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2001 - Roof - Strip
Town of Montville Building De6artment ^ Phone: 848-716 310 Norwich New )-ondon Tpk Fax: 848-723 Building / Trades Permit Permit Number BP2001-346 Permit Date 6/26/01 Permit Typ Building Permit Code R4 Job Street # 36 Job Location ALLEN DRIVE Map/Lot 090/045-000 Job Description Roofing - Strip Owner Contractor Danny & Nilda Rimas Header Building & Contracting Address 36 Allen Drive Addres P. O. Box 471 City Uncasville State Ct. City Old Mystic State Ct. Zip 06382 Telephone 848-3866 Zip 06372 Telephone 735-2032 Lic/Reg Number 565515 Lic/Reg Type HIC Exp Date: 11/30/01 Use Group R4 Code 1995 CABO Type Construction 5B Building Value $3,850.00 Building Fee $22.00 Plumbing Value $0.00 Plumbing Fee $0.00 Mechanical Valu $0.00 Mechanical Fee $0.00 Electrical Value $0.00 Electrical Fee $0.00 Other Value $0.00 Other Fee $0.00 Total Values $3,850.00 C/O Fee $0.00 Comments Plan Review Fee $0.00 State Ed Fee $0.62 Total Fees $22.62 Building Official's Signatur Date / ~;)Lcl-j It is the owners res ons' 44 ch dule the following re uired inspections minimum 24 hours notice re uired : ❑ Footings - prior to pouring concrete ❑ 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 ❑ Pool bonding ❑ Gas piping - pressure test and installation ® Final Inspection ❑ Rough HVAC ❑ Certificate of Occupancy - PRIOR to use or occupancy Town of Montville Permit # f cx 1-3i/ Building Department 310 Norwich-New London Tpke. Tel. 848-7166 Uncasville, CT 06382 Fax. 848-7231 Application for Building or Trades Permit BuiIdina Permit Trades Permit New Construction ❑ Accessory Structure ❑Tlumbing ❑Wechanicaf n Addition ❑oema Lion ❑EfectricaC Weating X[teration [Other j - 1riel ---Air Conditioning Gas T1' Ying Job Location t~C Cfa! (20603 Ul U1 07- lob Description/Materials^ j~~eLe' / (tA y~/ y9 7 fy 55 f/Ar~S o~ 7~ ~ ~ Owner.1/r()n4 m A S Mailing Address ACC6' 09-- LAC4 ,:rL ► (L-Le , C- T City ( Nc,ns u► t L State 6. Zip 3 97- Tel P /V411/ Contractor Al Mailing Address ~0. 40/ City-,/) L12 M y sJ L 0, State Zip 137 Z Tel 735- .I Zro 3 Z-- Contractor's License/Registration Type & Number 5:X51/ 5 Exp. Date/ ~ 0 64; New Rome Construction Contractors: Have you entered into a contract with a consumer for the proposed new home? ❑ Yes ❑ No 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 Date Construction Value Fee Building $ _Sd $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ 0 2 Total $ ~~5~'" Town of N'~ntvilIe Building Departmer ' Receipt No. F Date - n From: _ Lxo~-- / : VI Job Address: - ~___AI'l ~ - ' F# - _ ? Cash f" Check Check 4 ~ k Amount Permit 4 01-3 E€ Reccl~cd b}' - - 4 A RDTM INSURANCE BINDER, 04/09/2001 THIS BINDER IS A TEMPORARY INSURANCE CONT( f, SUBJECT TO THE CONDITIONS SHOWN ON' 'REVERSE SIDE OF THIS FORM. PRODUCER PHONE ($60)848-2201 COMPANY BINDER# A/C No Ext: FAX (860)848-2207 Blue Ridge Insurance Company 801040900952 Curtin Insurance Agency, Inc. GATE EFFECTIVE TIME DATE EXPIRATION TIME 620 Route #32, Box 387 X AM 07/02/2001 X 12:01 AM Uncasville, CT 06382-0387 05/03/2001 12:01 PM NOON X THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE: 02297 SUB CODE: PER EXPIRING POLICY AGENCY 000OS642 DESCRIPTION OF OPERATIONS/VEHICLES/PROPERTY (Including Location) CUSTOMER ID. INSURED 001 GMC SIERRA Timothy Header 001 TRAILER PO Box 471 Old Mystic, CT 06372 COVERAGES LIMITS TYPE OF INSURANCE COVERAGEWORMS DEDUCTIBLE COINS % AMOUNT PROPERTY CAUSES OF LOSS BASIC r-] BROAD SPEC GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ CLAIMS MADE FIOCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ RETRO DATE FOR CLAIMS MADE: PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ 100 , 000 ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS MEDICAL PAYMENTS $ X NON-OWNED AUTOS PERSONAL INJURY PROT $ UNINSURED MOTORIST $ UNDSG $ 100,000 AUTO PHYSICAL DAMAGE DEDUCTIBLE ALL VEHICLES X SCHEDULED VEHICLES X ACTUAL CASH VALUE X COLLISION: S00 STATED AMOUNT $ X OTHER THAN COL: Soo OTHER GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: SELF-INSURED RETENTION $ X WC STATUTORY LIMITS WORKER'S COMPENSATION E.L. EACH ACCIDENT $ 100,000 AND EMPLOYER'S LIABILITY E.L. DISEASE - EA EMPLOYEE $ 100 , 000 E.L. DISEASE - POLICY LIMIT $ 500,000 SPECIAL FEES $ CONDITIONS/ OTHER TAXES $ COVERAGES ESTIMATED TOTAL PREMIUM $ NAME & ADDRESS MORTGAGEE ADDITIONAL INSURED LOSS PAYEE LOAN # AUTHORIZED REPRESENTATIVE Elizabeth Occhionero/LO ACORD 75-S (1198) NOTE: IMPORTANT STATE INFORMATION ON REVERSE SIDE ©ACORD CORPORATION 1993