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HomeMy WebLinkAboutStrip and Re-Roof 2005 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 BUILDING PERMIT Permit Number: B2005-0324 Date: 22-Jun-05 Map/Lot: 096/024-000 Owner ID: 5318000 Project Location: 99 PARK AVENUE EXTENSION Unit: Job Description: Strip&Re-roof Owner Name: William Dersham Tenant Name: N/A Careof: 99 Park Ave Ext Uncasville CT 06382- Telephone: Contractor Name: Tri-State Windows Telephone: (860)443-8401 DBA: Lic/Reg Type: HIC Lic/Reg No: 519110 15 Lakewood Dr. Exp Date: 30-Nov-05 Oakale Ct 06370- Construction Value Permit Fees Construction Information Building Value: $5,600.00 Building Fee: $48.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $0.00 w/2004 Amendment $0.00 Mechanical Fee: Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $5,600.00 Penalty Fee: $0.00 Permit Code: R4 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.90 Total Fee: $48.90 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL,ELECTRICAL PERMIT INSPECTIONS ❑ Footing- Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill -Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor framing ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Certificate of Approval PA -rtificate of Occupancy Building Official's Approval: -mss 10,02/01 20:08 FAX 8487231 BUILDING DEPT ZO2 Town of Montville P / l Building Department 7 310 Norwich-New London Tpke. Tel. 848-7166 Un,casvil(e, CT 06382 Fax. B48-7231 Application for Building or Trades Permit Bnildina Permit Tirades Permit E Neu C iwrnurtvrt ❑Accessary Structure ❑Tf4ani ng El Yerlranical ❑ /torr Electrical ting I]ACtrrar�on Cit:ort (LOOP n 7rCart f7rr�"" Ass nnQicivrurig VIPme `� gas Job Locating ,'- T_` 1 i 1 E err Job Descripdon/Matsrials s[.W ` -Roo f- Owner _ Mailing Address Q City uV gvi,tl _ state CT Zip 06582. Tel $60 / BI G-1 65 contractur`Tiv-5rpfrE lot DS. Mailing Address I5- 4(tI�EuooDP, . .444,11-6 , CT oa C &toftlE_ - State Ci Zip_DbJ' 7O Tel 860/ 4 - $40 t Contractor's I..iarseRegist-ation Type&Number 19 110 Exp. Date II / 30 0 S New Home Construction Contractors: Have you entered into a contract with a consumer for the proposed new home?El Yes ❑ No I hereby certify that the proposed work will conform to the Basic Building Code and all other codes as adopted by the State of Connecticut and the Town of Montville and further attest that the proposed work is authorized by the owner in fee and that I am authorized to make application for a .- .r' for such work as described above. Owner/Agent Signatnr :1 / 7` f7 Date _ (p 12,.7 /OS Conatrar6nn value Fee Buil ding $ S Plumbing $ - $ Mechanical $ $ Electrical $ $ Other $ $— �.