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HomeMy WebLinkAboutAir Conditioning Town of Montville / BUILDING DEPARTMENT f^ 310 Norwich-New London Turnpike f 9 Uncasville, CT 06382 860-848-3030, Ex.t 82 Mechanical Permit Permit Number: M2002-078 Permit Date: 16-May-02 Permit Code R5 Job Location 8 ANN AVENUE UNIT MAP/LOT: 109/072-000 Job Description: Central Air Conditioning Owner Contractor RAYMOND M BATCHELDER Eastern/USA Fuel P. 0. Box 239 8 ANN AVE Unit: Bozrah, Ct. 06334 UNCASVILLE CT 06382 Telephone: 642-7832 Uc/Reg Type: S1 Use Group R4 Lic/Reg Number: 303675 Code 1995 CABO Exp Date: ~ 8/31/0.2 Construction Type 5B Construction Values Permit Fees Building Value: $0.00 Building Fee: $0.00 Plumbing Value: $0.00 Plumbing Fee: $0.00 Mechanical Value: $2,500.00 Mechanical Fee: $16.00 Electrical Value: $0.00 Electrical Fee: $0.00 Other value: $0.00 Other Fee: $0.00 Total Value: $2,500.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 E State Ed Fee: $0.40 Total Fees: $16.40 It is the owners responsibility to schedule the following reauired inspections (minimum 48 hours notice reguested)• ❑ 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 ❑ Rough Electrical ❑ Firestopping/draftstopping ❑ Electrical Service ❑ Insulation ❑ Rough Plumbing and Leak Test © Final Inspection ❑ Gas Piping and Pressure Test ❑ icate of Occupancy - Prior to use or occupancy Building Official's Signature: /z/ Z,-" ~r7 Town of Montville y Building Department Permit 31 0 Norwich-New London Tpke. Tel. 848-7166, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Trades Permit Application Form Dlyumcnng EI TY5cmcd 5techamcaf eating .fir Co;;& oning Gas Tiping Job Location Y /.I~d~ /J L)--Z__ Job Description/Materials s /~7 v r~C ,p 6~c~ C f } Owner h,e Mailing Address City Z>~i. e cv State C-1 '`-'Zip Tel FC C> /24? / 3,9, 2 Contractor 54~ Mailing Address k 93c/>,r-' 23!2 23' c, 2 !J ~ City CZ >d A State Zip OC 3,3-l- Tel ?CQ /C,4a I 3 Contractor's License/Registration Type & Number .S/ ~C>3~ Exp. Date /.3/ / G 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 ~Oaa, Date Zf' Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ -cea. $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $~5 Town o Montvihle Buildina Departrr-`nt Receipt No. Date From: 2 .,-le~ Job Address: Cash' check, Amount Received by ; r- c HEATING, ponNG & COOLING UftIMfMD CONTRACTOR Type: S1 RICHARD' O pOTHIER JR 414 PUTNAM PIKE DAYVILLE, CT 06241 EFFECTIVE EXPIRES LIC./REG. NO. 08/31/2002 3(1367 09101 SIGNED` Clientt-'- 32477: y ASTUSA DATE (MMlDOlYYj C.ERTIFICQ E OF LIABILITI INSUI ~►NCE 06/29/01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hilb, Rog -1 & Hzmilton 'Company ONLY AND "CONFERS NO "RIGHTS UPON THE' CERTIFICATE HOLDER. z,THIS CERTIFICATE ''DOES NOT AMEND,' EXTEND OR CT,, LLC ALTER THE COVERAGE 'AFFORDED BY THE POLICIES BELOW. State House Sq POBox 232100 Hartford, CT 06123-2100 INSURERS AFFORDING COVERAGE INSURED INSURERA:Great American Insurance Cam an Eastern USA Fuel, Inc. INSURER B:American Alliance Ins. Co. P.O. Box 239 INSURER C: Bozrah, CT 06334 INSURER D: i INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSA TYPE OFINSURANCE I POLICYNUMHER POLICY EFFECTIVEIPOLICYEXPIRATIO LIMITS AlDorm 11 A GENERAL LIABILITY PAC3 5 3 8 9 81 07/05/01 0 EACH OCCURRENCE sl 0 0 0 0 0 0 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire S loo 000 CLAIMS MADEa OCCUR I MED EXP (Anyone person) Is 5 0 0 0 PERSONAL BADV INJURY s1 0 0 0 000 GENERAL AGGREGATE s2 0 0 0 0 0 0 GENT- AGGREGATE LIMITAPPLIESPER, PRODUCTS-COMPICPAGG5 1 000, 000 O- I F-1 POLICY! I JPRCT LOC A IAUTOMOBILE LIABILITY ICAP3538982 107/05/01 107/05/02 ICOMPINDSINGLELIMIT ANY AUTO I(Eaac:idEent) S= 000 0 ALL OWNED AUTOS SCCILY INJURY (Per person) S SCHEDULEDAUTOS X 1 HIRED AUTOS : - 8CC!LY INJURY ~`-'INON-OWNED AUTOS (Per ac--:Cent) ZX . FRCPERTY CAMAGE S (-er :cement) GARAGE LIABILITY AUTO CNLY• EA ACCICENT: S _ ANY AUTO OTHER THAN. =A ACC S - AUTC ONLY: AG S 5 : EXCESSUABIL!TY UME3751689580 0-7/03/0= 07;%v^^5/01 EAc~-cccuR ._0-c X'. OCCUR CLAIMS MACE! AGG^c ATE _ CEDUCTIBLE X; RETENTION $10 000 - S A l WCRKERS COMPENSATION AND VC3 5 3 8 9 8 3 007/0-5/01 07/05/02 X :T nY L M1T5 EMPLOYERS' LIABILITY j E.L. EACH ACCICENT ? S5 O 0 000 1Z E.LCISEASE-EAEMPLOYE= _ $ ~ C. O 000 _ E L DISEASE-PCL!CY LIMIT- SS 0 0 c o o OTHER DESCRIPTION OF OPERATION$,'LOCATI0YSIVEIUCLES/EXCLUSIONS kDDED BY E.YDORSE.MEN't CERTIFICATE HOLDER I ADDn"30NALr,[SURED:t4SUREIZLETM3L- CANCELLATION SHOULDANYOFTHEABOYED690MON~DPOa CWIDW.C."r,ELLet)BEFORETHEDFFATION Evidence . DATE THEREOF.THEISSUING lNfWR1ER1aYF4f E9f•3RAVOATOMAIL30___DAtSWRITTEN HEATIfIG FIPNgS CONRRACTOR NOTICETOTHE CERT>FIOATIt HI?4A Alt FdfTF t4 T, at)TFAILtS TO DOSOSHALL IMPOSE NO OBLIGATION OR LIABILl7Y tW AHY ktNC1 UPON THE INSURER,ITS AGENTS OR R „ JR REPRESENTATIVES. 414 PJKE AUTHORIZED REPRESENT TIME ~e DA ; r'C'f 06241 sC ~ G~f . GT G L ' LIOIREG. NO EXPIRES ACORD CORPORATION 1988 A col~n 25-S C oeratnoo2 LAF o SIONED•