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HomeMy WebLinkAbout2003 - Roofing Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext. 382 Building Permit Permit Number: B2003-0534 Date: 18-Sep-03 Map/Lot: 074/038-000 Owner ID 117507 Job Location: 42 PINK ROW Unit Job Description: roofing Owner: Contractor: Martin Gottesdiener Centimark Corp. C/O Kostin Ruffkess and Co 12 Grand View Cirle 400 Bayonet St Ste 306 Canonsburg Pa. 15315- New London CT 06320 Telephone: (724)743-7777 Lic/Reg Type/No. 0 Exp Date: Tenant: Self Telephone: Construction Values Permit Fees Construction Information Building Value: $9,917.00 Building Fee: $58.00 Use Group: F-1 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1996 BOCA Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 5A Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: C4 Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $9,917.00 CO Fee: $0.00 Plan Review Fee: $0.00 State Ed Fee: $1.59 Total Fees: $59.59 =t is the owners responsibility to schedule the following inspections(minimum 48 hours notice required); ❑ Footing- Prior to pouring concrete ❑ Rough HVAC ❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab-Prior to pouring concrete ❑ Chimney-One flue above thimble ❑ Rough Framing ❑ Firestopping/draftsto in pP 9 ❑ Rough Electrical ❑ Insulation ❑ Electrical Service 0 Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany ❑ Gas piping and test Building Official's Signature: Ale _40- Town of Montville Building Department Permit ez 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 Application for Commercial Building Permit ❑J1(ew Construction []Addition []Alteration ❑ 'Utility Structure Other ) d--P /edoc,gce.q ,ti Job Location 'i4R/4- (OR/'� Job Description/Materials R.-p,%ee /? v-P" o,v C4 . Bj cti/c tvii Owner-T-4o0ro / /Pf C Op/" - Mailing Address iR 1 A RvW City UpcA sv, f/'e-- State C71, Zip 0487"2, Tel FG7O / S y / Contractor 4Q47TtMooP (i p • Mailing Address /a 4-/?4WS/ I//per Cr/PC�e City ( ,r/dv..A.42..3 StateeA Zip /5-3/5-- Tel 7 a `i/ "4/3/ 7 7) Contractor's License/Registration Type &Number Exp. Date / 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 permit for such work as described above. Owner Signature/Agent Si / ll g � �• Date c7 a 3 Construction Value Fee Building $ 9i? / 7 $ �� Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ a` 9 Total $ $ ,7 Town of Montville Building Department Receipt Date _ 9 I / 423 No. 03173 G From: - 4;,...., ,ter Job Address: Al .,, . /__ Amount $ , t`? Cash heck Check #//6 7 4// I (Circle one i Received by 4. ,+ /f",, j l,,r��/ 4, Permit # .7�Q() _3/ 09/2312003 09:42 8608489394 FARIA rr ,. PAGE 021@2 F al• .Lid �2gat:rax t .5 GLE-0C `.>.- >..".. n TIFIATENUMBER inteacee -.,.-,.. . .. .. .... 