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Chimney Liner 2008
sECEIcT % S• Postal $ervice D MAltx, R Doverage provided) CERTIFIED No insurance asps comp (Domestic Math Only; website at,N,plw. N (Dorn information visit our � For delivery inform 7133 OFFICIAL USE. ik fn postage Postmark N Certified Fee ere�� O Return nt equ ri ed) Atli, O (Endorsement Re4 `; 0011111 O Restrictede i fleQuired) IT' e (Endorsem , N Total Posta9 e&Fees O Sent _ -- ��-----' _ --- ... O Stre=t A'X /�f. - Q,1 / � t r..- Instructions uttirn�s Cjhj,State.zI- a -.e�evorse(•. PS Form 3800,June 2002 COMPLETE THIS SECTION ON SECTION Agent COMPLETE THIS A. Signature SENDER: complete r ❑Addressee 2,and 3.Also X C a-of. livery II Complete items a1is desired. item 4 If Restricted Delivery the reverse B. Received by(Printed Name) ■ Print your name and address onyx 0 es so that we can return the card to Y°U address different from item this card to the back of the mailpieCe, 0 No • Attach space permits. p. Is delivery address below: or on the front if eiIf YES,enter deliveryt, Article Addressed to' � a v- 4' f� Y D tti 3. Service Type Press Mail vox C�?, Certified Mail for Merchandise I ` t Do I� Registered ❑Return Receipt R C.O.D. Ii it/$. a, G 5!�0��C'/ ❑Insured Mail 4. Restricted Delivery?(Extra Fee) p Yes � 3861 9276 4 2894 OQO '7 O Q / A302595-024-1540 2. Article Number '�labs) (Transfer from service Domestic Return Receipt �.� d j PS Form 3811,February 2004 Town of Montville Building Department 310 Norwich-New London Tpke. Uncasville,CT 06382 Tel. 860-848-3030,Ext. 382 Fax. 860-848-7231 1/17/08 Mary Mcclure P.O.Box 43 Uncasville Ct 06382 RE: 95 Polly's Lane Dear Permit Holder This is a request for a status update on permit#B2007-0677 dated November 14 2007 to install a stainless steel chimney liner. If the project is complete please call our office between 8:00 and 4:30 to schedule the required inspection Respectfully yours Charles Corell Building Inspector cc: File Field Inspection Notice Town of Montville Building Department January 28, 2008 Address: 95 Polly's Lane Job Description: Install stainless steel chimney liner Permit Number(s): B2007-0677 Permit Date: November 14 2007 Not Approved Approval INSPECTION Date: Deficiencies Special Date Conditions Flue liner 1/28/08 DJ Final inspection for • 1/28/08 DJ certificate of approval Rev.Date: 1/18/06 Page 1 of 1 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: B2007-0677 Date: 14-Nov-07 Map/Lot: 102/029-000 Owner ID: 5633000 Project Location: /oJ" �` POLLYS LANE Unit: Job Description: Install stainless steel liner in existing flue Owner Name: Mary H Mcclure Tenant Name: N/A Careof: Po Box 43 Uncasville CT 06382- Telephone: (860)848-9849 Contractor Name: Telephone: (860)234-0654 DBA: Armstrong Chimney Services LLC Lic/Reg Type: HIC P.O. Box 217 Lic/Reg No: 508367 Taftville,CT 06380 Exp Date: Construction Value Permit Fees Construction•Information Building Value: $2,350.00 Building Fee: $24.00 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: $0.00 Penalty Fee: $0.00 Permit Code: R4 C of 0 Fee: $0,00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.38 Total Fee Paid: $24.38 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business dans 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 n Certificate of Approval Certificat- • Occu'.• Building Offidal's Approval: - Town of Nontville 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.: /3 2a°-(X' 77 Type of Work Occupancy Type Permit Type ❑New Construction illy Ingle Family 0 Building 0 Addition • Two-Family 0 Plumbing literation 0 Townhouse 0 Mechanical 0 Accessory Structure 0 Electrical CRS#: Job Address: 5 Per) (Street) (Unit) Job Description: 1 NS 5Thir €SS :5-TEELL.I NJ r2. 