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Town Water Tie In 2006
Field Inspection Notice Town of Montville Building Department January 27, 2006 Address: 55 PODURGIEL DRIVE Job Description: WATER SERVICE Permit Number(s): Permit Date: INSPECTION Not Approved Approval Date: Deficiencies Special Conditions Date Water Service • • 1"plastic coated 12/30/05 DJ copper Shut valves 12/30/05 DJ 12/30/05 DJ • Water system is not bonded;bonding jumper is • . Bondingrequired at meter. 1/27/06 DJ Backflow • • 12/30/05 DJ prevention Pressure • Pressure set at 40 PSI 12/30/05 DJ reducing valve • Thermal • Not required expansion • valve Certificate of 1/27/06 DJ approval • Rev.Date:10/18/05 Page 1 of 1 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 PLUMBING PERMIT Permit Number: P2005-0129 Date: 05-Jan-06 Map/Lot: 103/016-000 Owner ID: 5571000 Project Location: 55 PODURGIEL LANE Unit: Job Description: waster meter,backflow and tie to existing house supply Owner Name: Pamela I and Michael J Gonski Tenant Name: N/A Careof: 55 Podurgiel Ln Uncasville CT 06382- Telephone: Contractor Name: Oceanside Plumbing&Heating Telephone: (401)377-8712 DBA: Lic/Reg Type: P1 Lic/Reg No: 279721 181 Church Street Exp Date: 31-Oct-06 Bradford RI 02808- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $400.00 Plumbing Fee: $8.00 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: $400.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.06 Total Fee: $8.06 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 ❑d 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 ❑ Cey . - .f. cupancy Alt Building Official's Approval ` �, Town of Montville dO` Building Department c i • 310 Norwich-New London Tpke. 1%'I. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.:f /19 Type of Work Occupancy Type Permit Type ❑New Construction 4MSingle Family 0 Building 0 Addition Two-Family +�Plumbing Alteration 0 Townhouse EMechanical 0 Accessory Structure 0 Electrical CRS#: Job Address: V PO arpc./ 4e //(Nmber) (Street) (Unit) Job Description: Lir' i,' A c(e/ 'S #69Ck /2 r -7 To �)(�- 7`i', Ori SL C,-//A T Owner: A n17i(4 T III, Ci .4 vc,_ aI S'(E( Address: sS l)al Y "•ec [v- e- City: GA C/2'-) 5,C/`Yr( State: C ( Zip Code: `"63 P i- Telephone: �_ Contractor: 0671-2f0,--, 5. Oc , 'e/,3 7 /KTtr DBA: • Address: t l!ti ckei, City: `#46 FH State: A Zip Code: f o'.?- Telephone: ("re i^ ')7 -1"7/4 License Type/- License No.: a 79 7,2 ( Expiration Date:( /X —O 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. ❑ 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 thro 2 of the Residential Code. Owner/Agent Signature: 4,i g.-,Z' . Date: (0/—.2 1— —C7 S Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: /6 ci Plumbing Fee: • Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: • • C of 0 Fee: • Plan Review Fee: State Ed Fee: O, OG Total Fee: 'F. a 4 • Rrvised(Decem6er31,2005 Town of Montville Building Department File Receipt Date: 23-Dec-05 Receipt No: 940 Received From: Oceanside Plumbing&Heating Job Address: Podurglel Lane Fees Collected State Educational Training Fee Cash: $0.00 Cash: $0.00 Check: $145.08 Check: $1.08 Check No: 5225 Construction Value: $7,200.00 Demolition .u-• $0.00 Received By Joseph Summers °' j/ • Town of Montville • Building Department 310 Norwich-New London Tpke. Tel 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL .S I a.