�(1,Q Certificate of Occupancy _ — Plan Review Fee $ State Education S Total Town of Montville Building Department File Receipt Date: 22-Jun-05 Receipt No: 339 Received From: Tri-state windows Dis. Job Address: 99 Park Ave ext. Fees Collected State Educational Training Fee Cash: $0.00 Cash: $0.00 Check: $48.90 Check: $0.90 Check No: 10835 Construction Value: $0.00 Demolition Value: $0.00 Received By David M Jensen 9 9i, , .-.i- Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Address: Pools & Spas Above Ground Round EA $ 3,200.00 $ - Above Ground Oval EA $ 6,000.00 $ - In-Ground EA $ 20,700.00 $ Heater EA $ 3,465.00 $ - Hot Tub EA $ 5,250.00 $ - Roofing Strip & Reroof 16 SQ $ 350.00 $ 5,600.00 Overlay SQ $ 250.00 $ - Plywood SQ $ 125.00 $ - Plumbing Full Bath EA $ 5,000.00 $ - Half Bath EA $ 3,500.00 $ Garages Attached, 1 car EA $ 10,775.00 $ - Attached, 2 car EA $ 18,600.00 $ Attached, 3 car EA $ 25,810.00 $ Detached, 1 car EA $ 13,850.00 $ - Detached, 2 car EA $ 21,100.00 $ - Detached, 3 car EA $ 28,350.00 $ - Sheds SF $ 26.25 $ - Sheds with Electrical SF $ 26.25 $ Electrical Service 100 Amp EA $ 825.00 $ - 200 Amp EA $ 1.500.00 $ - Siding SQ $ 600.00 $ - Windows EA $ 445.00 $ - Doors EA $ 625.00 $ - Decks/Porches/Sunrooms Open SF $ 22.31 $ - Covered SF $ 62.69 $ Enclosed SF $ 123.90 $ - TOTAL BUILDING CONSTRUCTION COST $ 5,600.00 PERMIT FEE CALCULATIONS Fee Building $ 5,600 $ 48.00 Plumbing $ - $ - Mechanical $ - $ - Electrical $ - S - n Work Commenced before permit issuance S - CO Fee S - Plan Review $ - State Ed Fee $ 5,600 0.90 Total Fees S 48.90 Based on 2003 RS Means Residential Cost Data 6/21/2005 /' TRI-STATE WINDOW DISTRIBUTORS INC. •VINYL SID NG DOORS 15 LAKEWOOD DRIVE, OAKDALE, CT 06370 ' ROOFINGContractor Registration (860) 443-8401 TOLL FREE 1-800-538-3160 FAX (860) 443-6135 No 519110 Contract submitted to Work to be performed at Name i.// a I, Street 99' �ij jaye ex-1--, Street a Wt e— City,State um(lts v i/lam C+,. 0638 a City,State Phone Q y8,qe 51 L/ . / 7f/ e,d- Y73 y Phone We hereby propose to furnish the materials and perform the labor necessary for the completion of the following: a! I ,e)1iic4-1r►•G -1 i^ SI,,:e,✓J4c L.JiJ1 J ,,_C.1 rriGiAl di ra_fdec rE-t cci .,r / C/u4.71.5KT AI(1...) 141 11: le Gr ll.L.4 /✓f Lahvv Jrt,p af'tr! rGtj& -ee/7l (illi! / c Er �it-ol 10 GC r( / -1/rir �#--5 - Ter Aks,c k) 1 ' /'S/Ca tri ct^ Mt f L L i S T—C!( CIL O't Cl// PLS C Si WO r a r(zr-cts s V i1 iticra b It. 40 1 tr.c. y t - /�pm)of tti6� �6c /a oft al(S a S -1--kc oirl-e- _oteAr - Ai tai sh Ina t �1// > C yea,- J (Rig c t-c c Vr r ►N r v tri L-e �(t2ko A Ski n -c tp v tr i clf Vett-e n,f rv� e. II � / I y-� // � GrpTr 0'140 i'r e r_ -ra cap! s n_ r- tirn�r �4i orL Jo io a._Lc- inc(k)cls har�l.bec . / - . f S' ' 5/�,-�(a.��s !'os�.,•�r�(rl s/�;n S s r.