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HomeMy WebLinkAbout16x32 Above Ground Pool 2016-2017 ;i. i 7S6 ` Town of Montville Building Department `lbr3 310 Norwich-New London Tpke. Uncasville, Ct. 06382 860-848-6782 fiF �a,r is 09/13/17 Henry and Lisa R. Olander 19 Powerhouse Rd. Uncasville, Ct. 06385 Re: 19 Powerhouse Rd. I was recently informed by the Town of Montville Zoning Enforcement Officer that the above ground swimming pool installed at the above referenced address does not have a certificate of occupancy. In addition there is a deck(s), constructed without the required permit(s) and approval(s) that serve as access to the pool. Please be advised that use of the pool without the required certificate of occupancy and construction of the deck(s) without the required permit(s) and approvals are violations of Connecticut Building Code (violation notice attached). In order to avoid possible legal action,you must contact the Town of Montville Building Department within ten (10) days of receipt of this notice with a plan of compliance. If you have any questions you may contact me during regular working hours at the Town of Montville Building Department. Rega • ernon D. Vesey II Building Official Cc: file Town of Montville Building Department 310 Norwich-New London Turnpike Uncasville, Ct 06382 860-848-6782 09/13/17 Henry and Lisa R. Olander 19 Powerhouse Rd Uncasville, Ct. 09382 Re: 19 Powerhouse Rd, Uncasville, Ct. Certified Mail — Return Receipt Requested and Regular 1St Class Mail STATE BUILDING CODE §114 NOTICE OF VIOLATION AND ORDER TO ABATE On 09/11/17, an inspection was conducted of the premises located at 19 Powerhouse Rd. for the purposes of determining zoning compliance and compliance with the State Building Code as amended and the applicable referenced standards, adopted pursuant to the Connecticut General Statutes §29-252. The Code and said standards are available for your inspection at this office. The inspection revealed the following violation(s) of the State Building Code: 1. Section R110.1 of the 2012 IRC portion of the 2016 Connecticut Building Code— Use of a structure without the required certificate of occupancy 2. Section R105.1 of the 2102 IRC portion of the 2016 Connecticut Building Code— Construction of a deck(s) without the required permit(s) and approvals PURSUANT TO STATE BUILDING CODE §114, YOU ARE HEREBY ORDERED TO DISCONTINUE THIS ILLEGAL ACTION AND TO TAKE THE PROPER CORRECTIVE ACTION —DISCONNECT AND REMOVE THE GENERATOR WIRING IMMEDIATELY. Construction documents for work to be done shall be submitted to this office prior to the commencement of any construction in accordance with State Building Code §107. The review of all construction documents would avoid unnecessary expense that could result from non-complying changes. Please note that the correction of certain violations may require proper permits and approval from the Building Official and other local agencies prior to any construction. You are hereby notified that you have the right to appeal this order pursuant to Connecticut General Statutes §29-266(b) to the municipal board of appeals or Connecticut General Statute §29-266(c) in the absence of a municipal board of appeals. Variations or exemptions from the State Building Code may be granted by the State Building Inspector where strict compliance with the code would entail practical difficulty or unnecessary hardship, or is otherwise adjudged unwarranted pursuant to Connecticut General Statutes §29-254(b), provided that the intent of the law shall be observed and public welfare and safety be assured. Any application for a variation or exemption or equivalent or alternate compliance shall be filed with the local Building Official. This is the only order you will receive. Be advised that the Building Official is authorized to prosecute any violation of this order by requesting