HomeMy WebLinkAboutStrip and Re-Roof 2004 Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville,CT 06382
(860)848-3030, Ext. 382
Building Permit
Permit Number: 82004-0199 Date: 03-May-04 Map/Lot: 103/057-000 Owner ID 120014
Job Location: 35 POLLYS JANE__________________ Unit
Job Description: Strip&Re-roof
Owner: Contractor:
Michael A and Michele K Parks G.A. Denison&Sons, Inc.
131 Cedar Grove Ave.
i 35 Pollys Lane New London Ct. 06320-
Uncasville CT 06382 Telephone: (860)443-6541
j Lic/Reg Type/No. HIC 566806 Exp Date: 30-Nov-04
Tenant:
Self
Telephone:
Construction Values Permit Fees Construction Information
Building Value: $3,890.00 Building Fee: $22.00 Use Group: R4
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO
Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 5B
Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: R4
Other Value: $0.00 Other Fee:
$0.00 Comments:
Total Value: $3,890.00 CO Fee: $10.00
Plan Review Fee: $0.00
State Ed Fee: $0.62
Total Fees: $32.62
It is the owners responsibility to schedule the following inspections(minimum 48 hours notice reauired):
❑ Footing - Prior to pouring concrete ❑ Rough HVAC
❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat
❑ Concrete Slab-Prior to pouring concrete ❑ Chimney-One flue above thimble
❑ Rough Framing ❑ Firestopping/draftstopping
❑ Rough Electrical ❑ Insulation
❑ Electrical Service CRS#: 0 0 Final Inspection
❑ Rough plumbing and leak test ❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signatur:. /'' / . "''''''''''''' ---
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Town of Montville
Building Department
310 Norwich-New London Tpke. Permit #
Tel. 848-7166, Ext 81 ✓
Uncasville, CT 06382
Fax. 848-7231
One & Two Family Building Permit Application Form
❑New Construction [[Addition []Alteration []Accessory structure
gt;tther L_
Job Location S �� /1
Job Description/Materials (f. „� / ,
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Owner I/
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Mailing Address (/i ' L4..z�
CityiA Q State
a. Zip Tel . ;6 /SYS /�/
Contractor
64,4* 04.. Mailing Address A.,04.4.- �tl'e
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Contractor's License/Registration Type&Number S
Exp. Date_/ _/_____p__
I hereby certify that the proposed work will conform to the Basic Building Code and all other codes as ad
State of Connecticut and the Town of Montville and further attest that the proposed work is authorized bythe pted the
and that I am authorized to make application for a permit for such work as described above. owner in fee
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Owner/Agent Signature
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Date 5 1_7 ' JL
Construction Value
Fee
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$
Plumbing $ _
Building $
Mechanical $ $
Electrical $ $
Other $ $
Certificate of Occupancy $
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Plan Review Fee $ ,,el_______
State Education $
Total+ $
Town of Montville Building Department Receipt
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Date _ 1/ _/__4D V
No. 03770
From: - 1 �k`✓
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Job Address: // if
Amount $______(71,9?, hec
Cash Ck` Check #
% (circle one) <<
Received by r
ie i /! Permit #14)7,440_040/5) I
G.A. I)ENISON & SONS, INC.
Roofing& Remodeling
111 Cellar Grove Ave.
Nr•r‘ I notion.CI
Donna M. Nay has my permission to apply for a building permit for the
following property 3 S'
George A. Denison
-^-rm. �.� � A ./ �)°kY '' rY i � 'e� F g !? gam, DATE(MM/DINY()�
PRODUCER ..-- _____^ . •..,..._....._ _. _ _.. , ___ __ 26 83
THE INSURANCE PROFESSIONALS, INC. THIS CERTIFICATE t5 ISSUED AS A MATTER OF .INFORMAr on T
OF .� Omit AND CONFERS r;•:: RIGHTS UPON THE CERTIFICATE
AYt3
PO
SSFICE BOX 1007.
T T(Of CT 08340-1007JJ HOLDER. TIPS CERTIFICATE DOES PLOT AMEND, EXTEND OR
PHONE: 06O.448-5377 ALTERTH
- ECOVEItirGE AFFORDED BY THE POLICIES BELOW
_._.._.,._..R ______ OV....,..........,,_..... ,
FAX: 860-445.8418 --
_......:__.._._..__..._.. Agency Lie/it 000405234 INSURERS AFFORDING COVERAGE NAVC
INSURED
INSURER A. SCOTTSDALE IN`.•)RANCE COMPANY
G.A.DENISON 8,SONS,INC. _...... ------._.-
irdStJR[R 8: NATIONAL.COUNCIL OF W COMPEN
131 CEDAR GROVE AVENUE ___-_._. _.
NEW LONDON CT C;'.32O INSURER C.
