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TOWN OF MONTVILLE
BUILDING DEPARTMENT
310 NORWICH-NEW LONDON TPKE.
UNCASVILLE, CONNECTICUT 06382
Building Permit Tel. 860-848-7166 Fax 860-848-7231 Page:1
Printed:8117/99
Permit Number: BP1999-251 Approved:
Applicant: Northeast Home Impoovment Zoning:
39 Wedgewood Drive Addition:
Jewett City, Ct 06351 Block: 109 tot(s): 074-000
Parcel Number: PARC1999-407 Section:
16 Ann Ave. Township:
Uncasville, Ct 06382 Range:
Area:
Legal Description:
Builder Northeast Home Improvement
,39 Wedgewood Drive Voice: 860-376-0591
Jewett City, Ct 06351 Fax:
Local License: State License: 553370
Fees and Receipts:
Number Description Amount
FEE1999-1394 Building Permit Fee (Auto) $46.00
FEE1999-1395 Certificate of Occupancy Assessory structure $10.00
FEE1999-1396 State Educational Training Fee $1.28
Fees Total: $57.28
Construction Value: $8,000.00 Structure Use: Residential Start Date: 0/0100
Purpose: vinyl siding & windows End Date: 0/0/00
Floor Areas Impervious Surfaces
Living Space: 0.00 Basement/Storage: 0.00 House: 0.00 PorchMalk: 0.00
Garage: 0.00 Porches: 0.00 Garage: 0.00 Other: 0.00
Decks: 0.00 .Other: 0.00 Driveways: 0.00 Total: 0.00
Total Area: 0.00
Site Area: 0.0.0 Structure Area, 0.00
Percentage of Site:
- s_111949
Building fficials Signature 457 Date
Town of Montville
Building Department
310 Norwich-New London Tpke., UncasviIIe, Ct. 06382 `!'el. 848_
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APPLICATION FOR BUT DING PERMIT OF. TRADES PERMIT, Please fill out completely
Owner: ~ ~J-C -e- Mailing Address: /j- /4011 .-A-e,
City: d 1/ 41 l
7 -
State: - ` t Zip Code 6 ,Z Tel: Job Location: Ah/I Map/Block/Lot: ~7L
Jont ractor : 1 Jdd7 Mailing Address:
`l
i t y State
P^Cod~~~~~~**~r**~*~~~
;'tick Built: Modular Rome: Manufactured Home: Commercial: _
.ddition: Garage: Car Port: Shed:
~ - / Remodeling: Roofing:
Siding: Fireplace: Chimney: Windows: Pool: Demolition:
lumbing: Heating: Electrical:
Air Conditioning: Gas:
atio:--- Porch: --Deck: Retaining Wall: -New: Re air pe
placemer
-)b D' cription/Materials used: f~ r
(-t c,16
tcl- 17 ke-~,
.ze'- Type of Heat:
- Fireplace:
.of Stories: No. Rooms:
_ Bree~~.ay : -
Baths: Garage: -
Use:
I hereby certify that the proposed work will confornn to the Basic
i.ldir_g Code and all other Codes 'as adopted by the State of Connecticut, and
e Town of Montville and further L
attest ?-i~G
.,rte.- t the proposed wort: is authorized
the owner in fee and that I am auth ized make application for a permit
such work as described above.
ier/Ager_t Signature
Date ! d~J
signed by Contractor , type of license re 2/1
*~t*go
Building IDerartm-nr
cosist-ruct gD k1alue
Building, Fed
Plumbing -
Heating
Electrical
Air Cond.__ i
Other
Certificate of Occupancy ___1o d
Plan Review
Total _ ~ Rte' N,P
Cash/Checl:
fit, i1 n~i.id'~1~.•f'P i~, d
STATE QF CONNEC ICUT
i DEPARTMENT OF CONSUMER PROTECTION i
165 CAPITOL AVE • HARTFORD CT 06106-1630
I Be it known that
NORTHEASTHOME IMPROVEMENT INC
I SUITE 17
39 WEDGEWOOD DR
JEWET CITY CT 063511
Is hereby certified by the Department of Constimer Protection as a registered
HOME IMPROVEMENT, CONTRACTOR
REGISTRATION NUMBER: Q0553370
EFFECTIVE DATE: Woi/98
'
EXPIRATION DATE: 11/30/"
DBA: NORTHEAST HOME1WROVEMENT INC i
CONTRACTOR OF RECORID: JAMES r» AND Mark A. Shi£frn
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M/
,~+~p/~ DATE(MDD/YY) i
t`~ruL,LI].~i~l,. ..:07 14
MRT
, i i99
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
BYRNES AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE_ POLICIES BELOW.
108 SACHEM STREET COMPANIES AFFORDING COVERAGE
NORWICH CT 0 6 3 6 0 COMPANY
A C G U
INSURED COMPANY
NORTHEAST HOME IMPROVEMENT INC B
COMPANY
39 WEDGEWOOD DRIVE C
JEWETT CITY CT 06351 COMPANY
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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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY CBR 6 313 5 3 5/11/99 5/11/00 GENERAL AGGREGATE s2, 000, 000
x COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $2,000,000
CLAIMS MADE a OCCUR PERSONAL & ADV INJURY $1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
FIRE DAMAGE (Any one tire) $ 100,000
j
MED EXP (Any one person) $ 5 , 0 0 0
AUTOMOBILE LIABILITY PBAP4 8 2 2 3 5/01/99 5[01 00 300,000
COMBINED SINGLE LIMIT $
ANY AUTO
ALL OWNED AUTOS BODILY INJURY $
j K SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
j
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND ABH 17 6 74 9 5/11/ 9 9 5/11/00 X TORY LIMITS ER
EMPLOYERS' LIABILITY EL EACH ACCIDENT $ 100,000
THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 5 0 0 , 0 0 0
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
KEY BANK USA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT F LURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF AN KIND UPO E COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUT ORI2 REPRE TA E
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