HomeMy WebLinkAboutDemo House 2006 A
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: B2006-0005 Date: 07-Feb-06 Map/Lot: 078/052-000 Owner ID: 5433000
Project Location: 49 PEQUOT ROAD Unit:
Job Description: Demolish house
Owner Name: D.W. Holdings LLC Tenant Name: N/A
Careof:
33 Pequot Road
Uncasville CT 06382- Telephone:
Contractor Name: D W Transport&Leasing,Inc. Telephone: (860)848-1692
DBA: Lic/Reg Type: CA
Lic/Reg No: 1134
33 Pequot Rd. Exp Date: 30-Jun-06
Uncasville Ct 06382-
Construction Value Permit Fees Construction Information
Building Value: $500.00 Building Fee: $15.00 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: $500.00 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: $1,500.00
It shall be the owners repsonsibilitv 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 d❑ Certificate of Approval
;#0.- - ate •'Occupancy
Building Official's Approval: I� Air
1! — / —
4
Town of Montville
Building Department
DEMOLITION APPLICATION FORM • Permit No. 46-6:9&5
Job Address: 95 /4 t2e / is
(Number) (Street) (Unit)
Owner: . 7(-1 -1/041//7-5( C.
Address: . / E /ei e, Ae .
City: d//47ev[�f1✓I �! //Q Q State: Zip Code: -�� •
• Telephone: c ?v —84 Cl / 6' z . .
Contractor: I , - / & 7-t y 4‹,f Ji .,1J G
..2 - e-ol
City: //7l�f.P ! State: Zip Code: 4e-)67,
��r „p /� Li r > •
Telephone: a-70 0 ry J Z-- License Typj License No.: /Ad % Expiration Date: L5 7 �-6 •
•
I hereby certify that the proposed work will conform t-. e Demolition Code,State Building Code and all other.codes as adopted by the State of .
Connecticut and the Town of Montville and further : tet` the proposed work is authorized by the owner in fee and that. I am authorized to make . '
application fora permit for such work as describe. ...=rya
Owner Signature: �'� Date.: . �� 'd
• Contractor Signature: �,�/`� Date: . I-477'?- 6
Demolition Vali.ie: �G-& DPrnnlitinn Fee:
El Demolition contractor registration(Class A or B)(C.G.S.Sec. 29-402)
• The following are exempt from the registration requirements .
•
o Person engaged in the disassembling,transportation and reconstruction of historic buildings for historic purposes .
o Demolition of farm buildings
o Renovation,alteration or reconstruction of asingle-family residence
• o 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 thestructure subject to demolition •
❑ 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 .
o 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)
❑ 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)
❑ Uncas Health District approval •
•
Revised�Decern6er 31,2005 . •
Town of Montville
Building Department
File Receipt
Date: 01-Feb-06
Receipt No: 1011
Received From: DW Transport
Job Address: 41-43, 49, 51 Pequot Road
Fees Collected State Educational Training Fee
Cash: $0.00 Cash:
$0.00
Check: $45.00 Check: $0.00
Check No: 71336
Short/Over: $0.00
Construction Value: $0.00
Demolition Value $1,500.00
Received By Joseph Summers
/ -
rn.n of
CONSTRUCTION PERMIT APPROVAL
0-1
fes, U G ,-
Job escription
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 -' � / "`- //.2 7/0
❑ WPCA, Administrative r1/� _ �b l 0 L
Sigrifure/date "")-
atee
Comments:
WPCA, Operations //,7a
15,r
Signature/date.
Comments:
❑ Planning & Zoning
Siyr�at.urel date
Comments:
7 Health Department „K.4
U Department of Public Works
Comments:
•
❑ State Dept. of Transportation
:. Signature/date
Comments:
Fire Marshal / 27/6
•
Signature date
Comments: •
1?visedlugust 5,2005
r
(":0 AlRQG9
Mystic Air Qality Conu1tanth, Inc.
G�Ii'►��iori�?
0
liSi1lty 1204 North Road (Rt. 117) Groton, Connecticut 06340
September 30, 2005
Mr.David Waddington
D.W. Transport
41 Trumbull Street
New Haven, Connecticut 06510
Re: Post Abatement Inspection
Pre-Demolition Review
49 Pequot Road
Uncasville, Connecticut
Dear Mr. Waddington:
On September 30, 2005, our asbestos abatement project monitor, Christopher Muller
(monitor license#000427), completed a visual inspection at 49 Pequot Road Uncasville,
Connecticut for fulfillment of criteria for inspection prior to demolition. This site review was for
the purpose of determining whether the asbestos-containing materials sited in the asbestos
inspection were completely removed in order to allow for demolition to go forward,with regard
to asbestos issues.
