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Home My WebLink AboutRoof Overlay 2000 Town of Montville Building'Department Phone: 848-7166 310 Norwich New London Tpke Fax:848-7231 Building /Trades Permit Permit Number BP2000-125 Permit Date 4/14/00 Permit Type Building Permit Code R4 Job Street# 240 Job Location Raymond Hill Road Map/Block-Lot 087/001-000 Job Description shingle over existing -second layer Owner Mr. & Mrs. F. R. Brown Mailing Address 240 Raymond Hill Road City Uncasville State Ct. Zip 06382 Telephone 860-848-8864 Contractor J& R Construction Inc. *Mailing Address 238 Old Colchester Road *City Quaker Hill *State Ct. *Zip 06375 *Telephone 848-8773 Lic/Reg Number 553056 Lic/Reg Type Home Improvement Expiration Date 11/30/00 Use Group R4 Size Type Construction 5B Building Value $1,500.00 Building Fee $10.00 Plumbing Value $0.00 Plumbing Fee $0.00 Heating Value $0.00 Heating Fee $0.00 Electrical Value $0.00 Electrical Fee $0.00 A/C Value $0.00 A/C Fee $0.00 Other Value $0.00 Other Fee $0.00 Total Values $1,500.00 State Ed Fee $0.24 C/O Fee $10.00 paid check#806 Plan Review Fee $0.00 To • I Fees $20.24 Building Official's Signature �` � c Date W9/00 Required Inspection • Footings-Prior to pouring concrete ❑ Rough Heating and Air Conditioning • Footing Drains/Waterproofing-Prior to backfill ❑ Chimney-One flue above thimble El Framing Fireplace-Throat ❑ Rough Electrical ❑ Fireplace-Final ❑ Electrical Service ❑ Firestopping/Draftstopping Rough Plumbing-Leak test required [] Insulation Ell Pool Bonding and Electric ❑d Final Inspection for Certificate of Occupancy-PRIOR to Use or Occupancy co Town of Montville Building Department /bi 310 Norwich-New London Tpke. D Uncasville, Ct. 06382 Tel. 848-7166 Fax 848-7231 __6) Application for Building or Trades Permit Owner 0 d. mss f R. 13 na L/N Mailing Address 02 yd (647)/7,70A/ ///LL RP. City Zilic l //s'7 2 State C T Zip 0637-2 Tel.$`('D -'Z' - g'7-6 S(' Job Location .2 Vo gl/J17O41D ALL 1217- Map/Block-Lot p 7/z5O< - d Contractor\Tclk CO f7 c1CT, i r Mailing Address , 37 oLi DoL Dh t2n-e' /2d City c/H/reit )1/Z C State c7-- Zip D 62.2r Tel.TYo - 7'Y 0'2?_y Type of Permit ❑New Single Family ❑New Two Family ❑ Addition ❑ Commercial ❑ Industrial ❑ Alteration ❑ Garage ❑ Carport ❑ Shed P1 Roofing ❑ Air Conditioning ❑ Plumbing ❑ Heating ❑Electrical ❑ Gas ❑ Retaining Wall ❑ Deck ❑ Pool ❑Patio ❑ Porch ❑ Demolition ❑ Siding ❑ Windows ❑ Fireplace ❑ Chimney TobDescription/Materials o D c/eoZ `X i_.(7//19. 127,y/i> 1-A74/se dc'D o F /L','y e, C1---17.4 3 T/3.6 2 sz , -T,i5/ -/iss ,hoc/= .S I,,h9 L' Size Type of Heat Use [hereby certify that the proposed work will conform to the Basic Building Code and all other codes as adopted )y the State of Connecticut and the Town of Montville and further attest that the proposed work is authorized )y the owner in fee and that I am authorized to make application for a permit for such work as described above. Vew Home Construction Contractors: Have you entered into a contract with the consumer for the proposed Nork? 0 Yes ❑ No - / cf_.0 Dwner/Agent Signature ,f... / ,,,. Date -/ / /y I�?e0� sC.3 0 s^6 Lsontractors License/Re:. tration Type&Number/7/01-ie inrkpv')4, f7 T Exp.Date 1/ /36 l,200 0 Construction Value Fee ) Building $ / .00 •o-tf- $ j& Plumbing $ $ Heating $ $ Electrical $ $ Air Conditioning $ $ Other $ $ Certificate of Occupancy $ / Plan Review Fee $ State Education Fee $ 4( Total $ /5-061 $ eDf,2 %. (d--4 • • I, Td-g . Co“3-a2_ueTi o bt , the contractor working on the property located at o?VD giCY 7&V0 /7/izG claim exemption from Public Act 96-216 as a sole proprieter and I do not intend to act as a general contractor or prinicpal employeer. I also understand that there are new significant penalties under the Workers Compensation laws for misrepresenting ones employer status. Signed /4R, o Date (/—/ y(77 " PR... CER 1Pf AT OF LIABDiT }+� ;•;Y; ,� , DATE(MMlDD PRODUCER THIS CERTIFICATESUED AS A MATTER OF INFORMATION BYRNES AGENCY INC ONLY AND CONF NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. 108 SACHEM STREET COMPANIES AFFORDING COVERAGE NORWICH CT 06360 COMPANY A NATIONAL GRANGE MUTUAL INS CO INSURED COMPANY J & R CONSTRUCTION INC. & _ B JOSEPH PIERSA & RONALD PIERSA COMPANY 238 OLD COLCHESTER RD l_____C QUAKER HILL CT 06375 COMPANY D I R 'i COVEOES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TME INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OP 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE f POLICY EXPIRATION LIMITS DATE(MM/OD/YY) DATE(MM/DD/YY) A GENERAL LIABILITY MPP 8 218 2 9/26/99 9/26/00 GENERAL AGGREGATE _ 1 , 0 0 Q , 0 0 Q LX COMMERCIAL GENERAL LIABILITY PRODUCTS•COMP/OP AG S 1, 0 0 0 , 0 0 0 jCLAIMS MADE i.. OCCUR PERSONALE ADV INJURY $ 500, 000 �__OWNER'S&CONTRACTOR'S PROT i j EACH OCCURRENCE $ 500, 000 `` FIRE DAMAGE(Any ma Ore) $ 300, 000 F.__ MED EXP(Any one porton) $ 5, 000 ?i 1AUTOMOBILEUABILITY B7 P82182 96/99 9/26/00 500, 000 ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Por person) $ HIRED AUTOS I y H- NON-OWNED AUTOS BODILY INJURY _ $ (Per acddont) -- ` PROPERTY DAMAGE $ GARAGE LIABILITY I} AUTO ONLY•EA ACCIDENT I$ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY — — AGGREGATE $ EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND ^ A"�• •'.. EMPLOYERS'LIABILITY TORY LIMITS i ER EL EACH ACCIDENT $ THE PROPRIETOR/ INCL I V i EL DISEASE-POLICY LIMIT ,$ J PARTNERS/EXECUTIVE OFFICERS ARE; EXCL EL DISEASE-EA EMPLOYEE $ OTHER I ` 1 ----L-----__I I 1 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMSt FAX 848-8773 mA +yak :4MrRn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF MONTVILLE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL .O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT• BUY FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY MONTVILLE, CT of ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTA ::.:,,1 ;;,,, ;,,;,,;;;,,;" ,,:.,,;;. ,::,,•;.,:,,:, :•:,,,,•,:.: ....,.:,.,.;,,..,:,..,.,,.:.. .,, Sheri Kin • I K D X00**". tot .: