HomeMy WebLinkAboutDemo Garage 2008 Field Inspection Notice
Town of Montville
Building Department
August 6, 2008
Address: 78 Pequot Road
Job Description: Demo Garage
Permit Number(s) D2008-0014 Permit Date: May 15,2008
Not Approved Approval
INSPECTION Date: Deficiencies Special Date
Conditions
Final inspection for e •
certificate of 8/6/08 CC
demolition
Rex.Date: 1/18/06 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
DEMOLITION PERMIT
Permit Number: D2008-0014 Date: 15-May-08 Map/Lot: 078/013-000 Owner ID: 5443000
Project Location: 78 PEQUOT ROAD Unit:
Job Description: Demolish Garage
Owner Name: RBF Associates LLC Tenant Name: N/A
Careof:
62 Lasalle Road,Suite 219 West �^
Hartford CT 06107- Telephone:
Contractor Name: D.W.Transport&Leasing Inc. Telephone: (860)848-1692
DBA: Lic/Reg Type: Demo
Lic/Reg No: 1134
P.O. Box 462 Exp Date: 30-Jun-08
Uncasville CT 06382-
0o.0/aJ.4le Permit Fees Construction Information
Building Value: $2,900.00 Building Fee: $30.00 Use Group: IRC
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code
Mechanical Value: $0.00 Mechanical Fee: $0.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: IRC
Total Value: $2,900.00 Penalty Fee: $0.00 Permit Code: M1
C of 0 Fee: $0.00 Comments:
Plan Review Fee: $0.00
State Ed Fee: $0.00
Total Fee Paid: $30.00
It shall be the owners reusonsibility 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 REOUIRED UPON COMPLETION
❑ Insulation 0 Certificate of Approval
P ca : of• cupancy
Building Official's Approval:
Town of Montville F ' t'FSkU'CAi 1Ce dN
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 // ta —Fax. 860-848-7231
DEMOLITIONC, APPLICATION FORM PermIo
it No.: Q(.113
V Job Address: ? 1 erz-307 . 0•
(Number) /n� (Street) (Unit)
Job Description: eper'haLi,S i-i ( yA.R 4-Ge
Owner: MOaett .Ri5 el iftt KEN FH I tP-i &ROL) p
Address: 5Z L S F{Le RD ..i Ls t T e Zig
city: U)€.S-f Na 0"Eo 2V State: LT Zip Code: C ( 0 -r
Telephone:
Contractor: T.U.1.—T-T A- Y PC)27 Lc65/a'G- A .
h
DBA: -D‘ri e
Address: t,Ti" 0 • lc-7C_�x q6G.
City: V 13C01-5 V t(.,L e /� State: Ort- Zip Code: 6)&3'0 �-
�IL-
Telephone:V1% _LAO License Type: A" License No.: 113 4 Expiration Date: G"'CrSi
I hereby certify that the pro osed work will conform,,. t- • e Demolition Code, State Building Code and all other codes as adopted by the State of
Connecticut and the To /__ _v
Owner Signature: 7 / _ � /�/ /6e/�r cee Date: q—p`�Q�
Contractor Signature: Date: J
c.c, 00
Demolition Value: 29°0 Demolition Fee: 30
Items required for submission:
Demolition contractor registration(Class A or B)(C.G.S. Sec.29-402)
• The following are exempt from the registration requirements
• Person engaged in the disassembling,transportation and reconstruction of historic buildings for historic purposes
• Demolition of farm buildings
• Renovation,alteration or reconstruction of a single-family residence
c Demolition of a single-family residence or out building by an owner of such structure if it does not exceed a height of 30'-0",provided
that the owner will be present on site while such demolition work is in progress and the structure(s)have a clearance from other
structures,roads,highways equal to or greater than the height of the structure subject to demolition
C]/Copy of certificate of insurance specifying demolition purposes and providing(C.G.S.Sec.29-406);
• Liability coverage for bodily injury$100,000 minimum per person with an aggregate of at least$300,000
• Property damage$50,000 per accident with an aggregate of at least$100,000
❑ Certificate shall provide that the Town of Montville and its agents shall be saved harmless from any claim or claims arising out of negligence of the
applicant or his agents or employees in the course of the demolition operations.(C.G.S.Sec.29-406)
❑ Certificate of notice by all public utilities having service connections within the premises proposed to be demolished,stating that such utilities have
(severed such connections and service. (C.G.S.Sec.29-406)
L� Adjoining property owners have been notified by registered or certified mail at such owner's last address according to the records of the assessor.
