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Home My WebLink AboutReplacement Windows artment Receipt Town of Montville Qullding DeP - No. ~...:`o . DdlC ~ A ~ Job ress: Add h Chcck 4 Cas ((hc,c,k ~ nII10Uill ~C'irdconc) i Permit - .f -jzc. ,i~~ca hy ~ Installed Siding and Windows (q,vicet Date: / 1 '2 ~ lU 2 . ' To: 0 Location: ~S LKI L. To Whom It May Concern: This letter will authorize the following person(s) to act as agent(s) on behalf of RMA Home Services, Inc., 3200 Cobb Gallaria Parkway, Suite 200, Atlanta, GA 30339 to pull and sign for permits and inspections with respect to the installation, maintenance and repair of windows and siding under Connecticut Contractor license number 565522. Authorized person(s): Scott Goldbach r Contractor of Rec vid Katz RMA Home Servic c. STATE OF GEORGIA COUNTY OF COBB The faregoing instrument was acknowledged before me this 29`h day of October 2002, by David Katz. ~ , ~~.k 't~q_ C;- (Seal) Notary blic-State of Georgi Margaret Pavne Printed Name: O1/21/06 My Commission Expires: Personally Known X Or Produced Identification Type of Identification Produced Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Toll free (800) 210-8395 • Fax (770) 779-1333 INkY ~ ~ HOME IMPROVEMENT CONt'RACTOR R M A HOME SERVICES INC 3200 COBB GALLERIA PARKWAY SUI'I'E 200 ATI.ANTA, GA 30339 Concrxwr of Record: DAVID I+ATZ EFFECTNE ^cXPiFES - 565522 L,C. ~+EG ~vo. j 12/01/2001 ' 11/30/2002 . . . . w~ . PAGE 01/01 APPLIEDII 10l24/2002 13:18 4155083075 D11TE (MMYI)W"YY) - 10124/02- CERTIFICATE IS ISSUED AS A MAT'MR OF INFOaMATION D ERTIFiCATE OF LIABILITY ~NSURANC T5 UPON THE CERTIFICATE ACOR TM C TH TEND OR ~aooucea ONLY HOLDER• AND TH13 CER'~ CONFERS F~ NO ATE RIGHCOES NOT AMEND, r:X IED RISK SERVICES, INC. ALTER THE COVERA(9E AFFORDED BY THE POLICI~S BELOW APPL Nac# P.O. BOX 281900 94128-1900 INSUREAS AFFORDINO COVERAGE - SAN FRANCISCOi CA _ ~ INSUFERA: CQI~b~~Y~ It+8UpE0 INC. INSUREAB~ . -'T'-~ RMA HOME SERVICES, 200 INSURERC'. ~ 3200 COBB ~LLERIA PARKWAY, S ATLANTA, GA 30339 INSURERD . . • . IN9UREfl E: A POI~CY . THE POLICIESOFiNSURANCE ~ISTED BELOW HAVE BEE►~ ~SSUEO TO THE INSUtiED NAMED BOVE FORTHE PERIODINDICATED NOTW~T1'13TAN V CONTRACT OR OTHER DOGUMEM CWITH RESPECT TO WHIGM YMIS GERTIFICATE MAY BE ISSVED OR COVERAGES T TO ALL THE TERMS. EXGLUSIONS ANb CONOITIONS OF SUCH ANY REQUIQEME~'~T- TERM OR COND1710N OF AN _ MAY PERTAIN, THE 1NSURANCE AFFORDED BY THE POLICIES DESGFiIBED HEFEIN IS SU -~ICr ExP1RATIa+ ~RS pp~IC1ES. AOOHEGATE LIMITS SMOWN MAY HAVE BEEN REDVGED 8Y PAro C~'IMS. /DiFE pOLICY NUM6ER Lrn No rpCH OCCURRENCE s 1116N pENERAL LuBILIn 7FEMISES Eaoecuronca s COMMERCiAL GENERAL LUBaRY MEG E%P IMv an9 D_. CLAIMS MAOE ~ OCCUR PEfl90NAL~a ~0~ ~M~UaV GENGRAL.. s - - PRODUCTS • COMPlOP 0.G0 S : . 66hYL 4GGFIEGATE LIMIT AVPl1E3 PEPI: PRO• POLIGY LpC CQMBINEDSINGIELIMIT = fEo oode.nd AuTOMOewe uAewmr pNY PVTO ' gpp0.Y INJUHY = AL1.01NNED AUTOS (Per penon) SCMEDVLED AUTOS gOO1lY INJUR`I = . ~ (Paratcd~l HIREO AU'TOS NON4NMED AUTOS PROPERTY DAMAGE $ lCSl aca0aml AUTO GNLY • EA AGCIDENT OTMERTMAN GpqAGEL1AEiLITY ~A~ S AUTOONLY: AG,(q = ANY 11UT0 EACHOCCUFp6NCE 6 g1(LE66l)MBRELlAL1A61UTV AOOREOATE $ OCCUR ~ CLAIMS MAOE S I $ DEOVCTiBLE S WC TA U- ~OTH• HETENTION S ' WORKERBCONWENSATIONI.ND ~1~~02 ~~OIO3 E~~EACHACCID~NT A S EMrIOVEM3'IJiMI~.IrY E.L.DISEASE.