HomeMy WebLinkAboutHeating for SFR
Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville, CT 06382
(860) 848-3030, Ext. 382
Mechanical Permit
Permit Number: M2004-0071 Date: 02-Apr-04 Map/Lot: 043/009-026 Owner ID 1750
Job Location: 4 ALIOa'S 1bl~Y Unit
Job Description: Heating
Owner: Contractor:
RTT Development William Rheaume
1295 Route 32
35 Blais Road Uncasville Ct. 06382-
Uncasville CT 06382 Telephone: (860) 848-2647
Lic/Reg Type/No. Si 303676 Exp Date: 31-Aug-04
Tenant:
Self
Telephone:
Construction Values Permit Fees Construction Information
Building Value: $0.00 Building Fee: $0.00 Use Group: R4
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO
Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 5B
Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: R5
Other Value: $0.00 Other Fee: $0.00 Comments:
Total Value: $0.00 CO Fee: $0.00 Included on Building Permit
Plan Review Fee: $0.00
State Ed Fee: $0.00
Total Fees: $0.00
It is the owners responsibility to schedule the following inspections (minimum 48 hours notice required):
❑ Footing - Prior to pouring concrete ❑d Rough HVAC
❑ Backfill - Footing drains and waterproofing ❑ Fireplace Throat
❑ Concrete Slab - Prior to pouring concrete ❑ Chimney - One flue above thimble
❑ Rough Framing ❑ Firestopping/draftstopping
❑ Rough Electrical ❑ Insulation
❑ Electrical Service CRS 0 ❑ Final Inspection
❑ Rough plumbing and leak test ❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signature,
Town of Montville
1--i Ir Buildtnt- ?epartment Permit #
310 Norwich-New London Tpke.
Tel. 848-3030, Ext 82 UncasviLe, CT.06382 Fax. 848-7231
One & Two Family Trades Permit Application Form
nPfumding []Electrical E fMec/umicaf
HeatM
Air Conditioning
~ther Chas Piping
❑ .
Job Location
Job Description/Materials t 0, ~ - r l `7 Y L l r
Owner irk C-~3 Mailing Address
City Qt.c State C 7 Zip 3 Z Tel / I !cr ? Z
Contractor t k< <wr+ ~ a Mailing Address
City ~ , C.a.s State L-I Zip - Tel I ~ ~l LX q
Contractor's License/Registration Type & Number---,-, ~ t53 Fa Exp. Date
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 farther 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/
Construction Value Fee
Building $ $
Plumbing $ $
Mechanical $ $
Electrical $ $
Other $ $
Certificate of Occupancy $
Plan Review Fee $ .
State Education $
Total* $ $
r
STATE OF CONNECTICUT
IDEATING, PRING & COOLING UNLA
WILLIAM L RHE119 MOXLEY RU ICASVILLE, CTYPE: S1
LI'O. REG NO. EFFECTIVE 303676 09/01/2003 SIGNED
el'
1
Nafionallfidemr1i0l Co.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATION PAGE RENEWAL AGREEMENT.
Coverage is provided in 'Agency: 96018 Pr#: 1
Evergreen, National Indemnity Company The Pawson Group
(Carrier Code: 20362) 5 South Mairi Street
Branford, CT 06405
Carrier Policy 00300000.1675100
Carrier Prior Policy 003000001675099
1. The Insured: Rheaume Heating LLC Dba
Uncasville Oil Type of Business: Other
Mailing Address: '65 Maple Avenue Fein: 061479106"
Uncasville, CT 06382 Risk ID:
Other workplaces not shown above:
NO O'iHF,R WORKPLACES FOR THIS "POLICY
2. The policy period is from 12:01 a..m. on 6/02/2000 to 12:01 a.m. on-.602 /2001
at the.insured's mailing address.
3. A. Workers Compensation Insurance.: Part One of the policy applies to the Workers
Compensation Law of the states listed here:. CT
B. Employers Liability Insurance: Part.Two of the policy applies to work in each
state listed in Item 3.A. The limits of our liability under Part Two are:
Bodily Injury by Accident $ 100,"000 each accident
Bodily Injury by Disease $ 500.000 policy limit
Bodily Injury by Disease $ 100.000 each employee
C. 0-her States Insurance: Part 3 of the policy applies to all states, except ND, OH,
WA, WV,-WY and.the states. designated in 3A above.
D. This policy includes these endorsements and schedules:
WC000000A(04/92) WC000311A(08/91) WC000406(08/84) WC000414(07/90), WC060301(04/"84)
k WC060303B(04/96) WC060401(0,7/96)
4.. The premium -Fox this policy will be determined by our Manuals of Rules;.
Classifications, Rates and Rating Plans. All *information required belour is subject
to verification and change by audit.
Glas-sifications Code Premium Basis Rate Per. Estimated
No. Total Estimated $100 of..: Annual"
Annual.Remuneration 'Remuneration' Premium yF
SEE SCHEDULE OF OPERATIONS .1.
TGial Estimated Annual Premium 7,154.00
Minimum Premium $ 750.00 Expense Constant $ 180.00