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GFCI for Water Pump 2017
TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 ELECTRICAL PERMIT Permit Number: E2017-0236 Date: 28-Sep-17 Map/Lot: 016/026-000 Owner ID: 2388000 Project Location: 454 GAY HILL ROAD Unit: Job Description: Install a GFCI for a Gray Water!Pump Owner Nam Rose N Malinowsky Tenant Name N/A Careof: 454 Gay Hill Rd Uncasville CT 06382- Telephone: Applicant Name Joseph Bonner Telephone: (860)848-8539 DBA: Bonner Electric Inc. Lic/Reg Type El Lic/Reg N 181768 1865 Norwich-New London Tpke. Exp Date: 30-Sep-17 Uncasville CT 06382- 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: 2016 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $400.00 Electrical Fee: $30.00 Construction Type IRC Total Value: $400.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $0.10 Total Fee Paid: $30.10 It shall be the owners repsonsibility to schedule the followina 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 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 frami ❑ 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 ❑d Certificate of Ape oval Certif o occupancy Building Official's Approval: /..�., N�A Building Department 310 Norwich-New London Tpke. Tel.860-848-3030, Ext 382 Uncasville, CT 06382 Fax.860-848-7231 PERMIT APPLICATION FORM Permit No. c3C1 —Oa3(o Type of Work Occupancy Classification Construction Type Permit Type 0 New Construction ❑A-1 0 B ❑H-1 ❑I-1 0 R-I 0 S-1 7 Type IA ❑Type IIIB 0 Building ❑ ddition 0 A-2 0 B,Medical 0 H-2 ❑1-2 0 R-2 0 S-2 0 Type IB 0 Type IV 0 Plumbing Alteration 0 A-3 0 E 0 H-3 ❑1-3 0 R-3 ❑U 0 Type HA 0 Type VAElechanicai Change of Use 0 A-4 0 F-1 []H-4 0 1-4 0 R-4 0 Mixed 0 Type 11B 0 Type VB ectrical 0 A-5 0 F-2 0 M 0 Type IIIA CRS#: Property Address: 454 Gay Hill Rd.Uncasville CT,06382 (Number) (Street) (Unit) Job Description: Install a GFCI for a gray water pump Owner: Rose Malinowsky Tenant: Address: 454 Gay Hill Rd. -Address: City/State/Zip: Uncasville,CT 06382 J City/State/Zip: Telephone( 860 ) 848 8134 Telephone( ) - Applicant: Bonner Electric,INC. /w DBA Avtin e.. Liv`�� C �" Address: 1865 Norwich-New London Tpke. City- Uncasville State: CT Zip Code: 06382 Telephone(860 •) 848 8539 Contractors-Complete the Following: License/Registration Type: E1 License/Registration No.: 0181768 Expiration Date: 09/30/2017 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 7 am authorized to make application for a permit for such work as described above. Owner/Agent Signature: "- Date: 9/25/2017 Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: $400.00 Electrical Fee: 30.f20 Total Value: $400.00 Penalty Fee: C of 0 Fee: Plan Review Fee: _ State Ed Fee: .I U Total Fee: 3v_IC) Itarisec AnBvst23.2007 Town of Montville Building Department File Receipt Date: 27-Seo-17 ReceiptNo: 12691 Received From: Bonner Electric Job Address: 454 Gay Hill Road Town Fees Collected State of Connecticut Fees Collected Bldg Cash: 10.00 State Cash: 10.00 Bldg Check: 130.10 State Check: 10.10 Bldg Credit: 10.00 State Credit: 10.00 Fire Cash: 10.00 Fire Check: 10.00 Fire Credit: $0.00 Construction Value: 1400 00 Demolition Value: 10.00 CheckNo: 47373 Received By: Carmen Kneeland C(3A p e A1 (V\ lC-an n0 Court 454 Gay Hill Road 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/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 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 $ 400.00 Solar Install n TOTALS $ - $ - $ - $ 400.00 PERMIT FEE CALCULATIONS Construction Value Fee Building $ - $ - Plumbing y $ - $ - Mechanical y $ - $ - Electrical y $ 400.00 $ 30.00 Plan Review Fee y $ - Certificate of Occupancy Fee $ - Plan Review Fee $ - - State Education Fee $ 0.10 TOTALS $ 400.00 $ 30.10 Figures are based on the 2006 RS Means Residential Cost Data ONN � B- • RI September 25, 2017 This letter serves to authorize my employee, Brendan Marquis, to act as my agent to sign an electrical permit for the following address: 454 Gay Hill Rd. Uncasville 164 RT 82. Oakdale The work is scheduled to begin September 2017. Attached is a copy of my Connecticut license, along with our Certificate of Insurance. Thank you, +moi Jos ph B. Bonner, President Connecticut License No. 181768 E-1 1865 NORWICH-NEW LONDON URNPIKE • P.O. BOX 366 UNCASVILL.E. CT 06382 (860) 846-r`)39 • ( 60) 848-4270 FAX CT LIC. 102276 RI LIC. A000228 wwa:r onnerelectric.com s 7 ,., ,,,, ,-`-tas ,L Via# ,; Fat t q a1lfp, t ..; .