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Home My WebLink About16x23 Addition Plumbing 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:_P2015_0038 _ Date: __ 12-Mnv_1,5_Map/Lot:_03910.82_000 __Owner ID: _ 5523000 Project Location: 58 PIRES DRIVE Unit: Job Description: _Plurnbiaa forJNeyy_{ddition _ Owner Nam _EJizahetbLA._Bcotb Tenant Name NLA. _ Careof: 58�ires DrLve _Oakdale CT _0_63Z0- Telephone: Applicant Name _Rbab_ert H. I audette Telephone: _0160W2_7847 DBA: .lames._ honing Plumbina_&lHeatina Lic/RegType-- _P_1_ Lic/Reg N 203404 5LkRDute 32 Exp Date: 31:_-Oct-15 North Franklin CI___ _06254- Cnoctruction_Voslc PQrmi FPac Constntction_informotinn Building Value: S1/..00_ Building Fee: — S(L00_ Use Group: IRC Plumbing Value: $D,QO_ Plumbing Fee: SO.00L Code: 2005 State Building Code Mechanical Valu SteMechanical Fe SD DO Electrical Value: - SO0SL Electrical Fee: MOO__ Construction Type IRC Total Value: S0_00 Penalty Fee: - SO,QO_ Permit Code: R5 C of 0 Fee: Sn OJL Comment Plan Review Fe _SO 0(L Fees Included with Building Permit State Ed Fee: S0.0IL Total Fee Paid: ______ 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: 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 I. err ate of Occupancy _Buildino Qlficia&Aaata_v_al: --_-- --� -- — — f - Town of Montville Q (1) 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.:i9c: bI 5_ Type of Work Occupancy Type Permit Type ❑New Construction (ef Single Family 0 Building Addition 0 Two-Family [ Plumbing Alteration ❑Townhouse ❑Mechanical ❑Accessory Structure ❑ Electrical CRS#: Property Address: 5 ` (..4 (---Pi \''e.___'-----)'---01\)e__.- (Number) (Street) I (Unit) Job Description: 9 --c) (' I(1? La, � e d;11 n Ci)k.-2 Owner:��`L'_‘"e .YYI ' '` E12 c t he _ e-- �. t VCr-dress:/'�` / �� j � P - �/y City: 1 .K&a.\ e . State: ` /Zip Code:Q 3 7 C% Telephone )1 - Applicanth - _ LccQc* : "_ DB . Cc VY P ni1 Pc �1 � - Address: • I L Ci . A Shia i ^ State: C) Zip CodaY(P L- j Telephon ((?:151__221...-7S)11 7 Contractors -Complete the Following: tj License Type: l License N6.40-1Oj Expiration Datei 0 110is 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 flee 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„ •.05 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requireme ' chapters 33 th .u,h 42 of the Residential Code. l Owner/Agent Signature: $1/ i. Date: A i 3 Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: f -.: 3 iO00 ,0 U Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: � � ' PA K Total Fee: J g t&\\c\ O, t Ap.vued August 23,2007 I> i A STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION PLUMBING&PIPING UNLIMITED CONTRACTOR ROBERT H LAUDETTE JR 7 ANDREA LN i NORWICH,CT 06360-1679 LIC./REG NO. EFFECTIVE EXPIRES PLMA203404-P1 11/01/2 4 10/31/2015 SIGNED kt 'fr' 05/06/15 WED 15:29 FAX 8606424365 0003 AC-CPRE) CARPLO2 OP ID: R7 - CERTIFICATE OF LIABILITY INSURANCE I D06(M7/20YYYY) 14 THIS CERTIFICAT.: IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFIC,4TE DO:6S NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS C:EIRTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIV'i;OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If; s certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION Is WAIVED, subject to the terms and col' Iltlons of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder I I lieu of such endorsement(s). PRODucER M� ARCHAMBAIJLT IRIS PRANCE ASSOC. TAcT NAMOI Marc L.Archambault,CPCU,CIC 143 Providence St.F)Box 153 `I(aAJC,N,Oma;860-928-0811 