'INSURER D
INSURER _...._..____.. ._..
•COVERAGE
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T11E POLiCINS OF INSURANCE LISTED BELOW fIAVF BEEN'I$SIIFT) TO THE INSURI.:D NAMED AOOVE roil HIE POLICYf'£T2K)D INDICATED,
ZANY POL•ICREMENT. TERM OIC. (:ONOn1 E OF ANYrIN'"-"�'"'""""""'"
CONTRACT OR ,,i;TIER DOt;11RfF,Nr wail RES1'EC,f TO WHICH THIS CEEIPrICATFAMAY BF)SSUEUIOR[JINCd
MAY PERTA4+. 1HE INSURANCE APF0r40E0 BY THE POLICIES DESCRIBED fIET EL4 1:; r.'HJECI TO ALL TflI 150ms. EXCLUSIONS AND FONDIHONR OF SUCH
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POLICIES, Ar t; ,CATELTMIIE SHOWN MAY HAVE OEFN REDUCED BY PAID CLAIMS.
VCR POLICY NUMBER eGi.ICv_A;r/gcTN rUL1CY RXPIAATION •
,._,. �__ _ wpnnr} Dare H y LIMITS
GENEtiAl.LIABILITY4.
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CIS 03Tif154 I FEB 5 O4 s r r -,-
` FE(, f 0 5 EACH OCCURRENCE S 300,000
X •COIAMERCint,GENERAL LIMIII.11Y ^---._---..- — 00
I CLAIMS MADE X •PREMISES.IEa,neurroncel.. -_......_.. _ ,..._...._.:-_.....:,_.!DD---
IOCCUR
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A 1000
PERSONAL C.ADV Irt,l:!"tY 5 300,000
-- --.GREG ._..-...-.-_.-_.._ GENERAL AGGREGATE 5
acro AGGREGATE ITMr r APPLIES rEr+ 300,000
PRonocT S-C(MIVOP AGO. 's 300,000
POLICY .I - __.. ... .
1 1111
AUTOMOBILE.LIABILITY .._.._......_.-_......._..�.-_ _^^-_-^_ �..-.+.........
ANY AUTO COMBINED SINGLE LIMIT
(Lin accident) 5
All OWNED AUTOS _...._....._..-..__...._..-
SCHRDUL ED AI ITOS DODILY INJURY
PNAon) $
lItnen AUTOS
NON-OWNEPAI)TOS DDDIt.YINJURY s
(Per accident)
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GARAGF.I,IAr71LITY "' '"--�`--^^^----
ANY AUTO AUTO ONLY-EA ACCIOFNT $
DUI!!.:11 11 IAN LA ACC S
AUTO ONLY; •_..._.......__. -._—___._.._
EXCE991UMBERELLALiABIIJTY - _.__ "'^- ....
AG $
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OCCl64 EACI I OCCURRENCE
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AGGREGATE S •
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DEDUCTIBLE S
RErNIHON $ • S
WORT(1'.R5 COMPENSATION Alp IBA
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EMPLOYERS'LIABILITY I]f j 21 03 We r:nrv-
JUN T.1 04 X I I -Pow! j
0 sN7rfTpPnlerorwartnienrf:xervnva
0✓fiCBu+nAMa6q exr,Luoepr E.L.EACH ACCIDENT' 9 100 000 i
It yca, r wM+r EA-.DISEnSE•EA EMPLOYEEEMPLOYEEE 100,0
BPBCUL PROVRb•RSIOftA Apow
E.L.DISEASE-POLICY LIMIT 9 000,000
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DESCRIPTION OF OPERA1IONS/LOC��TION1VEf4ICI_F;,1'XCI .t",V3N i ADDED ENDORSEMENT,SPECIAL PROVISIONS__
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Cf RTIfICN.iF fiCJLUFR _ TADDITIC?NAI.INSURED:INS .!
___ INSURER LETTER:V ,„�fCE[.t.ATION ""
SHOut,.O ANY OF lIfE ABOVE DESCRID O POLICIES Di CAfdcEILFU BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILT,ENDEAVOR TO MAIL 10
DAYS Mr 1E1,1 NOTICE TO THE CER1IFICATE. HOLDER NAMFO TO THE LEFT,HUT
FAILURE TO On SO SHALT.IMPOSE NO OBLIGATION OR LIABILITY Or ANY WHO UPON rlIE
INSURER.IT'S AGENTS ON fi51'i-IESi:NTATIVES.
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