(C.G.S. Sec.29-406) 6,01\
-� 5/I�Uncas Health District approvalj,RC. Q , r//0T
Note: If asbestos abatement requires re val of building components i.e.doors and/or windows the abatement must be completed and
the clearance letter submitted to the district prior to any further demolition of the structure
❑ Fire Marshal Notification–To be completed by Building Department
Revised August 23,2007
Aprif8,2008
pS o�/.111( �3q vi)
00
Town of Montville A� (, cid
Building Department /90.) (
File Receipt R�`�7�pi �� 3
Date: 09-May-08 Receipt No: 3435
Received From: DW Transport
Job Address: 78 Peauot Rd
Fees Collected State Educational Training Fee
•
Cash: $0.00 Cash: $0.00
Check: $30.00 Check: $0.00
Check No: 2449
Short/Over: $0.00
Construction Value: $0.00
Demolition Value: $2,900.00
Received By Vernon D Vesey II
Town of Montville
Building Department
File Receipt ����
Date: 09-May-08 Receipt No: 3, '
00,tiw
Received From: DW Transport
• Job Address: 78 Peauot Rd /I
Fees Collected e Educational Training Fee
Cash: $0.00 Cash: $0.00
Check: $30.00 Check: $0.00
Check .: 2449
•.rt/Over: $0.01
Construction Value: $0.00
Demolition Val . Ae 900.00
,•/ jr.
Received By Vernon esey II c/ `�—
Page 1 of 2
' Online Storm Center I About CLAP I Job* I Site ma,
Connecticut CUSto
Light&Pbk cr ` # prxr 1t
fet Servie
f ►HMV ►Online Services ►Energy Efficiency at Home ►Energy Efficiency at Work ►Community Conner tions ►Conte I
' [M=MMININ,
Welcome SALEM01 [Edit My User Info]
Customer Inspector Approved Requests
Contractor
Municipal Official
Service Requests Please select a town from the drop-down menu below:
► View Requests
Streetlights Towns: !MONTVILLE H I
How to register
References&Resources
Request Date Lot Bldg Street Status Job
# Approved No No
Elec
New
I— 972528 7/23/2008 215B DOYLE RD APPROVED Resif
DES
(DN;
Elec
Exist
I— 986859 7/14/2008 238 MAPLE AVE APPROVED Corn
DES
(DN;
Elec
Exisi
I— 1096657 8/5/2008 78 PEQUOT RD APPROVED Resin
DES
(DN;
Elec
NORWICH New
I— 1119755 7/8/2008 2020 NEW LONDON APPROVED Corn
TPKE DES
(DN;
MetE
I— 1123764 7/17/2008 64 LN DURGIEL APPROVED Worl
NO
(CT)
PALMERTOWN Elec
I— 1132607 8/5/2008 274RD APPROVED Exisi
Resit
MetE
I— 1139035 7/14/2008 1588 OAKDALE RD APPROVED Worl
- NO
(CT)
MetE
I— 1144678 7/10/2008 5 1567 OAKDALE RD APPROVED Worl
- NO
(CT)
https://www.cl-p.com/wms/Inspector/inspectorapprovals.aspx?nl=insptrkrgst&a=1 8/5/2008
uN�HS HLHLFH DIST. Fax:8608879538 Apr 25 2008 8:10 P.02
UNCAS
HEALTH
DISTRICT
Your Local Health Department
Requirements For The Demolition Of A Structure
Property Address: 78 F PQ'OT Rb. U f1Gi95'v' tu` e g
Property owner: 7k 08 Q-127 $H WI 14(4 ` i's }N GRoC1.1p
Owner's Address: 'OZ (-(4)S4LLe HD _ West Et-B-RreeP_J7 CT
Owner's Telephone Number: 11(430-77(-1-c.[_ t CoL,9
1• Water line from well has been disconnected and sealed ❑ Yes
E'No well
2. Sewer line to the septic tank has been disconnected and sealed ❑ Yes
21No septic system
