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Window Replacements, Two Doors, Railing 2017
vrom. TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 BUILDING PERMIT Permit Number: B2017-0328 Date: 31-Jul-17 Map/Lot: 103/064-000 Owner ID: 5598000 Project Location: 3 POLLYS LANE Unit: Job Description: Replace Seven Windows,Two Doors&Replace Deck Railing Owner Nam Natasha Beeson Tenant Name N/A Careof: 3 Pollys Lane Uncasvflle _ C T 06382- Telephone: E P (860)213 3484 Applicant Name Marc Woviotis Telephone: (860)514-9565 DBA: American General Building Services Lic/Reg Type HIC Lic/Reg N 612994 P.O.Box 155 Exp Date: 30-Nov-18 1 Old Mystic CT 06372- Construction Value Permit Fees Construction Information Building Value: $5,053.00 Building Fee: $72.00 Use Group: IRC Plumbing Value: I $0.00 Plumbing Fee: $0.00 Code: 2016 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: &# $0.00 Electrical Fee: $0.00 Construction Type IRC '> Total Value: $5,053.00 Penalty Fee: $0.00 Permit Code: R4 t t C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 ;' State Ed Fee: $1.31 t Total Fee Paid: $73.31 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL,ELECTRICAL PERMIT INSPECTIONS ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete Cl Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor frami ❑ Electrical Service CRS No: n ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation El Ce.'' _ - of A.proval M Certific• iof 'c► pancy Building Official's Approval: / !/ Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: 69:17 -()DK Type of Work Occupancy Type Permit Type ❑New Construction ❑Single Family ❑Building ❑Addition ❑Two-Family ❑Plumbin jg Alteration ❑Townhouse ❑Mechanig Mechanical 0 Accessory Structure ❑Electrical CRS#: Property Address: .3 iO L^ty L✓- (Number) / ,($treet) O� (Unit) Job Description: 1dclI wn p(i)5( 0Oc 0L )0j�/ i...1. 0�� i t -1- (..,-n,_9 ,..) s Owner: ,AJ q ra.,c rJ Address: 3 Pa(. /r4 ++ ry City:( $S litV t / Statev� Zip Code: 3 , �Z Telephone( �Gd ) ZI 3 W Applicant: (Y\GjrC (_y_))v t cYf-(S • ,Qy�,� D s l / DBA: / i �h!C arv,dar_ R 4- c e cf /.., _ Y Address: /0_0.v. a, / 3-s-- ©Ltd /A� 7 �y City: Y r ,7 Grit State: Cl Zip Code: 0 6 3 ! L Telephone( RID) 51 y - `Z s'6r Contractors - Complete the Following: x License Type: i YP l) f c-` License No.:061 Z 2ert Expiration Date: /1 -,j 2 1$ i 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 fee and that I am authorized to make application for a permit for such work as described above. 0 By checking this box, I will follow the requirements of the 2014 NEC as the alternative compliance per section E3401.1 of the Residential Code, instead of the electrical requirements in chapters 34 through 43 of the Residential Code. Owner/Agent Signature: / e• Date: 7 — 2 ? / 7 Constrt/ tion Value Permit Fees Building Value: 4X 411100.- 0 40 � ` �53 Building Fee: "]a_c- Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: I- 3 Total Fee: 13 .3i Revised August 23,2007 Town of Montville Building Department File Receipt Date: 78-hil-i 7 ReceiptNo: 12506 Received From: Job Address: 3 PoHHyS Lane Town FeE+c['ollp•+o.i ate of Connecticut Fo Coll ij Bldg Cash: cn nn Bldg Check: State Cash: n nn State Check: Bldg Credit: n nn State Credit: Fire Cash:Q� o on Fire Check: Fire Credit: gp o� Construction Value' • CheckNo: Demolition Value: 1850 Received By: Carmen Kneeland Address: 3 Pollys Lane ITEM QTY $/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA Basement,Finished SF $ 41.96 $ - $ - Interior Renovations SF $ 36.09 $ - $ - $ - AMENITIES Kitchen EA $ - $ $ - Full Bathroom EA $ _ $ _ Half-Bathroom EA $ - $ - GARAGE Detached SF $ 71.53 $ - $ - MECHANICAL Warm-Air n Y/N $ i Hot Water n Y/N $ - Electric n Y/N Air Conditioning n Y/N $ $ - ELECTRICAL SERVICE Upgrade Amps $ - Subpanel EA $ 699.00 $ - Gen Set EA $ 3,850.00 $ - SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace EA $ 6,497.70 $ - Masonry w/lfireplace EA $ 7,096.65 $ - Masonry w/2 fireplaces EA $ 11,095.70 $ - Wood Stove,free standing EA $ 2,692.25 $ - Wood stove insert EA $ 1,859.77 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 