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Home My WebLink AboutDemo First Floor 2003 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext. 382 Demolition Permit Permit Number: B2003-0065 Date: 12-Mar-03 Map/Lot: 075/014-000 Owner ID 119513 Job Location: 69 POINT BREEZE ROAD Unit Job Description: demolish lower half of log cabin Owner: Contractor: Harold S Jr+ Harold S and Paula H Schwenk Arthur Goulart&Son 26 Bishop Road 80 Orchard Rd Bozrah Ct. 06334- Weston MA 02493-2279 Telephone: (860)887-0874 Lic/Reg Type/No. Class-A 685 Exp Date: 31-Mar-03 Tenant: Self Telephone: Construction Values Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABG Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 56 Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: M1 Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $0.00 CO Fee: $0.00 Included on Building Permit Plan Review Fee: $0.00 State Ed Fee: $0.00 Total Fees: $0.00 It is the owners responsibility to schedule the following inspections(minimum 48 hours notice required): ❑ Footing- Prior to pouring concrete ❑ Rough HVAC ❑ Backfill - Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab- Prior to pouring concrete ❑ Chimney-One flue above thimble ❑ Rough Framing ❑ Firestopping/draftstopping ❑ Rough Electrical ❑ Insulation ❑ Electrical Service [J Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany ❑ Gas piping and test Building Official's Signature: Y,-/f /'/ S2/22/20C3 01:21 781-891-5872 SCHWENK . ,...f.e-6E,.... 01 .. ' —112 10:04 860-889-3093 1110 Town of MoDnE:NiiiiAeND SHIA.E. • Permit,rif&24)_62,5 Building Department Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 82 Uncasville,CT 06382 Fax. 848-7231 Application for Demolition Permit , . . _12A:la_ _ ..... .. Il'a:s;cription/Materials De fn o 1...ed....)e_Ar: +4 1.4) L! i — Gyvts C? 1 .60 _ 0 .. .. IA:, _ v / go.e4-$....41i4601.1. Flpor _ c k Owner 14 a P (re?._ 4 aja- a ---t-__,,,,e61 k Mailing Address al OJLS . ____ State 1174 'florztractor_fait_ d.igtellMai I in g Address...426Si.5 A.Lee, fsL, 7-- ___._ ,..-- State (''I zip_04 33 y Teig4__ci ST7; 0_W 71 .. ;.,c.,7-1tor'a License/Registration Type dt Number lo i).5-* Exp.Date , hereby certify that the proposed work will conform to the Basica:I:Jail-1g Code and all other codes as adopted by the State of Connecticut and the Town of Montville, z1tractnr Signature ‘Zeit4244,t _ _ Date 3i3i 0_3 - 'I,`4/'.:.to.S'ip situ rt sl ,.. '‘. :6".• ''''''••.-'‘‘ Alt.4 V`-4-) ' . --PC, ,,,,,/ :7/ 11 " -, /1; .4)Rte 3 L.212 0,3 r_3•TrvlitionI Construction value $ $ Fee — State Edigation,Fee $ Total $ $ ......—______..... _ , 7----,. ----- --`61-- • ..,__ c.....,./,, (._.....2 dTh _....tVC e\) CIC>Z.)11747 . • . . 03/04/2003 12: 54 8606426076RLANDG I ACORD aATE1MMrntnn CERTIFICATE OF LIABILITY INSURANCE 1 03/04/2003 PRODUCLR0 642-7559 FAX (860)642-6876 THIS CELATE Is ISSUED AS A MAT R OF INFORMATION « ) R 1 {ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE RL&G Agency, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 210 Route 32 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 100 INSURERS AFFORDING COVERAGE Franklin, CT 06254 INSUReo Arthur Coulart & Son, Inc„ Arthur Coulart & INsuRERA' CNA Insurance Companies 26 Bishop Road INSURER B; i --! Box rah, CT 06334 INSURER C. _ , L________L____ M INSURER 0'IN __ SURER E. COVERAGES ITHE POLICIES CF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AOOVE FOR THE POLICY PERIOD INDICATED NOTWIThSTANDINO ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSJED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU.TME TERMS,EXCLUSIONS AND CONDITIONS)F SUCH POLICIES AGORE3ATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PWD CLAIMS. 3 __, TYPE OF INSURANCE POLICY NVMEER + 1 J,,,.,. OU .•.,.+ -L�IMITS-- GENERAL LIABILITY 8144779844 05/01/2002 05/01/2003 EACNUC;;uRREM10E I`' 1,JOQ O(1 113 COMMERCIAL GENERAL LIABIiT$ KIRE DAMAGE(Ary::n6 rue': I i` ^.'S_Q0,000 11111111 CLAMS MADE u OCCUR MEC EXP IAry cne q°for) $ 10 0.° A III PERSONAL a ACV INJURY 3 1,000 01° GENERAL AGGREGATE $ 2)000 001. GEN AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP A GG I$ Z,C9OO,GO NI POLICY III C7 PRO- III LDC > �AUTOMOBILE LIABILITY :1044779858 05/01/2002 05/01/2003 COMBINED SINGLE LIMIT Xs aecidentj ° X ANY AUTO 110003r 1,0 ALL OWNED AUTOS BODILY;KJ RY $ A SCHEDULED AUTOS (P°,pe�fon). - _ HIRED AUTOS. BOOILY it`JUN,Y IIINO"LOWNED AUTOS (Per acclaim)III 3 PRuoER TY DAMAGE S (Per e.:cadent) ~_I11 GGAANRAJE LIABILITY AUTO O.V-EA ACC'.OENT $ 7 ANY AU 10OTHER THAN _EA At:C'I i ` AUTO ONLY AGO1$ ..�_. EXCESS LIABILITY _EACH OCCURRENCE I `1 OC'UR 1-7 CLAIMS MADE AGGREGATE L x A- RETENTION $ $ WORKERS COMPENSATION AND 6144779661 -r05/O1/2002 05/01/2003 aTOkv umirs oThr EMPLOYERS'LIABILITY E L.EACH ACCIDENT $ S00,001 A E L.OI6EASE•EA EAIPLOYE$ T 500,04g E.L.DISEASE:.POLICY LIMIT $ 500 004 OTMER — ' L I DESCRIPTOR 01=01'ERATIONS4LOCATIONSNENK ES(EXCUSIONS Dr,E0 SY ENDORSQMENTISPECIAL PROVISIONS __ Coverage is extended to include demolition at Point Breeze, Montville CT CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DES'CRIRED PGLICIEA SE CANCELLED BEFG'FE THE EXPIRATION DATE THEREOF,THE(ISSUING COMPANY WILL ENOEAVVR TO MAI. f, Town of Montville 01Q DAYS WRITTEN NOTICE TO THE CIRTI I'ATE MOLDIER NAMED TO THE LEFT, t Building Dept out FAILURE TO MAS-SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LiAwLr°v Town Hal 1 _ OF ANY KIND UPON THE COMPANY.ITS AGENTS OR REPRESENTATIVES. Montville, CT A ITMORIMDREPRESENTATIVE ---' Michail Landeck MAL 0G_ '*1 ACORD 25x5(7197) AA a RD CORPORATION 19eE Town of Montville Permit# Building Department 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 Application for Demolition Permit Job Location 6q PO4 R r e c. qc /Ie l Job Description/Materials ►�0re °� pV e, Ca. ,✓i 1.j009 S a.r.� ��uIcLL `tieu4rv.10: ) F (Dor S cic-,1 Owner Mailing Address City State Zip Tel Contractor id/#4 Lf /c.5�k1Mailing Address ;(P 4ei s hop ed City BO Z(c-11 State ('I Zip Gla 33 V Tel g4,o / 7/ Q ?/ Contractor's License/Registration Type&Number eo P,5*- Exp.Date 3 / 3/ / 0'4 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. Contractor Signature Date .3 / 3 /03 Owner Signature Date / / Construction Value Fee Demolition $ $ State Education Fee $ Total $ $ NapeTown of Montville ;,,moi Building Department (860) 848-3030, Ext. 82 DEMOLITION PERMIT SIGN-OFF SHEET HEALTH DISTRICT ❑ The septic system has been disconnected, inspected, and approved. ❑ This structure is not served by a septic system. Signature Date Agency ❑ The well has been disconnected, inspected, and approved. ❑ This structure is not served by a well. Signature Date Agency MUNICIPAL SEWER/WATER 0 The municipal sewer line has been disconnected, inspected, and approved. 0 This structure is not served by a municipal sewer system. Signature Date Agency 0 The municipal water line has been disconnected, inspected, and approved. ❑ This structure is not served by a municipal water system. Signature Date Agency ELECTRICAL (Letter from utility company required) The electrical service has been disconnected, inspected, and approved. This structure is not served by the electric utility. (7yi/ ji.44;/IL i" 71 , , Signature Date Agency NATURAL GAS (Letter from utility company required) 0 The gas service has been disconnected, inspected, and approved. 0 This structure is not served by natural gas. Signature Date Agency Town of Montville Building Department 848-3030, Ext 82 Application Requirements For Demolition The requirements for demolition shall conform to the State Demolition Code (C.G.S. section 29-401) and BOCA Section 3310 & Section 110.0. Er- Certificate of Insurance specifying demolition purposes Liability coverage for bodily injury of at least $100,000/person with an aggregate of at least $300,000 ❑ Property damage of at least $50,000/accident with an aggregate of at least $100,000 ❑ Certificate shall provide that the town or city and its agents shall be saved harmless from any claim or claims arising out of the negligence of the applicant or his agents or employees in the course of the demolition operation. Certificate of notice executed by all public utilities having service connections stating that such utilities have severed such connections and service(Electrical, Sewer, Water, Gas) ❑ Certificate of registration from the State of Connecticut (Class A or Class B) Exception: ❑ Historic structure disassembling, relocation ❑❑ Farm Buildings Renovations, alterations of single-family residence Owner engaged in the demolition of a single-family residence or outbuilding Permit to be signed by the owner and demolition contractor ❑ Adjoining property owners shall be notified by registered or certified mail (min. 1 week prior to work being performed 3310.1) ❑ Fence to be erected during the operation, min. 8 ft high; fence may be waived at the discretion of the Building Official in writing Required Inspections: Minimum 24-hr. notice required Final After debris has been removed and property re-graded