1Njv int S n ,4. E Owner: l-►C C i IUa Address: I Q' Pb1-1_N IS City: f� � j F State: Zip Code: Ol.a 3? Telephone: � qZ. (-1'9 Contractor: DBA: 1 Rl atikith _ / c, FR.A/1 CC'S L c Address: 1). 0- !nn— �r City: i 11 1 E State: (-"r Zip Code: 0.03gC) Telephone: c -062S14-14 License Type: 14 License No.:5R(pf Expiration Date: 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. 51 By checking this box,I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. IOwner/Agent Signature: lU`1v1ls Date: I I (I 3 0-3-- Construction -3-Construction Value Permit Fees Building Value: ! Building Fee: 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: Total Fee: a,vireS Qeaw6rr 312005 Town of Montville Building Department File Receipt Date: 13-Nov-07 Receipt No: 3001 Received From: Armstrong Chimney Services Job Address: 105 PoIIv's Lane Fees Collected State Educational Training Fee Cash: $0.00 Cash: $0.00 Check: $24.38 Check: $0.38 Check No: 1131 Short/Over: $0.00 Construction Value: $2,350.00 Demolition Value: $0.00 Received By Charles Corell Address: 105 Polly's Lane ITEM QTY S/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA New Construction SF $ 114.17 $ - $ _ ' Basement,Finished SF $ 20.87 $ - $ _ Basement,Unfinished SF $ 11.28 $ - $ _ Crawl Sauce SF $ 8.46 $ - Interior Renovations SF $ 31.90 $ - $ - $ - MANUFACTURED HOMES Ground Anchors SF $ 5.86 $ - $ - $ _ Basement SF $ 11.28 $ - $ - $ _ - Crawl Space SF $ 8.46 $ - $ - $ _ AMENITIES Kitchen EA $ - $ - $ - Full Bathroom EA $ - $ - Half-Bathroom EA $ - $ - GARAGE Attached SF $ 4941 $ - $ Detached SF $ 63.21 $ - $ _ Under SF $ 912 $ - $ _ Carport SF $ 18.08 $ - MECHANICAL Warm-Air Y Y/N $ - Hot Water N Y/N $ - Electric N Y/N $ - Air Conditioning N Y/N $ - ELECTRICAL SERVICE Upgrade Amps $ _ Overhead,new Amps $ - Underground,new Amps $ _ Subpanel EA $ 545.00 $ _ Gen Set EA $ 3,500.00 $ _ SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace EA $ 5,907.00 $ - Masonry w/lfireplace - EA $ 6,451.50 $ - Masonry w/2 fireplaces EA $ 10,087.00 $ - Wood Stove,free standing EA $ 2,447.50 $ - Wood stove insert EA $ 1,690.70 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 39.16 $ - Porch SF $ 135.80 $ - Sunroom SF $ 160.82 $ - $ - POOLS&HOT TUBS Hot Tub EA $ 7,287.50 $ - $ _ Inground Pool EA $ 19,430.40 $ - $ - Above Ground Round EA $ 4,635.88 $ - $ _ Above Ground Oval EA $ 5,472.50 $ - $ - Pool Heater EA $ 8,167.50 $ - Inflatable Type Pool EA $ 1,542.42 $ - SHEDS w/o electrical SF $ 18.50 $ - w/electrical - SF $ 18.50 $ - $ _ RENOVATIONS Roofing,Overlay SF $ 3.38 $ - Roofing,Strip&reroof - SF $ 3.76 $ - Roof Sheathing - SF $ 1.19 $ - Siding SF $ 2.30 $ - Windows EA $ 423.50 $ - Skylights EA $ 955.54 $ - Doors,Exterior EA $ 401.50 $ - Oil Tank,275 Gallon EA $ - Oil Tank,550 Gallon EA $ MISCELLANEOUS CALCULATIONS $ 2,350.00 TOTALS $ - $ - S 2,350.00 $ - PERMIT FEE CALCULATIONS Construction Value Fee Building $ _ $ Plumbing Y $ - $ Mechanical Y $ 2,350.00 $ 24.00 Electrical Y $ - $ Working before Permit Issuance $ _ Certificate of Occupancy Fee $ Plan Review Fee $ State Education Fee $ 0.38 TOTALS $ 2,350.00 $ 24.38 Figures are based on the 2006 RS Means Residential Cost Data etons Chimney Services LLC P.O. Box 217 Taftville, CT 06380-0217 (860) 887-8981 * (860) 440-3317 * Fax (860) 859-3212 Proposal CT Lic# 508367 Don's Cell (860)234-0654 (860) 848-9849 