�Kc/ �ter_ ��� �at"c_. / K A:t er o►ti 0.ck i///�< r �rl /Ad-Le( / -DG>)sit S o &Ji//& Gc -/�d NOTES: ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED 1. PRICE $ 4/i •bO AND COMPLETED IN A SUBS ANTIAL WORKMANLIKE 2. DUE ON START $ Z, o00 •"4.) MANNER FOR�• THE SUM OF 9,0:10•c'° 3. FINAL PAYMENT $ Z COG. " DOLLARS t�trr`1 0SQry ft&ci -<-) DATE OF THIS TRANSACTION t, - 7--e) - O S NOTE: ALL PAYMENTS ARE TO BE PICKED UP WORK WILL BEGIN ON OR BEFORE {, - 25--0 f BY INSTALLATION FORMAN. FINAL PAYMENT IS DUE ON THE DAY OF TO BE COMPLETED BY Z b4 y S COMPLETION. THIS INSTRUMENT IS BASED UPON A HOME SOLICITATION SALE, WHICH IS SUBJECT TO THE PROVISIONS OF THE HOME SOLICITATION SALES ACT. THIS INSTRUMENT IS NOT NEGOTIABLE. NOTICE TO THE BUYER: 1. Do not sign this contract before you read it or if it contains a blank space. 2. You are entitled to a completely filled-in copy of the contract when you sign it. Accer i •I- TE IN OW DIST IBUTORS INC. C/`Wc'-.4-.`h--,'6 Seller Signature of Buyer i Signature Title Signature of Buyer i • CUT AND DETACH CUT AND DETACH BUYER'S RIGHT TO CANCEL: YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MID- NIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. NOTICE OF CANCELLATION (Date o You may cancel this transaction, without any penalty or obligation, within three business days from the above date! iransactionl If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable instrument executed by you will be returned within 10 business days following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION HOME IMPROVEMENT CONTRACTOR TRI-STATE WINDOW DIST INC 15 LAKEWOOD DRIVE OAKDALE,CT 06370 TRI-STATE WINDOW DIST INC LIC./REG NO. I EFFECTIVE EXPIRES 519110 ,12/01/2004 . r' 11/30/2005 SIGNED1�� F< _ 08/22/2005 08 : 55AM PAGE 2 OF 3 Cllent4:30701 — TRISWIt____"_. _ ACORD., CERTIFICATE OF LIABILITY INSURANCE DAEI164Muunrry6122/06 PRODUCER • THIS CERTIFI'ATE IS ISSUEC AS A MATTER OF INFORMATION Webster Insurance ONLY AND CT:NFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.TH 3 CERTIFICATE DOES NOT AMEND.EXTEND OR 914 Hartford Turnpike ALTER THE':OVERAGE AFFORDED BY THE POLICIES BELOW. Waterford,CT 06385 INSURERS Ai-FORDING COVERAGE _ -_ NAIC fl__ INSL,RED --•— — `NLA,HENA Miryland2urichCommercial ) — Tristate Window Distributors,Inc INOukEk E. 15 1 FK@V 9:d Cr{.,* IN:IS_EF__ --1I— Oakdale,CT 06370 INSURE ItU i INSUREkf. 1 COVERAGES 'HE POLICIES OF INSLRAN::E L,STEU BELOW HAVE BEEN ISSJED'U T-IE INSURED NA'F J ABOVE FUR SHE PC_ICY PER LD IND'LA'ED NU'NI'HSTAND!\_ ANY REQUIREMENT TERM OR CCNDI'ICI•;O°ANY CON'RACT UR OTHER DOCUMENT W RESPECT'')WHICH"HIS CER-IF IL:A'E Ma'r BE ISSUED CR MAY PEI"AIN 'HE INSLRANCEAFFORDELI BY"HE POLICIES DESCRIBED HEREIN IS SI S EC' -U ALL HE'EHN: E.XCLCSIUNa AND CUNOI IONS CF SUC1- POLICIES ACGRE3ATE LIMOS SHOWN MAY.1AVE BEEN REDUCED BY PAID CLAIMS It1POLCY€F€€r. T RATION LIMITS TYPE Of INSLRANCE POLICY DAT:I,.'.,•r.aaa •"I t•'•aaa .�- .