1.32-0t) Marsh USA Inc THIS CERTFIGITE IS ISSUED AS A NATTER OF INFORMATION ONLY ANE CONFERS ma$b(PFO Phos,Surf@300 o RAtTHE d CETTITFICATE HOLDER OTHER THAN THOSE PROINOED M THE P1�tatH.l/�'I,PA 16222 POLICY.TRW CERTIFICATE DOER NOT END,EXTEND OR ALTER TRE COVERAGE IFPORDEDs THE POLICES DESCRIBED HEREIN. CAPPANtE8 APF tr360,-ALL��� CENTS r COOP ANY �'+01rEYl11G£ A CONTINENTAL CASUALTY CO AS<UPFD ------- — i - NTIMARK CORPORATION cgMPrNY --._ 12 Grandma/Circle • 1i1A Cannensbura,PA 153/7 MAP ANY !_ C AMERICAN CASUALTY COMPANY OF READING,PA COMPANY O TRANSPORTATION INSURANCE COMPANY THIS IS TO CERTIFY THAT oO CIES OF INSURANCE ceecrL©EA +fEREIN HAW .,. .•. -_... Tt07WTHSi'ANDINO ANY REQU'Rc'-MEDT'FRM C R CONDITION OF MY CONTRACT OR OTHER TO �E Th RESPECT NAMED WERE-IN FOR THE PIRACY'PERIOD INDICATED ... PERTAIN,THE INSURANCE AFFORDED EY THE POLICES DFR RARE)HERON NSUR!PNIT ✓t.THEENTIMTH RE9�(,TTQ'WHICH. 011 THE CBtDflCATE MAY BE IS AGGREGATE OR MAY LIMITS 91O'AN MAY HAVE SEF.N REDUCED SY PAD CUISAS �Att.7M:;TER/As,IXTo 111TTUNS,W V MGT U9ONS OF 9lJL3+POLICES AIiGREG ATE CO OF INSURANCE I 4 LTR j CIA POLICY NUMBER I POUCYEFFEOTVE !POLICY EXPIRATION TYPE T AIRGESONY1 I ODATE(SIMONY)) corm A SEVERAL LIABILITY X534 105I01i93 6t01t04 X OOMM6rTgK GENERAL UAa4 iTY IGi_251 I cfNetAL AGGREGATE f 2,000,000 _ CLAMS MNJQ I K�OG R f i I r PRODUCTS-CUr1P/OP AGO •$ `1,x,000 OANER'Bd COITRACIYyt'SPROt1 ! I PERSONA_L7WINJURYS ti,(a0p,0Dp X R PRO.IFCTAGGRFCAT l ti_Ram I; 1ppQ0Ab I 1 I FIRE DAMAGE(Any metre) $ —.-_ 100,000 A AUTOrO@dELNASSJIT BUA25194D6A8 I"�EXA(A^Ya'•pe.cn) $ 25,000 2(.......- 05/0-1,493 ,105101/04( ANY AUTO CONJOINED aur ir LIMIT I$ 1,000,000 ____IILL OWNED AUTOS I -._ - SCHEML.ED AUTOS (aI I (For -„--. HIRED AUTOS + I NCT-OMS ALMOS ! I I1 L RS -�_____- I I — { I PROoERTY DAM ACE $ OARAuE UABA/IY _t MY AUTO f+ AITOONLY�EAA�p@NT f$ ,,,ly OI'KE4 THAN IuTO a1LY '-'4',.1.77.-..;7--,-,,,,L,„ --Y,44?�T ` PACK ACOosN7 $ rrEXCESSLIABILITY AGGREGATE $ 1 UMBRE A�CRM 1 EAAr4".1xUa{RENTZ 1'S 1 ISMER T?iAN UMBRELL A PCRM I AGGREGATE $ — C WORKERS faDAtPENSATI4l 1�41C251S�lS'.f�3(J4G2S)` !!!!!!I $ IEaPLovERSLIABanr06101103 06101104 1 wear-km- r Lyfti O i1NC?51fl4D438(Nil,OR.,WI) TcaC{.!NITS I 1 ER -.fit ':= C THERROPRIETOl/ x Q•�J 1>� 2E101/04 1EI_E11tH ACODBNT $ 1,000,000 PARTILERSFRECt/E E �!�'� IWG2518406t 7(CA) OSAQl4fD3 106101/04 a� ARE {S(O R e+ lt�•crMr $ f,LR10,001J c�LEII , EL COICABEF.AW EMPLQYEE.1$ -1,000,00[, I I I DEICEINSWV OB al£AATIONIiIpT,gTIOH>e7Pz'AicustBPEGAL ITEMI8 �. OTHER WORKERS'COMPENSATION-FOR INFORMATION PURPOSES ONLY-AZ State F nd fl8S3-2;OH Self 4y jr@d 112C4705105;WA Risk #804 219.004"WV Risk#79002151-101,NO Aaot*122447-NY State Fund?1320208.4 RE: Job 92600031125,Thomas G. Feria Corporation,365 Norwich/s4wr i ondoyr 7sverpike,LinasdYUte,Cr 05382 AANY OF THE ECLIDES OE8I A r takes Be O kNCELLEO BEFORE THE! IRATON DATE?HEREOF.' Thomas Q.Feria Corparati4n me IIfARPR AF!ORDi da OOMERAQ %mu. PEOBANOt TO MOL___20 MMS ItRITTEN sonar TO TIE ZPX of M2�LRTNA F+T AERE BUT RA.i UM IE TO O 8.X71 MOT OB NIR-;MFABE NO 081:65TON OR 385 laorvrx�ft/Moly ta►don iumpike ( Unceaviife,CT 05382 uAILRYOEAer KR.O trotA THE tRTMER AFEOHNvei.93le4M0E'tSA®tratat Qi^eanaATive%OR THE IMSUBM