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Strip and Re-Roof 2013
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: B2013-0169 Date: 13-May-13 Map/Lot: 111/020-000 Owner ID: 5725000 Project Location: 165 PRUE1T PLACE Unit: Job Description: Strip&ReRoof Owner Nam Paul A and Joan P Russell Tenant Name N/A Careof: 165 Pruett Place Oakdale CT 06370- Telephone: (860)437-3621 Applicant Name: Pete Silveira — Telephone: (860 76-0303 DBA: Silveira Roofing Lic/Reg Type RIC Lic/Reg No 565769 11 Shawan Dassee Road Exp Date: 30-Nov-13 Waterford CT 06385- Construction Value Permit Fees Construction Information Building Value: $12,600.00 Building Fee: $156.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $0.00 Mechanical Fee $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $12,600.00 Penalty Fee: $0.00 Permit Code: R4 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $3.28 Total Fee Paid: $159.28 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 El R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed Cl Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor framin ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC El Masonry Fireplace Throat or Chimney Thimble ❑Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Certifi .te of Approval ■ -rtificate of Occupancy 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.: V)E)1:1,3 Type of Work Occupancy Type Permit Type ❑ New Construction ❑ Single Family ❑Building ❑Addition ❑ Two-Family ❑ Plumbing ❑Alteration ❑Townhouse ❑ Mechanical ❑Accessory Structure ❑ Electrical CRS#: Property Address: ,/ .> j it 7 t Cik (Number) (Street) (Unit) Job Description: STS,p I- R•c-- Prvi(' Owner: mss,, R S S. L_ Address: SGS Oa*, Zr f'L/J Cc_ City: a4-k'OX/l. State: 4 j' Zip Code: Gra)/a Telephone(FC0 ) %') -3‘e/ Applicant: / S;CA.,;n,4- DBA: ✓.,^A 2— F S .ny Address: // 4 R r City: (f, Aier State: r Zip Code: e ‘3 S Telephone( )?),j - OSC) Contractors - Complete the Following: License Type: h/iC DS-Cc-2‘�/ License No.:///c-c5,5&31J69Expiration Date: //5c,A)/3 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. ❑ 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. Owner/Agent Signature: Date: 7C/://- Construction / /-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: Revised August 23,2007 Town of Montville Building Department File Receipt Date: 09-May-13 8372 ReceiptNo: Received From: Pete Silveira,LLC Job Address: 165 Pruett Place Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: $0.00 Bldg Check: $159.28 State Check: $3.28 Bldg Credit: $0.00 State Credit: $0.00 Fire Cash: $0.00 Fire Check: $0.00 Fire Credit: $0.00 Construction Value: $12,600.00 Demolition Value: $0.00 CheckNo: 4271 Received By: Carmen Kneeland CCAA yyLuel ryt _. acP Address: 165 Pruett Place 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 S - $ _ 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/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 2800 SF $ 4.50 $ 12,600.00 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 $ 12,600.00 $ - $ - $ - PERMIT FEE CALCULATIONS Construction Value Fee Building $ 12,600.00 $ 156.00 Plumbing y $ - $ Mechanical y $ - $ Electrical y $ - $ Working before Permit Issuance n $ Certificate of Occupancy Fee $ _ Plan Review Fee $ State Education Fee $ 3.28 TOTALS $ 12,600.00 $ 159.28 Figures are based on the 2006 RS Means Residential Cost Data STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION HOME PMPROVEMENT CONTRACTOR PETE SILVEIRA ROOFING LLC Zi SHAWANDASSEE RD WATERFORD,CT 06385 LIC./REG NO FFECTIVE � EXPIRES HIC.0565769 y01/2012 -�.. 11/30/2013 SIGNED : s From:Sandra Silveira Fax:(888)282-6070 To:8608487231@rcfax.con Fax: +18608487231 Page 2 of 2 5/9/2013 10:22 Client#:27079 PETESILVEIR ACORD-.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 5/09/2013 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 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 NAME: Smith Insurance,Inc. PHONE 860 739-3322 FAX 860-739-9494 15 Liberty Way EM ADDRESS:Ext): (A1C,No): ADDRESS: Niantic,CT 06357 860 739-3322 INSURER(S)AFFORDING COVERAGE NAIC i INSURER A:Hermitage Insurance Company INSURED INSURER B:Travelers Casualty&Surety Co Pete Silveira LLC INSURER C:Travelers Casualty PO Box 615 INSURER D: Niantic,CT 06357 INSURER E: 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 CONTRACTOR 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 INSR VWD POLICY NUMBER _ LIMITS (MMlDOlYYYY) (MM1DDlYYYY) A GENERAL LIABILITY HGL56733412 05/20/2012 05/20/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY �kI�iSTQ�a occurrence) $100,000 CLAMS-MADE X OCCUR MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 — POLICY PRO- ECT LOC $ C AUTOMOBILE LIABILITY BA9544P67Al2SEL 04/21/2012 04/21/2013 FEa aaiderDitsINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL S AUTONED X AUTODULED BODILY INJURY(Per acadent) $ X HIRED AUTOS X AAUTOS NON-OWNED PROPERTY DAMAGE $ — (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION$ _ $ B WORKERS COMPENSATION INUB0751 R82112 06/23/2012 06/23/2013 X Vc STATU- OTH- AND EMPLOYERS'LIABILITY ANY 1 N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Et EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? I y I NIA (Mandatory in NH) f yes,describe under E.L.DISEASE-EA EMPLOYEE $100,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Town of Montville SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE IMLL BE DELIVERED IN Building Department ACCORDANCE IMTH THE POLICY PROVISIONS. 310 Norwich-NewLondon Tpke. Uncasville,CT 06382 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S57861/M47697 DMR Town of Montville Building Department 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. Ike S iorc{r t( Place Property \ ��////''���Address t o t P` y Job De cription Required Department Approval Permit Issuance Approval Tax Collector .� ,�_� /it• - " 9/, Signature/date Comments: Planning & Zoning <t Signature/date ra(L4j29321-1-\ Comments: MN Fire Marshal 1 I Signature/date Comments: \k I LI./ ❑ Health Department Required for properties with private septic or well Comments: ❑ WPCA, Administrative Required for properties on sewer Signature/date Comments: ❑ WPCA, Operations When Required by WPCA Signature/date Comments: n 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: ❑ 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 Revised May 23,2011