HomeMy WebLinkAbout2003 - Air Conditioning
Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville, CT 06382
(860) 848-3030, Ext. 382
Mechanical Permit
Permit Number: M2003-0070 Date: 14-May-03 Map/Lot: 081/077-000 Owner ID 7012
lob Location: 27 ~EEH{~(_QO~ ROAQ Unit
Job Description: A/C in attic
Owner: Contractor:
Miles Mark and Lori Miller Stray Standish Heating & Air Conditioning
31 Clinton Avenue
27 Beechwood Road Norwich Ct. 06360-
Oakdale Cr 06370 Telephone: (860) 887-8999
Lic/Reg Type/No. S1 388945 Exp Date: 31-Aug-03
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: $6,000.00. Mechanical Fee: $34.00 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: $6,000.00 CO Fee: $0.00
Plan Review Fee: $0.00
State Ed Fee: $0.96
Total Fees: $34.96
It is the owners responsibility to schedule the following inspections (minimum 48 hours notice required):
❑ Footing - Prior to pouring concrete 0 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 ❑d Final Inspection .
❑ Rough plumbing and leak test ❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signature:
-ZZ-.
Town of Montville'
Building Department Permit #
310 Norwich-New London Tpke.
Tel. 848-7166, Ext 82 Uncasville, CT 06382 Fax. 848-7231
One & Two Family Trades Permit Application Form
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Other
Job Location p2 2 kee,-4 JC.II'y &
Job Description/Materials su ~z r Z v ~o
Owner 2V ~a Mailing Address o2 7 jOeeck Lyocj d
City - ✓l State Q 7' Zip r 3 ;U Tel iw d /!ZE/
Contractor JT /_c k- (V /le Mailing Address 7e- j, j U e-
C ity .10n r ov I L / State G f --Zip 1 4 3 661 Tel.,FI, 61 /
Contractor's License/Registration Type & Number Exp. Dater/_3j-/ Q _3
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_ Date
Construction Value Fee
Building $ $
Plumbing $ $
Mechanical $ $ Aq,
Electrical $
Other $ $
Certificate of Occupancy $
Plan Review Fee $
State Education $
Total $ $
Town of-Alonn'ille Building Departrr* -~t Receipt
4
'No. X47 S f
tE Date ;5/
From:
Job Address:
- Check #
Cash Chcck
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Amount clc nc
f Permit #
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Received by -
31 Clinton Avenue
00N Norwich, CT 06360
MEN
0:060 (860) 887-8999 Fax (860) 887-8890
"TANDISH -
HEATING AND AIR CONDITIONING 1-888-4 4
2QU0 www.standis ndish hvac.com
CT LIC.#309114/#388569
DATE:
TO:
SUBJECT: MY DESIGNEE -Donna M. Carter
TO WHOM IT MAY CONCERN:
I hereby designate Donna M. Carter to be my agent in acquiring the
Permit for
At 01-2 13e_e_c,4iwcf0r.ir
on behalf of Standish Heating & A/C, Inc. of Connecticut.
The work to be performed will be to:
Thank you. STATE OF CONNECTICUT
DEP4RTUENT OF CONSUMER PROTECTIO-V
Very truly yours, HEATING, PIPING C _ _ - cUNTRACTOx
Standish Heating & A/C, Inc. 1vacH %FJOUC uR
77 $ ~K~ PI." RD
~~CEr~'~''R2
TIM, Sl
~ rt6eur LIC. REG NQz EXPIRES
el 388945 t3Of~a£i X8/31/2003
License #388945 (S-1) 'SIGNED
Expiration date: 8-31-03 - - -
STANDISH HEATING & AIR CONDITIONING 002941
- - - - - - -
-To
STANDISH HEATING & AIR CONDITIO ING 4(,) Ceef
OPERATING ACCOUNT 002941
31 CLINTON AVENUE -57
NORWICH, CT06360'~ 9 tFIEca< f o
1
DATE AMOUNT
PAY
TO THE
ORDER
OF
AUTHORIZED SIGNATURE
294 i:01190057Ll: 9L.030 9473211'
- - - - -
002941
STANDISH HEATING & AIR CONDITIONING
TO REORDER CALL: TRANSFORM TECHNOLOGIES 800-226-2564 FAX: 770-729-9191
Apr 16, 08:25 EDT by: ACBCAROL BRANCH (EX (08:26) Page 2 of 2
. ~r DATE (MM/DDNY)
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04/160
/ 3
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
GENCORP INSURANCE GROUP ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
16 MAIN STREET COMPANIES AFFORDING COVERAGE
EAST GREENWICH RI 02818 COMPANY
A THE HARTFORD
INSURED COMPANY
STANDISH HEATING & AIR B
CONDITIONING INC COMPANY
31 CLINTON AVENUE C
NORWICH CT 06360 COMPANY
D
:Ot$SLIEEUI{aES:`;:;:i :::::::i:S::: :::::::::i::::::::'::: ::i::ii::: ::::::::::::::::::i: :5<:<::•
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
LTR DATE (MMMWYY) DATE (MMIDD/YY) LIMITS
GENERAL LIABILITY 0 2 S BANF 7 8 7 4 4/01/03 4/01/04 GENERAL AGGREGATE $ 2 , 000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG s2,000,000
IF7 CWM S MADE ~ OCCUR PERSONAL & ADV INJURY $1 , 0 0 0 , 0 0 0
ER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
FIRE DAMAGE (Any one file) $ 300,000
Mm EXP (Any am person) $ 1 0 , 0 0 0
AUTOMOBILE LIABILITY 0 2 UECFC 5 218 4/01/03 4/01/04 1,000,000
X ANY AUTO COMBINED SINGLE LIMIT $
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per p-)
X HIRED AUTOS BODILY INJURY
(Per aoddent) $
X NON-OWNED AUTOS
R PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY_ - -
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $ _
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS coMPEmAnON AND 02WECGP6523 04/01/03 04/01/04 TORY TuAjA X ER _
EMPLOYERS' LIABILITY -
EL EACH ACCIDENT $ 500,000
THE PROPRIETOR/ LNCL EL DISEASE-POLICY LIMIT $ 5 0 0 , 0 0 0
PARTNERS/EXECUTNE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 5 0 0 , 0 0 0
OTHER
DESCRIPTION OF OPERATIONS&OCATIONSNEIYCLES/SPECIAL ITEMS
3C# ~~ttarkTlCkAt
:3C •EFUCA'T~ i:~E6(F:#~R ; .
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
SAMPLE E~~XPIRIIATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY RS AGENTS OR REPRESENfATNES.
AUTHORIZED REPRESEHTATIVE
RICHARD A. PADULA, CIC CB A