10/18/2007 Ms. Mary McClure 105 Polly's Lane. Uncasville, CT 06382 Labor and material as needed to install a stainless steel liner into an existing flue, connected to a stove in the fireplace. The new liner is to be a 6" diameter as required by the woodstove. The liner will be wrapped with insulation, and installed as per UL Listing standards. The chimney will be cleaned first if needed,to remove as much creosote as possible. Priced as follows: All materials needed to install new liner and connect stove as required Labor to install new liner, and connect stove Grand Total $ 2,350.00 Note:Building Permit fee, if one is required, will be added to final invoice! Note: We accept Visa,Mastercard, Discover, &American Express for your convenience! All old and excess material to be removed, with complete work area left in original, neat condition. We propose to herebyfurnish labor, equipment& materials, as specified above for the sum of: P P Two Thousand Three Hundred Fifty& 00/100 dollars $ 2,350.00 Payment to be made as follows: 50% Deposit to order material Balance due in full the day of completion Ct Registration#508367 Home Improvement Contractor Agency: SAVA Insurance Group LTD, 750 Broad St, Waterford, CT 06385 Starting date: . Starting date negotiable as ou work is weather related. All material to be as specified. All work to be completed in a workmanlike manner according to Authorized •_ 1\ Standard practices. Any alteration from above specifications involving extra costs will be executed Signature .� •_ o— _ Only upon written orders,and will become an extra charge over and above the proposal. All Agreements contingent upon strikes,accidents or delays beyond our control. Note:This ar000sal may be withdrawn by us if not accepted within 15 days. Acceptance of Proposal—The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. I understand if the balan not paid on completion as specified above,Armstrong Chimney Services LLC reserves the option to charge a penalty of 10%on the balance due. Interest will begin to -at the rate of 18%annually from the day of completion. In the event of default by Buyer,the Buyer agrees to pay all costs of collection,including reasonable attorneys rr In addition dincurred by Seller til Date of acceptance w 12.[O 1 Signature(s) You,the buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the attached notice of cancellation on the reverse side for an explanation of this right. (Saturday is a legal business day in Connecticut)This instrument is based upon a Home Solicitation Sale,which sale is subject to the provisions of the Home Solicitation Sales Act. This instrument is not negotiable. L y o r U - a S Cr- r Y o f-a �._.,� a iN.,— c o E m c c / p iici. =:. c v vC e ; eo U ea i4 , o / E :v , CCF- :: o o Eo $ Eva m ti� r mo cn¢ OL ...1 •-1.: g p ,r m _ E c air ,tC aI, n c 0I— =ff,, u°� LL �AT `` Tir it oc "LL• Q Z c a.>. E Avt.ii♦ V1vt\`vi A, , k Tim r n�m x , r y �� , , r",� tOSm ; g .„, is - IP LA" '{ �• , �k\i/:/• , 23` ai ;lt•! 0.1-11 a / " „-. :cti s. • > S& SmC0�.LL c 8N • U. d-E -J_ o d pg � _' 3UaE pgffoSi x x § 1 _\ 1 o fcl a 631111 �,�,�,m 'E a ! . ',tib p c j 5u- - �\ yr 7 —� \ Itli y N "' 13ai co ,_.... N,\....). Isss,.........-.......Z.... ...... -..s...-..,,:jk. ,.•sysks,vs, Cs> ,,''. 