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HomeMy WebLinkAboutConcrete Slab, Cabinets, Ground Equipment, Antennas 2017 TOWN OF MONIVILLE Building Department �� uk~�� .9_ 3lON{)NW|CH'NEVVLONDON TURNPIKE �� ` � ` UNCASVILLE, CT 06382-2599 TEL. (860)848-3030 X382 FAX. (860) 848-7231 � ' -- BUILDING PERMIT Permit Number: B2017-0029 Date 25-Jo»'1/ mop/kt: 036/002000 Owner ID: 569000 Project Location: 401 CHAPEL HILL � Unit: - - Job Description: Add Six Panelxn������m����/�A���u���«G����� Owner Nam Subcarries Communications|no. �n mmo�e T-Mobile Comot --- - � -- _ 35 SouGriffen Road /3VWhite Oak pxe Bloomfield '---- ------_______ CT 06CO2- Old Bridge 6CO2-0/ucmdAo m| 08857 Telephone: (508)64 -0801 ---' APp|icantNomo D&A Construction Telephone: (203)520-8471 DBA: --- Lic/Reg Type MCO Lic/Reg N 901925 20Commercial 800et Exp Date: -' - --- __-________.__�____ 30-Jun-17 Branford CT 06405' Construction Value_______ Permitpoo� Co Fees Building Value: ___ $50,000.00 Building __ V750.00 Use Group: U Plumbing Value: ______ $0.00 Plumbing Fee: __ $0.00 Code: 2005 State Building Code Mechanical Valu____ $0.00 Mechanical �� Electrical Value: $0.00 Electricalpno� — --� " __ _ S0.00 Conx�vo«onType 2C Total Value: $50,00000 Penalty Fee: $0.00 Permit Code: C4 '___--____ _ C of 0 Fee: V50J0Commentnonnowowr* ----------- Fire Marshal Fee of$262.50 Paid $75.00 State Ed Fee: $13.00 Total Fee Paid: $888.00 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL,ELECTRICAL PERMIT INSPECTIONS 0Footino Prior to pouring concrete Li R Plumbing and leak test Li Deck Piers [] mElectrical II Backfill Footing drains and waterproofing LI Elec Trench with conduit installed H Concrete Slab Prior to pouring LI Pool Bonding D Anchor Bolts with sill plate and prior to floor frami Li Electrical Service CRS No: n UFrammg ElRHVAC [I] Masonry Fireplace Throat or Chimney Thimble LI Gas Piping and leak test 0p|,"Noomoq Draftstopping INSPECTION REQUIRED UPON COMPLETION 0 |nso|unon Certificate of Approval LI Certificate of Occupancy avnumooffioio|t /� -------a~~~- 14. . 1 ---- ((( c ))) NORTHEAST SITE SOLUTIONS Turnkey Wireless Development Northeast Site Solutions Denise Sabo 199 Brickyard Rd Farmington,CT 06032 860-209-4690 denise@northeastsitesolutions.com July 17,2017 Town of Montville 310 Norwich-New London Turnpike Uncasville,CT 06382 Building Department RE: 401 Chapel Hill Road T-Mobile Site#:CTNL814C-NSD Building Dept, The contractor(D&A Construction)is no longer available for the antenna installation located at 401 Chapel Hill Road and T-Mobile needs to change the GC to Construction Services of Branford LLC. As requested,Please find the attached COI,contractor's license and permit copy.. Let me know if anything else will be need for the change.Thank you very much for your help with this matter. Res,-ctfully, I Denise Sabo Mobile: 860-209-4690 Fax: 413-521-0558 Office: 199 Brickyard Rd,Farmington,CT 06032 Email: denise@northeastsitesolutions.com V L l V E AUG 23 2017 54 Main Street Unit 3 I Sturbridge Ma 01566 I f:413-521-0558 I www.northeastsitesolulons.com CPL-03 Rev 06113 578073 No STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION This is your registration certificate. Such registration shall be shown to any properly interested person on request. Do not attempt to make any changes or alter this certificate in any way. This registration is not transferable. In an effort to be more efficient and Go Green, the department asks that you keep your email information with our office current to receive correspondence. Questions regarding this registration can be directed to the Occupational&Professional Licensing Division at dcp.occupationalprofessional@ct.gov. Mailing address: Email on file to be used for receiving all notices from this office: CONSTRUCTION SERVICES OF BRANFORD LLC Imayzler@csolb.com 63-3 N BRANFORD RD BRANFORD, CT 06405-2860 li[ECIEUVE AUG 2 3 2017 . . .41, .. .. . +, i a_ a ! a i a fr a`� a i ayr� a w a i- a i' * ♦ II,* a a 11 L .._..