�J 0,24i L L 1N/_?-' • Property Address 4,1A-res-(2.— ..1==i0/#0 la-4r!00 Job Description The applicant is responsible for obtaining all of the required approvals checked off on this form. No building permit will be issued until all of the required signatures have been obtained. • Required Department Permit Issuance Approval Approval Tax Collector aN,. r/ os Signature/ date Comments: WPCA, Administrative p \� )�Ib� L Si yature/ date Comments: ❑ WPCA, Operations Signature!date Comments: ❑ Planning &Zoning • Signature/ date Comments: ❑ Health Department Signature/ date Comments: ❑ Department of Public Works Signature/date Comments: ❑ State Dept. of Transportation Signature/ date • Comments: • ❑ Fire Marshal Signature/ date Comments: . vised-August 5,2005 ACofY7 'CERTIFICATE OF LilABILITY INS11.11RANCE CSR LP ., "TrM EAIDD,YYY,/, PaocucER — T OC .ANSI 12/14/05 THIS CCEFt.MICA-1'1g ISSUED AS A MATTER OF JNFORMATJON Waads:iaaaee fur.asace Inc. ONLY ANII3 CONFERS NO RIGHTS UPON THE CI:,RTIFICATE 3?• 0. S ox 4 6 HOLDER THIS CERTIFICATE DOES NOT',MENm),tXTEND OR ALTER T. Is COVERAGE AFFORDED 8Y TI1E FCLICIES BELOW. Wycalting �� oas. -Cama _ phones 401-539-7G00 9ayc1401-534 7265 --__.. IrvsuRas – I INSURERS ►FFURDINCI COVERAGE _ NAIC# . ovilwR1RA Peerless Ineuranoe r. Steven A ois, tx+:. • - It4 URER$:. a a'-col.Ouk4i1-t m/uroae/ co INSURER c: +mss .++y x..� ,Y _r_j. . . . '''— pp1 urhP tut ag !oating,=tet • Bradford RI 0280 8 ItvsurR C: C:Ot RAGiE3 INSURER E; THE4oLICIEEtr RieuRsw.E I ASTED'BELOW HASTE BSL ISSUED RD TNT lh>}$1JRED NAMED ABOVE FOR THE P::LILY I�EJRIDD INDICATED.NOTWITHSTANDING • ANY REQUIREMENT,TERM SSR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO mitt,I THIN GERTIFICATT.MAY BEJLSSLIED OR klAYPEI?TAW,,THE INSURANCE AFFORDED BY TNS POI.JCILS DESCRIBED 4iiIREIN IS SUBJECT TO ALL THE TEPP I:i•EaCLU$IQNSAND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE SEEM REDUCED BY PMII CLAIMS. TICSR ADD•L LTR INSRD TYPE OF IN E URANCE POLICY NUIIIBER I SLI 'POLIC9 ipA O DATE�G6AALD i DAl'ESIiIWIlDDIYi}' LI::Cl7$ 4 j GENERA.LIABILr'Y A 1' K COMMERCIAL GE4.4ERAL LIABILITY I EACH OCCURREMGE $1 0�O,00 0 CCs 971456 04/30/05 04/30 06 PTR MIS (ESac um22--�6 O CLAIMS IAA{� J�OCCUR 1 � / �PREMISES(ES dCn:rpnce ';50O,.aaQ MED EXP(Myon-person) 1$10,000 PERSONAL&AIN INJURY i41,000,000 – GENERALAGGREGATE_ 1 52,000,000�� ! GGEEN'L AGGREGA'fl'LIINIT APPLIES REP• PRODUCTS•COMP/OP AG 3 $2,00 0 r 000 I x {POLICY 1-074 IT LOC AUTDMOaILE Lim iii Y I ANY AUTO I COMc deDSINGLELi/IT (Edooccident) E 1,000,000 ALL OWNED AJTUS C X SCHEOULF�p,U9',?$ 08745219-0 BODILY INJURY I$ 04/30/05 04/30/06 0712w Per4on) HIRED AUTOS Y'WOR KION.OWNEQ4 tJTOS I ((PPtnpLrprAcnt) Y II _ $ _ I PROPERTY DAMAGE; S (Pa-accident) GARAGE LIABILITY i_____ —--- AUTO ONLY-EAACC3jENT- s 1 ANY AUTO - OTHER THANgA ACC $ AUTO ONLY: AOC, $ E7CCESSRAMBRELGI i-40104IY ` EACH OccuRRENCE 52,000,000 A x I ocr-uR. �` �i CLANS'MADE CQ 971135e I 04/30/05 04/30/06 AGGREGATE i I$2,Doa,00o . DEDUCTIBLE S RETENTION ip $ WORKERS C:ONPENSATICN MO I $ ---4 EMPL B WORKERS L,IA€N$ TORY LIMBS - ER J ANY PROPRIETOWPARTNIER`IEXECUTIVE 10000023736 12/01/05 1:/01/06 E.L.EACHACCI0ENT_ 1$500,000 rlrajgFRU45i45tER EY.'`LL'-:Ri If y85.describe under EL DISEASE-EA EMPLOYElq S 500,000 It_ PSCy;6tSlON511C�v N–. E.L,DISEASE-Pt?uC Y LIMIT'S$5 0 D,0 0 0 OTHER - - _ _ _.,.:._-_5(11114ZIA),...". )ESCRIPT1ON OF OPERATIONS L L>;)CATIC+NE/VEHICLES/EXCLUSIONS ADDEC ENOOR5EMENT L SPECIAL PRO%I ilONF, TJi c Pillahjssg & Reatinir - Certific; is Bolden is noted as an Aei 9itI.anal insured - ProjectsMontville Commons, tlncasvi17.0r T - Further Add.it 1.02243 I17eured1iic + are: Second Family, LLC - The Home Depc - Stop & Shop Supermarket Co. - 'IC,u i V j _ � .ERTIFICATE HOLDER — -- CANCEttAT1C:l al - "_ -- NITT'ANY SHOULD ANY OF I NE AHOVE DESCRIBED POLICIES EIE CANCELLED BEFORE THE EXPIRATION Nittany C.c,n0t,ructioi1, 'Uric. DATE THEREOF,'I IB IS:IUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN ATrzalm :.toadw'ICk/Sarah Dickie a NOTICE TO THE C I iRIFICATE HOLDER NAMED TQ THE LEFT,BUT F,ULURE TO DO SO SHALL Fax: 50H-285-1947 61 East Main St.-Suite #4 IMPOSE NO OBU UPON T iTION OR LIABILITY OF ANY KIND HE INSIIRER,ITS AGENTS OR Norton, &A02766 .t.SEI�R MT:; 4_440, AW:s407..71-411. -,,11,1,54KE ...-. at,4-.401.4..... / ©ACDRD E:ORPQRATION 1988 Z0/T© 39dd IINdhJf1SNI 33SIMIUO0M 5g7L6E5TRh P$ :PT CP : T 1, 3I i wL♦ tiYi�Ilwi4L'F4ir• tlik, 1A 1 •r� : u1�+.r :f #l(`r r; 't•P rOII t d,,1,�, Y,;,,,,i'+` ,,,H�r , ((y�{ `,•0 �,,.,, ,1 D1�4;f �1,1 t- 1 on 1,,�{ jV�t {(^ 1 litg r • 1a{`IA' 4 ( � t6>R Uh``'4 Ii ��Il d k `i' j}}��,, vS •` t'�, � 1 1 as ,' �i " '",:1 'y'-�;, a .i off it, ;,•. 'Gl,ii �yy���� 't i h ti, }'4t 1:.4 ;tI�y t`,r g 'r , tiYl: ��� D, "���� 1�a��I I � -46'� my.. �� /•IIf, 3 ,,'iL,�� '' {.i' b+('1`, m^ '., , f t i;(,- � 11 r' i Na�al'or 8r. lt,,,ht " Z 1 7i,..,. tnt(d',_1, C ed,1111iL'l 9,xit 1' f^,�I�1 iii; dtS10S�t� (r`�, 1�iiuL ,,,',c , iift l'1.r , a roc. , 2d .Podurgiel pane. tawoka--24 t;d�durgiel� u .Y?: � t'P'd" ,'>�" Ahlerona--39 Podurgiel Lane, d i1oti' -- Lane, Nagler/Lemieux:-33 Podurgiel Lane, Jo: neon--3$ Podiel L,rle, 36' Podurgiel Lame, Alfieri--39 Podur odWallen/ tLi 1\te.Cayaewaki-- e of 40 Podurgiel Lane, Scopeli.tis--43 Pod rgiel Zane, Lada''in--44 Podurgiel - Lane, $icknel] - -47 Podurgiel Lane, Ntedrick--48 Podur 3.u% 52 Podurgiel bane, Barbey 55 Podur 3 Lane, Dunn-- 52 todur3iel Lane, Murphy9-14 Lanes, ielGonLane, ajek/giel Lane, in Uneaaville, CT - ATIMA $4 gr�durgi€el. Lace, B �ak�Fowler all i • I 1 be 4 re 1 Aijj 1 c&pip OF co ONN I / INC sj'�i �'C Zj ,I P I t, h, f SrL' ' PI Jr��ITSDC o��c1ur 0 27 RFG, ilk, I� RCD�BO pNr�CTp 9/2 _oRv �r s IS R 1 , T SI QN :; 1 F TRI 0``08 .*,..,„, ..a ,,p/„,11 Xp/gFS 10/31/2ooG 1 i ZI3 J 7_.g �r1Hr1 .-11,1 ..ytrlet.t7 77Cn IHt,t,,,,,li — .