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CERTIFICATE OF LIABILITY INSURANCE DATE PRODUCER (860)437-7282 TAX: (860)447-5656 THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sava Insurance Group Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 750 Broad Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Waterford CT 06385 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A =amass INSURING ARMSTRONG CHflVEY SERVICES, LLC INSURER B EXCELSIOR INSURANCI 11.045 P.O. Box 217 INSURER C PSERI,ESS INSURANCE 24198 INSURER D HARTPORD INSURANCE CO. TAFTVELIJK CT 06380 INSURER 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! IICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGRE TE LMITS SHOWN MAY HAVE BEEy$ED PAID CLAMS. INSR ADM. POLICY EFFECTNE POLICY IO N LTR TYPE OF INSURANCE LMMIDOdYY} POLICY NUMBER I DATE � EXPIRAT DATE IM RA , LIMITS GENERAL UAB*.ITY EACH OCCURRENCE s 1,000,000, DAMAGE TO RENTED COMMERCE .GENERAL LVABIITY PREMISES(Ea ocwrrence) $ 200,000 A CLAIMS MAGE EOCCUR CBP9860045 6/24/2007 6/24/2008 MEDE)(P(Any dnePerson) $ 10,000 PERSONA,.&ADV IN.A RY s 1,000,000 1111 GENERAL AGGREGATE $ 2,000,000 GENt AGGREGATE LIMIT APPLES PER PRODUCTS-COMP/CP AGG $ 2,000,000 X pot.CY El.E G' i l LOC , AUTOMOBILE LIABILITY COMBINED SINGLE L Mr s 1,000,000 ©AN'!AUTO (EsecaaenU B III ALLONMEDAUTOS 5A9869241 6/24/2007 6/24/2008 BODLYIN,AJR., N SCHEDULED AUTOS (Perperscro ' ■ HIRED AUTOS BODILYINJURY (Per!cadent) s MI NON-OWNED AUTOS e PROPERTY DAMAGE s (PM ecodeK) ' GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ■ AN`AUTC OTHER THAN EA ACC,$ AUTO ONLY AGG s EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000 © 00CUr: ED CLAIMS MADE AGGREGATE q 2,000,000 s C . DEDJcTIBLE 009860645 6/24/2007 6/24/2008 $ X RETENTION $10,000 s D WORKERS COMPENSATION AND X TOR Y T M S. ,FR- EMPLOYERS'LIABILITY ANY CROPR€TOR/PARTNER,EXECUTIVE E L EACH ACC/DENT s 500,000 OFFICERMEMBEREXCLUOEG? 5717C465 10/1/2007 10/1/2008 EL DISEASE-EAEMPLCTEE$ 500,000 If yes.descrte under SPECIALPROV"SIONSWow - , EL DISEASE-POLICY_IMI7 s 500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSWE/CLESIEXCLUSIONS ADDED BY ENDORSEMENAPECUL PROVISIONS Chimney cleaning/rival r CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Updated proof of Insurance EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAL CT 10 DAYS WRITTEN NOTICE TO TIE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE THE ,^��, 4 Diana BusceLto,'D� w j4"44k6", Chimney Services LLC P.O. Box 217 Taftville, CT 06380-0217 (860) 887-8981 * (860)440-3317 * Fax(860)859-3212 CT Lic#508367 Date: II/I3)0—+ To Whom it may concern, Dionne Sergiy has my permission to sign for, and obtain permits, using my license number,for job(s)to be completed for�� the followin Customer,as per the signed proposal. Name: J- `1 )c_ CW2,E Address: 105 P 1 S [ Otoc_As c 3Ya--/ k You, Donald R • mstrong -. . _,.J STATE OF CONNECTICUT \` I)FP,4R7'J1/:.VT 01 ('Or1'SL'afFR PRO77(TIO\' HOME IMPROVEMENT CONTRACTOR DONALD ARMSTRONG PO BOX 217 TAFTVILLE,CT 06380-0217 LIC./REG NO. 4R\1STTp Tk AsoNBY EXPIRES .05083: 12/0 2004. 1/30/2008 Town of Montville Suildina Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville,CT 06382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL 1 0 'lou -fS I OtICY.NSfi Pioperty Address Job Description 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 *r \\\ 3 0 Signa f date Comments: ❑ WPCA, Administrative - Y Yl � t 1�1r�1 Comments: ❑ WPCA, Operations Signature!date Comments: ❑ Planning &Zoning Signature/date Comments: ❑ Health Department S+ sato e' date Comments: ❑ Department of Public Works Signature! date Comments: 0 State Dept. of Transportation (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 Comments: Fire Marshal 111 t`k Lq si,nature/`1atE Comments: RfviseIAugust S,2005