
Protluct Gafegory Complete UIlrndow llnrt
_.__s_.
Series: 100 Series
xProtluct Type a, ti PrcturelTransom
Product Group: Picture/Transom Insert
Exterior View
Product Configuration P►cturelTransom
.c.<#�_....�_.._•�..:.J.w.r,...._Y1 ...............^ �.T A., .._,._ -::, .._._...._r�v.�. ._-_.__- ;Lv__._.�._.. _ .... _.< _ _.._.. >.
Room Location Living m
f i {Enhanced Performance z No
. t
Standard Width: Custom
Standard Height , Custom
Frame Height: 73
t Measurement Type Frame Sqe
?.:-w..sr..',,;+i-r_..,..._..�...G.._.........�.,.:.x._�.....{ ,...,_..,,..,�,_...,...� f -.0....�,.,k;v....__.-._....
} ° Overall Frame Width: 58.5
Overall Frame Height_ r__
Frame Width 58.5
7.k
}
..<,�,��
Interior View RO Height: 73.375
Venting i Handing Fixed
r
Frame Option: Insert
;Exterior Frame Color White ,
Interior Frame Finish Color: White
�lnsfallatiori Zip Code +` � 11935 '� � {
U.S.ENERGY STAR®Climate Zone: North Central
Glass Construction Type t D a/Pane '
.{i+.t:r.....w.H..a_. �-..wY.w...__....,.....4,h...{,v...„..c .Fv..-.._✓...__.....�...i..�......rvr+. J.+,_. „-.,s.»..•..r......x.. n '�+, -, __
Glass Option: Low-E
High Altitude Breather Tube's t = No, N`
7D-17u"t,.....,,..az:-:.....-_,...,..<a.--.......,.._-......�r__.ti+...
Glass Strength: Tempered Sound Control(STC-Temp)
tiGl s Tntr r No Tnt r Y
a..a�f..�..._s_..,�....:;�...'�...._..�rf•�,.i....��::�.y...w,..,,.x_....,.,,4,. ..,._�.�-..«...,w s....,�;...�..,....w..,.-,a r..r...,»......._ix x _:_....., .
Specialty Glass: None
5
Gas Fdl f ,r {; Argon
Glass/Grille Spacer Color: Stainless
E=Jlfenor Frame Extenders � � �� ',No' sr r f _ x
Exterior Sill Extender: No
wr'�t?..�- :'.'7' ",,,,q"'^q :i"` 1"' y_. r- fix ✓ �. { ti' d"
installation Matenal'Opt�ons Ott r � " No � � � �
2 I
Grille Type: No Grille(s)
c UnrtrU Factor Y j 0 27? - ,
Unit Solar Heat Gain Coefficient(SHGC): 0.32
W.
U S ENERGY STAR®Cer[rfled No
Unit CPD Number: AND-N-82-11943-00001
Vendor Number 0014818 ,
Vendor Name: HDISANDERSEN LOGISTICS
SKU Description: HDIS-ANDERSEN-100 SERIES-WINDOWS
Supplier CustomerSeivrce Number t (866)466-3578 r
Catalog Version Date: 0710112025
�Wrridow/,Door Wraps Labor Only(Per' a YHDE CAT WIN r '� �r f .v.
Each) _r..
New Exterior Pvc Casing F&I(Per Lineal Ft.): HDE CAT WIN
L(X�r
Operlrng) f.i°Y P� t r i �
Interior Frame Finishing Paint Grade Pine- HDE CAT WIN
Material Only(Per Open):
T
if er
Frame Fmrstir 9 Labor only(Per'yJ YHDE CAT WIN
pe
Install J-Channel F&I(Per Opening): HDE CAT WIN
Flange Wrhdow Rer»aVal w/Rernstallatron HDE CAT WIN " X
Interior Wood Casing 3 1/4 Paint Grade Pine- HDE CAT WIN
Mat Only(Per Lineal Ft):
r
!lrtt_enor Easing Labor Only_ Per gpenrng HDE CAT WIN
Window/Door Wraps-121-150 UI-Material HDE CAT WIN
Only:
Line Itern Adders Original
Cut Down Opening-Egress Openings Only(Per Opening)
Quantity.
New Exterior Pvc Casing F&I(Per Lineal Ft.)
Interior Wood Casing 3114 Paint Grade Pine-Mat Only(Per Lineal Ft)
Y
3p � x a� '� :�� 4 30
Flange Window Removal w/Reinstallation(Per Opening)
QUantrty
Interior Casing-Labor Only-Per Opening
an;,,{{,,��
...��y„ -,,,,.a_..f.
Wind
o
w
/Door Wraps-121-150 UI-Material Only
Window/Door Wraps-Labor Only(Per Each)
. 3