44.07 $ - Porch SF $ 149.38 $ - Sunroom SF $ 176.90 $ - $ _ POOLS&HOT TUBS Hot Tub EA $ 8,016.25 $ - $ Inground Pool EA $ 31,550.00 $ - $ - Above Ground Round EA $ 6,299.46 $ - $ - Above Ground Oval EA $ 7,019.75 $ - $ Pool Heater EA $ 8,984.25 $ - $ - Inflatable Type Pool EA $ 1,200.00 $ - $ _ SHEDS w/o electrical SF $ 25.55 $ - w/electrical SF $ 26.85 $ - $ RENOVATIONS Roofing,Overlay SF $ 3.50 $ - Roofing,Strip&reroof SF $ 4.50 $ - Roof Sheathing SF $ 1.51 $ - Siding SF $ 6.75 $ - Windows 7 EA $ 550.00 $ 3,850.00 Skylights EA $ 1,051.10 $ - Doors,Exterior 2 EA $ 601.50 $ 1,203.00 Oil Tank,275 Gallon EA $ - Oil Tank,550 Gallon EA $ - MISCELLANEOUS CALCULATIONS Solar Install n TOTALS $ 5,053.00 $ - $ - $ - PERMIT FEE CALCULATIONS Construction Value Fee Building $ 5,053.00 $ 72.00 Plumbing y $ - $ Mechanical y $ - $ Electrical y $ - $ Plan Review Fee y $ Certificate of Occupancy Fee $ Plan Review Fee $ State Education Fee $ 1.31 TOTALS $ 5,053.00 $ 73.31 Figures are based on the 2006 RS Means Residential Cost Data �R CERTIFICATE OF LIABILITY DATE(MM/DD/YYYY) INSURANCE I 7/19/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. 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). PRODUCER -CON IAL I NAME: Jessica Rando Northeast Financial Group,LLC PHONE 8607393124 FAx A/C No,Ext): I ,No): (860)739-6207 PO Box 567 r-MAIL ADDRESS: Jarando@nefinancialgroup.com INSURER(S)AFFORDING COVERAGE NAIC# Fast Lyme CT 06333 INSURER A: MAIN ST AMER ASSUR CO INSURED 29939 INSURER B: Liberty Mutual Insurance American General Building Services,LLC INSURER C PO BOX 155 INSURER D: INSURER E: OLD MYSTIC CT 06372-0155 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSH AUUL'UtlH LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICTU-1- POLICY EXP/Y X COMMERCIAL GENERAL LIABILITY (MM/DDYYY) (MM/DD/YYYY) LIMITS EACH OCCURRENCE $ 1000000 CLAIMS-MADE X OCCUR UAMA&aL IU KENT EU — PREMISES(Ea occurrence) $ 500000 A MED EXP(Any one person) $ 10000 MPT0480J 05/06/2017 05/06/2018 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: _ PRO- GENERAL AGGREGATE $ 2000000 — X POLICY JECT LOC OTHER: PRODUCTS-COMP/OP AGG $ 2000000 AUTOMOBILE LIABILITY Data Compromise $ 25000 COMBINED SINGLE LIMI f ANY AUTO (Ea accident) $ OWNED —SCHEDULED BODILY INJURY(Per person) $ AUTOSHIRED ONLY _AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY NON NED AUTOSS ONLY (Per ac dentDAMAGE $ — ) UMBRELLA LIAB _OCCUR EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE $ _ AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY PER kr-PROPRIETOR/PARTNER/EXECUTIVE Y/N ,STATUTE I l ER B OFFICER/MEMBER EXCLUDED'? N/A WCS_31 S-602722-001 05/04/2017 05/04/2018 E.L.EACH ACCIDENT $ 100000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Additional Insured: Lisa Lowe&Associates and the Town of Montville CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Natasha Beeson THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3 Pollys Lane AUTHORIZED REPRESENTATIVE Uncasville,CT 06382 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL r 3 0 l.l.y s L.Va- / ,C ssv c,c.u/ c4—, 063 k Property Address (.16 h 0 0 4--/ 1-2-e,pt,A-cc--nitz437- Job Description Required Department Approval ' Permit Issuance Approval Tax Collector n /-2..g I 7 signature/date Comments: ® I Fire Marshal Al IrA ��-- 5\ tuba Signature/date tat Comments: l ❑ Planning & Zoning Required for all permits except Signature/date Plumbing, Electrical,Mechanical, Roofing,Siding,Windows& Doors ❑ Health Department Required for properties with private septic or well Signature/date Comments: WPCA, Administrative DPyr f i c re-rn Required for properties on sewer I 7� 1 i7 C.4 Signature/date Comments: ❑ WPCA, Operations When Required by WPCA Comments: Signature/date ❑ Department of Public Works Required when project includes driveway work or certain drainage requirements Signature/date Comments: ❑ Montville Police Department Required for all permits EXCEPT one and two family residential Signature/date Comments: ❑ Copy of State Dept. of Transportation Certificate 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 Final Inspection Revised March 23,2015