-4.0*:;:,- S. �- S' �� 1 .` €;+6<_it,* at'�jr&s� £< ,P� `f ,',100 'f 1° ' r>4 ''' a ,,ft,:t,, — t s" f c„,,, Q i Y , a a z n x i ' ' k',.°4-.' '"r1. w t""4,, . 1. gkr z. , •,...41 °4 4e1 °, # 0 ° -•. �: w gq� ,: rpo Li ° w I en vD V tom ; a W C i.i ell w. E.-+ 0 o P 8 r—o i ,,„.v,..„ a) 0 6 ,, ci, ,--, , „..... 1.„,,,. i F O M ›, V Q Y s •—� { +.0C C•1 crN 7:14 Q =- >7 o ''� ^Q M_ z, w ' `E 1 p > CI i-t +sem ;,X4 '*"1 ,' , Q W r4 t • 4s*. ,, � >' .411. h. [G " , ,y,to' s: , i 7 x a ,--`43",4 h I fk i a .°'.... ti eLB Client#:610353 BONNEELEI ACORD,,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 12/13/2016 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. 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 USI Insurance Services LLC PHM PHONE -------- ------- (A/C,No,Ext):855 874-0123 FAX FAX 4 530 Preston Avenue E-MAIL (A/C,No): 203 634-5701 Meriden,CT 06450 ADDRESS: 855 874-0123 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Continental Western Insurance C 10804 INSURED INSURER B:Travelers Property Cas.Co.of 25674 Bonner Electric,Inc. INSURER C:Evanston Insurance Company35378 1865 Norwich-New London Tpke. P.O.Box 366 INSURER D: Uncasville,CT 06382 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 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'SUB LTR TYPE OF INSURANCE )INSR IWVDR POLICY NUMBER POLICY EFF POLICY EXP (MWDD/YYYY)i(MWDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY i I CPA027910318 12/31/2016'';12/31/2017EACH ��OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR i PppREMISES(EaEoNccTu ante) $250,000 X X,C,U Inlcuded . — MED EXP(Any one person) $5,000 ---- PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 • $ OTHER: • A AUTOMOBILE LIABILITY ! CAA027910518 12/31/2016112/31/2017(EaaBcdeOswGLELIMIT $1,000,000 X ANY AUTO • ;BODILY INJURY(Per person) $ ALL OWNED —7 SCHEDULED I AUTOS AUTOS • j BODILY INJURY(Per accident) $ X HIRED AUTOS X AUNOSNMED I I PROPERTY DAMAGE $ (Per acadent) • B j X UMBRELLA LIAB X OCCUR ZUP91M2089316NF 12/31/2016:12/31/2017 EACH OCCURRENCE $10,000,000 EXCESS LIABCLAIMS MADE; • • AGGREGATE _ $10,000,000 DED XI RETENTION$1 0,000 $ A WORKERS COMPENSATION : • _--- --- AND EMPLOYERS LIABILITY Y/N WCA027910718 12/31/2016112/31/201T X I STATUT€ °R " ANY PROPRIETOR/PARTNER/EXECUTIVE -. : OFFICER/MEMBER EXCLUDED? N l IN/Ai I(Mandatory in NH) -- I E.L.EACH ACCIDENT $1,000,000 If yes,describe under E.L._ DISEASE-EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $1,000,000 C 'Contr Polution 1 1 16CPLONE60290 12/31/2016;12/31/2017 $5M each incident/agg Professional $IM each incident/agg Deductible • ! $5,000 each incident DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) SAMPLE Certificate of Insurance CERTIFICATE HOLDER CANCELLATION SAMPLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SAMPLE ACCORDANCE WITH THE POLICY PROVISIONS. SAMPLE,ZZ AUTHORIZED REPRESENTATIVE 9 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S19429448/M19420353 MDKZP Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL 454 Gay Hill Rd. Uncasville CT, 06382 Property Address Install a GFCI for a gray water pump Job Description Required Department Approval Permit Issuance Approval Tax Collector %�/•� o-. , �9/..z7/ / 7 /7 Signature/date Comments: / Fire Marshal /:i ,, � , Signature/dat• 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: ❑ WPCA, Administrative N,q 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 Revised 5farch23,2015