that legal counsel of the jurisdiction, or the Office of the State's Attorney, institute the appropriate proceeding at law. Per Connecticut General Statutes §29-254a and §29-394, and State Building Code §114.4, any person who is convicted in a court of law of violating any provision of the State Building Code or for failure to comply with the written order of a building inspector for the provision of additional exit facilities in a building, the repair or alteration of a building or the removal of a building or any portion thereof shall be fined not less than two hundred not more than one thousand dollars or imprisoned not more than six months or both. This office seeks and anticipates your cooperation, and looks forward to working with you in the interest of building and life safety for a timely resolution of this serious matter. If you have any questions, please feel free to contact this office at 860-848-6782 Regar , ,i011#11" ernon D. Vesey II Building Official Town of Montville Cc: File TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE U NCASVI LLE, CT 06382-2599 TEL. (860)848-3030 X382 FAX. (860) 848-7231 ELECTRICAL PERMIT Permit Number: E2016-0186 Date: 05-Jul-16 Map/Lot: 068/017-000 Owner ID: 5684000 Project Location: 19 POWERHOUSE ROAD Unit: Job Description: Electric for Above Ground Oval Pool Owner Nam Henry Jr and Lisa R Olander Tenant Name N/A Careof: 19 Powerhouse Road Uncasville CT 06382- Telephone: (860)908-8295 Applicant Name Christopher Roderick Telephone: (860)391-7015 DBA: Accurate Electric Lic/Reg Type El Lic/Reg N 197123 587 Norwich Road Exp Date: 30-Sep-16 Salem CT 06420- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 Fees Included with Building Permit State Ed Fee: $0.00_ Total Fee Paid: $0.00 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 ❑d R Electrical ❑ Backfill-Footing drains and waterproofing ❑d Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete 0 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 Drafistopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation /❑ Certificate of Approval ❑ Certificate of Occupancy # . Building Official's Approval: & r ' � , Town of Montville IIP 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.: £c9L1 p --CTP Type of Work Occupancy Type Permit Type o New Construction 0 Single Family ❑Building ❑Addition 0 Two-Family 0 Plumbing ❑Alteration 0 Townhouse Mechanical 0 Accessory Structure Electrical CRS#: l Property Address: / /70 4-J7'e— _,+ S-t. (Number) (Street) (Unit) Job Description: /4 Grc, ; •-ebt: I Owner: L(‘ SGL (r)!C..--) CJ t.c"--- Address: / 9 Pc ..rt /7YSvS'C_ City: O/1 Gast', I I t- State: [, \ Zip Code: 0428-2_ Telephone( fide ) ? '6 -_tYLi " Applicant: Arc_iirA-��1-t m C Chi .-._.J i 1?nc1 C/i CIC DBA: ACC4./rc f t /eCi- -.. .- Address: S G , rr., G A ..c1 } / 7 `' g £ 39/ r City: ---Cde,---) State: � \ Zip Code: OG' 1[-/ Telephone( ) - �Of'-� Contractors- Complete the Following: f":20 , �,, License Type: 4%/ _!:License No.:(I/f;/23 Expiration Date: 20-2a/6 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 perm' r such work as described above. perm' 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. Owner/Agent Signature: Date: 7—/-& Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: 1 • Electrical Value: Electrical Fee: 11INAM $t Total Value: Penalty Fee: C of O Fee: r Plan Review Fee: D State Ed Fee: Total Fee: Rcviu&August 23,2007 vJ�v State of Connecticut x Y,` r Workers' Compensation Commission 7A•cc „Ir 1:0 rAP � Please TYPE or PRINT IN INK taazza Proof of Workers' Compensation Coverage when Applying for a Building Permit for the Sole Proprietor or Property Owner who WILL NOT act as General Contractor or Principal Employer APPLICANT FOR BUILDING PERMIT Name of Applicant for Building Permit CAP'y J Property located at / 1 F GJ f� / / 3✓J in the City/Town of li'A1C L'ij V' I I ATTEST If you are