Loading...
Air Conditioning 2001 Town of Montville Building Department Phone: 848-7166 310 Norwich New London Tpke p Fax: 848-7231 Building / Trades Permit Permit Number M2001-136 Permit Date 9/18/01 Permit Type Mechanical Permit Code R5 Job Street# 20 Job Location RAINBOW DRIVE -- _ Map/Lot 016/T29-000 Job Description Air Conditioning Owner Contractor Ethel T. Deas Broad Brook Heating & Cooling Address 20 Rainbow Drive Address 405 Old Jewett City Road City Uncasville State Ct. City Preston State Ct. I Zip 06382 Telephone 848-8715 Zip 06365 Telephone 887-0147 Lic/Reg Number 388799 Lic/Reg Type S1 Exp Date: 8/31/02 Use Group R4 Code 1995 CABO Type Construction 5B Building Value $0.00 Building Fee $0.00 Plumbing Value $0.00 Plumbing Fee $0.00 Mechanical Value $429.00 Mechanical Fee $10.00 Electrical Value $0.00 Electrical Fee $0.00 Other Value $0.00 Other Fee $0.00 Total Values $429.00 C/O Fee _ $0.00 Comments: Plan Review Fee $0.00 State Ed Fee $0.07 Total Fees $10.07 i Building Official's Signature J YerY71 Gtr Date ,9/./M-C--7/ It is the owners responsibility to schedule the following required ns ections (minimum 24 hours notice required): Footings -prior to pouring concrete Backfill -footing drains and waterproofing CI 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 V Rough HVAC ❑ Certificate of Occupancy - PRIOR to use or occupanc s Town of Montville Permit # I. 6 Building Department 310 Norwich-New London Tpke. Tel. 848-7166 Uncasville, CT 06382 Fax 848-7231 Application for Building or Trades Permit Building Permit Trades Permit ❑ .New Construction El Access Structure O1�' ❑4'lum6ing �9Kec(ranical ❑Action ElDemo1Ition EIECectrical Meati ❑Alteration ['Other Air Conditioning —Gas PiPing Job Location j C3 �,s� r Job Description/Materials =vis-(-61t I( Al oCa 1 ('W ,4 tL Owner C fhz i, Mailing Address ()C.) Lko 1(e IC r City kRv1 Ca ( r (le State Zip D 6 3 -.1 Tel ray Contractor T>CCckc\${ ,mak +iec, -/y, +Cim 6.0/Mailing Address (-1c cc 3 C i..1,y it City YC `�-� State(' ► Zip 06. 3 Co 5 Tel &6D/ cff-?/ C./y 7 Contractor's License/Registration Type&Number j i 3 g`rz Exp. Date g•-' / 3/ / dpc, ), New Home 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 Signatu • 1r - _ _ % Date T / /..32 / Ci/ Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ y )'? $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education C Total $ • $ 7'S $ /o. 07 ----.................minimuni. , Town of Montville Building Department Receipt Date / /_p_i____ No. 01082 From: Job Address: - V Amount $ Cash Check # $ e . Received by ....\ Pennit # FRur1 : FH::{ rJCi. — —�— Sep. 14 2001 11:1ERM P1 ACORD CERTIFICATE OF LIABILITY INSURANCE LDATE(MMIODNY) 09/14/2001 ODucER (860)848-2201 FAX (860)848-2207 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Agency, Inc- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE urti n Insurance Q g yr HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ' ;Z0 Route #32, Box 387 ALTER THE COVERAGE AFFORpE0 BY THE POLICIES BELOW_ . Incasville, CT 06382-0387 INSURERS AFFORDING COVERAGE "a'.7RED Broad Brk Heating &Cooling LLC msvpay.A Hartford _ _._- 405 Old Jewett City Rd INSURER B. —. Preston, CT 06365 INSURERc. -- INSURER D. INSURER E: ,OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY P4eR1OD INDIOATED.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 CO/CATIONS OF SUCH POLICIES-AGGREGATE'LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. ,_ i POLICY EFFEfTIVE I POLICY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER DATE(MM'DOIYY) OAT MM'DIVYNI GENERAL LIABILITY O02SBAKK9011 105/14/2001 105/14/2002 EACH C7CCURRENCE X COMr.ffi RCIAL GENERAL LIABILITY f LIRt I AMAG,E(Any one fire) $ 300,000 j MFD EXP(nnv'ono pawn) $ 5,000 L 1 CLAIMS MAl?A it X I OCCUR ' A PERSONAL&ADV INJURY I S S00,000 1 I c ENERAL AGGREGATE (R 1•,000,000 GENII_AGGREGATE UNITAPPLLIIEES PER. PRODUCTS•,7OMarOP.44.14 II$-- 1,000,000 POLICY PET f{ I LOC I I �` _ . AUTOMOBILE LIABILITY IO2UECD154645B I OS/24/200/ 05/14/2002 COMBINED SINGLE L AST $ ANY AUTO I (Es accident) S00,000 ALL OWNEDAUTOS + .BODILY INJURY S ri SCHESULEDAUTOS (Porperson) A HIRED AUTOS BODILY INJUf-V' $ X-1 NON-OWNED A;lTDS (Per accident) '' (PQROer PERTY DAMAGE $ GARAGE LABILITY — ectiaentl - AUTO ONLY-EA ACCIDENT I $ ANY AUTO I OTHER THAT: EA ACCrrI$ AU10ONLY' : AGCI EXCESSILIABILITY I EACH OCCLIRRENCE IS LLL___ f JJJ! OCCUR I�I CI.A:MS MADE it AGGREGATE i $ `II I r,EDucTIaLE f FE.2,22V S ---T, �S 7f v.'ORKERECOMPENSATION AND . 2WECJR4881 105/14/2001 45/24,/2002 I X TORT Llmni II aR — I EMPLOYERS'LIABILITY + 1rEL.£4.ID-.AOCIDENT S 100,00C A I I EL.O'.SEASE-EA EMPLOYEES 100,00C { E-L.DISEASE•POLICY LIMIT $ 500,000 OTHER .—.------------1--.--- ----i------- DESCRIPTION OF OPERATIONS..!LOCAT(ONSNEHICLES1EXCLUSIGNS ACTED BY ENDORSEMENTI5PECIAL PROVISIONS CERTIFICATE HOLDER .,.DDITiONALINSUREb;INSURER LETTER• CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OATS THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDR NAMED 70 THE LEFT, Town of Montville Building Department BUT PAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 310 Rte #32 OF ANY KIND UPcN THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Uncasville, CT 06382 AUTHORIZED REPRESENTATIVE J��� t Carlos Cool/Gl- `J'"� ACORD 25-S(7(97) FAX' 848-7231 CwACORD CO,2PORATPGw 19