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HomeMy WebLinkAboutRoofing, Siding, and Windows 2002 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030, Ext.82 Building Permit Permit Number: B2002-471 Permit Date: 14-Aug-02 Permit Code R4 Job Location: 426 RAYMOND HILL ROAD UNIT: MAP/LOT: 032/003-000 Job Description: Roofing,siding,windows, kitchen and bathroom remodel Owner Contractor FRANCES S BILLINGS W. R.Allen PO Box 506 364 RAYMOND HILL RD Unit: Quaker Hill,Ct 06375 UNCASVILLE CT 06382 Telephone: 860-447-2992 Lic/Reg Type: HIC Use Group R-4 Lic/Reg Number: 503385 Code 1995 CABO Exp Date: 11/30/02 Construction Type 5B Construction Values Permit Fees Building Value: $16,000.00 Building Fee: $94.00 Plumbing Value: $2,000.00 Plumbing Fee: $10.00 Mechanical Value: $4,000.00 Mechanical Fee: $22.00 Electrical Value: $4,000.00 Electrical Fee: $22.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $26,000.00 C/O Fee: $10.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $4.16 Total Fees: $162.16 Jt is the owners responsibility to schedule the following reauired inspections(minimum 48 hours notice requested): ❑ Footing-Prior to pouring concrete ❑d Rough HVAC ❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab-Prior to pouring ❑ Fireplace Final • Rough Framing ❑ Chimney-One flue above thimble 0 Rough Electrical Firestopping/draftstopping ❑d Electrical Service Insulation O Rough Plumbing and Leak Test ❑ Final Inspection ❑ Gas Piping and Pressure Test ❑d Certificate of Occupancy-Prior to use or occupancy Building Official's Signature: Town of Montville i► Building Department Permit#. zocrz c/"2) 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Building Permit Application Form New Construction 0 Addition ACteration 0 Accessog Structure OOther Job Location (311W /2.44//kov..1 hidiel Job Description/Materials `Qp f /2212.4514S- 410 /,G-A4- 1/1/ZJ/2AJ 41444-A-0,?Id/ Zeidt. Owner WO" 41/401 Mailing Address P(', ZC ( S 06 e City -d, State &/ Zip Tel /W7 7 i 1'/9Contractor W i/( . dia0.+ Mailing Address /?ti 4K-S-0‘ City ZLIAMX State 4" Zip Tel / 00/p2ff 2 Contractor's License/Registration Type&Number , -O.33tc Exp. Date d 130 ICA. 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 C. 4 11.1.4 ad Date 6 'l " Construction Value Fee Building $ / OO $ >y- - Plumbing $ Zoo.i" $ Jo - Mechanical $ yet,c— $ Zz - Electrical $ q ,— $ 2 z — Other $ $ Certificate of Occupancy $ ,c'-- Plan Review Fee $ State Education $ hi,/e Total $ 2 ^roo,— $ /4.2,/G I Town of Montville Building Department Receipt 1 Iri Date -se / /9 / oz wr No. 01039 From: Job Address: 2 61/ ./2.4c4)1,10/.4) 1/1-1 R 0 0 Amount $ /6 Z. /6 Cash Check #/_5 974 (circle one) Received by Permit STATE OF ('ONN1i1 '7'I(1.