3. Oil tank has been emptied ❑ Yes
2Nooil tank
a. Copy of invoice for removal of oil attached ❑ Yes ❑ No
4. Asbestos inspection completed and form submitted to CT DPH (lyes ❑ No
a. Copy of DPH form attached ElYes ❑ No
b. Asbestos abatement completedyes (Attach copy of clearance letter)
Abatement not required
c. Asbestos abatement requires removal of building components i.e. doors and/or windows that
requires a demolition permit ❑ Yes ❑ No
NOTE: If asbestos abatement requires removal of building components i.e. doors and/or
windows that require a demolition permit, the abatement must be completed and the
clearance letter submitted to the District prior to any demolition other than that required
for the asbestos abatement.
l ---b av t O W -rvr, rYC��
f am the owner/contractor of the property at 7 l
-Te0001 Which is going to be demolished. Ice ' "-
at the above
requirements have been met.
,gKat P-'owner/contractor
This form must be notarized and returned to the Uncas Health District before the District will sign off for
the demolition
r�I tcPvl M. ROBERTS
NOTARY PUBLIC
COMMISSION EXPIRES OCT.31,2012
372 West Main Street -2"°Hook, Norwich,CT O63Bo-6440
Telephone No. (BM 823.1189 PAX No. (864} 887.7898
E-Moil: office@uncoshd.org
Internet: http://www.uneashd.org
State Use Only
I STATE OF CONNECTICUT j Postmark Date
yCheck#:
DEPARTMENT OF PUBLIC HEALTH Transmittal#
DEMOLITION/NOTIFICATION FORM j Record#
This form is to be completed and postmarked or hand delivered to the Connecticut Department of Public Health at
least ten (10) days prior to the start of demolition as required by the Regulations of Connecticut State Agencies
(RCSA), Section 19a-332a-3. In case of emergency notifications, this form is to be completed and postmarked or
hand delivered within one (1) working day following the start of demolition. A copy of the written order requiring
demolition prepared by a state or local building official shall accompany each emergency demolition notification.
Faxed originals are not acceptable. Revisions to the original notification form may be faxed.
Each demolition notification must be accompanied by a fee of twenty-five ($25) dollars. A check in that amount
made payable to "Treasurer,State of Connecticut" must be submitted with the notification form. If it is determined
that during demolition, asbestos abatement that disturbs more than ten (10) linear or twenty-five(25) square feet of
asbestos will occur, then an asbestos abatement notification form shall be filed with the Department of Public Health,
in accordance with §19a-332a-3 of the RCSA. This form shall be submitted at least ten days prior to the start of
asbestos abatement. (Please turn over for further instructions.)
1. TYPE OF NOTIFICATION:
A. NEW )C B. EMERGENCY C. REVISED ITEMS REVISED
2. FACILITY OWNER/OPERATOR: �- ,` j
NAME: '�5Q CT �(�f1114-N T'ls u M A N eco f
ADDRESS: 52 L 1 s/l LL . WD ..
CITY: I.AJ S'S7 I'Tti STATE: 1-7. ZIP: O O7
PHONE#: (' 6O) 77 t{-t b bQ CONTACT PERSON: RobetT Rs K N'1 ttK
3. DEMOLITION CONTRACTOR:
NAME: O.Gt,.—MAN S PORT f L e,5,'/'G-
ADDRESS: go , 5epc 46 2
CITY: U NCASII
1�Q STATE: el- ZIP: 063 ''Z
PHONE#: ( /90) -16 2 CONTACT PERSON: 'DA V l p W p p/NO-TCO/
In accordance with Section 61.145 of the U.S. Environmental Protection Agency's National Emission Standards for
Hazardous Air Pollutants(NESHAPs)regulation, the owner or operator of a facility shall, prior to the commencement
of renovation or demolition, inspect the affected portions of the facility for asbestos, including Category I and
Category II nonfriable asbestos. An asbestos abatement notification form filed in this situation shall satisfy the filing
requirements of the demolition notification.
4. PRE-DEMOLITION ASBESTOS SURVEY CONDUCTED BY:
NAME: N��t^S`( (C A(R/, RD IAC UT 4 (OIYS di.-7/44/1.5
ADDRESS: ('60 4- NO27C7 /C D
QTY: l.s'f.ZOTON STATE: C 7 ZIP: 06 346
PHONE#: (p 'O) 144 Q-71(“i INSPECTOR DPH LICENSE#: CIO 04/
DEMOLITION DEMOLITION
5(A). START DATE: 6-19 5(B). COMPLETION DATE: 5—ZO
(D/M/YY) (D/M/YY)
Phone:(860) 509-7367/Fax(860) 509-7378
Telephone Device for the Deaf: (860) 509- 7191
410 Capitol Avenue,MS#51 AIR
P.O. Box 340308
Hartford, CT 06134-0308
Affirmative Action/An Equal Opportunity Employer
Demolition Notification Form Page 2
6. NAME OF FACILITY:
NAME: 511-M e_
ADDRESS:
CITY: STATE: ZIP:
7. USE OF FACILITY:
A_ SCHOOL(K-12) B.PUBLIC BUILDING C. MANUFACTURING D. OFFICE
E.COLLEGE F. COMMERCIAL G.CHURCH/SYNAGOGUE. IL RESIDENTIAL
#OF DWELLINGS L OTHER (SPECIFY) 61.CON t' LEND
& BUILDING DATA: 300 SQUARE FEET / #OF FLOORS AGE
9. DEMOLITION DISPOSAL FACILITY:
NAME: HO¢Ptty < ?� . R '{Ck.ts
ADDRESS: NO 12.(4-4-9 CSV
CITY: 1' ArtTV Q-D STATE: (LT o ZIP:
10. DEMOLITION'WASTE HAULER: c,t'/
NAME: DkL .T sf PO E7 tens `X CT
ADDRESS: ~P-0 . Lam!®x// � C7% `
CITY: U tV C4 s I(IQ. STATE: eT. ZIP: 040 312
11. PERSON COMPLETING
. THIS FORM:
NAME: AV tJ TDittfer�rO
t
ADDRESS: 0. 130)( `rh
-T 11/
CITY: K y �_��� STATE: Cl . ZIP: Ck2C/gj 0 Z
SIGNATURE: Apr
DATE:
Further instructions regarding notification
In all cases of demolition, one and only one notification form (either for demolition or for asbestos
abatement, as applicable) shall be sufficient to satisfy the DPH regulatory requirements for demolition
notification. A previously submitted asbestos abatement notification form, filed with the DPH for
demolition purposes,shall satisfy the demolition contractor's obligation to notify DPH.
Revision date 10/22/04
dnotif4
Lcuti 14: er 8607746535 LABOSSIERE BUILDERS
• PAGE 01i'01
• C\-c, AIR
q�
EMystic A11L � 1tCOnLltaI1C.