— _�...T..,._.. - __ .. C.. ! STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION i . -' a 1 .. I Be it known that 1 t CONSTRUCTION SERVICES OF BRANFORD LLC A 4, i r . ,,fI 63-3 N BRANFORD RD iJ •t. iI BRANFORD, CT 06405-2860 ' .� I Ifir, '� { ti.. fl has been certified by Department of Consumer Protection as a V *- \ .' MAJOR CONTRACTOR ' ;r 7 4 CSB COMMUNICATIONS ''``�-- Registration #: MCO.0900576 :4 i f" > i Effective Date: 07/01/2017 I Expiration Date: 06/30/2018irelAex."0/z , „ .� verify online at www.elicense.ct.Rov Michelle Seagull,Acting Commissioner j 0 . .------ CONSTI0-CL PATRA2 A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 01/06/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT ONT CT Kimberly L.Twerdy Smith Brothers Insurance,LLC. PHOX 68 National Drive,Suite 2 (A/c,NE No,Ext):(860)430-3358 I(FAA/C,No): Glastonbury,CT 06033 ADMDRESS:ktwerdy@smithbrothersusa.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Hartford Fire Insurance Co. 19682 INSURED INSURER B:Aspen American Insurance Co 43460 Construction Services of Branford, LLC DBA CSB Communications INSURER C:Twin City Fire Insurance 29459 CSB Holdings,Inc. INSURER D: 63-3 North Branford Road Branford,CT 06405-2848 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ CLAIMS-MADE X OCCUR 02 UEA QT7195 01/01/2017 01/01/2018 DAMAGETORENTED 300,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1+000+000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE_ $ 2,000,000 POLICY X JEC7 X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER EBL AGGREGATE $ 2,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO 02UEAQT3051 12/31/2016 12/31/2017 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED ONLY NON-OWNED ND PROPERTY DAMAGE (Per accident) $ B X UMBRELLA LIAB X OCCUR $ EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE CX0054F17 01/01/2017 01/01/2018 AGGREGATE $_ DED X RETENTION$ 0 Aggregate $ 10,000,000 C WORKERS COMPENSATION II _ AND EMPLOYERS'LIABILITY STATUTE I !EERFi ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 02 WEA QT3049 01/01/2017 01/01/2018 1,000,000 OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) 1,000,000 If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Commercial Property 02UUMHX6196 12/31/2016 12/31/2017 Jobsite Limit 1,000,000 A Commercial Property 02UUMHX6196 12/31/2016 12/31/2017 2 �,a 2 CVIET DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is requi Evidence of Insurance. AUG 232017 ____ , ......., _____ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDR / -REPRESSE-NTATIVE 1 �i�1+1U>ZL�.S �K� ACORD 25(2016/03) + ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD July 9, 2017 Mak CONSTRUCTION RE: T-Mobile CTNL814C- NSD 401 Chapel Hill Road, Montville Dear Sir or Madam: I hereby authorize Denise Sabo of Northeast Site Solutions to transfer the building permit on behalf of D&A Construction Management Inc to Construction Services of Branford. If you have any questions, please feel free to contact me (203)488-5494. Thank you. Chris Jardine AUG 23 2017