the owner of the above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named property and you WILL NOT act as the general contractor or principal employer,you are not required to have workers'compensation insurance coverage. CHECK ONE(1) BOX ONLY and complete the following: UI am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer. Signature of OWNER Applicant - i" rte{/// lJ I am the SOLE PROPRIETOR of a business doing work at the above-named property.I WILL NOT act as the general contractor or principal employer. Name of Business ,A C( A-, C Federal Employer ID#{FEIf1f-F�Z # 2 7-/7 0 Signature of SOLE PROPRIETOR Applicant �- ` Birk Manufacturing, Inc. 860.739.4170 P " BIRK 14 Capitol Drive 860.739.4677 F Engineering Thermal Solutions East Lyme,CT 06333 www.birkmfg.com ISO 9001:2008 and ISO 13485:2003 Certified ,`;-, $ _.... 3 1 _M I I \— G_\ r U c 0moo, ` c .1 _ I-, .-.‘4) -;..:?.._*_4_,_ --e-;:_\ s , 1 f T- 10 1 1 N I I 1 { I f 9 O O.\\\ i 1 / C.:-.0 t .CO S � y. Nw i , �PS Na Q, 4- 4q-5ytl C� g' .?,,.F. r. V OG or �Oi 0m 23 r tr' 0OI -I --] o 2 II W dp f o J lv XI m pJ11;., mi... co W _1 x �r. ui\ r „r. '-- CoC •Q .may aM Cc 0 S r mO x. ` ` �; o r o -. 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'Zir • I CI) Al trt V I R w � �4 �� Va 03 f Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Property Address per/ Job Description Required Approval Department Permit Issuance Approval --1 Tax Collector 7/// C, Signature/date Comments: Fire Marshal Signature/date Comments: 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: av1 WPCA, Administrative (JJh. , U2øt1 ( (( 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: ❑ 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 1ev4sed March 23,2015 • 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: B2016-0259 Date: 05-Jul-16 Map/Lot: 068/017-000 Owner ID: 5684000 Project Location: 19 POWERHOUSE ROAD Unit: Job Description: Above Ground Oval Pool Owner Nam Henry Jr and Lisa R Olander Tenant Name N/A Careof: 19 Powerhouse Road Uncasville C:T 06382- Telephone: (860)908-8295 Applicant Name Property Owner Telephone: DBA: Lic/Reg Type Lic/Reg N 0 Exp Date: Construction Value Permit Fees Construction Information Building Value: $7,020.00 Building Fee: $96.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $711.00 Electrical Fee: $30.00 Construction Type IRC Total Value: $7,731.00 Penalty Fee: $0.00 Permit Code: R8 C of 0 Fee: $10.00 Comment Plan Review Fe $9.60 State Ed Fee: $2.01 Total Fee Paid: $147.61 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 0 R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete 0 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 Draffstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑ Certificate of Approval �f 0 Certificate of Occupancy Building Official's Approval: � r1 / `Z Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL POOL PERMIT APPLICATION FORM Permit No.: 6.1 `31 Type of Work Permit Type Above Ground Pool ❑ Pool Heater ❑ Building ❑In-ground Pool 0 Deck ❑Plumbing ❑Hot Tub/Spa ❑Accessory Structure ❑Mechanical I I��, yL 0 Electrical 1 tff / Property Address: tq PQUJQ{ E��e t2�� v �Ui ( 1 Ci (Number) (Street) (Unit) Job Description: �]rp v� G rnt kt1c OVCJ PcrTI Owner: ti.lerWl C �c O(aiev Address: iq 1bU3 4-bxQ City: U 1\( V1 I (P, State: CT Zip Code:aCA D Z Telephone( AC 0 ) c7 - O G`1c Applicant: ► ,It11/ (.f c(i. f /I, Cl i iev DBA: 1 1 I " Address: t "1(��cb(,'Y 1-Ioty P.d `� City: ACC J1A\ (P State: (I Zip Code: cQU b 2_ Telephone(%O) q Cg. _ 529 6 Contractors -Complete the Following: License Type: License No.: Expiration Date: I hereby certify that the proposed work will conform to t - 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 ,ork is authorized by the owner in fee and that I am authorized to make application for a permit for such work as describe. above. — , Owner '� / /Agent Slgnatt Date: l�/ 1 i Construction Value Permit Fees Building Value: Building Fee: �tL,.,.C�C Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: –►( , (>C.) Electrical Fee: 3C),(x-) Total Value: --711 .00) Penalty Fee: C of O Fee: j O,O(J Plan Review Fee: Q.Le C� State Ed Fee: a C'I Total Fee: 14-4--i. t RcviseEAugust 23,2007 Town of Montville Building Department File Receipt Date: 01-Jul-16 ReceiptNo: 11469 Received From: Accurate Electric Job Address: 19 Power House Rd. Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: Bldg Check: $0.00 $147.61 State Check: $2.01 Bldg Credit: $0.00 State Credit: Fire Cash: $0.00 $0.00 Fire Check: $0.00 Construction Value: $7.731.00 Fire Credit: t0.00 Demolition Value: $0.00 CheckNo: 108 Received By: David Jensen /E) • Address: 19 Power House Rd. 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 $ - 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/1 fireplace EA $ 7,096.65 $ - Masonry w/2 fireplaces EA $ 11,095.70 $ - Wood Stove,free standing EA $ 2,69225 $ - 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 1 EA $ 7,019.75 $ 7,019.75 $ 710.05 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 EA $ 550.00 $ - Skylights EA $ 1,051.10 $ - Doors,Exterior EA $ 601.50 $ - Oil Tank,275 Gallon EA $ Oil Tank,550 Gallon EA $ MISCELLANEOUS CALCULATIONS TOTALS $ 7,019.75 $ - $ - $ 710.05 PERMIT FEE CALCULATIONS Construction Value Fee Building $ 7,020.00 $ 96.00 Plumbing y $ - $ Mechanical y $ - $ Electrical y $ 711.00 $ 30.00 Working before Permit Issuance $ Certificate of Occupancy Fee $ 10.00 Plan Review Fee $ 9.60 State Education Fee $ 2.01 TOTALS $ 7,731.00 $ 147.61 Figures are based on the 2006 RS Means Residential Cost Data v�'v State of ConnecticutE 7A h ' Workers' Compensation Commission _' .. " ",,,,lit. Please TYPE or PRINT IN INK Proof of Workers' Compensation Coverage when Applying for a Building Permit for the Sole Proprietor or Property Owner who WILL NOT act as General Contractor or Principal Employer APPLICANT FOR BUILDING PERMIT Name of Applicant for Building Permit Property located at ICI n r 4]v(A __ td in the City/Town of 1.11\CC &)t lk / M n-k (E ATTEST If you are the owner of the above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named property and you WILL NOT act as the general contractor or principal employer,you are not required to have workers'compensation insurance coverage. CHECK ONE(1) BOX ONLY and complete the following: 611 I am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer. Signature of OWNER Applicant a__. w A, ❑ I am the SOLE PROPRIETOR of a business doing work at the above-named property.I WILL NOT act as the general contractor or principal employer. Name of Business Federal Employer ID#(FEIN) Signature of SOLE PROPRIETOR Applicant GPRO AC ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/26/2016 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. I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 CONTACT Noel Janovic NAME: LEVINE INSURANCE GROUP LLC PHONE (860)739-4444 (A/C.No.Extl: (AAC No): (860)739-6861 221 Boston Post Road ADDRESS:noel@ligct.com P.O. Box 339 INSURER(S)AFFORDING COVERAGE NAIC# East Lyme CT 06333 INsuRERA:Firemens Ins Co of Washington DC 21784 INSURED INSURER B: C B Construction, Inc, DBA: Treat's Pools INSURER C: P.o. Box 205 INSURER D: INSURER E: Norwich CT 06360 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1622601114 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMM/DD/YYYYI (MM/DD/YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED 250 000 PREMISES(Ea occurrence)_ $ CPA5240402 3/1/2016 3/1/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS CAA5240403 3/1/2016 3/1/2017 BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH - AND EMPLOYERS'LIABILITY X STATUTE ER Y!N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 500,000 A (Mandatory in NH) WCA5240404 3/1/2016 