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Home My WebLink About2002 - Cable & Meter Socket Replacement Town of Montville Building Department, Permit # Field Inspection Notice Date Job Location Irv Approved Type of Inspection /G - ction when the f owing corrections have been completed: ❑ Not Approved - Please call for re-inspe 1 k g Official dii is Buil q. Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, CT 06382 860-848-3030, Ext. 82 Electrical Permit Permit Number: E2002-390 Permit Date: 11-Dec-02 Permit Code R5 Job Location: 11 ALLEN DRIVE UNIT: MAP/LOT: 090/061-000 Job Description: Electric Entr nce Cable & Meter Socket Owner Contractor RICHARD P + LEORA A GROH CIQ Bonner Electric, Inc. P. 0. Box 366 11 ALLEN DRIVE Unit: Uncasville, Ct. 06382 UNCASVILLE CT 06382 Telephone: 848-8539 Lic/Reg Type: El Use Group R4 Lic/Reg Number: 102976 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: $850.00 Electrical Fee: $10.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $850.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.14 Total Fees: $10.14 It is the owners respons b"Ift to schedule the following required inspections (minimum 48 hours notice reqUesteAk ❑ Footing - Prior to pouring co crete ❑ Rough HVAC ❑ Backfill - Footing drains and aterproofing ❑ Fireplace Throat ❑ Concrete Slab - Prior to you ng ❑ Fireplace Final ❑ Rough Framing ❑ Chimney - One flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping 0 Electrical Service ❑ Insulation ❑ Rough Plumbing and Leak Test ❑ Final Inspection ❑ Gas Piping and Pressure Te Certific of 0 cu cy - Prior to use or occupancy Building Official's Signature: .3 Town of Montville f Building Department Permit # G z - 3 G 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Trades Permit Application Form El Pfum6ing ®Electrical EIMechanical Heating Air Conditioning -Gas Taping Other Job Location 11 Allen Drive, Uncasville CT 06382 Job Description/Materials outside cable change on side of house (may need meter box) Owner Richard Groh cki Mailing Address 11 Allen Drive City Uncasville State CT Zip 06382 Tel 860/ 848 /9882 Contractor BONNER ELEC RIC INC. Mailing Address P.O. Box 366 City Uncasville State CT Zip 06382 Tel 860 / 848 / 8539 Contractor's License/Regis ation Type & Number 102976 E1 Exp. Date 09 / 30 /03 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 B nner Vice President Date 12 /09 /02 Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ Other $ $ Certificate of Occupancy, $ Plan Review Fee $ State Education $ Total $ $ v Pf4 - ,-,~~t Receipt - • ~ o n of ~.~ontvltc I3uilclin.g,pepartn No. % ; Date From= Job Address: _ Check I 06 ~ ~ Gash r . tllydconc - --1 Amount ' Pcriilit r~ Received b ' E. ~,P h ~Y `k ~f i rt a f i all ELECTRICAL UNLIMITM CONTRACTOR 10EPH P BONNER 776 OLD COLCHESTER RD UNCASVILI-E, CT G6382 TYPE: El EFFEC I N - EXPIRES L1C.JREG NO. 09/30/2003 102976 10/01/2002 SIGNE^ ---7T- p 0 coRDCERTIF CAT R,OF LIABILITY INSUR NCE 12/28/200 PRODUCER (860) 848-2201 FAX (&&.,449-2207 -THIS CERTIFICATE IS 1, jED AS A MATTER OF INFORMATION Curtin Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 620 Route #32, Box 387 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Uncasville, CT 066382-0387 INSURERS AFFORDING COVERAGE Georgia Tracey INSURED Bonner Electric Inc. INSURER A: Blue Ridge Insurance Company P 0 Box 366 INSURER B: Peerless Insurance Co. Uncasville, CT 06382 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BE OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITI 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- AGGREGATE LIMITS SHOWN Y HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LIMBS LTR TYPE OF INSURANCE POLICY NUMBER DATE M DATE MM/DD GENERAL LIABILITY 001118 12/31/2001 12/31/2002 EACH OCCURRENCE $ 1"000,0001 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 300,0001 CLAIMS MADE FxIOCCUR MED EXP (Any one person) $ 10 , 00 A PERSONAL & ADV INJURY $ 1, 000, Oq. GENERAL AGGREGATE $ 3 , 000 , 00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,000 POLICY jECOT LOC AUTOMOBILE LIABILITY 003577 12/31/2001 12/31/2002 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY $ A SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY 0'00506 12/31/2001 12/31/2002 EACH OCCURRENCE $ 5,006, X OCCUR CLAIMS MADE AGGREGATE $ A 5,000,00'0 $ 5,000,00 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND 0013 59 12/31/2001 12/31/2002 X TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,0 A E.L. DISEASE - EA EMPLOYE $ 1,00,06( 00 E.L. DISEASE - POLICY LIMIT $ 1,000i OTHER 87101766 12/31/2001 12/31/2002 1,000,000 nstallation Floater B DESCRIPTION OF OPERATIONSILOCATIONSNE LESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS VERIFICATION OF INSURANCE FOR 11 ALLEN DRIVE, UNCASVILLE, CT CERTIFICATE HOLDER X ADD ZONAL INSURED; INSURER LETTER: _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL To Whom It May Concern 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, I BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Carlos Cook/GT ACORD 25-S (7197) OACORD CORPORATION 1988 ,s r