-I IIII \T(II ((1\1( I/11;1'/ (11( 11(\ HOME IMPROVEMENT CONTRACTOR W R ALLEN&CO INC PO BOX 506 UNCASVIX..LE,CT 06382 Contractor of Record:WILLIAM R ALLEN LIC./REG NO. I E ttCTIVE EXPORES 503385 12/01/2001 I 11/30/2002 .40 wa4 SIGNED Ai. �L4 s., • FROM : CURT IN INSURANCE AGENCY FAX NO. : B6084E2207 Aug. 14 2002 09:21AM P1 -- _ —�-� %CORO CERTIFICATE OF LIABILITY INSURANCE \ DATL IIypIA1DD 0a/14/2007. FAX (860W.8-2201 THIS CERTIFICATE IS ISSUED ASA MATTER Of r.FORM41ION uCER (860)$48-2201 ONLY AND CONFER'S TlO RLG4iXS UPON THE CERTIFICATE vin Insurance Agency, Inc. HLCL11ER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 0 Route #32, BOX 387 ALTER THE COVERAGE AFFORDED EY THE PL,1L.CIES BELOW. casville, CT 06382-0357 � INSURERS AFFORDING COVERAGE ______ RED G In Carpets; W.R.��i0. , Inc, dba INSURER A. 'rave l ai"S uat"Q4l><1 — S1 Rte 32 INsuRSE8_ --- Quaker Hill, CT 06375 it4suRERC. h0'L9 A R 0: -- %%SUREl.B: VERAGES HE POLICIES OF INSURANCE CONDI ION OFAANNY CONTRACT OR OTHER DOCUMENT WIT}1 VE BEEN ISSUED TO THE INSURED NAMED RESPECT TO WHICH.THIS CERTIFICATE MAYS ISSUED OOVE FOR THE POUCY PERIOD INDICA re.7, R I ,NY PER A IN, I TERM OR CONDITION dAY PERTAIN,THE INSURANCE AFFORDED 8Y THE POLICES DE$CRILREl1 HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF S'‘.5C1-4 'OLlC1E2.AGGREGATE U .T8 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — STP ' 3....T ON LIMITS 3 POWC1NtIMtSGR D�TEW:-,h•.W TYPE OF pXSUR.dNGE DA GENERAL LIAO-STY (I 6802 S3C1180INDO1 10/T8/2002 110/13/2002 51C4ocrau2ENCE $ 1,000,0001 X CRRs DAMAGE(Any one Care) $ 30011 $ . XMSM[:RGIAL GENEFY�L LlAB1Lt1'! tf DTI MED EXP(Any one poison} i S 5,' 1 1 7 CLAIMS MADE OCGUR nM RER3ONAL8ADV INJURY r1.vW,0 —. CEHLFeAi AGGREtaA1E i 2,01�0s Ir r I rR00UCT5-COMPIOP AGG $ 1,600,14t ORM AGGREGATE LIMIT APPLIES PER: POLICY I _ PEa 1 1 LDC D01 10/18/28 AurouwiuE. ►s►LtTY I811053C1180IN0011 10/1002coM5INEh siNGLG LIMIT $ ,5a,coite pII ?i 505004, , ► ANY AUTO l ALL OW AUR S 1 I BOOILr INJURY S (Per X SCHEDl1'.F.D AUTas f ,.• X 14IRPAAUT05 80' DILacclY 1NJuRY S I(PerXsem) X NON-OWNED AUTOS M— —_ PRAPERTY DAMAGE i (Pet accident) ------- - AUTO ONl Y-EA AGCID N f S GARAGE LIABILITY SA ACC s OTHER THAN ANY AUTO .w 10CWEY: AGG t Excess LIAMLITY '--WSFCUP6S3H7614INDO1 10/18/2001 10 13/2001 eAcH otrAmeNc4 t 1 _ 000, 111 x OCCUR S.I.AIMS lace �AGER.rr-i47F i A Sr §-- DEDUCTIBLE $ RETENTION S WORKERS COWL/CATION AND THUB82I0288201 10/18/2001 10/18 002 X . v Atil- 1111WAIIIIIIIIIIIIM EMPLOYERS LIABILITY C.L.EACH ACCIDENT $ 1.,009,`, I A Q-L.DISBASF-EAEMPLOYF.E S 1.,0 0,, I , IEEl,DISEASE-POOLICT"t:114ttT I 1,060,I 11. ..--+ OTHER - t srfaxpTiON OfATION91LOCATIOIMEHIC C Y� @Y SIN YpS6ENT1SPE NIE PROVISOMS )fcc6 Site. 36 4 Raymond Ni CERTIFICATE aDtxw Ir►+I.INSLXgC;INSURERLEfTER� CANCELLATION !' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE-CANCELLLfI 1FOrte TM! EXPIRATION DATE THEREOF.THE ISSUING 1NSURIM WILL ENDEAISOR TO MAIL. _m__DAY$WRITTEN NOTICE TCI THE GLRYIFICAFP h OLDEA MASA TO THE LEFT, Town of .Mantvi l J e 1 BtF?FAILURE TO YAW EUCH Ranct MBA.IMPOSE NO OBLIGATION OR LIABILITY 310 Route #32 of AIWA—PO LeAt 0*iNSL&SER.LTB AMENTS OR REPRESE/NTATIVES. UnCaSvil l e, CT 06382 AUTHORED RRPRESENTATNE ,,ar1 as Cook/G7 +ty, ACORD 23.5(7/9n FAX 848-7231 I CORX CORS N?AW