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HomeMy WebLinkAboutA/C, Heat Pump and Condenser Field Inspection Notice Town of Montville Building Department December 9, 2016 2016 Ct Building Code Address: 245 Raymond Hill Road Job Description: Install Ductless Split A/C&Heat Pump on 36,000 BTU Condenser Permit Number(s) M2016-0174,E2016-0308 Permit Date: November 3,2016 Not Approved Approval INSPECTION Date: Deficiencies Special Date Conditions Three wall units 12/6/16 DJ Circuits labeled • 12/6/16 DJ • Exterior condenser 12/6/16 DJ Electric 12/6/16 DJ • Final inspection and • • 12/6/16 DJ certificate of approval • Rev.Date: 1/18/06 Page 1 of 1 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860)848-3030 X382 FAX. (860) 848-7231 ELECTRICAL PERMIT Permit Number: E2016-0308 Date: 29-Nov-16 Map/Lot: 087/024-00A Owner ID: 5810000 Project Location: 245 RAYMOND HILL ROAD Unit: Job Description: Electrical for Heat Pump Owner Nam Lori Jean Lafayette Tenant Name N/A Careof: 245 Raymond Hill Road Uncasville CT 06382- Telephone: (860)848-8558_ _ ------- ---- Applicant Name Bonner Electric Telephone: (860)848-8539 T DBA: Lic/Reg Type El 1865 Route 32 Lic/Reg N 181768 P.O.Box 366 Exp Date: 30-Sep-17 Uncasville CT 06382- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $600.00 Electrical Fee: $30.00 Construction Type IRC Total Value: $600.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $0.16 Total Fee Paid: $30.16 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 ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor frami ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Certifi • - of Approval ■ ertific• • O• .•ancy Building Official's Approval: • Town of Montville Building Department 310 Norwich-New London Tpke. Tel 860-848-3030 at 382 Uncasville, C-T-06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: E- I(p- 0305 Type of Work Occupancy Type Permit Type ❑New Construction 0 Single Family 0 Building ❑Addition 0 Two-Family 0 Plumbing ❑Alteration 0 Townhouse 0 Mechanical 0 Accessory Structure VI Electrical CRS#: Property Address: a?LI5 Ra ♦r�oxur� 11 i( Qi (Number) (Street)A (Unit) Job Description: (J.L.,-4-‘ 4✓ , Owner: Lot)rI 1- af Aye./ft Address: 071.i �J S Kety,,,,,,,.,,J 0t t I 4 City: U ivf-cc.5 ill I(C State: CT- Zip Code: 06.36A Telephone(&k) )9 - 65-56 Applicant: DBA: ,)&,v4,-- Elec"k-A, Address: /8(05 A'T 301 A) &x 3(c 6 City: 4.4VCien-,.7aiP State: C r Zip Code: (')&382 Telephone( )EyP. - 133 S'31 Contractors -Complete the Following: License Type: 4-1 License No.:C)16/140a Expiration Date: 9/3o/ o/7 I hereby certify that the proposed work will conform to the State 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. ❑ By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. / '. / 08//d Owner/Agent Signature: Date: Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: it redo Electrical Fee: 30. -, Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: • L(.Q Total Fee: c .1 'T' wised August 23,2007 Town of Montville Building Department File Receipt Date: 28-Nov-J6 ReceiptNo: 11875 Received From: Bonner Electric Job Address: 245 Raymond Hill Road Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: $0.00 Bldg Check: $30.16 State Check: $0.16 Bldg Credit: $0.00 State Credit: $0.00 Fire Cash: $0.00 Fire Check: $0.00 Fire Credit: $0.00 Construction Value: $600.00 Demolition Value: $0.00 CheckNo: 46403 Received By: Carmen KneelandCr0 n( "u' ) M 1! j_00AS Address: 245 Raymond Hill Road ITEM QTY $/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA Basement,Finished - SF $ 41.96 $ - $ - Interior Renovations SF $ 36.09 $ - $ - $ AMENITIES Kitchen EA $ - $ - $ - Full Bathroom EA $ - $ - Half-Bathroom - EA $ - $ - GARAGE Detached SF $ 71.53 $ - $ - MECHANICAL Warm-Air n Y/N $ - Hot Water n- Y/N $ Electric n- Y/N $ _ Air Conditioning n Y/N $ - ELECTRICAL SERVICE Upgrade Amps $ - Subpanel EA $ 699.00 $ - Gen Set EA $ 3,850.00 $ - SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace EA $ 6,497.70 $ - Masonry w/lfireplace EA $ 7,096.65 $ - Masonry w/2 fireplaces EA $ 11,095.70 $Wood Stove,free standing - EA $ 2,692.25 $ - Wood stove insert EA $ 1,859.77 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 44.07 $ - Porch - SF $ 149.38 $ - Sunroom SF $ 176.90 $ - $ - POOLS&HOT TUBS Hot Tub EA $ 8,016.25 $ - $ - Inground Pool EA $ 31,550.00 $ - $ _ Above Ground Round EA $ 6,299.46 $ - $ _ Above Ground Oval EA $ 7,019.75 $ - $ _ Pool Heater EA $ 8,984.25 $ - $ _ Inflatable Type Pool EA $ 1200.00 $ - $ _ SHEDS w/o electrical SF $ 25.55 $ - w/electrical SF $ 26.85 $ - $ - RENOVATIONS Roofing,Overlay SF $ 3.50 $ - Roofing,Strip&reroof SF $ 4.50 $ - Roof Sheathing SF $ 1.51 $ - Siding - SF $ 6.75 $ - Windows - EA $ 550.00 $ - Skylights - EA $ 1,051.10 $ - Doors,Exterior - EA $ 601.50 $ - Oil Tank,275 Gallon - EA $ _ Oil Tank,550 Gallon EA $ - MISCELLANEOUS CALCULATIONS $ 600.00 TOTALS $ - $ - $ - $ 600.00 PERMIT FEE CALCULATIONS Construction Value Fee Building $ - $ _ Plumbing y $ - $ _ Mechanical y $ - $ _ Electrical y $ 600.00 $ 30.00 Working before Permit Issuance $ - Certificate of Occupancy Fee $ _ Plan Review Fee $ - State Education Fee $ 0.16 TOTALS $ 600.00 $ 30.16 Figures are based on the 2006 RS Means Residential Cost Data tit t0 1 so t a 4",. H' a gg .. , ,,,,,. fr4- I W z 00 C f, w pof 0 W o . ., xl ` a CO x ° - V ,i' H o p 0 en 00 sf 44 v �+ oo Z 4-.,.5; f 1 Ati .4)-4 — Ai : .e 0-4 It „ Nw VAw j t . T-4 M co Ni 64 ' �! W V �i z .� { I ' .01 • �4 {� v ct ( • a ..: '� 9 I j W U (:-°:,:it 4, . :� W W , } ., $Z g' ,� X� }`°"' F S '� Ad),w '''.41'N:;� `,$ vfh � 9 � ,0 1-„ .iq , f t ,1, , , ,., ` Client#: 610353 BONNEELEI ACORDT„ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/17/2015 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 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 NAMEACT Beverly Adamick USI Insurance Services LLC PHONE (ac,No,Ext):855 874-0123 FAX No): 203 634-5701 530 Preston Avenue E-MAIL Beverly.Adamick@usi.biz CT 06450 ADOREss: y.Adamick@usi.biz 855 874-0123 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Continental Western Insurance C 10804 INSURED INSURER B:Travelers Property Cas.Co.of 25674 Bonner Electric, Inc. 1865 Norwich-New London Tpke. INSURER C P.O. Box 366 INSURER D .... Uncasville,CT 06382 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 ADDLISUBR POLICY EFF ' POLICY EXP LTR TYPE OF INSURANCE INSR!WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY ' CPA027910317 12/31/2015112/31/2016 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $250,000 MED EXP(Any one person) $5,000 X,C,U Included I PERSONAL&ADV INJURY $1,000,000 • • GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 7�PRO- POLICY Xi JECT LOC I 1 I PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CAA027910517 12/31/2015112/ 31/201 I{EaM81'NdEeD SINGLE LIMIT $1,000,000 XI ANY AUTO 1 I BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NOTN-O ED j PROPERTY DAMAGE $ j (Per accident) B X UMBRELLA LIAB X OCCUR ZUP91M208931 12/31/201512/31/2016 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS MADE I AGGREGATE $10,000,000 DED I XI RETENTION$10,000 I $ A WORKERS COMPENSATION WCA027910717 12/31/2015112/31/2016 X PER OTH- AND EMPLOYERS'LIABILITY Y/N ! STATUTE _ ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 OFFICER/MEMBER EXCLUDED? N N/A' I ,000,000 (Mandatory in NH) E.L.