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HomeMy WebLinkAbout2003 - Electric Entrance Cable/Ceiling Fans Town of Montville Building 11epartment _ Permit # - - Date Field Inspection Notice _7/ ` I 4 E Job Location a gApproved Type of inspection E - call for re-inspection when the following corrections have been completed: ❑ Not Approved. Please E R :f - tt;.. Bw ding Official Town of Montville - Building Department Permit # Field Inspection Notice Date /Z- Job Location rOVetl Type of Inspection 0L wc- f ❑ App "ot Approved Please call for re-inspection when the following corrections have been completed: 1-2 ' (a ~l.) Si ern Q'1'.. 1 6 0 i Building Official i Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, CT 06382 860-848-3030, Ext. 82 Electrical Permit Permit Number: E2002-392 Permit Date: 11-Dec-02 Permit Code R5 Job Location: 4 BASEVIEW COURT UNIT: MAP/LOT: 094/010-000 Job Description: Electric Entrance Cable & Install Ceiling Fans Owner Contractor ELLIS J JR + MAUREEN RICE Bonner Electric, Inc. P. 0. Box 366 4 BASEVIEW COURT 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 SB 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: $2,000.00 Electrical Fee: $10.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $1,000.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.32 Total Fees: $10.32 It ir, the owners re o i ility to schedule the following required inspections (minimum 48 hours notice reauested): ❑ Footing - Prior to pouring concrete ❑ Rough HVAC ❑ Backfill - Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab - Prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney - One flue above thimble W Rough Electrical ❑ Firestopping/draftstopping d❑ Electrical Service ❑ Insulation ❑ Rough Plumbing and Leak Test ❑ Final Inspection ❑ Gas Piping and Pressure Test C ificate of 0 ncy Pri o use or occupancy Building Official's Signature: r Town of Montville • (A Building Department Permit # 50-0--Z392- 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Trades Permit Application Form F~Pfumding ®Efectricat nMe hanicaf ITfeating Air Conditioning -Gas P47ing ❑ Other Job Location 4 Baseview Court Montville CT Job Description/Materials Replace 60 Amp Service with 100 Amp Service, and install two (2) ceiling fans. Owner Jim Rice Mailing Address 4 Baseview Court City Montville State CT Zip 06353 Tel 860 / 848 /8242 Contractor BONNER ELECTRIC, INC. Mailing Address P.O. Box 366 City Uncasville State CT Zip 06382 Tel 860 / 848 / 8539 Contractor's License/Registration 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 $ A Other $ $ Certificate of Occupancy, $ Plan Review Fee $ State Education $ L Total zd I ~ Town of- Iontville Buitding Departu'it Receipt i Date No. From: / G~;Q~ Job Address: Z-.O -LC_~ 0 ~ jt { Amount $J Cash r-'Chet Chcck ('"c1, onc) f Reccivud by c~ Permit # ELFCTRTCAL UNLIMITED CONTRACTOR JOSEPH P BONNER 776 OLD COLCHESTER RD UNCAS\?ILLE, C,T 06382 TYPE. E1 EFFECTIVE EXPIRES LIC./REG NO. 10/01/002 09/30/2003 102976 _ SIGNE a DATE (MMIDD/Y n ACORD,. CERTIFICATOF LIAB_ ILI°TY INSU_R"VCE 12/28/2001 PRODUCER (960)$4$-2201 FAX (86`. 49-2207 THIS CERTIFICATE IS 1:. ED AS A.MATTEK OF INFORMATION Curtin Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6,20 Route #32, Box 397 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Uncasvil l e, CT 06382-0397 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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR TYPE OF INSURANCE POLICY NUMBER DATE fMfDDNY) DATE (MMfDDNY) GENERAL LIABILITY 001119 12/31/2001 12/31/2002 EACH OCCURRENCE $ 1, 000 , 00 JC COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 300 , 00 CLAIMS MADE a OCCUR MED EXP (Any one per") $ 10,0001 PERSONAL & ADV INJURY $ 1,600,00(o A GENERAL AGGREGATE $ 3, 060, GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 3,000,000 POLICY FIJEC°T LOC 12/31/2001 12/31/2002 AUTOMOBILE LIABILITY 03577 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY $ (Per person) A SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (PeraccidenQ NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY ANY AUTO OTHER THAN EA ACC $ AUTO ONLY, AGG $ EXCESS LIABILITY 00506 12/31/2001 12/31/2002 EACH OCCURRENCE $ 5,006,000 X OCCUR CLAIMS MADE AGGREGATE $ A 5,000,000 $ 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 0 A E.L. DISEASE - EA EMPLOYEd $ 11W0100, E.L. DISEASE - POLICY LIMIT $ 11000,0110 OTHER lation Floater ND87101766 12/31/2001 12/31/2002 1,000,000 Instal B DESCRIPTION OF opmxnONSJLoCATIONSNEHICLESIEXCLUSIONSADDED BY c_NDORSEMENTISPECIAL PROVISIONS VERIFICATION OF INSURANCE FOR 4 BASEVIEW COURT, MONTVILLE, CT CERTIFICATE HOLDER X ADDITIONAL 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, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /GT Carlos Cook ACORD 25-S (7197) ©ACORD CORPORATION 1988