MMS CFRTFiCATP. WARM DBA eta ay: V SGOit I' IT ylict A8 of -•- Town of Montville Building Department 848-3030,Ext 382 COMMERCIAL PERMIT SIGN-OFF SHEET operty Address Job Description: ) 0,01 _ zI t r monI,A A/se .2 The owner/agent shall be responsible for the completion of the form, no certificate of occupancy will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-Ext.339 Approved ❑ Permit#: ❑ Not Applicable Septic System Date Inspected and ❑ Approved ❑ Not Applicable Food Service Establishment Date Approved El Permit#: ❑ Not Applicable Private Well Date WPCA DEPARTMENT 848-3030,Ext 881 Approved ❑ Permit#: ❑ Not Applicable Municipal Sewer Date House Trap ❑ Outside ❑ Inside Approved ❑ Permit# ❑ Not Applicable DEPARTMENT OF PUBLIC WORKS 848-7473 Approved ❑ Permit#: ❑ Not Applicable Director Date POLICE DEPARTMENT 848-7510 Approved ❑ Permit#: ❑ Not Applicable Officer in Charge Date PLANNING &ZONING DEPARTMENT 848-3030,Ext 381 In-Compliance ❑ Permit#: ❑ Not Applicable Zoning Date In-Compliance ❑ Permit#: ❑ Not Applicable a land-Wetlands Date FI' A ' . • cE 848-3030 Ext 384 Approved �"' w ❑ Permit#: ❑ Not Applicable Fire el shal Date 0.2003 4:03PM NO.530 P.2/3 2-03 v-3 PAGE 1 of 2 CENTIMARK SALES AGREEMENT 12 Grsntiview Circle, Canonsburg, PA 15317 tt53 S 1 724 /43 /777 Job Number. Reference Number j Purchaser Job Loi ution Name:THOMAS G.FARIA CORPORATION , Name;;THOMAS G.FARIA CORPORATION Address. 385 NORWICH NEW LONDON TURNPIKE ; Address:1386 NORWICH NSW LONDON TURNPIKE City: UNCASVILLE I City: UNCASVILLE State: CT ! Zip: 10638_?, State:CT I Zip:'0.6382 Contact: DON SAWYER 1 Phone:;860-848-9271 Phone 860-848-9271 _ _ Building(s)/Section(s):IREA_R OFFlc ROOF Description of Work Per Proposal Dated: SEPTEMBER 2002 Or as Follows: Sales information, Paynrcill Terms and lNarrunty Purchase Price: $9,017.00(SALES TP? NOT INC(_t1DED) Warranty to be issued In the name of: Purchase PO#: I 1.'THOMAS G.FARIA CORPORATION CentiMark Sales Rep:MARK THOMAS I 2, Office Location: ROCKY HILL,CT Warranty Length/Yrs:j2D YEARS Phone#: 800.990-0706 • Payment Terms;'NET 30 DAYS Purchaser to initial acknowledgement of Payrnera ; ; __, Purchasing Credit irrioru,utivn RLQUIRED • Bank Name: Account#: Address: i Contact:: I Phone#: City: Trade References: 1. Trade Reference: _._.._ — - 1 Phone: Address: I Clty:j I State: Zip: • • 2. Trade Reference: .. Phone:. Address: - _I City:' ! State. Zip: 3. Trade Reference: _ Phone: Address: City: _ I State: Zip: By my signature below,I certify that I have authority to bind the purchaser and have had the opportunity to review the terms of this Agreement,including those set forth on the reverse. On behalf of the Purchaser, I understand and accept said terms and agr o be bou • thereby. I also authorize the release of credit Information to Centimark Corporation //ow' j ce i ----Che, cam? _ c" • /7-r=5-• t . / -.r i C c3 Approv-. and acce-fed by purchaser Printed Name and Title Da SUBJECT TO THE FOLLOWING TERMS AND CONDITIONS ON REVERSE