• DISEASE EA EMPLOYEE $1,000,000 If yes,describe under 1 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $1,000,000 1 1 1! DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) SAMPLE Certificate of Insurance CERTIFICATE HOLDER CANCELLATION SAMPLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SAMPLE ACCORDANCE WITH THE POLICY PROVISIONS. SAMPLE,ZZ AUTHORIZED REPRESENTATIVE OA _. ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD 1M1 ARR1 dA7/11/11 RR4Rc7Q C41 f17P Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Applicant is responsible for obtaining all of the required approvals. No •ermit will be issued until all the re.uired si•natures are obtained. (YNCz y070/0 `-11‘ I Property Address • tO (C ak-LJ F Pct‘47)-9 Job Description Required Department Permit Issuance Approval Approval $ i/fz/ fL Tax Collector j / r Signature/date Comments: Planning &Zoning G� Signature/date # Comments: Fire Marshal /,l /i 24= f Signature/date Comments: ❑ Health Department Required for properties with private septic or well Comments: ❑ WPCA, Administrative Required for properties on sewer Signature/date Comments: ❑ WPCA, Operations When Required by WPCA Signature/date Comments: ❑ Department of Public Works Required when project includes driveway work or certain drainage requirements Signature/date Comments: ❑ Montville Police Department • Required for all permits EXCEPT one and two family residential Signature/date Comments: O State Dept. of Transportation Required for Structures over 100.000 sq.ft.or with more than 200 parking spaces-Official copy of STC Certificate of Operation required—per CGS 14-311 Signature/date Building Department Review Complete Signature/date Revised May 23,2011 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860)848-3030 X382 FAX. (860) 848-7231 MECHANICAL PERMIT Permit Number: M2016-0174 Date: 03-Nov-16 Map/Lot: 087/024-QUA Owner ID: 5810000 Project Location: 245 RAYMOND HILL ROAD Unit: Job Description: Install Ductless Split A/C and Heat Pump on a 36000 BTU Condenser Owner Nam Lori Jean Lafayette Tenant Name N/A Careof: 245 Raymond Hill Road Uncasville .._CT 06382- Telephone: (860)204-1199 Applicant Name Rick Hatch Telephone: (860)848-9993 DBA: R&W Heating Energy Solutions LLC Lic/Reg Type S1 Lic/Reg N 303639 10 Witter Road Exp Date: 31-Aug-17 Salem CT 06420- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $10,850.00 Mechanical Fe $132.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $10,850.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $2.82 Total Fee Paid: $134.82 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 ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor frami ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble 0 Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Is Certificate of proval • 'e i 'c• o� f Occupancy Building Official's Approval: i own or ivlontvuie Building Department 310 Norwich-New London Tpke. Tel.860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 PERMIT APPLICATION FORM Permit No.:rilD J1 if Type of Work Occupancy Classification Construction Type Permit Type ❑New Construction 0 A-1 ❑B ❑H-1 ❑I-1 ❑R-1 ❑S-1 ❑ Type IA Type IB BuildingID Addition 0 A-2 0 B,Medical H-2 0 1-2 R-2 S-2 Type IB 0 Type IV0 Plumbing❑Alteration A-3 ❑E H-3 0 1-3 R-3 0 U Type IIA Type VA 0 Mechanical al['Change of Use 0 A-4 F-1 H-4 1-4 0 R-4 Mixed Type IIB Type VB ❑ElectricalA-5 F-2 0 M 0 Type IIIA CRS#: Property Address: 24 5 9,,e,y morel t V\\ c\ (Number) (Street) (Unit) Job Description: 9 Zone ' 1 c-�esss 1- Y4eA± p.)tY)f) On •g(p.a 606 0-0 Crxtletnw- Owner: Ti r t L.eSCNP Tenant: Address: 2'-15 'P'Gy r c _..Address: City/State/Zip: �1V Y�Lp CST �D� City/State/Zip: Telephone(&OD ) LOL( - ILq q Telephone( ) Applicant: �,\CAC_ Rej,*c.)I DBA: 1)..tW "1erL*4rr I %y SoW4t-t 6nLLC. Address:_1Q W\}tom City cSCZein State: C-T Zip Code: Nat-116 6 Telephone(Ria) )c1- - °ICA Contractors -Complete the Following: License/Registration Type: S 1 License/Registration No.:c O3(p 39 Expiration Date: (8-13 1 1 I hereby certify that the proposed work will conform to the State 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: 70- T t�7 Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: (V.Si-TO Mechanical Fee: I ) .00 Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: 3y. , Qeuiser August 23,2007 Town of Montville Building Department File Receipt Date: 3t Ort-16 ReceiptNo: 11807 Received From: R&W Heatina Enerav Solutions Job Address: 245 Raymond Hill Road Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: 50.00 Bldg Check: $134.82 State Check: $ 2.212 Bldg Credit: $0.00 State Credit: $Q.00 Fire Cash: $0.00 Fire Check: $0.00 Fire Credit: $0.00 Construction Value: $10.850.00 Demolition Value: $0.00 CheckNo: 11276 Received By: Carmen Kneeland CetA J/ , ����,^ Address: 245 Raymond Hill Road ITEM QTY $/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA Basement,Finished - SF $ 41.96 $ - $ Interior Renovations SF $ 36.09 $ - $ - $ AMENITIES Kitchen EA $ - $ - $ Full Bathroom EA $ $ Half-Bathroom EA $ $ GARAGE Detached - SF $ 71.53 $ - $ MECHANICAL Warm-Air n Y/N _ $ Hot Water n Y/N _ $ Electric n Y/N Air Conditioning n Y/N $ - $ ELECTRICAL SERVICE Upgrade Amps Subpanel EA $ 699.00 $ - Gen Set Fes, $ 3,850.00 $ - SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace CA $ 6,497.70 $ - Masonry w/tfireplace Fes, $ 7,096.65 $ - Masonry w/2 fireplaces CA $ 11,095.70 $ - Wood Stove,free standing EA $ 2,692.25 $ - Wood stove insert EA $ 1,859.77 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 44.07 $ - Porch SF $ 149.38 $ - Sunroom SF $ 176.90 $ - $ POOLS&HOT TUBS Hot Tub EA $ 8,016.25 $ - $ Inground Pool EA $ 31,550.00 $ - $ Above Ground Round EA $ 6,299.46 $ - $ Above Ground Oval EA $ 7,019.75 $ - $ Pool Heater EA $ 8,984.25 $ - $ Inflatable Type Pool EA $ 1200.00 $ - $ SHEDS w/o electrical SF $ 25.55 $ - w/electrical SF $ 26.85 $ - $ RENOVATIONS Roofing,Overlay SF $ 3.50 $ - Roofing,Strip&reroof SF $ 4.50 $ - Roof Sheathing SF $ 1.51 $ - Siding SF $ 6.75 $ - Windows EA $ 550.00 $ - Skylights EA $ 1,051.10 $ - Doors,Exterior EA $ 601.50 $ - Oil Tank,275 Gallon EA $ Oil Tank,550 Gallon EA $ MISCELLANEOUS CALCULATIONS $ 10,850.00 TOTALS $ - $ - $ 10,850.00 $ - PERMIT FEE CALCULATIONS Construction Value Fee Building $ _ $ _ Plumbing y $ - $ Mechanical y $ 10,850.00 $ 132.00 Electrical y $ - $ Working before Permit Issuance $ _ Certificate of Occupancy Fee $ Plan Review Fee $ State Education Fee $ 2.82 TOTALS $ 10,850.00 $ 134.82 Figures are based on the 2006 RS Means Residential Cost Data r • I!.,,Ira..;.;`.*,. E::i'a41!{��; fid+ ,.•'.)iY.�.4.:..e. ',Ft"- `•'1., w "-�' r,: --.':•'`,. ...,.. �: . ! r,' A r t,r !� %:. ANY fS. l.�.3 •1 r. —.f L _0 C rr _ — ; a U .-. ' . ". ) . g In )) l 1:4 sjj 7 ► <,' `' ct (-----2 .',$)0,- Z CZ '(.1.-?) ;:) ' a,-.,,t-,:•:. j . •..5.,;. ,_. C..). " LT... U4.1 1 ccc a M g E--4 0 ________=_A ,•,:.,-,,...,• c...) c) -,_,,„,p,„,. .."4.4.„,--.‘ -- g ,ar•_-:-.... w a a r—i livr-----_-,e,--.3.• 'rt _ a F-1 c = '• ' _ti v . .4 G •0 _ < w W y =`r • . '+,,•lr :..4:::r.rp.i1't •Ie.fl :.4e. .7 AlyP i• /i- : a K: . .. T .:.� s r A'..,.._./. � �3.r.a @O? +Vi•o- :Ir 'h-+{k:F- �,` h=.ii _NI. ';.1.v,• :'.1,q f4_ . a+ ..1,-ts3'.A t`C .. r �v10,.1.....'