ACM Materials
At this time, all of the stipulated asbestos-containing materials are completely
removed from the house and property. There is no visible asbestos related dust or debris
remaining from these materials in the building, as required by US EPA NESHAPS and the State
of Connecticut regulations to allow demolition to proceed.
As allowed for by State standards for asbestos abatement,there were no final air tests
performed at this site. As such, there can be no entry into this building by any service contractors
or other non-asbestos personnel. Should such entry be needed, you will need to contact Mystic
Air to return to conduct air tests.
Thank you for selecting Mystic Air Quality for these services.
Sincerely,
IAZCIE-tk,
Richard Haffey
President
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
y�,GAIR9.
MystIc ACon8ultant8
CO by
%LIP 1204 North Road (Rt. 117)
Groton, CT 06340
Report of Inspection of Asbestos Removal, N'cinal
Renovation, and Demolition Project [] Interim
Date: O. O-OS
Site Location: PC. ViL.t.. Cl-
Building
rBuilding Identification: 'tj `i%gn)Oc3F 641
Containment Location: .- 5,5-vv‘E-—
pJ'Final Inspection Passed
[] Inspection Indicates More Work to be Done
CHECKLIST:
Residual dust on:
YES NO YES NO
Va. Floor e. Vertical
b. Horizontal su faces
surfaces f. NIA-
c. Pipes g. Ducts
d. Ventilation
Iiih. Register
equipment i. Lights 411
FIELD NOTES: Pion ---c- 1
, _ 1�n fcNT
�H\N\LZ — <�\-4,oni\vc.-45
FINAL AIR SAMPLE RESULTS: to be Analyzed
] PCM Analyzed on Site
Sam # Sam #
S le # mple #
ample #
ga--------
INSPECTOR: 611. /1/10,,,e-k_
Printed Signature
As the owner of this property, I am requesting the permanent removal of the existing CT Light&
Power Company (CL&P) electric service and meter(s)to allow for the demolition of the building in
accordance with all applicable Connecticut General Statutes. I certify that the building is vacant.
Removal of Service for Building Demolition
CU !� RgYYEM(CRS)TRACKING NUMBER REMOVAL maEctL�
~
ADDRESS WHERE LECTRIC SEVICE IS TO BE PERMANENTLY REMOVED Ae4 /reel'
TOWN STATE ZIP CODE
4'Nc�vf t e b t5.rOci 2--
ACCOUNT NUMBERS 7,05_ / /
// MEI ER NUMBER(S)
COMMENTS / -' is 71n ,fie E�2/h /i1'�� D/1/� c2vf�6 �s
r�alsr2 # /I,e-- -o . ' fe
4,oh,11P-4211 jet
PRINT NAN4:10F PROPERTy/6 et,/
�. SIGNATU+
MAILING ADDRESS iV 0 L
TOWN1
01 /�/I�'// STATE ZIP CODE
TELEPHONE NUMBER OF PROPERTY OWNER Q Q _ (� - 2.
o
Beth A.Jabs
NOTARY PUBLIC
State of Connecticut
My Commission Expires 04/30i�'$ r
Notary Public Date • '=rized
—CL&P Internal Use Only--
Date service removed: .. a 114 �fieti...',tu
-Mittto whrti`ifthi Sign-o' formrwas re timed. File this completed form with this completed service removal
work order.
PRINT NAME OF CLAP REPRESENTATIVE SIGNATURE OF CLAP REPRESENTATIVE -
DATE
To Avoid Delays, Please Complete All Information On This Form and Mail the Original Form to
CL&P.
FAX copies will not be accepted
U.S. Postal: Overnight Express:
Mail To: CL&P Clearing Desk Mail To: CL&P Clearing Desk
Connecticut Light & Power Co. Connecticut Light & Power Co.
P.O. Box 2985 176 Cumberland Ave.
Hartford, CT 06104-2985 Wethersfield, CT 06109
•
CONNECTICUT Department of Public Safety,
Division of Fire & Building Safety
Yf
DEMOLITION CONTRACTORS CERTIFICATE
NO: 1134 CLASS :A „-✓. --�
DATE ISSUED:2005/07/01 EXPIRES :2006/06/30
Certification as a Demolition Contractor is hereby granted
to the person or firm named hereon.
Name of Designated Technical Expert : David Waddington
SIGNED (DTE)
ISSUED TO: D.W. Transport & Leasing, Inc .