°rsuLT��4' 1204 North Road (Rt. 117) Groton, Connecticut 06340
April 29, 2008
Ms.Melissa Labossiere ��li
Labossicrc Builders f%y
136 Wauregan Road Fl
Danielson, Connecticut 06239 (�
Re: Pre-Demolition Inspection(04/24/08)
78 Pequot Road—Uncasville, Connecticut
Location:Garage Only
Dear Ms. Labossiere:
As requested, Mystic Air Quality Consultants, Inc. conducted a survey of accessible areas prior to
demolition at the address above on April 24, 2008.This survey was directed by Christopher Eident.a
Connecticut State licensed asbestos inspector(license 4000015),to determine the presence of
asbestos-containing materials. The samples were analyzed at Environmental Hazards Services
(NVLAP# 101882-0)in Virginia.
Summary of the findings
Upon testing by polarized light microscopy,all samples collected and analyzed from the
locations above were found to be non-asbestos containing..
Limitations of the survey
Though every effort was made to examine wail cavities and other areas for pipe insulation and
other PACM,this survey and report only deal with accessible areas of the building.Additionally,there
may be other non-accessible materials above ceilings, behind walls,and below floors that become
evident during your demolition activity.Should the requisite EPA/OSHA competent person working
for the contractor discover such materials they will need to be tested for asbestos content so
determinations of their abatement and disposal(if required)can be made,
This survey only addresses asbestos and does not make any representations about other hazardous
or potentially hazardous materials or regulated wastes that are typically considered during building
demolition or renovation such as PCBs in lighting ballasts,mercury in fluorescent lights or in
thermostats,fuel oil tanks,electric and gas utilities,or lead inpaint or any site specific items related to
manufacturing or commercial processes or activities that were historically carried on at this location.
Please do not hesitate to contact us with questions relating to the sample results. We thank you for
the opportunity to conduct this survey.
Sin ly,
Ch pher J.Eident CIfH,CSP,RS
CEO
Enclosure 1: Laboratory results
Enclosure 2: Chain of Custody
Enclosure 3: Roster of Suspect Materials
Communications (24 hours):
Office: (860) 449-8903 FAX: (860) 449-8860 Toll Free: 1 (800) 247-7746
website: www.mysticair.com e-mail:magc2@aol.com
05/14/2008 15:06 FAX 18608482869 DW TRANSPORT
X
� 001
•
CONNECTICUT Department of Public Safety,
fDivision of Fire & Building Safety +
DEMOLITION CONTRACTORS CERTIFICATE :fr__ .� s
NO: 113�E CLASS :A ,
DATE ISSUED:2007/07/01 EXPIRES:2008/06/30
Certification as a Demolition Contractor is hereby granted
:n;-• to the person or firm named hereon.
Name of: ec Designated Technical finical
Expert :
SIGNED (DTE) David Waddington �:
ISSUED TO: D.W. Transport &
P Leasing. Inc.
i
P.,0..' Box 462
Un :
cativille �s2
CT as f
_
AUTHORIZED BY: 04L CZp �Le...
Sp-987 -C z'
a
i
I
1 I
•I
•
I
u'J.
:�i'-''INLti
i'�V.
i•f ��1���
may.:'
i'...Y7:'-.,:!.,:•':,:�;•.w,.`.;�.r�v„'��;,:_ h'i:^.;:7:77::..,:::.:...:� ' titin;�:�
•
i •
i •
•
•
May 12 08 08:19p Robert Tatro 860-774-9692 P.1
B.T. ELECTRIC, LLC
\L. 12.L_Nyc
I lacl AM:.I.1 i?g,'.. 1 ic- IX•mi.”
To Whom It May Concern:
The power in the garage at 78 Pequot Rd was permanently disconnected in order to
demo.
Thank you,
Robert Tatra
1111. ' t ''' (--• A,0 a
v
ILI
)1(3'
1\1)(k
j 6 0- , 114(111100-1:111
41)1/4
b IP
WI 31/T1 (pti,('
6
,..
Nilo
e6 f--I
S
/0' v