IN� Putnam,CT 06260.0' 53 EMAIL (Arc,No)1 860.928-6462 Marc L.Archambauh CPCU,CIC ADpRESS: INSURER(S)AFFORDING COVERA1 E NAIC 11 INSURED INSURER A!Harleysville Insurance 26182 James v3arboni Plumbing and Heath! ,Inc. a1SURFR6; 574 Flo ite 32 INSURER c North I rankiin,CT 06254 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTI('c` THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTO1 f-ISTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TFIIS CERTIFICATE MAY E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND C)NDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR Ni -s=- POLICY EFF MULICV'kXP LTR TYPE Cl INSURANCE _21/SR WV➢ POLICY NUMBER YI')IMMIDDIYY {MM1DDlYYYY}I LIMITS GENERAL LIABILITY PEACH OCCURRENCE �$ 1,000,000 A X COM%WPC'A._(ENEPAL LIABILITY SPP61118T 07/01/2014 07/01/2015 P7 ' --• PREMISES{Ea occurrence} $ 300,000 0.AlMSNL]E �OCCUR MED EXE'(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 Galt AGGREGATE ,MIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 f l gin- I I PRODUCTS.COMP/OP AGG $ 2,000,000 . I Pou,;.Y 1/141 of LOC 'AUTOMOEILELIABIIL rY COMBINED Si G= A X ANY ALTO BA61117T 07/01/2015 BODILY accident} $ 1,000,000 ALL OWNED SCHEDULED 07/111/2014 07/01/2015 (Par parson) $ AUTC'S NON-OWNED BODILY INJURY(Per accident) $ Auros HIRED AUTOS AUTOS -1751,61-?I y DAMAGE •"— jPER ACCIDENTL $ X UM81tELLA LPA! CCuR S ,q I MD LIAE EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE CM 877728T 07/01/2014 07/01/2015 AGGREGATE $ 1,000,000k DED Ell ,,E ENTIC'N$ IMO 'WOnKERE COMPEN: ATION $ APD EMPLOYERS'L; ELM( W C STAT' U111- L5 A IH- A j ANYPRDPRIETDRPI TNERIE CUTivE YrN WC61116T TORY LLMIEP OFFICEPAIEMBER Fd :LUDED? N I A 07/01/2014 07/01!2015 E.L.EACH ACCIDDENT $ 500,000 (Mandator,'In NH) If yo:.dasa�be un0�>r E.L.DISEASE-EA EMPLOYEE S 500,000 DESCRIPT;ON OF'l F:RATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERA?! NSI LOCATIONS 1 VEHICLES (Attach ACORD 101,Addleonel Remarks Schedule,If more apace Is required) CERTIFICATE HO:..[ ER _ CANCELLATION TOWM001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF MONTVILLE ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPT. 310 NORWICH-NEW LONDON TURNPK. Aur"°wzeDREPR>sENTATroE UNCASVILLE,CT 06382 —1/7/04<, "1/1/f Z 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(20101Cs: The ACORD name and logo are registered marks of ACORD 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 Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained. Property Address fl( r --G31 7cD+I, Job DP an - Required for all permits ® - At least one required for all permits D -Required as indicated below Required Department Permit Issuance Approval Approval • Tax Collector51. / Signature/date Comments: • Planning & Zoning Cskl Signature/date Comments: • Fire Marshal i/A Signature/date Comments: Health Department Required for properties with septic systems-Not required for Plumbing, Electrical, Mechanical,Roofing,Sidinq,Windows&Doors Signature/date Comments: WPCA, Administrative Required for properties on sewer Signature/date Comments: WPCA, Operations When Required by WPCA Signature/date Comments: [ Department of Public Works Required when project includes driveway work or certain drainage requirements Signature/date Comments: [ State Dept. of Transportation Required for Structures over 100,000 sq.ft. or with more than 200 parking spaces-Official copy of STC Certificate of Operation required-per CGS 14-311 Signature/date Building Department Review Complete Signature/date Rrvisedhbovemi r5,2008