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HomeMy WebLinkAboutElectric Service 2002 Town of Montville Building Department Date // / / / 0 Z_ Field Inspection Notice Permit # Job Location /7 0 12-14YM0 N D yi/LL T2-0 Approved Type of Inspection Not Approved - Please call for re-inspection when the following corrections have been completed: V Building Official Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030,Ext.82 Electrical Permit Permit Number: E2002-338 Permit Date: 24-Oct-02 Permit Code R5 Job Location: 170 RAYMOND HILL ROAD UNIT: MAP/LOT: 085/005-000 Job Description: Electric Service Owner Contractor IRENE H DESAULNIER High Standard Electric 10 Crown Street 170 RAYMOND HILL ROAD Unit: Norwich,Ct.06360 UNCASVILLE CT 06382 Telephone: 889-4166 Lic/Reg Type: El Use Group R4 Lic/Reg Number: 103487 Code 1995 CABO Exp Date: 9/30/03 Construction Type 5B Construction Values Permit Fees Building Value: $0.00 Building Fee: $0.00 Plumbing Value: $0.00 Plumbing Fee: $0.00 Mechanical Value: $0.00 Mechanical Fee: $0.00 Electrical Value: $2,000.00 Electrical Fee: $10.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $2,000.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.32 Total Fees: $10.32 It is the owners responsibility to schedule the following required inspections(minimum 48 hours notice requested); ❑ Footing-Prior to pouring concrete ❑ Rough HVAC ❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab-Prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney-One flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping © Electrical Service ❑ Insulation ❑ Rough Plumbing and Leak Test ❑ Fin. Inspection ❑ Gas Piping and Pressure Test i/ Certificat- . •ccu, i.r to use or occupancy Building Official's Signature: // i Town of Montville Building Department Permit#1 Z,6•z— 310 Norwich-New London Tpke. Tel. 848-3030,Ext 82 Uncasville, CT 06382 Fax. 848-7231 Application for Commercial Trades Permit (Plum6ing ECectrica( j 31echanicaf c b gfeating 23 la Air Conditioning Ga pother Job Location /7 O eiz`1 L 12 b - Job Description/Materials I (-L., (?o )4 Y1"r> JCt2�, /- c C Owner_,E6 ivC' C—S A 1,1_4.• 1 j i IZ Mailing Address /Z,-vi»-N w r> 14 ) C L J2/) City Li wC1, to// State Zip CL-3 g 2.Te1 0 / / 3 22-3 Contractor)J" 4E"G E e3'd Zi kailing Address ) b GJ2U w�v ��• City JV b2w L 1,4 State elZip (yS b /Sd`) / 1/16G, Contractor's License/Registration Type&Number Ge) - I b 3 9 ) Exp. Date v' 9 / 3 o / O 3 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 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. Owner/Agent Signature --- � c Date I V /�2 / '2— Construction Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ 2, oot›, $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ 0 32_ Total $ $ /o .7Z Town of Montville Building Department Receipt Date /o / z.:2 / o No. IJ129; ID From: ------------ Job Address: Jam© ,ZA✓MO,4►> /-4/L( PO f it 11) Amount $ /O ._..;Z- Cash Check Check # r Circle one) Received by , -----)v+eNM.-e.,0 Permit #�7�ea-- SI \ II . 01 ( 1 )\\I I II( 1 1 ELECTRICAL UNLIMITED CONTRACTOR GARY L RYAN 15 BOG MEADOW RD NORWICH,cr 06360 TYPE: El LIC.✓REG.NO. EFFECTIVE EXPIRES 103487 I . 10/01/2002 I 09/30/2003 SIGNED a-- .......:::::.: ::::.>i: ::; f':: ;: ::S,:;::;::::::: :i::% y;:.:;::: •: ::. ::<:. ,::;:;:;.::::::;::: :: :':::::::::::..� MM/DD/YY : :. :.::: "':: '' ;: :. ::::.;. .: ....;,:, ... ::.. .: .. ' ii:: ::: .:.;:.... .,.' •' DATE( ) :AN '' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BYRNES AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 108 SACHEM STREET COMPANIES AFFORDING COVERAGE NORWICH CT 06360 COMPANY A NATIONAL GRANGE MUTUAL INS CO INSURED COMPANY HIGH STANDARD ELECTRIC INC B COMPANY 10 CROWN STREET C NORWICH CT 06360 COMPANY .:....:....... I D 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) A GENERAL LIABILITY MP 18 5 8 5 3 1/29/02 1/29/03 GENERAL AGGREGATE $2 , 000, 000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG 52 , 000, 000 • CLAIMS MADE X OCCUR PERSONAL&ADV INJURY 5 1, 000, 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE • $1, 000, 000 FIRE DAMAGE(Any one fire) $ 200, 000 MED EXP(Any one person) $ 10, 000 A AUTOMOBILE UABIUTY B1I85853 1/29/02 1/29/03 1, 000, 000 COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY 5 NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: J EACH ACCIDENT $ _ AGGREGATE $ EXCESS UABIUTY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC I 8 5 8 5 3 1/29/02 1/29/03 X TORY L MITS ER • EMPLOYERS'UABIUTY EL EACH ACCIDENT $ 100, 000 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 500, 000 PARTNERS/EXECUTIVE — OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100, 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS FAX 887-7262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF MONTVILLE-BLDG DEPT. EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ATTN: VERNON VESEY II 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 310 NORWICH NEW LONDON TPKE BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABIUTY UNCASVILLE, CT 06382 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA I.................................................................................................................................Sheri....King............... SK D • +a+a