HomeMy WebLinkAboutHeating for SFR
Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasyille, CT 06382
(860) 848-3030, Ext. 382
Mechanical Permit
Permit Number: M2003-0078 Date: 23-May-03 Map/Lot: 043/009-007 Owner ID 49533
Job Location: 119 FO S11'JH 9p Unit
Job Description: Heating
Owner: Contractor:
Rtt Development Inc William Rheaume
1295 Route 32
35 Blais Rd Uncasville Ct. 06382-
Uncasville CT 06382 Telephone: (860) 848-2647
Lic/Reg Type/No.-S1 303676 Exp Date: 31-Aug-03
Tenant:
Self
Telephone:
Construction Values Permit Fees Construction Information
Building Value: $0.00 Building Fee: $0.00 Use Group: R4
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO
Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 5B
Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: R5
Other Value: $0.00 Other Fee: $0.00 Comments:
Total Value: $0.00 CO Fee: $0.00 Included on Building Permit
Plan Review Fee: $0.00
State Ed Fee: $0.00
Total Fees: $0.00
It is the owners responsibility to schedule the following inspections jminimum 48 hours notice ren ui~ red)a
❑ Footing - Prior to pouring concrete F,/~ Rough HVAC
❑ Backfill - Footing drains and waterproofing ❑ Fireplace Throat
❑ Concrete Slab - Prior to pouring concrete ❑ Chimney - One flue above thimble
❑ Rough Framing ❑ Firestopping/draftstopping
❑ Rough Electrical ❑ Insulation
❑ Electrical Service ❑ Final Inspection
❑ Rough plumbing and leak test ❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signature:
Town of Montville
Building DepkIment Permit #
4_
310 Norwich-New London Tpke.
Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231
One & Two Family Trades Permit Application Form
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7X- --feating
Air Conditioning
-Gas PiPing
Job Location t-'~-1•
Job Description/Materials 1 is---
Owner iC_ IC 1,.~ ! ~ zn. Mailing Address__ R 1 a,. Q
City f ~ t State CT Zip G 7 Tel / O y
Contractor ~l~af~tlta Mailing Address
City ~ y C* 07 State Gr Zip Tel
Contractor's License/Registration Type & Number 5 JL'3 6"'_ Ca Exp. Date 2/ ,.3 %
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 Z4 4 d [ Date_ . 1
Construction Value Fee
Building $ $
Plumbing $ $
Mechanical $ $
Electrical $ $
Other $
Certificate of Occupancy
Plan Review Fee
State Education
Total'
► "i' v , PrPilvG & COOLIN<3 L NLII1 'ED CONTKACroR
I LIAM L RHEAUIv1E
119'MOXLEY,ROAD
UNCASVILLE, CT 06352
TYPE: Sl t
C. ! REG N0. EFFECTIVE ?
f EXRf~tES,
303676 09/012002_.; 08131D3<
4J
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National lm-lemaitf Co.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY.
INFORMATION PAGE RENEWAL AGREEMENT
Coverage is provided in Agency: 96018 Pr#: 1
Evergreen National Indemnity Company The Pawson Group'
(Carries Code: 20362) 5 South Main Street
Branford, CT 06405
Carrier Policy 00300000.1675100
Carrier Prior Policy 003000001675099
1. The Insured: Rhe'aume Heating LLC Dba
Uncasville Oil Type of Business: Other
Mailing-Address: 65 Maple Avenue Fein: 061479106
Uncasville, CT 06382 Risk ID:
Other workplaces not shown above:
NO O1HER` WORKPL..ACES FOR THIS POLICY
2. The po'l:lcy period is from 12:01 a.m. on 6/02/2000 to 12:01 a.m. on 6/02/2001'
at the.insured's mailing address.
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers
Compensation Law of the states listed here: CT
B. Employers Liability Insurance: Part.Two of the policy applies to work in each
state listed in Item 3.A. The limits of our liability under Part Two are:
Bodily Injury by Accident $ 100,000 each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease $ 100,000 each employee
C. 0-her States Insurance: Part 3 of the policy applies to all states, except ND, OH,.
WA, WV, WY and the states designated in 3A above.
17. This policy includes these endorsements and schedules:
WC000000A(04/92) WC000311A(08/91) W0000406(08/84) WC000414(07/90) WC060301(O4/84)
sdC060303B(04/96) WC060401(0,7/96)
4. The premium for this policy will be determined by our Manuals of Rules;.
Classifications, Rates and Rating Plans. All information required below is subject
to verification and change by audit.
~y
Classifications Code Premium Basis Rate Per. Estimated
No. Total Estimated $100 of.;;. Annual
Annual Remuneration Remuneration'.:; Premium x
SEE SCHEDULE OF OPERATIONS
Total Estimated Annual Premium 7,154.00
Minimum Premium $ 750.00 Expense Constant $ 180.00 .1
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