3/1/2017 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE **CUSTOMER'S COPY** THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Andrew Levine/JANOVI • ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS(12A ramani, 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. iq I)�w 1 u fid, LLu\UVi1 l l e C 3S L Property Address _l_4\cAat t(k-(- \ of 4.1ihoic 6.6DOnd PCO Job Description ® - Required for all permits ® - At least one required for all permits ❑ -Required as indicated below Required Department Permit Issuance Approval Approval Tax Collector —+-- -I Co%-o/ , fa Signature//date Comments: Planning & Zoning � �/G Signature/ ate Comments: 7-.>107-131"-'- 'l.�G) Fire Marshal 7P-41,() Signature/date Comments: ® Health Department Required for properties with septic systems—Not required for Plumbing,Electrical,Mechanical,Roofing,Siding,Windows&Doors Signature/date Comments: // ,, 1111 WPCA, Administrative C�/y�, It/„&I— ([ (2c)// (�- 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 ,�vitufgkovcmficr5,200$ tisAFETY BUOY" POOL ALARM MODEL PGRM-SB ooIgua r PBM INDUSTRIES, INC. MADE IN THE USA ASTM 0 cE c....____. V ASTM F 2208 APSP The AssSpa Professon if onals Floats In Pool Pool&Spa Professionals I Battery Powered Low Battery Indicator Completely Portable Subsurface Detection :. Meets Barrier Laws Ye 4111 4 UO yQ- Eas To Use IIt ' '3i Automatic Reset In House Affordable Price Remote Receiver Patent Pending 0 i4 ` . See back for more details & information about the Poolguard "Safety Buoy" Pool Alarm, Call us at 1-800-242-7163, or visit our website. www. poolguard . com REV. 9/2011 ‘,..AV,..?'4":1;,N rr{-. mitt ) sit'k 4 1 , "lei17- 1 - 4 ',41 ' :.. ....i iii: 's li • , v.•y 1l 1• ea ll 0. ,kl 1t).f, J ( /V '. 11i;Sf' ,yr1 1 „7,rt} Yom' y)� 6 1 v.. 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FPro yos.plr:,r,iVd warranty Now Features Self-Closing, Self Latching Gate Latch is 72" From Ground „,•-• . . ,. 40.1 ,..,,,,,, •. . ,..i -,•...., a' , , .,,,/ .i i ,,, ,i, , 1..,\ ',T•I's ''r'..." 1 if,' El .......... . i ,/l1:::1'....''i''-'! ;,1 - -" . /li ir . , 1, . t 'I, ii. . ,,,-•••'. i ........li_ :....i...L_ii...I . l i1 , 1 , , , U.S. Postal Service"' CERTIFIED MAIL® RECEIPT j L Domestic Mail Only R 1 For delivery information,visit our website at www.usps.core. pl ,o N Certified Mail Fee cli Extra Services&Fees(check box,add fee as appropriate) ra Return Receipt(hardcopy) $ O ❑Return Receipt(electronic) $ Postmark Here 8'' 0 ❑Certified Mail Restricted Delivery $ O El Adult Signature Required $ El Adult Signature Restricted Delivery$ O Postage N $ rq Total Postage and Fees 1 -� Sen ,0eA iv D /2. treet nd Ap. o.,or PO Box No. 4 /ZR/fs c;ry,State,zt0 A e- OG 3 3 2 G/ ICCIc PS Form 3800,April 2015 PSN 7530.02-000.9041 See Reverse for Instructions SENDER: COMPLETE THIS SECTION COMPLETE THS Sr CTION ON DELIVERY • Complete items 1,2,and 3. ir • Print your name and address on the reverse IF - `� ❑Agent so that we can return the card to you. i / IBI Addressee IN Attach this card to the back of the mailpiece, B. R- rived by -' -d Name) C D. e of Delivery or on the front if space permits. f /1 1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes If YES,enter delivery address below: 0 No /%'Ry V-..lism /. ac/941o'crc. /9 PvccieRbauJa" A, UAO,iJa/«<7 , ni 06 3c9 2 3. 11111 I111111 I I 1111 II ' 1111 0 Adul0 Service Signature tune Restricted Delivery 0 Registered Mail Express® Mail Restricted 9590 '-•Certified Mail® Delivery 9402 2772 6351 1057 62 ❑ ertified Mail Restricted Delivery 0 Return Receipt for ❑Collect on Delivery Merchandise 2. Article Number(Transfer from service label) 0 Collect on Delivery Restricted Delivery 0 Signature ConfirmationTM i Mail 0 Signature Confirmation 7 016 1370 0001 0 87 0 4 353 i Mail Restricted Delivery Restricted Delivery SOO) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt