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HomeMy WebLinkAbout2016 - Strip and ReRoof 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: B2016-0059 Date: 29-Feb-16 Map/Lot: 096/016-000 Owner ID: 5331000 Project Location: 137 PARK AVENUE EXTENSION Unit: Job Description: Strip&ReRoof Owner Nam Lucy Burgess Tenant Name N/A Careof: 137 Park Ave Ext Uncasville CT 06382- Telephone: (860)377-3643 Applicant Name THD At-Home Services Telephone: (401)447-7172 DBA: Lic/Reg Type HIC Lic/Reg N 565522 908 Boston Tpke. Exp Date: 30-Nov-16 Shrewsbury MA 01545- Construction Value Permit Fees Construction Information Building Value: $8,679.00 Building Fee: $108.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $8,679.00 Penalty Fee: $0.00 Permit Code: R4 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $2.26 Total Fee Paid: $110.26 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 frami ❑ Electrical Service CRS No: ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation .' at of Approval - 1-ate of Occupancy Building Official's Approval: v----• Qo I(13 c Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: e)�j, ( -c&S7 Type of Work Occupancy Type Permit Type ❑New Construction Q Single Family ❑'(3uilding ❑Addition ❑Two-Family ❑Plumbing D'Alteration 0 Townhouse ❑Mechanical 0 Accessory Structure 0 Electrical CRS#: Job Address: 137 Park Ave + (Number) (Street) (Unit) Job Description: 5+flp + re-rix)c (H-) se?" asphal-- no - --tirt_tctUrca.i chancyz Owner: M i r' SurryS Address: i 37 tkrI( Avco E)44 - City: lAnC e(Svt Ile State: C_ � Zip Code: 663W663WTelephone: C* 377-? ;'f3 Contractor: 11—it> DBA: Address: 9DSustL ) •Tp City: Shf 2t `S,VU State: /. MA Zip Code: 0I54:5 Telephone: No i) 91-7 702 License Type: H«. License No.: c35‘..,5 522 Expiration Date: (I 1 3b/1 I hereby certify that the proposed work will conform to the State 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 permit for such work as described above. 0 By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. -_" Owner/Agent Signature: Date: 270,06 Construction Value Permit Fees Building Value: S'-/' — Building Fee: Plumbing Value: ` Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: Rued Deccm6er31,2005 Town of Montville Building Department File Receipt Date: 24-Feb-16 ReceiptNo: 11136 Received From: THD At\-Home Services Job Address: 137 Park Avenue Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: $0.00 Bldg Check: $110.26 State Check: $2,26 Bldg Credit: $0.00 State Credit: $0.00 Fire Cash: $0.00 Fire Check: $0.00 Fire Credit: $0.00 Construction Value: $8.679.00 Demolition Value: $0.00 CheckNo: 14567 Received By: Carmen Kneeland rcorii LY\ l 1 L ulc c d Address: 137 Park Avenue ITEM QTY $/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA Basement,Finished - SF $ 41.96 $ - $ Interior Renovations SF $ 36.09 $ - $ - $ AMENITIES Kitchen EA $ - $ - $ Full Bathroom EA $ - $ _ Half-Bathroom EA $ _ $ GARAGE Detached SF $ 71.53 $ - $ _ MECHANICAL Warm-Air n Y/N $ - Hot Water n Y/N $ _ Electric n Y/N $ _ Air Conditioning n Y/N $ _ ELECTRICAL SERVICE Upgrade Amps $ _ Subpanel EA $ 699.00 $ _ Gen Set EA $ 3,850.00 $ - SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace EA $ 6,497.70 $ - Masonryw/lfireplace - EA $ 7,096.65 $ - Masonry w/2 fireplaces EA $ 11,095.70 $ - Wood Stove,free standing EA $ 2,69225 $ - Wood stove insert - EA $ 1,859.77 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 44.07 $ - Porch - SF $ 149.38 $ - Sunroom SF $ 176.90 $ - $ - POOLS&HOT TUBS Hot Tub EA $ 8,016.25 $ - $ _ Inground Pool EA $ 31,550.00 $ - $ _ Above Ground Round EA $ 6,299.46 $ - $ - Above Ground Oval - EA $ 7,019.75 $ - $ - Pool Heater - EA $ 8,984.25 $ - $ - Inflatable Type Pool EA $ 1,200.00 $ - $ - SHEDS w/o electrical SF $ 25.55 $ - w/electrical SF $ 26.85 $ - $ _ RENOVATIONS Roofing,Overlay SF $ 3.50 $ - Roofing,Strip&reroof - SF $ 4.50 $ - Roof Sheathing SF $ 1.51 $ - Siding - SF $ 6.75 $ - Windows EA $ 550.00 $ - Skylights EA $ 1,051.10 $ - Doors,Exterior - EA $ 601.50 $ - Oil Tank,275 Gallon EA $ _ Oil Tank,550 Gallon EA $ _ MISCELLANEOUS CALCULATIONS $ 8,679.00 TOTALS $ 8,679.00 $ - $ - $ - PERMIT FEE CALCULATIONS Construction Value Fee Building $ 8,679.00 $ 108.00 Plumbing y $ _ $ - Mechanical y $ _ $ - Electrical y $ - $ - Working before Permit Issuance $ - Certificate of Occupancy Fee $ - Plan Review Fee $ - State Education Fee $ 2.26 TOTALS $ 8,679.00 $ 110.26 Figures are based on the 2006 RS Means Residential Cost Data 'L-i:2 Ra t,?-,.': 491405 CoRPORATIGI4 STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION 165 Capitol. Avenue + Hartford Connecticut 06106 Attached is your Home Improvement Contractor Registration. This registration is not transferable. The Department of Consumer Protection must be notified of any changes to your registration within thirty(3o)days of such change. Questions regarding this registration can be directed to the License Services Division at(860)713-6000 or email dcp.licenseservicesRct.gov. Visit our web site at www.ct.gov/dcp to verify registrations,download applications and the booklet for The Connecticut Contractor for Home Improvement and New Home Construction. STATE OF CONNECTICUT I)EP4RI'VENT OFCONS?'1IER PROTECTION HOME IMPROVEMENT CONTRACTOR THD AT-HOME SERVICES INC THD AT-HOME SERVICES INC CUMBERLAND OFFICE PARK CUMBERLAND OFFICE PARK 2690 CUMBERLAND PARKWAY,SUITE 300 2690 CUMBERLAND PARKWAY,SUITE 300 ATLANTA,GA 30339 ATLANTA,GA 30339 THE HOME DEPOT INSTALLED SALES LIC.i RE6 NO. EFFECTIVE EXPIRES HIC.0 : 12/; /2015 11/30/2016 _IGNED_. 7?7::'7:1"":4':14r*t- 4. :� h4 3 7,!. , t,i ryx .:';: �r r- --.*;r.-4.-,•' ...,-.:.--,‘,.......,),•-g.$:',:',..- v d + .f r.$•Fr' + ,.:.: .: r...,-;;-",k; , " .;‘,1.----;--..$-:,.: , 1` -ti ' fit: 5.. I aM § 8 .+ n Al. a f , ,p r ,fl b '11J` , —_..J tJ' --A', ,J ►kms ktk STATE OF CONNECTICUT + DEPRTMIE`T OF CONSUMER PROTECTION Be it known that j - i • r r ' E THD AT-HOME SERVICES INC I CUMBERLAND OFFICE PARK 2690 CUMBERLAND PARKWAY, SUITE 300 --.;,`;'d _ ATLANTA, GA 30339 s. is certified by the Department of Consumer Protection as a registered 1 T 44 i 3' 1 HOME IMPROVEMENT CONTRACTOR . `t Registration # HIC.0565522 ! , -1- I THE HOME DEPOT INSTALLED SALES n > , -� > tEffective: 12/01/2015 Expiration: 11/30/2016 ' .. a 421—% , -..., ,,, J. .ihan A.Mum:,arm:,Cemm ticsinncr iii- `4 I ,w`�- a!'S► ,I 4 ---,N. -'rs .47 ,N' r, ,fir tom► j, T-_.. . 4-_ 41 -.-4; nom. q— di 43 t�. ,k ... .. .t. .1. .r't . 1,...''',1.4.4 _?;-;hVis.\. .374 k,l,'. . i ' "� `, .. . .,:. .. ,1.'�..r' .�y. .+.,c:,. i. t$,+. A CERTIFICATE OF LIABILITY INSURANCE DA 01MIDDIYYYI) 02/242 242 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(ies) must 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: PHONE FAX TWO ALLIANCE CENTER (A/C,No,Ext): (NC,No): 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 30326 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC i 100492-HomeD-GAW-15-16 INSURER A:Steadfast Insurance Company 26387 INSUREDINSURER B:Zurich Arnencan Insurance Co 16535 THD AT-HOME SERVICES,INC. DBA THE HOME DEPOT AT-HOME SERVICES INSURER c:New Hampshire Ins Co 23841 2690 CUMBERLAND PARKWAY,SUITE 300INSURER D:Illinois National Insurance Company 23817 ATLANTA,GA 30339 • INSURER E: _ INSURER F: I COVERAGES CERTIFICATE NUMBER: ATL-003242685-09 REVISION NUMBER:7 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 I TYPE OF INSURANCE ADDL'SUBR1 POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MMIDDNYYY) (MMIDDIYY YY) A GENERAL LIABILITY • GL04887714-05 03/01/2015 03/01/2016 EACH OCCURRENCE $ 9,000,000 -X DAMAGE TO RENTED t 000 000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR LIMITS OF POLICY XS MED EXP(Any one person) _ $ EXCLUDED OF SIR'.$1 M PER OCC PERSONAL&ADV INJURY $ 9,000,000 GENERAL AGGREGATE —.$ 9,000,000 j — GEN'L AGGREGATE LIMIT APPLIES PER: ! PRODUCTS-COMP/OP AGG $ 9,000,000 71 POLICY JE O- LOC $ B AUTOMOBILE LIABILITY BAP 2938863-12 03/01/2015 031012016 COMBINED SINGLE LIMIT 1,000000 (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) $ AUTOSAUTOS — NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS I I (Per accident) $ I $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE I AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION WC017731493 (AOS) 03/01/2015 03/01/2016 X WC STATU- OTH- AND EMPLOYERS'LIABILITYTORY LIMITS ER C ANY PROPRIETOR/PARTNER/EXECUT VE Y/N WC017731495(AK,KY,NH;NJ,VT) 03/01/2015 03/01/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICE Ory In ER EXCLUDED? N NIA D (Mandatory In NH) WC017731494(FL) 03/01/2015E.L.DISEASE-EA EMPLOYEE S 03/01/20161000,000 , If yes,describe under Conitnued on Additional Page , I 1,000,000 , DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Addttlonal Remarks Schedule,It more space Is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION THD AT-HOME SERVICES,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DBA THE HOME DEPOT AT-HOME SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2455 PACES FERRY ROAD ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee -.t+x'«�� I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Applicant is responsible for obtaining all of the required approvals. No .ermit will be issued until all the re.uired si.natures are obtained. Part, Ave Ex+ t casvi I1 q- OE 3 Z Pioperty Address re- r© • Job Description Required Department Permit Issuance Approval Approval Tax Collector 2 01 f Comments: Signature/d to / Planning &Zoning X_///9"--- Signature/date Comments: Fire Marshal 17/7 * Ili Signature/date Comments: l i<_ ❑ Health Department Required for properties with private septic or well Comments: • ❑ WPCA, Administrative ���'`—'� <77 X7/17 Required for properties on sewer Signature/d Comments: ❑ WPCA, Operations When Required by WPCA Signature/date Comments: L� Department of Public Works Required when project includes driveway work or certain drainage requirements Signature/date Comments: ❑ Montville Police Department • Required for all permits EXCEPT one and two family residential Signature/date Comments: ❑ State Dept. of Transportation Required for Structures over 100,000 sq.ft or with more than 200 parking s.aces-Official co. of STC Certificate of O.eration re.uired—.er CGS 14-311 Signature/date Building Department Review Complete Signature/date Revised 23,Pin State of Connecticut Workers' Compensation Commission L. , ) o- WI" Please TYPE or PRINT IN INK Proof of Workers' Compensation Coverage when Applying for a Building Permit for the Sole Proprietor or Property Owner who WILL NOT act as General Contractor or Principal Employer APPLICANT FOR BUILDING PERMIT Name of Applicant for Building Permit Property located at in theCity/Townof ATTEST If you are the owner ofthe above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named property and you WILL':NOT act as the general contractor or principal employer,you are not required to have workers'compensation insurance coverage. CHECK ONE(1) BOX ONLY and complete the following: ❑ I am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer. Signature of OWNER Applicant—. --- - ------ LI I am the SOLE PROPRIETOR of a business doing work at the above-named property.I WILL NOT act as the general contractor or principal employer. Name of Business Federal Employer ID#(FEIN) Signature of SOLE PROPRIETOR Applicant