-- -'""t A 1 GENERAL LIABILITY PAS41498453 •10'28/04 10/28/05 EA:,.0:'CLPRE r.CE 151.000.09L_ .I L'..m.,2,E' FENTEL s100000Q © COMMERCIAL GENERAL UAINLRY NL9 PRfES(L walruses) , ,walruses) I ■CLAWS MADE `OCCUR MEL Exc•,.L N IA i.,' x10.000 I PEN .:,1‘.).4.a AL IN.Ukv x1,000,000 _ NENEk/d AG:kEC.r.TE 52,000,000---'"-_ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS.COMP/OP AGO 5000,000 • POLICY N.O. I LOC iJk><T t I — - 7 -- — ----- FAU'OMOKLE_IABI;•R1 COM[a,NEL SINGLEL'MIT c ,Ea:,.r-Oe e ._.■ .Vr Y eU1 C _______________—...1-- III ALL OP/IIED ALTOS bCUIL°IN.UF• c 3ChEIJULEL ALT=S -- . HIFEL FLI"L$ ',.I bCUIL"IF,.LF` c Fa,acuOaM; • hONOWNEC AR v: FROFEP.TV L'+M.,:E 5 —,.__�� GARAGE UAFFLTY AUTO ONLY-EA ACCIDENT s : IIII Als,ktr1GOTHER THAN EA ACC ALTO ONLY AGC S EXCESSNMbRELLA LIABILITY :EA::-O:CL FRENA E _ J OCCUR CLAIMS MACE i 7,GGHEG!•TE S c S I RELCP:TIbLE T __ kETE1i11ON _5__ _ _____ —""-' 'NC STATJ• Ol-. A WOKHEHS COMPENSATION AND -__-^--'YC4'49854502-_- --~'10128/04 10/28/05 TX ,TNC STA 1T1 ,.� ENPLOYLHS UAb'LTr E.L.c..Cr-FC.;_ NI I s14Q,000 ! OFFFECFRIEEEkExCLU.)f.L OU1PE �— — OFF.�4MEMbEkEnCLU7EC I ,EL.DISEASE•FJ,EMP.OVEE`51QQ,000 IA a 7a?C,La tftiM EL.76EASE•POUCV LiUI•T !,s500 000 SP.�CI�r PROVI9FON8 bMow --_,__ _ ----i----- I OP*( LESCRIP'ION Of CFE FUTONS,LOC.`IONS I VEHICLES I E7.C.USIONS*DUEL by ENDORSEMENT I SFEQAL HIeOY1SION5 CERTIFICATE HOLDER CANCELLATION l SHOULD ANY Of TRE ABOVE DESCWSED POLICE,SE CANCELLED BEFORE TRE EXPIRATION Town of Montville DATE THEREOF,THE ISSWNS INSURER*ILL ENDEAVOR TO NAIL In DAYS WHITTEN 310 Norwich-NL TpK NOTICE 1C THE CERTIFICATE HOLDER NAMED 1 0 THE LEI' HUT FAILURE TO DO SO S*A_L Uncasville,CT 06382 IMPOSE NO OSUGATION OR LIABI.flY OF IP,Y echo A0W IKE INSURER.ITS AOE$TS OK REPRESENT A''YES _____.... AUT ROWEL, (HEFFIE SF-W AA'PIE , L d"EFGFiN ',�/ —, ACORO CORPORATION 1988 ACORD 25(2001/08)1 of 2 #M53732 NPJ 06/22/2005 08:55AM PAGE 3 OF 3 f � t I � IMPORTANT It the certificate holder is an ADDITIONAL INSURED.the policy(ies)must oe endorsed A statem r`n this certificate does ret corter rights 10 the certificate holder In i eu of such erccrsement(s:. if �' )�A i' " W. E ' `' '�"� to t1?terms and conditions of the policy certain policies may require an endorsement. A statement on tis certificate does not center rights to tie cert ,ate holder n lieu of such eroersemeni(s;. DISCLAIMER Tt e Certificate o1 i lsuratr.P on the '!versa side o this torr•1 dues no constitute a c intra the issuing insurer's) authorte'i representative or oroeucer.and the rkniticeto holder nor i1 rid !t attirmatvely or negativa'y arnerc. extend or ater the coverage attcrded by the p•-1 ides lister thereon ACORD 25•S'2001/04:1; 2 et 2 #N15273. BUILDING PERMIT AUTHORIZATION FORM I Richard A. Deabay, President of Tri-State Window Dist. Inc., 15 Lakewood Drive, Oakdale, CT, authorize 1t t.E.b3 1.ArRSo6. to procure a building permit, this date for work to be completed at 1 �QK• �VE. ��CT, UctisuBELE Cf The type of work to be done will consist of !.)Ew woof. SIGNATURE OF AUTHORIZATION /jcPzet4