33 Pequot Rd
Uncasv' lle, T 06382
AUTHORIZED B SP-981-C
01 u6 16:56 FAX CPM INSURANCE SERV INC a001
At ,D CERTIFICATE OF LIABILITY INSURANCE OF ID AM DATEIMMDWYY
/ YYI
DWZ'RA-1 01/27/06
PRDDUC,. . . This CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CPM Insurance Services, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
90 Hinman Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Cheshire CT 06410
Phone: 203-272-3521 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Lincoln General Ins Co
D. -W. Trans ort & Leasing, Inc INSURERS: American Alternative
CT Scrap LLL• DW Holdings LLC;
Wadd Power LLC INSURER c: Great American Ins Co
33 Pequot Road INSURER D; Essex Ins Co
Uncasville CT 06382 --
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR T1iE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSK ADM L POLICY NUMBER POLJCYEN-ECTI EX
UCYPIRNTI
LTR INSRE TYPE OF INSURANCE DATE(MMIDD/Yl�' DATE(MM/DD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $k j 000,000
D X X COMMERCIAL GENERAL LIABILITY CGL 062135 04/15/05 04/15/06 PREMAISES(Eaoccuronca) $50,000
CLAIMS MADE I XI OCCUR MED EXP(Any one person) $Excluded
PERSONALS ADV INJURY $ 1,000,000
GENERAL AGGREGATE $2,000/000
GE 'L AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OP AGG $1,000,000
POLICY X PRO-JHCT I—II-OG
AUTOMOBILE LIABILITY
COMBINEDSINGLE LIMIT 81,000,000
A X ANY AUTO LWI 100365-02 04/15/05 04/15/06 (Ea accident)
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Per accident) $
X MCS-90 PROPERT'DAMAGE S
(Per e;,ciden°
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT s
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG S
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S 10,000,000
B X1 OCCUR CLAIMS MADE 60A2UB000080200 04/15/05 04/15/06 AGGREGATE s 10,000,000
$
DEDUCTIBLE S
X (RETENTION $10,000 $
WORKERS COMPENSATION AND WC S(RTU- 01H-
TORY
LIABILITY TORY LIMITS ER
E•L,EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $
II yes,de*cribc under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S
OTHER
C Contr Equip MC1341o5e (1,000 DED) 04/15/05 05/15/06 Contr Eq 721,000
C I Cargo t .c1S41ose (1,000 nEn) 04/15/05 05/15/06_ Cargo 15,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Town of Montville is named as additional insued, held harmless
CERTIFICATE HOLDER CANCELLATION
TOWNM-8 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO GO SO SHALL
Town of Montville IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
310 Norwich-New London Tnpk
Uncasville CT 06382 REPRESENTATIVES.
AUTH ED REPRESENTATI
ACORD 25(2001108) @ACORD CORPORATION 1988
01/27/2006 16:56 FAX CPM INSURANCE SERV INC Z002
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
•
ACORD 25(2001/08)
Jan, 27. 2006 4: 15PM No. 3673 P. 2
ACORD 01/27/
CERTIFICATE OF LIABILITY INSURANCE D /DD/Y1')
01/27/2006
PRODUCER Serial# 100664 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
TYLER COMPANIES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
330 ROBERTS STREET HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
E HARTFORD,CT 08108
INSURERS AFFORDING COVERAGE NAIC#
`INSURED OEM AMERICA/DW TRANSPORT&LEASING INC INSURER A: THE PHOENIX INSURANCE CO
330 ROBERTS STREET INSURER B:
EAST HARTFORD, CT 06108 INSURER C:
INSURER 0:
I INSURER E:
COVERAGES
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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTLBR NASRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA T,I�O�N
R SR - DATE(MM!DD/YY) DATE(MMIDDlYY) LIMITS
G-
ENERAL LIAEILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES (Ea occurenco) 5
CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $
PERSONAL G ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S
-I POLICY n JEGT n LOC
AUTOMOBILE LIAUILiTY
COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
-
ALL OWNED AUTOS
_
SCHEDULED AUTOS BODILY INJURY $
--- (Per person)
HIRED AUTOS -
BODILY INJURY $
NON-OWNED AUTOS (Pcr acddent)
PROPERTY MAGE
(Per accident $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY:
AGG $
-
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
JOCCUR 0 CLAIMS MADE AGGREGATE S
$
DEDUCTIBLE
RETENTION $ $
WORKER'S COMPENSATION AND THR-UB-100D6752-05 02/28/05 02/28/06 X f TORYIh{I1 I °R
A EMPLOYERS'LIABILITY
-
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED?
M tleecdbe uISIOnder EL DISEASE-EA EMPLOYEE $ 1,000,000
SPECIAL PROVNS below _ EL DISEASE-POLICY LIMIT ,$ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATION8NEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
TOWN OF MONTVILLE DAT T REOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
310 NORWICH- NEW LONDON TURNPIKE ICE 0 THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
UNCASVILLE, CT 06382 MPDS=NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPR .ENTATIVES.
AUTH.-IZED REPRESENTATIVE OF TYLER COMPANIES
I
ACORD 25(2001/08) ®ACORD CORPORATION 1988