~E $ ANY OFFlCEFVMIEMB RE GLUDEpxECUTIVE O2~J'OOOOOrJO3 E,~.qSE0.SE•P0LICYLIMIT S Ny es. dewribe uaCer SDKIALOROVISIONS Wbw OTNER DEGCpIPT10N OC OKPATIONS I 40CATION5 f viH1C4E5! f xCW SIOhB ADDED OV FNDOR9EMENT 18PiCIAL AtONS10►15 CANCELLATION CERTIFICATE NOLDER SMOULD ANY OF 7NE NBUVE OE6CNiSgD POLICIE6 9E C1INGELlEO BEFp11E lME Q%flATON DAT6 TMEREOF,THE ~UING IN6L111ER W1LL ENOeAVOR TO MNL --3e- OAY9 WRITTEN N0T1LE TO T11E CER7IFICATE HOLOEN N11ME0 TO TNE IEFT, BUT FAILURE TO 00 50 SMALL IMrDOE IM OOLKi11T10N OR LAABIUTY OF ANY KR10 UVO}I TNE IN3URER, ITS AGEHTS OR i1£PPES6IRATWiS. Aun4oaao AcvncacNlAnvf QD04843 C►ACOfID CORPORA710N 1988 AGOfiD 25 (2001108) Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, CT 06382 860-848-3030, Ext. 82 Building Permit Permit Date: 02-Dec-02 Permit Code R4 Permit Number: 62002-717 ]ob Location: 28 CEDAR LANE UNIT: MAP/LOT: 106/0_ ]ob Description: replacement windows Owner Contractor RMA Home Services SUSAN H+ CHRISfOPHER S MACKAY 345 Greenwood Street Unit: Worcester, Ma. 01607 28 CEDAR LANE Telephone: 508-341-9401 UNCASVILLE CT 06382 HIC Lic/Reg Type: Use Group R4 Lic/Reg Number: 565522 Code 1995 CABO Exp Date: 11/30/02 Construction Type SB Construction Values Permit Fees Building Fee: $16.00 Building Value: $3,000.00 Plumbing Fee: $0.00 Plumbing Value: $0.00 Mechanical Value: $0.00 Mechanical Fee: $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Other Value: $0.00 Other Fee: $0.00 C/0 Fee: $10.00 Total Value: $3,000.00 Plan Review Fee: $0.00 Comments: - State Ed Fee: $0.48 Total Fees: $26.48 ti ~ibil~tv to sched~le the follo~vina rea~ired insne ions (minimum 48 ho~rs notice ren~o dl: ❑ Rough HVAC ❑ Footing - Prior to pouring concrete ❑ Fireplace Throat ❑ Backfill - Footing drains and waterproofing ❑ Fireplace Final ❑ Concrete Slab - Prior to pouring ❑ Rough Framing ❑ Chimney - One flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping ❑ Insulation ❑ Electrical Service ❑ Rough Plumbing and Leak Test ~ Final Inspecdon ❑ Gas Piping and Pressure Test rtificate ofp apa - Pr' o use or occupancy / Building Official's Signature: ~ Town of Montville , Building Department Perniit ~ ' 2 ~ 17 310 Norwich-1`dew London Tpke. Uncasville, CT 06382 Fax. 848-7231 Tel. 848-3030, Ext 82 One & Two Family Building Permit Application Form J~ew Constructiorc ❑ Ada'ition Afterativn n Accessory Structure ~Otker ~r n !Z-P ~ j4 c Pm ?n L Job Location -7 Job Description/Materials ~ r / / _ 1 9 ~v-✓ t L-t e ~ ~ ~s /~JO S7 rJ`(" vl G'~-Rri~ PS J ~~~(2~(G7~+rn G.J<•-~ ~ l C'~ r r S~ S v Sc, h~~ ~C~ Mailing Address Owner L~ p Tel 3 6 7/ City State Zi v~' cas u; ~lt, Contractor P m 14 F`O L) Mailing Address Zf State Zip ~ l G~~ Tel ~ u~' / 3 Y(1 ~ c~ j City orc `'y ~ r 3 Contractor's License/Registration Type & Number .~k55 2 Z f-{ ( L Exp. Date 1L I 0 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. Date Owner /Agent Signature Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ Other $ Certificate of Occupancy ~ Plan Review Fee $ State Education Total