..:•:-A''' ' . .. ,4. 1,..,•,-....,.4. ..41.„., 7 � ____.—....,,,, RANDW-1 OP ID:KM ACORN- DATE(MM/DOIYYYY) 4.........-- CERTIFICATE OF LIABILITY INSURANCE 04/11/2016 THIS CERTIFI.ATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE LIES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS L?RTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVL OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to tho 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 CONTNAME: Mark Mark S Spinnato Bouvier Insurance PHONE 860-859-9821 FAx _ 860.561-8778 80 Norwich New London Tpke INC,No,EsII: (A1C,No): Uncasvllle CT 06382 E-MAIL ADDRESS: mspinnato@binsurance.com Mark S Spinnato INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Pacific Insurance Company 10046 INSURED R&W Heating Energy Solutions INSURER B:Patrons Mutual Ins.Co. 14923 LLC INSURER C: • 10 Witter Road Salem,CT 06420 INSURER D; 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 TYPE OF INSURANCE ADDL SUETS POLICY EFF POLICY EXP LIMITS LTR INSR wvn POLICY NUMBER (MM/DD/YYYY) IMMIDDIYYYY) GENERAL UABIUTY EACH OCCURRENCE S 1,000,000 PBP2622848 04113!2016 04113/2017 DAMAGE TO RENTED S 100,000 B X COMMERCIAL GENERAL LIABILITYPREMISES(Ee occurrence) CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 ___ _______ _ PERSONALaADV INJURY S 1,000,00d GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000, POLICY ECTLOC I S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ (Ea accident) $ B X ANY AUTO BAP2350074 04/13/2016 04/13/2017 BODILY INJURY(Per person) $ 1,000,00d — ALL OWNED SCHEDULED BODILY INJURY(Per accident) S HIRED AUTOSAUTOS _ AUTOSAUTOS I ON-OWNED JPERPACC DENT)AGE S — I S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE lI S 4,000,000 B EXCESS UAB CLAIMS-MADE PBP2622848 04/13/2016 04/13/2017 AGGREGATE 4,000,000 DED X RETENTIONS 0.00 1$ WORKERS COMPENSATION WC STATU- IOTH- AND EMPLOYERS'LIABILITYY/N i TORY LIMITS . ER_ A ANY PROPRIETOR/PARTNER/EXECUTIVE N/A I 02WECEH3447 04/13/2016 04/13/2017 E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH). . I E.L.DISEASE-EA EMPLOYEE S 1,000,000 DESCRIPTION OF OPERATIONS•balow I E.L.DISEASE-POLICY LIMIT S 1,000,000 I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) • • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE R&W HeatingEnergyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Solutions LLC 10 Witter Rd. . , AUTHORIZED REPRESENTATIVE Salem,CT 06420 • •e...,6 14( ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL P operty Address Jo Description Required Department Approval ' Permit Issuance Approval Tax Collector e0/3 i// (� Signature/date Comments: Fire Marshal J /044 Signature/date Comments: ❑ Planning &Zoning Required for all permits except Signature/date Plumbing,Electrical,Mechanical,Roofing,Siding,Windows&Doors ❑ Health Department Required for properties with private septic or well Signature/date Comments: ❑ WPCA, Administrative Required for properties on sewer Signature/date Comments: ❑ WPCA, Operations When Required by WPCA Signature/date Comments: ❑ Department of Public Works Required when project includes driveway work or certain drainage requirements Signature/date Comments: - ❑ Montville Police Department Required for all permits EXCEPT one and two family residential Signature/date Comments: ❑ Copy of State Dept. of Transportation Certificate Required for Structures over 100,000 sq.ft.or with more than 200 parking spaces-Official copy of STC Certificate of Operation required—per CGS 14-311 Signature/date Building Department Final Inspection Revised March 23,2015